1 national rural health mission pip: 2012-13 mission flexipool

Sr Act. No. Initiative
NATIONAL RURAL HEALTH MISSION
PIP: 2012-13
MISSION FLEXIPOOL
Budget
Approved
for 2011-
12
Budget
Proposed
for 2012-
13
Final
Budget
Approved
in NPCC
1 B.1 ASHA 3802.53 4051.87 3951.507
2 B.2.1
Untied funds to health
facilities
1933.00 1937.60 1936.850
3 B.2.4 Untied funds to VHNSC 3980.00 3987.30 3967.440
4 B.3 AMG to health facilities 2286.20 2325.50 2296.600
5 B.4.1
6 B.4.2.1
7 B.4.2.2
8 B.4.2.3
Up gradation of CHCs, PHCs,
District Hospitals to IPHS
Un-interrupted power
supply to IPHS institutions
QUALITY ASSURANCE IN
IPHS FACILITIES
BARRIER FREE
ENVIRONMENT IN
HOSPITALS
12507.20 13022.39 13143.650
416.28 664.08 660.000
1362.29 1224.70 1234.820
0.00 400.00 341.080
9 B.4.4.2 Mobility support 542.60 1649.80 1103.550
10 B.4.4.3
11 B.4.4.4
12 B.4.4.5
13 B.4.4.7
14
B.5.1-
5.3
15 B.5.6
16 B.5.7
17 B.5.8
Equipment maintenance
and repairs
Disability workshops at
District Hospital
Modernization of Hospital
Kitchen
Public Health Estate
Management Cell
New Construction,
renovation and setting up of
health facilities
Construction of Block Health
Office
Major Civil Works for
Operational FRU
Major Civil Works for
Operational of 24 X 7
224.90 568.80 568.800
0.00 150.00 150.000
0.00 310.00 310.000
143.19 123.90 120.300
7095.00 13131.34 8866.050
190.00 1286.00 711.500
225.000
603.000
1
Remarks
about
changes
made

Sr Act. No. Initiative
18 B.5.9
19 B.5.10
20 B.5.11
Civil Works to operationalise
Infection Management and
Environment Protection
Plan (IMEP) at health
facilities
Strengthening of Training
Infrastructure
Third Party Evaluation of
Civil Works
Budget
Approved
for 2011-
12
Budget
Proposed
for 2012-
13
Final
Budget
Approved
in NPCC
123.55 104.70 104.700
1481.60 2459.00 1696.500
0.00 262.00 194.000
21 B.6 Corpus grant to HMS/RKS 2449.00 2457.00 2458.000
22 B.7.1 District Health Action Plans 292.80 370.75 370.750
23
B.8.1 -
B.8.2
24 B.8.4
Constitution and Orientation
of Community leaders and
of VHSC, SHC, PHC, CHC, etc.
Guided tours of MLAs/MLCs
and office bearers of ZPs
137.81 317.70 176.500
56.80 102.60 68.400
25 B.9 Mainstreaming of AYUSH 1394.82 1240.53 1358.130
26 B.10.1 Strengthening of IEC Bureau 83.60 129.00 111.000
27 B.10.3
Implementation of IEC/BCC
Stretagies
1167.81 1088.40 764.400
28 B.10.4 Health Mela 0.00 200.00 64.000
29 B.10.5
Creating awareness on
declining sex ratio
0.00 161.00 161.000
30 B.10.6 Other activities 0.00 274.63 210.630
31 B.11.1 Mobile Medical Units 608.02 932.92 932.920
32
B.12.1 -
B.12.2
33 B.14.3.2
34 B.14.3.4
Emergency and Referral
Services
Organization of epilepsy
camps with the help of
Epilepsy Foundation
Mumbai
Capacity Building and
organization of Epilepsy Day
3076.28 10785.40 11301.400
15.90 68.20 53.900
0.00 25.60 21.600
35 B.14.3.5 Health Advise Call Center 143.00 184.60 86.690
36 B.14.4 NGO Program 516.50 284.40 247.800
2
Remarks
about
changes
made

Sr Act. No. Initiative
37 B.15.1
Community based planning
and monitoring (CBM)
Budget
Approved
for 2011-
12
Budget
Proposed
for 2012-
13
Final
Budget
Approved
in NPCC
292.10 241.10 234.320
38 B.15.2 Quality Assurance 171.700
39 B.15.3.1 Monitoring and Evaluation 761.57 834.09 765.968
40 B.15.3.2
COMPUTERIZATION OF
HMIS, E-GOVERNANCE & E-
HEALTH
220.00 1113.68 1113.680
41 B.15.3.3 MCTS 0.00 1963.40 632.354
42 B.15.3.4
43 B.15.3.5
Strengthening of
Supervision and Monitoring
System
Establishment of grievance
Cell
0.00 484.40 484.140
38.40 42.84 42.840
44 B.16 Procurement 2767.82 11180.03 7005.970
45 B.18.1
46 B.19.2
47 B.19.3
State Procurement
Management
Biometric attendance for
health staff
Prevention of Sickle cell
Disease
599.60 783.12 783.720
632.52 550.12 397.120
1914.33 1815.26 1815.250
48 B.19.4 Telemedicine 340.02 328.72 328.720
49 B.21.1
Package of Neonatal Care by
ASHA (PNC BY ASHA)
0.00 12.89 12.898
50 B.21.2 Multi centric Birth Cohort 0.00 39.00 39.000
51 B.22 SHSRC 100.00 100.00 100.000
52 B.23.1.1
53 B.23.1.2
54 B.23.1.3
Operationalization of
Superspeciality Hospital for
Child Eye Care
Provision of Hired Vehicle
for Opthalmic Surgeons for
Cataract Operation
Procurement of Ophthalmic
Equipment for Cataract
Operation
0.00 29.88 29.880
0.00 12.90 12.900
0.00 413.05 413.050
55 B.23.3 Support to NVBDCP 0.00 306.99 169.470
3
Remarks
about
changes
made

Sr Act. No. Initiative
56 B.23.4
57 B.23.6.1
58 B.23.6.2
Support strengthening
RNTCP
Renovation of Occupational
Therapy and Kitchen
Department in 4 Regional
Mental HOSPITALS – 2 nd
PHASE
Leptospirosis Prevention
And Control
Budget
Approved
for 2011-
12
Budget
Proposed
for 2012-
13
Final
Budget
Approved
in NPCC
800.00 810.000
500.00 153.00 153.000
0.00 124.90 124.900
59 B.23.6.3 Support to HIVS 0 249.63 102.500
60 B.23.6.4 Additional Budget for IDSP 0.00 28.32 40.400
61 B.23.6.6 Support to RI 200.00 1466.91 180.330
62 B.23.7 Hematology Program 0.00 486.59 497.760
63 B.23.8
Short term certificate course
for Medical Officers in PHD
0.00 0.00 40.200
64 B.24.2 Maher scheme 66.00 76.00 76.000
65 B.24.4
66 B.24.5
67 B.24.6
68 B.24.8
69 B.24.9
70 B.24.10
71 B.24.11
72 B.24.12
73 B.24.13
Volunteers to tribal and LEA
PHCs
Mobility support to tribal
institutes
Solar backup in tribal and
LEA health institutions
Organization of Specialist
Medical and Dental camps
through Medical Colleges in
tribal areas
Pilot project to Reduce the
IMR in Melghat Region
Co-ordination Cell for tribes
in selected Tribal District
Hospital
Integration of palliative care
in Jawhar tribal block of
Thane district
Establishment of Nutritional
Rehabilitation Center in
tribal areas
Establishment of Medicine
warehouse
24.60 24.60 12.240
496.60 670.30 670.300
595.50 595.50 192.000
231.00 250.20 250.200
96.72 81.92 81.920
28.80 29.52 24.600
13.50 13.50 13.500
41.40 92.16 92.160
1742.23 150.00 150.000
4
Remarks
about
changes
made

Sr Act. No. Initiative
Budget
Approved
for 2011-
12
Budget
Proposed
for 2012-
13
Final
Budget
Approved
in NPCC
74 B.24.14 Telemedicine in Tribal areas 0.00 32.45 32.450
75 B.25
Special PIP for Backward
districts
1742.23 4251.34 4251.340
Total 59475.62 96110.01 82921.240
5
Remarks
about
changes
made

SECTION - B.1: ACCREDITED SOCIAL HEALTH ACTIVIST (ASHA)
A trained female community health worker called as Accredited Social Health Activist (ASHA)
is being provided to tribal as well as non-tribal areas in the approximate ratio of one per 1000
population.
Year of starting
the scheme
2007-08
(old scheme)
SUMMARY INFORMATION OF THE SCHEME / INITIATIVE
Budget sanctioned
for year 2011-12
Budget proposed
for year 2012-13
Budget
Proposed in
NPCC
6
Remarks
3802.53 4051.87 3951.507 -
SUB SECTION – B.1.1 SELECTION AND TRAINING OF ASHA
Selection of ASHA
Sir Area Target Appointed
%
Appointed
1 Tribal areas 9523 9523 100
2 Non-tribal areas 49861 49766 99.80
Total 59384 59289 99.28
As mentioned above total 59289 ASHA are appointed in Maharashtra by December 2012.
Training
Training of ASHA has been initiated as per GOI guidelines through a cascade model. In Tribal
areas of Maharashtra, first two phases of the training of ASHA under HBNC VI & VII Module is
almost completed and State is planning to undergo training of HBNC in Non –tribal areas of
Maharashtra from 2012-13.
Module wise status of training in tribal and non-tribal areas is mentioned below:

Module
Table -: ASHA training status of Maharashtra state as on December 2011
Tribal areas
%
Non-tribal areas
%
Total (Tribal+
Nontribal)
Target Achiev e Target Achiev e Target Achiev e %
Module – I 9523 9523 100 49766 49405 99 59289 58928 99
Module – II 9523 9501 100 49766 48024 96 59289 57525 97
Module – III 9523 9388 99 49766 45712 92 59289 55100 93
Module – VI 9523 9098 96 49766 26502 53 59289 35600 60
Module – V 9523 8812 93 49766 1289 0 59289 10101 17
Module – VI &
VII (First Phase)
Module – VI &
VII (Second
Phase)
9523 7776 82
9523 1588 17
9523 7776 82
9523 1588 17
Budget requirement for training of ASHA and support staff
ASHA training will require budget for Training of Trainers (ToT) and actual training of ASHA.
Total budget required will be as follows:
Sir Module
Table -: Budget required for ToT – 2012-13
No. of ASHA trainers to be trained in
2012-13
Tribal Non-tribal Total
Budget
required
/ASHA
7
Rs. In Lakhs
Total
budget
required
1 Module – I 0 0 0 0.017 0
2 Module – II 0 0 0 0.017 0
3 Module – III 0 0 0 0.017 0
4 Module – IV 0 0 0 0.017 0
5 Module – V 0 0 0 0.017 0
6 Module – VI 330 664 994 0.077 76.538
Total
Budget required for training of ASHA is mentioned in table below:
76.538

Sir
Module
Table -: Budget required for training of ASHA – 2012-13
8
Rs. In Lakhs
No. of ASHA to be trained in
2012-13 Total
Tribal Non-tribal Total
Budget
required
/trainee
budget
required
1 Module – I 50 100 150 0.02 3
2 Module – II 50 100 150 0.014 2.1
3 Module – III 50 100 150 0.014 2.1
4 Module – IV 50 2000 2050 0.014 28.7
5 Module – V 300 5000 5300 0.014 74.2
6
7
8
9
Module – VI & VII
(1st Phase)
Module – VI & VII
(2nd Phase)
Module – VI & VII
(3rd Phase)
Module – VI & VII
(4th Phase)
Total
Training of Block Facilitators and Block Community Mobilizes
100 25000 25100 0.021 527.1
500 5000 5500 0.021 115.5
5000 0 5000 0.021 105
3000 0 3000 0.021 63
920.7
Training of Block Facilitators and Block Community Mobilizes is to be conducted for 6 th and 7 th
Module. Budget required for this training is as follows:
Sir Category
Table – Training of Block Facilitator
No. of ASHA to be trained
for Module VI & VII
Tribal Non-
Total
tribal
Budget
required
/trainee
Rs. In Lakhs
Total
budget
required
1
Block Community Mobiliser (First
Phase)
10 100 110 0.025 2.75
2
Block Community Mobiliser (Second
Phase)
50 50 100 0.025 2.5
3
Block Community Mobiliser (Third
Phase)
50 0 50 0.025 1.25
4 Block Facilitator (First Phase) 100 800 900 0.025 22.5
5 Block Facilitator (Second Phase) 600 800 1400 0.025 35

6 Block Facilitator (Third Phase) 500 0 500 0.025 12.5
Total 76.5
Total budget required for training of ASHA
Total budget required for ASHA training include budget for ToT and budget for actual training
of ASHA. Total budget required is mentioned in table below:
Table -: Budget required for training of ASHA (Tribal and Non-tribal areas)
Sir
In Lakhs
Particulars Budget
1 ToT for ASHA 76.538
2 ASHA training – tribal and non-tribal all modules 920.7
3 Training of Block Community Mobiliser and Block Facilitator 76.5
Total 1073.74
The budget requested is on the assumption about per batch expenditure as mentioned in
table above. However, the actual budget requirement may vary. If additional budget is
required, that will be managed from savings of ASHA or other schemes.
SUBSECTION - B.1.2 : MEDICINE FOR ASHA
The medicines in the ASHA kits are revised as per GOI guidelines. Following list of medicines
are proposed for ASHA kits. The quantity will be decided by the state level committee keeping
in view the prices of the this medicines and limiting the price of the ASHA medicine kit to
Rs.600 per kit-
List of Drugs provided in ASHA Kit
Sr. Medicines
1 DDK for Clean deliveries at home
2 Tab. Iron Folic Acid (L)
3 Tab Punarvadu Mandur (ISM Preparation of Iron)
4 ORS Packets
5 Tab. Paracetamol
6 Tab. Dicyclomine
7 Povidine Ointment Tube
8 Thermometers
9 Cotton Absorbent Roll
9
Rs.

10 Bandages, 4cm X 4 meters
11 Tab.Chloroquine
12 Condoms
13 Oral Pills (In cycles)
Number of kits and budget required for year 2012-13 is as follows:
Table -: Budget required for ASHA medicine kit
Rs.
In Lakhs
Total budget
Sr. Area Unit price No. of kits required required
1 Tribal areas 0.006 9523 57.138
2 Non-tribal areas 0.006 49483 296.898
Total 59289 354.036
SUBSECTION - B.1.3 TO B.1.6: INCENTIVE TO ASHA UNDER JSY, FW SERVICES, CHILD HEALTH
AND OTHER INCENTIVES
It is proposed to provide performance based incentive to ASHA through PHCs during monthly
orientation meetings. The incentive is being provided by Cheque. Rates of ASHA incentive and
budget source are as follows:
Table: Performance incentives to ASHA
No Activity Incentive rate
1 a
1 b
2
3
JSY delivery in PHC or any recognized
hospital
( Tribal area)
JSY delivery in PHC or any recognized
hospital
(Non-Tribal Areas)
Motivation of BPL/SC/ST beneficiary
for tubectomy
Motivation of any beneficiary for
vasectomy
Rs. 350/- per delivery (with
conditions of JSY for Tribal
areas
Rs. 200/- per delivery (with
conditions of JSY for Non-
Tribal areas.
Budget
Resource
10
RCH
RCH
Rs. 150/- per operation RCH
Rs. 200/- per operation RCH
4 Completion of DOTS (RNTCP) Rs. 250/-Case completed RNTCP
5
Radical treatment of malaria Positive
case
Per slide Rs.5/- for
preparation of Blood Slide
Malaria
Per case Rs.20/ for treating Malaria

No Activity Incentive rate
6 Leprosy treatment
7 Control of epidemic (outbreak)
8 Control of epidemic (dehydrated)
Bringing pregnant women for HIV
9
testing in PPTCT centers
Registration of positive pregnant
10 mother at Anti Retro-Virus Treatment
center
11 Admission of HIV +ve mother for
delivery in PPTCT center
Follow up of HIV positive mothers at 6
12 week, 6 th Month and 18 th month (or as
recommended by MSACS)
Referring for RTI (Reproductive Tract
13 Infection) / STI (Sexually Transmitted
Infection) to SC/PHC/RH/SDH/DH
Referring for Clubfoot Newborn to
14
SC/PHC/RH/SDH/DH level
Referring for Clubfoot Newborn to
15 further treatment at District Hospital.
(after PHC MO Diagnosis)
Per month Immunization at Village
16
Level
Quarterly Meeting of ASHA on
17
Immunization (Yearly 4)
Informed AEFI ( Adverse Event
18
Following Immunization) case to
PF positive case
Per case Rs.50/- for treating
PV positive case
Rs. 100/ - for newly
detected case
Rs. 400 – MB case
completing treatment
Rs. 200 – PB case
completing treatment
Rs. 100/- for giving first
hand information of
outbreak
Rs. 50/- per case for timely
referral of dehydrated
patient to PHC/RH/DH
Rs.50/- per mother
Rs.200/- per mother
Rs. 1000/- to ASHA
Rs. 750/- per follow up
Rs. 200/-
Rs. 100/-
Rs. 500/-
Budget
Resource
11
Malaria
NLEP
NLEP
NLEP
Mission-
Flexipool
Mission-
Flexipool
Mission-
Flexipool
Mission-
Flexipool
Mission-
Flexipool
Mission-
Flexipool
Mission-
Flexipool
Mission-
Flexipool
Mission-
Flexipool
Rs.75/- RI Fund
Rs.75/- RI Fund
Rs.50/-
Mission
Flexipool

No Activity Incentive rate
19
SC/PHC
Motivation of community for toilet
construction
20 Birth Information (SC/PHC)
21
22
23
24
25
Registration of Birth including issuing
birth certificate (with or without child
name)
Death Information (SC/PHC) of Age
group 0 to 5 child
Incentive to ASHA for Death certificate
(Age group 0 to 5 child)
Incentive to ASHA for information of
women death for the age group
between 15 to 49 years
Incentive to ASHA for recording of
Maternal death for the age group
between 15 to 49 years
26 Yearly Immunization
27
28
29A
29B
Bringing critically ill child to hospital
(for tribal areas only)
Sickle Cell control program (
Amaravati, Dhule, Nanded, Akola,
Washim, Buldhana, Aurangabad,
Jalgaon, Raigad)
To give information about sickle cell
Disease in Gram sabha (Two
gramsabha in a year )
To motivates Self help groups,
adolescent girls and boys
Rs. 50/-toilet construct
Rs.20/- per Birth
information
Rs.30/- per Birth
Registration
Rs.75/- per information
Rs.50/- per certificate
Rs.100/-
Rs.500/-
For fully immunized
children: Rs. 1000/-for
100% immunization
Rs. 750 if 90%
immunization
Rs. 50/- per child
Rs. 50/- per ASHA per
Gramsabha
Budget
Resource
Total
Sanitation
Campaign
Mission -
Flexipool
Mission -
Flexipool
Mission -
Flexipool
Mission -
Flexipool
Mission -
Flexipool
Mission -
Flexipool
Mission -
Flexipool
Mission -
Flexipool
Mission -
Flexipool
12
Sickle Cell Fund
Rs.40/- per meeting Sickle Cell Fund
29C Solubility test Rs. 5/- per test Sickle Cell Fund
29D Red & Yellow card distribution Rs.20/- per card Sickle Cell Fund
29E Follow up to sufferer patient’s Rs.15/- per visit Sickle Cell Fund
29F Incentives for successful marriage Rs.1000/- per marriage Sickle Cell Fund

No Activity Incentive rate
prevention prevented
Budget
Resource
30 Cataract operations
Rs. 100/- per patient for
transport
NPCB
Rs. 75/- per patient for IEC NPCB
31 HBNC (As per GOI guidelines) Rs.250/- per New born
Mission
Flexipool
32
33
Follow Up of Discharge Children From
NRC
Promotion of menstrual hygiene
scheme
Rs.50 /- per follow up (Total
4 follow up)
Mission
Flexipool
a Number of sanitary napkin soled Rs.1/- per napkin Sale of Napkin
b
34
a
35
Number of meeting of adolances girl
organized (one per month)
Hemophilia and Thalassemia disease
Program (Nagpur, Nashik, Amravati,
Pune)
ASHAs provided IEC about Hemophilia
and Thalassemia disease to Gram
Sabha, 4 sessions per year
Plus Polio Immunization Campaign
(IPPI)
Rs.50/- per meeting
Rs. 50/- per session/
GramSabha
Rs. 75/- per day (4days) for
Home visits & Polio booth
activities
Rs. 20/- per day (4days) TA
(As per Central Government
Guideline)
Untied Fund of
Sub Centre
Mission-
Flexipool
13
Plus Polio
Total performance of ASHA during month is recorded in one register and ASHA is paid based
on this record.
Budget required for performance based incentive
Budget required for ASHA incentive as per the activities, rates and source through NRHM
Mission Flexi-pool is as follows:
Table -: Budget requirement for performance based incentives to ASHA
Rs. In Lakhs
Area incentive/ASHA No of ASHA
Total budget
required
Tribal areas 0.01 9523 95.23

Area incentive/ASHA No of ASHA
Non-tribal
areas
Total budget
required
0.005 49766 248.83
Total 59289 344.06
Table -: Budget requirement for HBNC
Sr. Area Incentive /ASHA No of ASHA
Rs. In Lakhs
Total budget
required
1 Tribal areas 0.01 9523 95.23
2 Non-tribal areas 0.005 20000 100
Total 29523 195.23
Table -: Total Budget requirement for performance based incentives to ASHA
Rs. In Lakhs
Sr. Area Incentive /ASHA
1 Tribal areas 190.46
2 Non-tribal areas 348.83
Total 539.29
Each ASHA is provided one register for entering the work done during month. Performance
based incentive is paid to ASHA during monthly meeting along with meeting stipend. During
2012-13, it is proposed to pay the incentive to ASHA by account payee cheques by the PHCs.
SUBSECTION – B.1.7: AWARDS TO ASHA
ASHA are increasingly taking part in majority of the health services provided to patients,
particularly in tribal and inaccessible areas. It is proposed to give awards to good functioning
ASHAs.
For provision of awards, the criteria will be: ASHA with good record keeping, consistent
performance and higher compensation. In one district 3 ASHA at district level and 2 ASHA per
block,
Considering there are 33 districts, 353 blocks budget required for this activity will be as
follows:
Sir
No
Type of Award
Award
Amount
No. of units
14
Total Budget
Required
1 District Level (3ASHA ×33 dist= 99) 0.26 33 Districts 8.58
2 Block Level (2ASHA×353 Block=706) 0.14 353 Blocks 49.42
4 Function at District Level 0.25 33 Districts 8.25
Total 66.25

SUBSECTION - B.1.8 : SUPPORT MECHANISM FOR ASHA
Considering the services expected to be delivered, ASHA needs to get support from village,
various health functionaries, health institutions, PRI, RKS, local self help groups, etc.
Therefore a strong network has been developed amongst all the stakeholders. NRHM has
published guidelines regarding support mechanism for ASHA. Maharashtra has developed
support mechanism as per the guidelines. Salient features of support mechanism are as
follows:
• Appointment of Program Managers (ASHA) and at all District HQ
• Appointment of Block Facilitator @ one per 10 ASHA in tribal and one per PHC in nontribal
areas.
• Quality improvement in monthly reorientation meeting at all PHCs.
Budget Requirement
Budget required for support mechanism is as follows:
Table -: Budget required for ASHA support mechanism
Sir Particulars
Budget
/ unit
Total
Units
15
Rs. In Lakhs
Budget
required
A State level
1 Salary/TA of Program Manager 3.6 1 3.6
2 Salary of Data Assistant 1.32 1 1.32
3 Salary of Statistical Investigator 1.15 1 1.15
State total 6.07
B District Level
1
Salary TA/DA of Community Mobiliser (Rs.
12500/PM)
1.7 33 56.1
3 Contingency 0.2 33 6.6
4
Block Community Mobiliser Bi-monthly Meeting at
District Level
0.06 33 1.98
District Total 64.68
C Block Level
1 Block level contingency 0.02 353 7.06
2 Block Community Mobiliser (salary + TA/DA) - Tribal 1 50 50
Block Community Mobiliser (salary + TA/DA) - Non-
Tribal
1 50 50
Block total 107.06
D PHC Level
1 Block Facilitator (1/PHC) 25 visits/PM Rs. 150/visit 0.45 1500 675
2 Block Facilitator Monthly meeting (12), Rs. 0.018 1500 27

Sir Particulars
3
150/meeting
ASHA Software contingency to Block Facilitator ( 315
Tribal PHC & 1494 Non-Tribal PHC) Outsourcing of
data entry
Budget
/ unit
Total
Units
16
Budget
required
0.005 1809 9.045
4 ASHA meeting (Rs.150/-) 0.018 47500 855
5 Honorarium to MO for reorientation 0.024 1809 43.416
6 LHV Honorarium 0.06 1809 108.54
7 Contingency 0.01 1809 18.09
PHC Total 1736.091
Grand Total 1913.901
SUBSECTION - B.1.9 : ASHA MENTORING GROUP
NRHM has instructed to establish ASHA mentoring groups at state, districts and block level.
State level mentoring group is responsible for policy decisions regarding ASHA. District level
group is involved in planning, implementation and monitoring of the ASHA program. Block
level group is mainly responsible for implementation and monitoring of the program.
Budget requirement for ASHA mentoring group is as mentioned in table below:
Table :- Budget required for ASHA Monitoring group 2012-13
Rs. In Lakhs
Sir Level
Unit
cost
State Level
No.
of Budget
units required
Tribal areas
No. of Budget
units required
Non-tribal areas
No.
of Budget
units required
Total
Budget
required
1 State level 0.05 2 0.1 0 0 0 0 0.1
2 District
Level 0.02 0 0 15 0.3 18 0.36 0.66
3 Block level 0.01 0 0 70 0.7 283 2.83 3.53
Total 0.1 1 3.19 4.29
SUMMARY OF ASHA BUDGET REQUIREMENT
Total budget required for ASHA scheme for year 2012-13 is mentioned in table below:

Table -: Total budget requirement for ASHA scheme
17
Rs. In Lakhs
Sir Particulars
Budget proposed
for 2012-13
1 Selection and Training of ASHA 1073.74
2 Medicine Kit 354.036
3 Performance Incentive 539.29
4 ASHA Award 66.25
5 Support Mechanism 1913.901
6 ASHA Mentoring Group 4.29
Total 3951.507
SECTION - B.2 : UNTIED FUNDS
SUB-SECTION - B.2.1 TO B.2.3 : UNTIED FUNDS TO HEALTH FACILITIES (CHC/PHC/APHC/SC)
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2006-07 1935.35 1933.00 1937.60 1936.850
Rs. in Lakhs
Remarks
Health Sector reforms under NRHM aim to increase functional, administrative and financial
resources and autonomy to the field units under which every health institution from Subcentre
to SDH will get untied grants for any additional activities.
Necessity of untied funds has been felt mainly due to unavailability of funds for undertaking
innovative centre-specific need based activity as allotment of funds to institutions has
traditionally been of the nature of untied funds for implementation of particular activity /
scheme and this hardly left any fund with the public health facility.
Regarding addition of SDH/GH/WH for untied funds, explanation is as follows:
CHC scheme was introduced in Maharashtra in 1980s. That time CHCs were established in the
State as per GoI norms but renamed as Rural Hospitals. No. of beds, Staffing pattern,
infrastructure, service delivery system, everything is as per GoI norms of CHC, only the name
is changed to Rural Hospital. Maharashtra Health Systems Development Project was
introduced in the State in 1998. Some of the CHCs (RH) were upgraded to 200 beds, 100 beds
and 50 beds with addition of specialities. To differentiate them from Rural Hospital, names
were changed to General Hospital (200 beds) and Sub-District Hospital (50 and 100 beds).
Catchment area and basic structure of these hospitals is same as Rural Hospital or CHC. All

these hospitals have functional RKS. As these hospitals are considered in CHC group it is
requested to sanction Untied funds to all the Hospitals. For convenience, all these hospials
are separately shown in grant distribution in table below.
Regarding addition of APHC, explanation is as follows:
In Maharashtra there are 795 health facilities which are between Sub-Center and PHCs. One
doctor, one nurse, one Pharmacist and one attendant is posted in these health facilities which
are called either dispensaries or APHC. Normally these centers are situated in medium size
villages. These centers do not provide emergency services and FW operation services. Except
this all the services including immunization, delivery, IUD, RNTCP and other Disease Control
Program Services beside curative services are provided by APHC. Considering this, it is
requested to sanction Untied funds to APHCs.
One more hospital is started at Bhivandi District Thane. Therefore number of CHCs is now
458. Budget is requested for 458 CHC level hospitals.
List of all the health facilities for UF is submitted in Annexure.
Grant distribution
During year 2011-12, untied grants have been distributed to all the Sub-Centers, Primary
Health Centers, Rural Hospitals & Sub District Hospitals in the state. Untied grant to Sub-
Centers have been released to the account jointly operated by Sarpanch of SHC village and
ANM. Untied grants of other health institutions are released to RKS. Similarly, for year 2012-
13, untied funds are to be released to all health facilities as follows:
Table – : Budget required for untied grants 2012-13
Rs. In Lakhs
Budget required
No. of
Total
Sir Type of hospital institutions
Unit rate budget
eligible
required
1 Sub-Centre 10566 0.1 1056.6
2 APHC 795 0.25 198.75
3 PHC 1810 0.25 452.5
4 RH (30 beds) 366 0.5 183
5 SDH (50 beds) 56 0.5 28
6 SDH (100 beds) 23 0.5 11.5
7 WH (60-335 beds) 9 0.5 4.5
8 GH (200 beds) 4 0.5 2
Total 13629 1936.85
18

SUB-SECTION - B.2.4 : VILLAGE HEALTH SANITATION WATER SUPPLY AND NUTRITION
COMMITTEE
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2006-07 4070.8 3980 3987.30 3967.440
19
Rs. in Lakhs
Remarks
VHNSC are established in every revenue village. VHC is provided with untied fund which has
to be utilized for IEC, household survey, preparation of health register, organization of
meetings at village level, etc. Untied fund is made available through NRHM Flexible Pool
Fund.
Norm of GoI for Untied fund to VHNSC is Rs. 10000/village. Same amount of fund is
distributed all revenue villages irrespective of the population. Thus, revenue villages with
population less than 500 or more than 10000 gets same amount of fund. Therefore it is
proposed that, Maharashtra will request the funds from GoI based on population criteria.
Out of total villages available in the state, VHNSC is established in 39872 villages in the State
as on 31.3.2012. Number is increased from last submission due to addition of new villages.
Budget is requested for all these 39872 villages. In addition to this, there are 73 forest
villages. Forest village function as normal revenue village. They have Village Panchayat, they
vote for PRI members and are included for all the development work. Only difference of these
villages is that they are situated on forest land so are not declared as revenue villages. These
villages are in maximum need of VHNSC funds but are deprived of that. Therefore, it is
requested to add these villages in VHNSC list.
Budget requirement of untied fund for VHNSC as follows:
Sr.No.
Table - Budget requirement to Village Health Committee
VHNSC
committees
established in
Revenue
Villages
1 39945
Population
wise Norms
Population
wise No. Of
Villages
Budget
proposed per
village
Rs. In Lakhs
Total PIP
0-500 8122 0.05 406.10
501-1500 19673 0.08 1573.84
1501-5000 10548 0.15 1582.20

Sr.No.
VHNSC
committees
established in
Revenue
Villages
Population
wise Norms
Population
wise No. Of
Villages
Budget
proposed per
village
20
Total PIP
5001-10000 1255 0.24 301.20
10000+ 347 0.30 104.10
Total 39945 0.82 3967.44

SECTION - B.3 : ANNUAL MAINTENANCE GRANTS (AMG)
SUBSECTION - B.3.1 TO B.3.4 : ANNUAL MAINTENANCE GRANTS TO HEALTH FACILITIES
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2006-07 2497.2 2286.2 2325.5 2296.600
21
Rs. in Lakhs
Remarks
Annual Maintenance Grants are distributed for maintenance of physical infrastructure of
health institutions. GOI has directed to use the grant for regular maintenance of physical
structures of health institutions including provision of water, toilets, their use and their
maintenance.
As mentioned in GOI guidelines, distribution of AMG is proposed in Sub-Centers, PHUs,
Primary Health Centers and Rural Hospitals of the state functioning in own building.
Regarding addition of SDH/GH/WH for AMG, explanation is as follows:
CHC scheme was introduced in Maharashtra in 1980s. That time CHCs were established in the
State as per GoI norms but renamed as Rural Hospitals. No. of beds, Staffing pattern,
infrastructure, service delivery system, everything is as per GoI norms of CHC, only the name
is changed to Rural Hospital. Maharashtra Health Systems Development Project was
introduced in the State in 1998. Some of the CHCs (RH) were upgraded to 200 beds, 100 beds
and 50 beds with addition of specialities. To differentiate them from Rural Hospital, names
were changed to General Hospital (200 beds) and Sub-District Hospital (50 and 100 beds).
Catchment area and basic structure of these hospitals is same as Rural Hospital or CHC. All
these hospitals have functional RKS. As these hospitals are considered in CHC group it is
requested to sanction AMG to all the Hospitals.
List of Hospials submitted in Annexure
List of PHCs is submitted in Annexure.
In Maharashtra there are 795 health facilities which are between Sub-Center and PHCs. One
doctor, one nurse, one Pharmacist and one attendant is posted in these health facilities which
are called either dispensaries or APHC. Normally these centers are situated in medium size
villages. These center do not provide emergency services and FW operation services. Except
this all the services including immunization, delivery, IUD, RNTCP and other Disease Control
Program Services beside curative services are provided by APHC. Considering this, it is
requested to sanction AMG to APHCs.

List of APHC is submitted in Annexure.
List of Sub-Centers submitted in Annexure.
Budget requirement for AMG for year 2012-13 is given in table below.
Table – : Budget required for Annual Maintenance Grants – 2012-13
22
Rs. In Lakh
Sir Type of health institution
No. of
institutions
No. in
own
building
AMG
Budget
Unit rate
required
1 Sub-Centre 10566 8286 0.1 828.60
2 APHC (PHU) 795 480 0.5 240.00
2 PHC 1810 1614 0.5 807.00
3 CHC 458 421 1.00 421.00
Total 13629 10801 2296.60

SECTION - B.4 : HOSPITAL STRENGTHNING
SUBSECTION - B.4.1.1 TO B.4.1.4 : UPGRADING HEALTH FACILITIES TO IPHS
Year of
starting the
scheme/
initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year 2011-
12
Budget
proposed
in PIP
2012-13
Budget
Proposed in
NPCC
2008-09 12960.8 12507.20 13022.39 13143.650
23
Rs. in Lakhs
Remarks
Maharashtra has started upgrading the health institutions to IPHS since last three years. As
per GoI timeline, all the facilities are to be upgraded to IPHS by 2010-11. However, because of
want of manpower and infrastructure, it is becoming difficult to upgrade the health facilities
in large scale. Therefore selected facilities fulfilling basic criteria are considered for up
gradation. Once these facilities are upgraded, new facilities will be taken up.
Scheme of up gradation
IPHS up gradation is being carried out in Phases. Health Facilities willing for upgradation are
screened for following criteria :
Table : Criteria for designating health facility for IPHS Upgradation
Sub Center PHC Hospitals excluding
DH
Own building Own building Own building Own Building
Post of ANM filled in At least one MO
MBBS
Post of MPW (M)
filled in
At least 3 deliveries
per month
OT, labour room and
Laboratory functional
At least 10 deliveries
per month in building
Availability of at least
three specialists
(OBGY, Pediatrics &
Anesthesia) on
regular or contract
basis
Blood Storage Unit
functional
At least 30 deliveries
/month. Cesarean
Section and neonatal
DH
Availability of at least
five specialities
(Medicine, Surgery,
OBGY, Pediatrics &
Anesthesia) on
regular or contractual
basis
Blood Bank
Functional
At least 50 deliveries
per month. Cesarean
Section and neonatal

Sub Center PHC Hospitals excluding
DH
IPD (excluding
delivery) minimum
30/month
OPD – minimum
1000/month
24
DH
care facility available care facility available
IPD (excluding
delivery) minimum
60/month
OPD – minimum
3000/month
IPD (excluding
delivery) minimum
100/month
OPD – minimum
5000/month
Once facilities are designated for upgradation, actual upgradaton is carried out in following
steps
Sir Step Activity
1 Step -1 Identification of health facilities. Health facility is identified
considering the criteria mentioned in table above. Delivery point
criteria is applied since 2011-12.
(Completed)
Step -2 Improvement in basic amenities required to patients – drinking
water, toilets, mattresses, linen, patient furniture, sitting
arrangement, signages, etc.
(Completed)
Step -3 Upgrading PHC to 24×7 status (9 criteria to be fulfilled) and
Hospitals to FRU status (10 criteria to be fulfilled). Deficit of
Training, equipment procurement, civil works, medicine, etc are
identified and fulfilled through IPHS funds.
(Completed for 80% facilities
Step -4 Health Facility is upgradated to IPHS standards. Services to be
provided by that facility are enlisted. Gaps in providing these
services are identified and fulfilled through IPHS Funds.
Step -5 There is no provision of inspection of facilities to award IPHS
status in IPHS guidelines of GoI. Maharashtra has decided to
establish committees at district, circle and state level to inspect

Sir Step Activity
the facility and award IPHS status if it fulfills IPHS criteria.
(Proposed in 2012-13)
Step - 6 IPHS designated facilities with good utilization are identified
functioning improved by strengthening 28 procedures related
quality care.
Criteria for selection of health facility
Main aim of the IPHS up gradation is to provide quality services. For this, good functioning
health facilities and facilities with potential to get improved are being considered for up
gradation. GoI has provided guidelines for number of deliveries to be conducted for inclusion
of PHCs as 24×7 PHC and hospitals as FRUs which are being called as delivery points.
Considering this, criteria applied for selection of health facility for up gradation are as follows:
Table : Criteria for selection of health facility for IPHS Up gradation
Sir Criteria SC PHC Hospitals (CHC
to Dist
Hospitals)
1 Infrastructure Should be
functioning in
own building.
2 Water supply Adequate or
source should be
available
3 Manpower Two ANM and
one MPW
should be
available
Should be
functioning in
own building
Adequate or
source should be
available
At least one MO
MBBS
Should be
functioning in
own building
Adequate or
source should be
available
At least three
specialists :
Obstratician,
Pediatrician and
Anesthetist
4 OPD >1000/month >3000/month
5 IPD (excluding delivery) >30/month >90/month
6 Deliveries >3/month >10/month >20/month for
25

Number of institutes upgraded
RH/SDH
>50/month for
DH
IPHS has not specified method for declaration of facility as upgraded to IPHS. Therefore in
year 2011-12, achievement of upgradation was decided by self declaration of the facility that
they have achieved IPHS. Latest figures of upgradation are as follows:
Sir
Table - : Status of up gradation of Health Institutions as per IPHS standard
Type of
Institution
Total no.
in state
No. of
health
facilities
designated
for upgradation
24×7
PHCs/ FRU
upgraded
IPHS
Upgraded
26
Fulfilling
criteria of
delivery
point
1 Sub-Centre 10580 2997 1755 1521
2 PHC 1810 1067 594 242 658
3 RH/SDH/GH 447 224 132 73 188
4 WH 9 9 9 6 9
4 DH 23 23 23 18 23
Total 12874 4319 757 2094 2299
For year 2012-13, we are establishing committees at District, Regional and State level and
developing evaluation formats for each type of facility. Once the facility approaches District
Health Society to inform about achievement of IPHS status, the committee will visit this
facility for certification.
Sir Type of facility Head of
Committee
Table – IPHS Evaluation Committees
Other members Certificate
issuing
authority
1 Sub-Center RCH Officer One THO, MO DTT,
Representative of CEO, One
IMA representative, One senior
reporter, One NGO
representative
2 PHC DHO DTO, MLCD, RCH Officer,
Representative of CEO, One
DHO &CEO ZP
Deputy Director
i/c Circle and

3 Rural Hospital
Sub District
Hospital, WH
of up to 100
beds.
4 DH, GH and
WH more than
100 beds
Deputy Director
of Health
Services
Joint Director
(Hospitals)
Activities included and Gap filling under IPHS
IMA representative, One senior
reporter, One NGO
representative
Asst. Director (Cl), Principal
HFWTC, Representative of
District Collector, One IMA
representative, One senior
reporter, One NGO
representative
Joint Director (FW), Joint
Director (T), One Deputy
Director, One Dy Secretary
from PHD, One IMA
representative, One senior
reporter, One NGO
representative
District Collector
Joint Director
(Hospitals) and
Commissioner
(FW)
Director of
Health Services
and ACS PHD
GoI has specified standards for each type of health facility. These standards are for services to
be provided and human resources, medicine, equipment, instrument, infrastructure,
diagnostic facilities, medicine storage system and support services required to provide these
services. External Facility Survey of designated health facilities was carried out three years
back. Accordingly plans for upgradation of all the desittanted services were prepared.
Accordingly the facilities are being upgraded.
Since last year (2011-12), Maharashtra has developed one Set of Formats to record the gaps
of one year. This set contains eight forms related to human resources, medicines, equipment
(purchase and maintenance), civil works, support services, etc. In each form information of
total need of the hospital is recorded, supply from Government, donations, user fees charges
and any other local resources (e.g. Cess funds) is recorded and substracted and final gap is
identified. This gap is converted into budget and submitted to District and State. Each of the
Plan Format is checked at district and state level and approval is given on facility basis to each
facility separately.
One such format of DH and PHC is submitted in Annexure to get idea of this detailed and
extensive exercise.
Increase in cost of the upgradation.
Budget requested under this scheme is for upgradation of the facility and maintenance of
facility to IPHS standards. Initially cost of construction and equipment procurement is very
high (last year) and afterwards, cost of human resources, medicine, consumables and
27

maintenance of equipment increases. Thus, in first phase, budget requirement is for
upgrading the facility and in second phase it is for maintaining the IPHS. In Maharashtra we
have observed improvement in OPD, IPD and delivery services by 56% above the non-IPHS
facilities. This increases the cost of second phase hospitals.
Budget requirement of upgradation was calculated on average basis till 2010-11. In 2011-12,
individual planning formats were introduced and budget requirement was calculated based
on gaps. It could not be completed till the time of submission of PIP so in PIP, the calculations
were partially based on plans and partially on averages. However, for planning of 2012-13,
IPHS planning workshops were conducted in each districts with the help of IPHS Coordinators
and submitted in PIP. Thus, this year planning is individual center based except for Sub-
Center, where plans are still on average basis. Facility wise gaps identified and budget
requirement is submitted for information. As these plans were prepared in February,
additional grants received after plans were prepared (Rs. 51.30 Crores + Rs. 53.8 Crores =
105.1 Crores). Some of the budget although mentioned in Plan is not completely utilized in
planned year as it takes some time to get specialist and equipment required for services.
List of facilities selected for upgradation
List of facilities designated for Upgradation in 2012-13 is submitted in Annexure.
Utilization of IPHS facilities
Additional resources are made available to selected health facilities to upgrade infrastructure
and manpower to IPHS. After going through the data of last three years it is observed that
utilization of health facilities have increased remarkably. Although this increase is slow for
deliveries, improvement in IPD cases indicate this will also catch up by next year.
Utilization of services of IPHS PHCs as compared to non-IPHS PHCs is as follows:
Table – Utilization of IPHS PHCs over non-IPHS PHCs
Sir Indicator IPHS PHC
Non IPHS
PHC
Difference
28
%
Increase
1 OPD/month/PHC 975 731 244 33%
2 IPD/month/PHC 81 48 33 68%
3 Deliveries/month/PHC 9 4 5 125%
Table above indicate that utilization of IPHS PHCs over non-IPHS PHCs is very high. Even in
IPHS PHCs the utilization has increased by 34%, for deliveries, 57 for new OPD and 47% for
IPD. Although number of deliveries per PHC is lower than expected, efforts will be made in
2012-13 to increase the average deliveries in IPHS PHCs to increase to 25 deliveries/month. It
seems to be quite possible after introduction of JSSK in the State.
Similarly for hospitals also there is increase in utilization of services as mentioned in table
below:

Table – Utilization of IPHS CHCs over non-IPHS CHCs
Sir Indicator IPHS RH
Non-IPHS
RH
Difference % increase
1 BOR 59.4 14.1 45.3 23.7
2 New OPD 2638 1516 1122 57.5
3 New IPD 290 138 152 47.6
5 Deliveries 26 9 17 34.6
6 LSCS 2 1 1 50.0
In hospitals, all the indicators have shown remarkable increase in IPHS hospitals. This will
further strengthen during 2012-13.
Plan for year 2012-13
Following actions will be taken for up gradation of health facilities during 2012-13:
• Systematic plans are prepared based on external facility survey to upgrade the health
facilities to IPHS. Facilities having less than desired level of deliveries have been
examined on case by case basis. In the places where there deliveries are not as per
desired and where there is no possibility of further improvement, such facilities have
been discontinued for up-gradation for year 2012-13. There are few non-IPHS facilities
where the deliveries have substantially increased. These facilities have been included
in the plan.
• JSSK have been introduced in the State with very good response from community. It
has been observed that this is increasing the overall demand for services in the
PHC/Hospitals. Thus, for better implementation of JSSK, the PHC/Hospital need to
have well equipped laboratory, good quality labour room and Operation Theater and
medicines required for mother as well as other patients also. Medicines included in
JSSK will be procured through JSSK. But other medicines and requirements of hospital
strengthening will be taken from IPHS up-gradation funds to avoid duplication.
• During the visit of Joint Secretary (GoI) to Maharashtra, some of the issues were
discussed with Commissioner (FW) and MD. These are : Establishing Dialysis Units in
district Hospitals, Upgrading Burn Wards in District Hospitals and improvement in OPD
services. Provision for these activities is also made in IPHS Up gradation Plans of
Hospitals.
• MCTS has enabled us to track every mother and child. We have introduced recording
of Expected Place of Delivery for these mothers. Now district officials can tell us in
advance how many deliveries will take place at home, in SC, in PHC or hospitals on
particular day based on this data. With the help of this data Scheme called ‘Book your
Bed (BYB)’ have been introduced in all the health facilities designated for upgradation
to IPHS standards. In this scheme, all the mothers in areas will be shown the
health facility. Bed will be booked in name of mother in advance willing for delivery in
hospital and will be displayed at the entrance of female ward.
29

• First step towards IPHS up gradation for hospitals is compliance of FRU status.
Therefore, hospitals where three basic specialties OBGY, Pediatrics and Anesthesia are
available and hospital is functioning in own buildings are only being included for IPHS
up gradation. Efforts will be made to increase the availability of other specialists and
nurses to provide maximum possible specialty services mentioned in IPHS as per bed
strength.
• Similarly, all the SDH and District Hospitals in state will be included for IPHS up
gradation. Five specialties are being provided to all the hospitals – Medicine, Surgery,
Gynecology, Pediatrics and Anesthesia will be provided on priority considering the
goal of NRHM. In addition to this, maximum efforts will be made to get available
additional 9 specialties as per bed strength of District Hospitals.
• One government RH is run by NGO under PPP mode catering around 1.2 Lakh
populations at Sastur Dist. Osmanabad. As this hospital has started specialty services
and undergoing delivery, cesarean section operation, this hospital will also be
included for IPHS up-gradation.
• There are three areas in the state which are most backward and do not have facilities
nearby. These areas have very high (3 times the state average) MMR and almost
double IMR. Considering this, it has been decided by state to provide special package
to specialists and nurses in these areas. Also these areas will require good residential
accommodation. Considering this, special package for upgradation of these hospitals
is being implemented from October 2011. Details of these areas is as follows:
Sir District Names of RH/SDH Total
No.
1 Gadchiroli SDH Aheri, RH Sironcha, RH
Bhamragad, RH Dhanora, RH
Etapalli
2 Amravati
(Melghat area
only)
SDH Dharani, RH
Chikhaldara, RH Churni
3 Nandurbar RH Akkalkuwa, RH
Dhadgaon, RH Molgi
Remarks
5 Very remote and LEA
affected areas. Except
Dhanora, all other more
than 100 KM away from
DH. No specialist facility
available since
establishment.
3 Very remote reserve
forest area. Very high
IMR and MMR. No
speciality services
available.
3 Very remote area within
Satpuda mountain
range and Narmada
30

iver. No specialities
available since
establishment. High IMR
and MMR.
• Facility survey of hospitals included in up gradation will be carried out by External
Expert agency.
Budget requirement
Considering above factors and based on the IPHS guidelines, one Planning Format was
prepared by SHS and distributed to all the districts. Plans received from the districts are
analysed and only the health facilities fulfilling Delivery Point criteria or with potential of
improvement in delivery services have been included in the upgradation list. We have ready
plans for each of the facility in the state. SC plans are kept at the level of District Society and
all the plans for PHC and higher health facilities are scruitinised by Quality Assurance wing of
the SHS. Although we have detailed plans of each facility, the budget required is mentioned
as average of these facilities. List of facilities is also attached in annex.
i) Budget for upgradation of facilities except special focus hospitals
Budget required for up gradation is as follows:
Table -: Budget required for up-gradation of health institutions as per external facility
survey
Rs. In Lakhs
Sir Type of facility
No. of
facilities
fulfiling
criteria of
delivery point
No. of faciities
included for
IPHS
Upgradation
Average
Budget
required
per unit
31
Total budget
required
1 SC 1521 1521 0.25 380.25
2 PHC 658 658 6 3948
3 RH 110 110 20.15 2216.5
4 SDH – 50 51 51 24.3 1239.3
5 SDH – 100 23 23 41.7 959.1
6 GH – 200 4 4 72.5 290
7 WH - (300 +) 2 2 72.6 145.2
8 WH - (200-299) 2 2 54.9 109.8
9 WH - (

ii) Budget required for special focus Hospitals
Total 11 hospitals have been included as special focus hospitals in the state. These are very
remote hospitals, without availability of specialists, far away from District Hospitals and with
very high IMR and MMR. As per plan, Budget required for upgrading hospitals except human
resources is as follows. Human resources budget is requested in RCH Component under
Infrastructure and Human Resources.
List of special focus hospitals submitted in annexure
Table : Budget required to extremely difficult Hospitals for up gradation
Rs. In Lakhs
Sr Activity
1
2
3
No. of
facilities
Average
Budget
required per
unit
32
Total budget
required
Provision of Laboratory and Blood
Bank Equipment
Repairs and new construction of
6 9.5 57
Operation theatre, Labour room and
Blood Storage Unit
11 16.5 181.5
Repairs and New Construction of
Quarters
11 88 968
Total 1206.5
iii) Establishment of SNCU
This part of SNCU added in IPHS as per remarks on RCH Flexipool.
IMR of Maharashtra as per SRS is 28/1000 live births. About 70% part of this IMR is
contributed by early neonatal deaths. Therefore unless neonatal care is improved, the IMR
will not go down effectively. Considering this, special emphasis is being given to establish
SNCU. NBSU and NBCC. GoI has published IPHS standards for these units and provided
financial guidelines. Based on these guidelines, total 34 SNCUs are being established in the
State as per GOI Norms. In the 34 units a detailed facility assessment with respect to Human
resources, equipment & operationlization was carried out, using GOI facility assessment
checklist.
The restructuring of the 33 units is under process, except for Daga Womens Hospital, Nagpur
which is complete, and the remaining units will be completed by December 2012. Other units
are being redeveloped as per IPHS and budget is handed over to PWD. It is expected that civil
works of all the 34 SNCU will be complete by December 2012. However till December 2012
SNCUs are temporarily shifted in other premises and the service to the sick newborns and
LBWs will be continued. The calculation of Human resources for first nine months is as per the
beds currently available which are 250 beds in the State, and for the last two months, once

the SNCUs are as fully operationlized as per GOI norms human resources is calculated for
every 12 beds (1 Pediatrician, 3 Medical Officers, 10 Staff Nurses). Also in the organizational
cost for printing of Neonatal Case record sheets, Admission registers, Follow-up registers,
Protocols related to Housekeeping, asepsis, Hand washing as well as IEC material for publicity
of SNCUs will be included. As per remarks on RCH division, human resource and related issues
are included in RCH PIP. Component wise inclusion in PIP is submitted below:
Sir Activity Component Remarks
1 Construction of SNCU MFP Budget handed over to PWD. Works
started. Completion of Daga Hospital.
Others will be completed by
December 2012.
2 Medicine and consumables RCH FP GoI has provided list of medicines for
SNCU. These medicines will be
3 Manpower (Pediatrician
MBBS doctors and Nurses)
4 Larger equipment as per GoI
list
5 Minor equipment as per GoI
list
procured as per need of SNCU.
RCH FP Proposal approved. Appointment
process will start in May 2012. Actual
appointments as and when required.
MFP Only deficit equipment to be
procured. Specifications finalized.
Process will start once 50% civil work
is complete. Procurement at state
level.
MFP Only deficit equipment to be
procured. Specifications finalized.
Process will start once 50% civil work
is complete. Procurement at District
level.
6 Equipment maintenance MFP It is extremely important to keep the
equipment fully functional and
maintained to avoid accidents.
7 Support services MFP Cleaning and other services round
the clock to maintain cleanliness
which is crucial for prevention of
infections.
8 Contingency MFP Procurement of one computer
system, maintenance of records,
internet, furniture, etc.
Considering the services above, budget required for SNCU under MFP is as follows:
Sir Type of institute
Cost per
unit
No. of units Total cost
1 Larger equipment as per GoI list 11.5 34 391
2
Minor equipment and instrument as per
GoI List
9.2 34 312.8
2 Maintenance of Equipment 3 34 102
33

Sir Type of institute
Cost per
unit
No. of units Total cost
3 Support services 3.6 34 122.4
4 Contingency 1.2 34 40.8
Total 969
List of SNCU is attached in Annexure
Total budget required for IPHS up gradation
Considering the budget requirement of health facilities in all the areas of the state and special
inputs required for very remote hospitals, total budget requirement for IPHS Up gradation is
as follows:
Table : Budget required for IPHS Up gradation
34
Rs. In Lakhs
Sr Particulars Budget requested
1
IPHS upgradation of health facilities except hospitals in very remote and
difficult areas
10968.15
2 IPHS upgradation of health facilities in very remote and difficult areas 1206.5
3 Operational expenses of SNCU in IPHS Hospitals 969
Total 13143.65

SUBSECTION – B.4.2 : STRENGTHENING OF DISTRICT, SUB-DISTRICT HOSPITALS, CHCs AND
PHCs
SCHEME - B.4.2.1 : UN-INTERRUPTED POWER SUPPLY TO IPHS INSTITUTIONS
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2007-08 605.75 416.28 664.08 660.000
35
Rs. in Lakhs
Remarks
In the remarks about this activity, it was mentioned that this should be part of activity B.4.1.
It is submitted that budget requested under B.4.1 is related to IPHS Upgradation based on
gaps identified in upgradation and also for maintenance of upgradation. As Solar Power
System is not mentioned in IPHS guidelines of GoI, this activity is separately requested.
There is severe electricity problem in state. Presently electricity is available only for a period
of about 12 hours in 24 hours. IPHS health institutions require continuous power supply.
Therefore following options are being implemented in state for un- interrupted power supply.
Table :- Various equipment used for un-interrupted power supply in health institutions
Sir Type of institute Equipment used for un-interrupted power
supply
1 Sub-Center Inverter
2 PHC Inverter, Solar back up
3 Hospitals up to 50 beds Inverter, Solar Back up
4 Hospitals beyond 50 beds Inverter, Express Feeder
Inverters are procured from Untied funds or RKS funds. Budget for express feeder is provided
through User Fees collection and only deficit budget is paid through IPHS funds.
It has been observed that solar power system is very helpful at PHC level. One Solar
Photovoltaic System has been developed by College of Engineering Pune. Presently we have
provided Solar Photovoltaic System to320PHCs of state. This covers almost all the tribal PHCs
in the state. During year 2012-13, it is proposed to provide solar back up to non-tribal PHCs
with high number of deliveries. Two highest number of deliveries PHCs per district will be
taken up for this scheme. Solar systems which are more than 2 year old also require
maintenance. Budget is also proposed for maintenance of old system.

Monitoring of the solar back up system
All the solar systems are in remote places of State. For the solar photovoltaic system of last
year, one arrangement is made for condition of the system. The system sends one SMS daily
to District HQ and State HQ regarding working condition of the system. If there is any
problem in the working, the SMS informs that. This is reviewed daily by software and system
out of order is checked and maintained. It is proposed to install this system to all the old
systems also. Cost of each system including Sim Card is about Rs. 9000 to 9500/system.
Budget required for solar power backup
Budget required for solar power backup and maintenance is mentioned below:
Table – :Budget required for solar power backup
Sir Type of institute
Cost per
unit
No. of units
Rs. In Lakhs
Total cost
1 Solar Power Backup – PHC 9.2 63 579.6
2
Adding monitoring
systems
system to old
0.092 300 27.6
2 Maintenance of solar back up in PHCs 0.24 220 52.8
Total 660
SCHEME - B.4.2.2 : QUALITY ASSURANCE IN IPHS FACILITIES
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2010-11 1150.24 1362.29 1224.70 1234.820
36
Rs. in Lakhs
Remarks
The activity of Quality Assurance was mentioned in PIP guidelines of GoI in 2010-11. That
time this activity was submitted and got approval also. However, activity could not be
implemented as Technical Support Partners could not be appointed. Therefore this was again
requested in PIP of 2011-12 and again got approval. It took long time to clear the preconditions
and NGOs selected so the activity started in October 2011. Now MoU is made with
four Technical Support Partners and NHSRC and this is fourth month they have started work.
This project is for one year only. It will finish by December 2012. Therefore it is requested to
continue the project for this year.
Substantial numbers of health facilities in Maharashtra state are being upgraded as per IPHS.
Maharashtra has started the quality improvement measures for such PHCs and hospitals. As

part of this, all the hospitals will be provided with 28 procedures required for improvement in
functioning of hospitals. These procedures are prepared by experts under supervision of
NHSRC. The health facilities after completion of procedures, will get ISO certification.
Technical support of NHSRC is being taken for ISO certification of health institutions. As per
guidelines from NHSRC, groups of health institutes will be made to facilitate the certification.
The institutes will be supported by technical supervisors for certifications.
The amount mentioned in the table below will be paid to NHSRC/Consultants selected to help
state in getting ISO certification. Consultants have been selected by NHSRC by National
Competitive Bidding. Additional budget will be required for supervision of the activity from
state and regional level. The supervision will be in the form of SHS personnel, POL and
contingent expenses.
Budget required for certification is as per NHSRC guidelines. Total budget required is as
follows:
Table : - Budget required for ISO certification of Health Institutions
Sr. Type of facility
No of
beds
No. of
facility
Annual
Budget
required
per
facility
Budget
required
for year
2012-13
per facility
37
Rs. In Lakhs
Total
budget
required
1 PHC 6 120 2.64 2.24 269.28
2 RH 30 36 4.94 4.20 151.16
3 SDH 50 40 4.94 4.20 167.96
4 SDH 100 20 9.91 8.42 168.47
5 GH 200 3 14.86 12.63 37.89
6 WH 151-300 2 14.86 12.63 25.26
7 WH 335 1 19.86 16.88 16.88
8 WH 60 2 6.46 5.49 10.98
9 DH 151-300 17 14.86 12.63 214.73
10 DH 301-450 5 19.86 16.88 84.41
11 DH 541 1 24.76 21.05 21.05
12 Supervision charges 267 0.25 66.75
12 Total 514 1234.82

SCHEME - B.4.2.3 : BARRIER FREE ENVIRONMENT IN HOSPITALS
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
New 0 0 400 341.080
38
Rs. in Lakhs
Remarks
Hospitals need to have barrier free environment for handicap patients as per the directions of
GoI. There are specialized agencies to convert the hospitals into Barrier Free Hospitals.
Commissioner of Handicap has submitted one proposal for conversion of the hospital into
Handicap Friendly Hospital. It is proposed to select 6 districts in the state. The Consultants
approved by Government will be given responsibility of advising about the work to be carried
out. Actual work will be carried out by State PWD as per GoM guidelines.
Hospitals selected for this scheme are : Nashik, Parbhani, Amarawati, and Bhandara.
As per remarks on this subject, estimate of the work is obtained from State PWD. Component
wise budget required will be as follows:
Table – Budget required for conversion of District Hospital into Barrier free hospital
Rs. In Lakhs
Sir Activity
No. of
facilities
Average
Budget
required per
unit
Total
budget
required
1
Renovation work of hospital to suit the
handicap persons
4 20.42 81.68
2 Internal electrification to suit handicap 4 2.25 9
3
Water Supply and sanitation specially for
handicap
4 2.4 9.6
4 Lift with shaft for handicap 4 45 180
5 Sign boards, name plates 4 1.5 6
6 Ramp renovation 4 2 8
7
Contingency, computerization and add to
DSR/Market rates
4 11.7 46.8
Total 341.08

SUBSECTION - B.4.4 : LOGISTICS MANAGEMENT AND IMPROVEMENT
SCHEME - B.4.4.1 : EXTERNAL FACILITY SURVEY
Activity deleted as per the remarks of Deputy Commissioner (MH)
SCHEME - B.4.4.2 : MOBILITY SUPPORT
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2008-09 1251.2 542.6 1649.80 1103.550
39
Rs. in Lakhs
Remarks
Mobility support is required to transfer emergency patients, attending epidemics and
transferring serious patients, attending accidents and natural calamity, etc. and also to
transfer routine patients, support to implement the activities related to National Health
Programs and visit to ASHA, ANM and health institutions for supportive supervision.
Plan of action 2012-13
Approach for mobility support will be as follows:
• Support to existing ambulances in the form of repairs, POL and hiring driver if required
if the state government grants are not sufficient due to higher load in health
institution. This budget will be provided to RKS of the institution. This will ensure 24
hours availability of ambulance
• Provision of ambulances wherever not available.
• Review of all supervisory vehicles available in state and provision of supervisory
vehicles where ever not available.
Budget requirement 2012-13
About 85% PHCs/Rural Hospitals and all District Hospitals have ambulances. However many of
the presently available ambulances are off road as they require repairs. It is proposed to
provide funds for repairs, POL and driver salary whichever is deficit, to these institutions
through RKS with condition that repairs to be carried out only by authorized dealers.
Supervisory vehicles will be provided to BPMU (30) and District level officers who are directly
engaged in support and supervision of NRHM activities in the state such as RCH Officers (33)
and RMO (Outreach) (33). Presently, these officers are provided hired vehicles but in two
years hiring, one new vehicle can be procured. Therefore, procurement of vehicle will be

eneficial. Expenditure on driver and POL for district level supervisory vehicles will be borne
from state funds.
Supervisory work of the officers supervising NRHM works has increased many fold. As each
health facility is being monitored from district and state level, lot of information is being
collected and officers are also travelling to health facilities to go through the discrepancies.
We have submitted proposal for hiring of vehicles to district officials through RCH. This costs
about Rs. 3.0 Lakh per officer in one year. Currently cheaper supervisory vehicles available on
RC costs about 4.5 Lakh. Thus, this cost will be cleared within one and half year. Considering
life of vehicle for 12 years, this will be really beneficial to the SHS. Cost on driver and POL will
be borne from regular budget of State Government. It will not have any impact on the NRHM
budget. Considering this, it is requested to sanction this proposal along with the supervisory
vehicles.
Budget proposed for providing vehicles to all the health institutions is as follows:
Sr Institution
Table – : Budget required for mobility support– 2012-13
No. of
functioning
institution
Support for on road
No. of
vehicles
Unit
cost
Budget
required
Requirement for new
purchase
No. of
vehicles
Unit
cost
Budget
required
40
Rs. In Lakhs
Total
budget
required
1 PHC 1809 1809 0.25 452.25 30 4.9 147 599.25
2 RH/SDH
DH and other
453 453 0.3 135.9 21 6.9 144.9 280.8
3 District
hospitals
Level 35 118 0.5 59 0 0 0 59
4 Supervisory
vehicles
440 0 0 0 35 4.7 164.5 164.5
Total 2737 2380 647.15 86 456.4 1103.55
SCHEME - B.4.4.3 : EQUIPMENT MAINTENANCE AND REPAIRS
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2009-10 150.5 224.9 568.8 568.800
Rs. in Lakhs
Remarks

Health equipment is essential part of hospital. They need to be purchased and maintained
properly for quality services. IPHS requires that every equipment should be repaired
immediately and within 30 days. State Government has separate Health Equipment Repairs
Units at all the 8 circle level and one at state level. Support to these units will help in repairs
of health equipment in the state.
It is difficult to repair the health equipment in difficult areas of the state as no technician is
available. Experience of last year indicates that HEMR unit and private repair agencies cannot
reach these difficult areas. Therefore it is opposed that separate agency will be established in
High Focus districts and Melghat area of the state for repairs of equipment.
Explanation for remarks on this activity is as follows:
1. State Government has already established the Health Equipment Maintenance Unit at
8 places. We are strengthening these units by providing mobility support, deficit
manpower, additional spare parts and operational expenses.
2. All the newly procured equipment are covered under AMC for one to five years
depending upon contract at the time of purchase. Such equipment are repaired by
company. This unit repairs all the equipment not on RC. It also helps the head of
hospital to get the contract people at hospital in time.
3. This unit do not handle sophisticated equipment like Sonography machine, Auto
Analyser, High end ELISA machines, CT SCAN, etc. Such machines are maintained from
regular funds by AMC with authorised service agency. Budget of IPHS is used in IPHS
facilities only in case of gaps.
4. We have serious problem of getting equipment repaired in high focus districts. This
problem has become acute because we are providing lot of additional resources to
these institutions for strengthening in which equipment are also supplied. Incidentally
all these areas are heavy rainfall areas and due to this also equipment go out of order
frequently. Many of the times the technicians from manufacturers do not come in
time for repairs in these areas. Considering this, one pilot project was carried out with
the help of one Mumbai based NGO to train technicians, wardboys, nurses in handling
and maintaining equipment in Nandurbar district. This project was successful but after
some time it was realised that it is difficult to maintain the system with the help of
non-technical persons like this. Therefore it was decided to hire one agency for such
purpose. At least 3 agencies two from Mumbai and one from Nagpur have shown
willingness to participate in this project.
Considering above remarks, it is proposed to approve the activity.
Budget required for repairs of equipment is as follows:
41

Table : - Budget required for Health Equipment Maintenance
Sir Particulars Unit cost No. of units
1
2
Mobility support to HEMR unit - one
vehicle per circle
Hiring engineer /technician (mechanical,
electronic, electrical) as per requirement
and load - five per circle
42
Rs. In Lakhs
Total
budget
required
3 9 27
2.8 44 123.2
3 Initial training of engineers 2.5 4 10
4 Spare parts - Rs. 3 Lakh/district 3 33 99
5 Civil Works as per need 1 8 8
Hiring of agency for health equipment
maintenance in high focus districts
73 4 292
6 Contingency including office maintenance 1.2 8 9.6
Total 568.8
SCHEME - B.4.4.4 : DISABILITY WORKSHOPS AT DISTRICT HOSPITALS
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
New 0 0 150 150.000
Rs. in Lakhs
Remarks
Summary information – Section 42 of “The Persons With Disabilities (Equal Opportunities,
Protection Of Rights And Full Participation) Act,1995’’ mentions regarding provision of Aids
and appliances to persons with disabilities and the appropriate Governments shall by
notification make schemes to provide aids and appliances to persons with disabilities.
Accordingly every District hospital with reference to GR dated 01.03.12 Disability workshops
have been sanctioned. The staff of occupational therapist, Prosthetic and orthotic technician,
leather worker and helper has been sanctioned.
Activities completed - Presently there is no workshop is operational.

Plan for 12-13 – Approximately 700 square feet area is essential for installation of disability
workshop. Equipment like Portable jigsaw machine, Drill Machine, Electric Hand drill
Machine, Grinder can be procured and installed by guidance of All India Institute of physical
Medicine and Rehabilitation. Splints, Calipers, Orthotic (Artificial limbs), Crutches, and Boots
for leprosy patients can be prepared in workshop which will be beneficial to disabled
patients.
Particulars of plan
Sir No Particulars
Unit cost in
lakhs
Number of units
43
Total cost in
lakhs
1 Construction of Disability 30.00 3 90.00
workshops at District
Hospitals of approximate
size 700 square feet
2 Installation of furniture 20.00 3 60.00
and equipment
Total amount proposed in PIP 12-13 150.00
SCHEME - B.4.4.5 : MODERNIZATION OF HOSPITAL KITCHEN
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
New 0 0 310 310.000
Rs. in Lakhs
Remarks
Summary information – Due to increased load of patients in hospitals due to JSSK, there is
need to provide quality food in limited manpower in hospital. Modern kitchen gazettes are
very essential to handle increased need.
Activities completed - Presently hospital kitchens of District, mental and women hospitals of
more than 200 beds are providing quality food to 60% of admitted hospital patients through
existing cooks.

Plan for 12-13 – 23 District hospitals, 4 women hospitals of more than 200 beds and 4 mental
hospitals are proposed for procurement of modern kitchen gazettes such as Mixer, Grinder,
Miller Machine, Chapatti puffer, hot case, Tea urns, Bulk cooker, Refrigerators, Atta kneading
machines etc.
Budget requirement
Sir No Particulars Unit
lakhs
cost in
1 Provision of modern
kitchen gazettes to
kitchens of 23 District
hospitals, 4 women
hospitals of more than 200
beds and 4 mental
hospitals
SCHEME - B.4.4.6 : DISTRICT IPHS MONITORING WING
Number of
units
10.00 31 310.00
Total cost in
lakhs
Issue of manpower under NRHM as discussed in State health Society EC Meeting under
Chairmanship of ACS (PH & FW). Review of total posts was done and decision have been
taken to retain some staff and remove some staff. Shifted to SPMU/DPMU with explanation
for continuation.
SCHEME - B.4.4.7 : PUBLIC HEALTH ESTATE MANAGEMENT CELL
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned for
year 2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed in
NPCC
2011-12 0 143.19 123.90 120.300
44
Rs. in Lakhs
Remarks
Most of the health facilities in Maharashtra are constructed on land either donated by donor
or on government land.
There is need to update the record of land of health facilities in the state for following
reasons
• Infrastructure development
• To make availability of land for constructions of the new health facility.
• To remove the encroachment on health facility.

• To update the records of land of health facility.
Many of these lands are not in the name of health department. In some facility the
boundaries are not cleared.
Considering the above fact, Public Health Estate Management Cell is established in
state Health society & at regional places in the Deputy Director Health office during 2011-12.
The State Health Society, Maharashtra Mumbai have already established four Public Health
Estate Management Cell in the state & remaining five will be established till March 2012.
Performance of Public Health Estate management Cell
As mentioned in remarks, performance of PHEC is submitted.
The performance of Public Health Estate Management Cell is as follows:
Sir Name of the
circle
No of
health
institutes
visited
Record
Updated
Encroach
ment
Removed
Land made
available for
construction
1. Pune 194 451 0 0
2. Aurangabad 206/65LL 87/61L 2
3. Nagpur 275 122 0 0
4. Latur 311 168 0 01
The budget required for the continuation the project during 2012-13 is as follows:
Table : Budget required for Estate Management Cell during 2012-13
(Rs. In Lakhs)
Sr. No. Designation No. of
persons
in each
unit
1 Senior Estate
Manager
2 Junior Estate
Manager
No. Of
Unit
Budget per
unit
Budget
required
45
7
Remarks
1 8 3.60 28.8 One each at
circle level.
1 9 2.40 21.60 One at state
level & eight
at circle level

Sr. No. Designation No. of
persons
in each
unit
3 Program Officer
at state level
4 Program
Assistant
5 Travel &
Mobility
6 Office
Contingency
7 Office
equipment&
Furniture
No. Of
Unit
Budget per
unit
Budget
required
46
Remarks
1 1 3.00 3.00 One officer
at State
Health
Society.
1+1 9 1.20 12.00 Two at State
Health
Society &
one each at
regional
office.
9 5.00 45.00
9 0.60 5.40
9 0.50 4.50
Total 16.3 120.3

SECTION - B.5 : NEW CONSTRUCTION, RENOVATION AND SETTING UP OF HEALTH FACILITIES
New construction, repairs of health facility infrastructure in Maharashtra is carried out by two
agencies. Infrastructure Development Wing is established to carry out construction work of
buildings of PHC/PHU and Sub-Centers. Contractual Junior Engineer, Deputy Engineer and
Executive Engineers are appointed in this wing. This wing is headed by Superintending
Engineer who is regular SE from PWD. In addition to this, Executive Engineers of PWD also
supervise the work of IDW engineers wherever necessary.
No additional charges are levied on the works done by IDW wing.
New construction of Hospitals, Nursing Schools and Regional Warehouses is carried out by
Public Works Department of Government of Maharashtra. PWD claims 5% Centage charges
for all works done and it is included in estimate provided by PWD.
Both the wings – IDW and PWD use DSR for making estimates.
For specified works such as construction of SNCU or construction of Audiometry Room, PWD
hires special architect for planning. Architect is selected from approved panel of PWD and
payment to architect is made as per approved government rates. Fees of architect are
included in estimate provided by PWD.
Considering the volume of work being done in Health Department and time bound program
of NRHM funds, PWD has appointed Chief Engineer Aurangabad as Nodal Officer for Health
Department works. Positive difference with PWD is observed after appointment of Nodal
officer.
One new software ‘Construction Tracker’ is introduced in Maharashtra state for all health
department constructions. The work is registered in the system immediately after awarding
administrative approval. Work is tracked till possession. It is proving very usefull to the state
for timely completionof construction.
SUBSECTION - B.5.1 TO B.5.3 : NEW CONSTRUCTION AND RENOVATION OF SUB-CENTERS,
PHCs AND CHCs
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2005-06 4267 7095 13131.34 8866.050
47
Rs. in Lakhs
Remarks

Health Care Infrastructure
Maharashtra has established large number of health Institutions throughout the state.
Construction, repairs and routine maintenance of these institutions are carried out from plan
and non-plan grants of the state. Public Health Department usually does not get sufficient
funds for these purposes. As a result, health infrastructure was in poor condition in most of
the districts. However, after getting additional support under NRHM, now most of the health
institutions are repaired, having water supply and drainage facilities and electrification.
Health Institutes require funds for maintenance and repairs of existing buildings,
construction of additional facilities in old buildings and construction of new buildings where
they are not available.
A birds eye view of the infrastructure available in state and short fall is shown
below.
District Requirement of Infrastructure DH CHC PHC SHC
Required as per population norms 30 417 2051 12637
Existing Facilities 27 367 1816 10578
Under Construction 2 19 144 788
Shortfall 1 31 41 1271
1. Progress during 2011-12
Following actions have been taken to speed up the repairs and construction activities.
• Infrastructure Development Wing (IDW) is established in all the districts of the State.
• IDW is headed by one Superintending Engineer from Public Works Department of
Government of Maharashtra on deputation. Eight posts of contractual Executive
Engineers are sanctioned in the state to supervise the district civil works progress.
• At district level, IDW is headed by one contractual Deputy Engineer. He is supported
by 3–4 Junior Engineers. (One Junior Engineers appointed for every four blocks.)
Accordingly 33 posts of Deputy Engineers are sanctioned out of which 30 are in place
and 93 post of Junior Engineers are sanctioned out of which 87 posts are filled in.
• Powers of administrative approval and technical sanctions are decentralized and
delegated to District Societies. Accordingly, District Health Officer/Civil Surgeons have
powers to sanction new construction work up to 15 Lakhs and Chief Executive Officers
of Zilla Parishads have full powers for administrative sanctions of works to be under
taken in their district.
• Instructions are issued to all the districts to construct new buildings as per state plans
of hospitals and quarters.
• Public Works Department of Maharashtra State uses DSR for preparing and
sanctioning work estimates. Districts are permitted to use the same rates for NRHM
works.
Information about new construction works sanctioned under NRHM
48

Health
Facility
New Construction sanctioned under
NRHM so far in High Focus Districts
(i.e. Nandurbar / Gondia /
Gadchiroli)
2007
-08
2008
-09
2009
-10
2010
-11
2011
-12
New Construction sanctioned under
NRHM so far in
Non-High Focus Districts
2007
-08
2008
-09
2009
-10
2010
-11
49
2011
-12
DH
SDH
and
0 1 0 0 0 0 1 2 1 1 6
other
hospital
s above
CHC
0 0 0 0 0 0 1 0 1 0 2
CHCs 0 2 0 0 0 0 7 3 0 0 12
PHCs
Other
Health
facilities
above
SC but
0 0 0 0 11 0 13 17 8 28 77
below
block
level
(may
include
APHC
etc.)
0 0 0 0 0 0 0 1 10 0 11
Sub- 5 5 7 0 21 38 234 193 103 101 70
Total 5 8 7 0 32 38 256 216 123 130
81
5
Health
Facility
Information about Upgradation works Sanctioned under NRHM
Upgradation sanctioned under
NRHM so far in
High Focus Districts
(i.e. Nandurbar / Gondia /
Gadchiroli)
2007
-08
2008
-09
2009
-10
2010
-11
2011
-12
Tot
al
Upgradation sanctioned under
NRHM so far in
Non-High Focus Districts Total
2007
-08
2008
-09
2009
-10
2010
-11
2011
-12

DH
SDH and
0 2 1 3 0 37 116 56 43 20 278
other
hospitals
above CHC
0 6 4 14 3 23 63 28 10 3 154
CHCs 3 9 1 0 1 38 77 77 30 9 245
PHCs
Other
Health
facilities
above SC
17 59 142 165 8 628 567 839 470 142 3037
but below
block level
(may
include
APHC etc.)
0 4 6 15 0 0 44 0 0 0 69
Sub-Centres 67 126 68 293 2 606 701 676 356 219 3114
Total 87 206 222 490 14 1332 1568 1676 909 393 6897
Progress of Works Sanctioned under NRHM
Progress of New Constructions
Completed Under Construction Sanctioned but Yet
Health Facility High
Focus
Districts
Non High
Focus
Districts
High
Focus
Districts
Non
High
Focus
Districts
High
Focus
Districts
Non
High
Focus
Districts
Total
DH
SDH and other
1 5 0 0 0 0 6
hospitals
above CHC
0 0 0 2 0 0 2
CHCs 2 5 0 5 0 0 12
PHCs 0 17 0 29 11 20 77
Other Health
facilities
0 11 0 0 0 0 11
Sub-Centres 15 502 8 142 15 25 707
Total 18 540 8 178 26 45 815
50

2. Plan for the year 2012-13
During last four financial years, priority was given to repairs of health institutions
because this resulted into making the health institutes functional with minimum budget. Now
following policy decisions have been taken regarding execution of Civil Works in the state:
• Henceforth minor repairs will be carried out locally by Rogi Kalyan Samittee from
funds such as AMG, RKS and if necessary the IPHS funds.
• For repairs of institution, either State government or IDW budget will be utilized for
major repairs of health institutions.
• New constructions to be focused on blocks that have list infrastructure and are
backward.
• Plans for new construction should be in accordance to the latest developments in
technologies for hospitals constructions.
• All civil works are to be budgeted under mission flexipool only (including budget for
minor civil works which earlier used to be booked under RCH Flexipool.)
• Priority will be given for construction of Sub-Centers, PHCs and Quarters of critical
staff.
• In one institution, no budget from two sources will be utilized for civil works.
The Information about proposed works to be undertaken in 2012 -13 and budget
required for that is as below.
District : Maharashtra
Proposed PIP 2012-2013
(Rs. In
Sr.
No.
Type
of
Heal
Phys
ical
New Construction
Unit Budg Propos
Cost et ed
Repairs / Upgradation
Phys Budget Propos
ical Requir ed
Total
Physic Budg
al et
1 DH 0 0 0.00 0 11 325.00
9
Month
s
11
325.0
0
2 SDH 0 0
New
0.00 0 15 204.00
9
Month
s
15
204.0
0
3 CHC 1
Constru
ction 1
CHC @
96 L
New
96.00
12
Months
57 658.25
9
Month
s
58
754.2
5
4 PHC 53
Constru
ction
22
PHCs @
2339.
00
12
Months
304
1997.6
6
6
Month
s
357
4336.
66
51

5 SHC 109
Total 163
annexed.
72 L
(31
Qtrs. )
New
Constru
ction
109 SCs
@ 18 L
1962.
00
4235.
00
9
Months
475
862
1284.1
4
4469.0
5
6
Month
s
52
584
1025
3246.
14
8866.
05
The list of the facilities that are proposed for new construction and upgradation is
SUB-SECTION - B.5.4 : SETTING UP OF INFRASTRUCTURE DEVELOPMENT WING
As per remarks, shifted to Program Management Section
SUBSECTION - B.5.5 : GOVERNMENT DISPENSARIES AND OTHER RENOVATIONS
SUBSECTION - B.5.6 : CONSTRUCTION OF BLOCK HEALTH OFFICE, FACILITY IMPROVEMENT,
CIVIL WORKS OF BEmOC AND CEmOC CENTERS
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2009-10 245 190 1286 711.500
Rs. in Lakhs
Remarks
Mission Flexi pool has sanctioned activity for construction of BPMU. It is proposed to
construct the BPMU in all the blocks phase wise. There are 56 BPMU situated in government
buildings. Repairs of these BPMU will be carried out. THO will also be provided with quarters
in phased manner. As strengthening of the BPMU is very important for monitoring of NRHM
activities, it is proposed strengthen this activity.The BPMU will have office, one meeting
hall,furniture and quarters for THO in tribal areas.
In the districts where there is no Medical College, DPMU also need to be strengthened. This
will be carried out from same funds.

In remarks, it has been mentioned to submit details where the BPMU is to be established. In
this regard it is submitted that, BPMU is already established in 353 places in the state. From
regular side, one Taluka Health Officer (THO), one Jr. Clerk, one Health Assistant and one
MPW are appointed in BPMU. One Accountant and one DEO are sanctioned under NRHM.
They are appointed at all the blocks in the state.
Budget requirement
Budget required for this activity is as follows:
Table – Budget requirement for BPMU/DPMU
Sir Particulars Unit cost
1
2
3
No. of
block
53
Rs. In Lakhs
Budget
required
Repairs of BPMU/DPMU quarters, etc.
functioning in Govt. Buildings
3.5 33 115.5
New Construction of BPMU/DPMU, HQ
quarters in non-tribal areas
40 5 200
New Construction of BPMU/DPMU,
quarters in tribal and LEA areas
44 9 396
Total 711.5
SUBSECTION - B.5.7 : MAJOR CIVIL WORKS FOR OPERATIONALIZATION OF FRU
Until last Year (i.e. 2011-12) this programme was a part of RCH Programme. But as per the
current Guidelines of GOI, all civil construction works are to be incorporated in Mission
Flexipool. Hence this programme is incorporated under Mission Flexipool. The details are as
below.
FMR
Code
B.5.7
Activity Unit Rate
Minor Civil works for
operationalisation of
FRUs
Rs. 5 Lakhs/
FRU
No of
Institutes
The list of works is annexed Separately.
Total
Amount
Required
Demand
FRUs - 45 225.00 225.00

SUB-SECTION - B.5.8 : MAJOR CIVIL WORKS FOR OPERATIONALIZATION OF 24×7 PHCs
B.5.8
Minor Civil works for operationalisation of 24 X 7 PHCs
Until last Year (i.e. 2011-12) this programme was a part of RCH Programme. But as
per the current Guidelines of GOI, all civil construction works are to be incorporated in
Mission Flexipool. Hence this programme is incorporated under Mission Flexipool. The details
are as below.
FMR
Code
B.5.8
Activity Unit Rate
Minor Civil works for
operationalisation of 24
X 7 PHCs
Rs. 3 Lakhs/
PHC
No of
Institutes
The list of works is annexed Separately.
Total
Amount
Required
54
Demand
PHCs - 201 603.00 603.00
SUBSECTION - B.5.9 : CIVIL WORKS TO OPERATIONALIZE INFECTION MANAGEMENT AND
ENVIRONMENT PROTECTION PLAN
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2011-12 0 123.55 104.7 225.000
Rs. in Lakhs
Remarks
As per the Environment Protection Act, every hospital is required to have the infection
management and environment protection plan. Following actions are taken in Maharashtra
state:
All the hospitals are handing over the hospital waste to agency appointed by Government at
GoM fixed rates.
All the PHCs and SCs dispose of medical waste in deep burial pits as per the design approved
by the act.
All the doctors and nurses need to be trained in infection management and environment
protection. Training of all the health facilities in block will be carried out at block level in one
of the RH/SDH/DH
Budget required for this activity is as follows:

Table : Budget required for Construction in Infection Management and Environment
Protection Plan
Rs. In Lakhs
Sir Particulars
1
2
Budget per
unit
No. of units
55
Total
budget
required
Biomedical waste Pits at
PHCs/Hospitals without central
agency
0.7 66 46.2
Biomedical waste pits at SC
conducting delivery
0.3 195 58.5
Total 104.7
SUBSECTION - B.5.10 : STRENGTHENING OF TRAINING INFRASTRUCTURE (Training institutes
and nursing Schools)
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2006-07 1548.30 1481.6 2459 1696.500
Rs. in Lakhs
Remarks
Training is essential part of implementation of any program. Trained manpower is essential to
provide quality services. Considering the importance of training in implementation of NRHM
activities and in achieving the NRHM goal, utmost importance is given to training in the state.
Training infrastructure in state
Maharashtra has strong training infrastructure. Maharashtra has currently one Public Health
Institute at Nagpur, 6 HFWTCs at divisional HQ, 33 District Training Centers, 23 Hospital
Training Centers and 38 Block Training Centers. Considering the health circles and districts,
one more HFWTC is established in Konkan Region under financial support of NRHM.
Areas covered for strengthening
Following areas are being covered for strengthening of infrastructure
• Majority of training centers do not have basic training equipment. Additional required
equipment will be provided to training institutes.
• Vehicles require to training centers for field visits. Vehicles will be hired by the
institute as and when required.

• Civil Works or extension of training and staying capacity of the institute as per need of
institute
• Support in up keeping of training institute premises particularly the hostel.
Training institutes covered for strengthening
Following training institutes are covered for strengthening
• District Training Centers (33)
• Hospital Training Centers (23)
• Health and Family Welfare Training Centers (7)
• Public Health Institute Nagpur (1)
• Nursing Schools (31)
Compliance of remarks
Compliance about remarks are as follows:
1. Approval for civil works and construction of Training Institutes is Rs. 1039.63 Lakh (Not Rs.
1481.6 Lakh). Expenditure for this activity is Rs. 1007.592 (97%) for the year 2011-12.
2. This budget is utilized mainly for maintenance / repairs of main building and hostel Extension.
One HFWTC is constructed (Thane), one new hostel is constructed at Nagpur and extension of
hostel is carried out at Nashik, Aurangabad and Amravati.
3. From the budget of year 2011-12, Extension of HFWTC Nagpur Hostel, Repairs of Kitchen of
Nagpur HFWTC, Electrification of Hostels, New Hostel at Pune, Construction of DTT Building at
3 places (released Rs. 15 Lakh as first installment) were sanctioned and approved.
4. For year 2012-13, budget for Training Institutions and Nursing Schools is requested in one
activity so budget is increased. This year, remaining amount of new hostel at Pune, Kolhapur
and Thane will be paid, Kitchen of Nashik and Amravati will be repaired. In addition to this,
budget for minor repairs of main and hostel buildings will also be carried out.
Budget is revised for all the centers considering additional budget received under reappropriation.
Final requested budget is as follows:
Budget requirement for strengthening of training institutes
Budget required for these activities is mentioned below:
Table – Budget requirement for strengthening of training institutes
Sir Activity
Average
Unit cost
No. of
units
56
Rs. In Lakhs
Budget
requirement
1 Minor civil works and furniture
i District Training Center 3 33 99
ii Hospital Training Center 2 23 46
iii HFWTCs and PHI 15 8 120

Sir Activity
Average
Unit cost
No. of
units
57
Budget
requirement
iv Nursing Schools 6 31 186
v BTCs 1 8 8
Total 459
2
Construction/extension
institute
of training
i District Training Center 18 3 54
ii Hospital Training Center 85 3 255
iii HFWTCs and PHI 45 8 360
iv Nursing Schools 45 8 360
v BTCs 0 0 0
Total 1029
3
Provision of required training aid and
equipment
i District Training Center 1 33 33
ii Hospital Training Center 0.5 23 11.5
iii HFWTCs and PHI 3 8 24
iv Nursing Schools 4 31 124
v BTCs 0 0 0
Total 192.5
4
Library for training institutes and data
management center
2 8 16
Grand Total 1696.5
Subsection B.5.11: Third Party Evaluation of Civil Works
In NRHM, execution of civil works pertaining to state sector Buildings (i.e. District
Hospitals, Sub District Hospitals and CHCs) is done by State PWD and execution of works
pertaining to Zilla Parishad sector i.e. PHCs and SCs is done by Infrastructure Development
Wing (IDW) established in every district. As far as State PWD is concerned there is a separate
wing called “Vigilance and Quality Control Wing” for monitoring the quality of works being
executed by PWD. But for the works executed by IDW there is no independent quality
assurance wing.
Hence it is decided to get the quality control work (pertaining to IDW works) done by
appointing a separate agency at State level for “Third party evaluation.” The State Executive

Committee also sanctioned the proposal for appointing a separate agency for third party
evaluation in the E.C. meeting held on 22-12-2011.
The scope of the work for “Third Party Evaluation” is decided on the basis of system existing
in “Sarva Shiksha Abhiyan” in Education Department and it is as below :
1. The consultant / representative (Engineer) shall visit each site of work for minimum
four times during the construction of work. These visits shall be when the construction work
is at Excavation level, at plinth level, at beam / slab level and at completion stage for issue of
completion certificate.
2. The consultant, at his own cost, shall check the quality of the materials brought on the
site of work and ensure that the materials are in accordance with the specifications generally
prescribed for the work. The laboratory test results of the materials tested be submitted to
district CEO, ZP.
3. consultant should remain present in the co-ordination / review meeting to be held at
State level or at District level once in a month or earlier as required (at no extra cost.)
4. As per the intimations, the consultant or his authorized Engineer should accompany to
the IDW Engineers when they take site visits / organize meetings at District level.
5. If any deviation in design / construction or compromise in quality is observed during
the site visit of consultant, it should be immediately reported to CEO, ZP at district level and
SE, IDW, Mumbai for further action.
6. Consultant shall organize with his own arrangement and equipments, at his cost, a
one day workshop to impart training to District IDW Engineers at mutually agreed suitable
place at district. The expenses towards the TA & DA of participants except the consultant) will
be borne by NRHM. A suitable place will be made available free of cost to consultant for
arranging such training programme.
7. The consultant shall appoint two Engineers (Minimum Qualification B.E. Civil) for each
district. If the no. of works in any district are more than 500 then an extra Engineer for 250
works should be appointed.
8. Consultant shall submit monthly report about the general progress of the works (for
each work).
9. Consultant should suggest the remedial measures to be carried out if any defects are
noticed, during construction.
10. Consultant should suggest the ways and means for economical construction. (To
reduce the cost of construction without affecting quality of work.)
11. Consultant should suggest methodology “to check and ensure the quality of work
done” (by IDW Engineer) and check the work quality accordingly.
12. Consultant shall not issue any instructions directly if in his opinion it is found
necessary to change specifications or modify design. The same shall be brought to the notice
of regional Executive Engineer and SE, IDW, Mumbai.
13. The consultant shall have minimum 3 years experience in the field of civil works of
similar magnitude to that of the works covered in the proposed project.
58

14. Consultant shall have to prepare “Manual for good construction practices” and
“Checklist” covering all the items to be executed as per the estimate and furnish it to IDW,
Engineers.
15. After the work is completed consultant shall issue completion certificate as per format
approved by SE, NRHM, Mumbai.
The procedure for appointing such agency at state level is in progress and it is
expected that the agency will be fixed upto the end of March 2012. Hence provision for the
above activity is necessary in PIP 2012-13.
Provision is done on lumpsum basis i.e. @ 2.0% of the total budget for civil
construction. The total budget for civil construction (i.e. Mission flexipool + Minor civil works
for FRUs and 24 x 7 PHCs) is 88.66 + 2.25 + 6.03 = 96.94 Crores.
Hence budget required for third party evaluation of civil works is :-
2.0 % x 9694 (Lakhs) = 194 Lakhs.
59

SECTION - B.6 : CORPUS GRANT TO HMS/RKS
SUBSECTION - B.6.1 TO B.6.3 : ROGI KALYAN SAMITEE (RKS) OF DH/SDH/CHC/PHC
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2005-06 2446 2449 2457 2458.000
60
Rs. in Lakhs
Remarks
Rugna Kalyan Samitee (RKS) is important step towards communalization of health care
delivery. It is established to improve the hospital services, make the services community
oriented and self-sufficiency of community in planning and implementation of their health
needs. Well functioning RKS supported by VHCs forms excellent responsive health service
delivery model.
All the functioning health facilities such as PHCs/RHs/DHs have established RKS and
registered.
Budget requirement for year 2012-13
Budget requirement for RKS in Maharashtra is given in table below:
Table – : Budget requirement for RKS for year 2012-13
No. of
Rs. In Lakhs
Total budget required
Sir Type of facility
functioning
facilities
Unit rate
Budget
required
1 PHC 1810 1.00 1810.00
2 CHC(including
RH/SDH/WH/GH/Malvani Malad)
458 1.00 458.00
4 DH including Leprosy, Mental, TB,
Ortho and Referral Hospitals
38 5.00 190.00
Total 2306 2458.00

Year of starting
the
scheme/initiative
SECTION : B.7 : PREPARATION OF DISTRICT HEALTH ACTION PLANS
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2006-07 277.8 292.8 370.75 370.750
61
Rs. in Lakhs
Remarks
In order to make NRHM fully accountable, the district health action plan will be the principal
instrument for planning, implementation and monitoring, formulated through a participatory
and bottom up planning process. District Health Mission constituted as per guideline is
responsible for the planning of district.
GOI in NRHM Activities and Norms has published that up to Rs. 20.0 Lakhs can be utilized per
district for surveys, workshops, studies, consultations, orientation in the process of
preparation of District Health Action Plans.
Budget requirement
Considering the bottom up approach being used by Maharashtra and also the funds utilized
during preparation of PIP of 2011-12, it is proposed to request for the budget as mentioned
below for preparation of PIP of year 2012-13.
Table –: Budget required for preparation of PIP for year 2012-13
Sir Particulars Unit cost
No.
units
of
Rs. In Lakhs
Budget
required
1 District Health Action Plan at block level 0.75 353 264.75
2
HFWTC for Preparation and Compilation
workshops
6 8 48
3 Circle offices for supervision 1 8 8
4
State PIP (All components - meeting,
review, printing, etc)
50 1 50
Total 370.75

SECTION - B.8 : PANCHAYATI RAJ INITIATIVE
SUBSECTION - B.8.1& B.8.2 : CONSTITUTION AND ORIENTATION OF COMMUNITY LEADERS
AND VHSC, SHC, PHC, CHC, ETC& : ORIENTATION WORKSHOP, TRAINING AND CAPACITY
BUILDING OF PRI AT STATE, DISTRICT HEALTH SOCIETIES AND PHC LEVEL
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
New 0 137.81 317.70 176.500
62
Rs. in Lakhs
Remarks
In Maharashtra, Village Health Committees have developed in all revenue villages, SC
Committees in all SCs and RKS in all health facilities at and above PH level. Orientations
training of members of these committees have been conducted during 2009-10. It is
proposed to carry again the orientation of these members with the help of SHSRC. Budget
required will be for snacks of the members and booklet to be given to each member. Training
of all VHNSC and SC members in PHC along with RKS members will be carried out at PHC level.
There will be around 100 participants for each orientation camp. Responsibility of this
training will be given to Health and Family Welfare TrainingCentres.
Large number of Panchayat Raj leaders are involved in NRHM. In Maharashtra, Panchayat
elections are being conducted in February 2012. New Members will be elected in all the Zilla
Parishads. These members need to be oriented.
Compliance of remarks is as follows:
1. Trainings were started in July 2011 but discontinued as it was realised that Panchayat
elections were to be held around November. Elections were held and new members
came into existence in February. Training of elected members conducted in March
2012.
2. Total trained persons are 35636 RKS members and 39755 VHC members.
3. Considering the trainings conducted, budget is revised and submitted for approval.
4. New members will be trained in July August 2012.

Budget required for this activity is as follows:
Table –: Budget required for PRI member workshops
Sir Particulars Unit cost
No. of
batches
63
Rs. In Lakhs
Budget
required
1 Preparation of training material 0.1 353 35.3
2 Charges for arrangement and food 0.2 353 70.6
3 Contingency 0.1 353 35.3
4 Supervision charges to HFWTC/block 0.1 353 35.3
Total 176.5
SUBSECTION - B.8.3 : ORIENTATION WORKSHOPS FOR DISTRICT AND STATE HEALTH
SOCIETY MEMBERS
Activity deleted as per remarks
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
SUBSECTION - B.8.4 : GUIDED TOURS FOR MLAs, MLCs AND OFFICE BEARERS OF ZILLA
PARISHADS
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2011-12 0 56.8 102.6 68.400
Rs. in Lakhs
Rs. in Lakhs
Remarks
MLAs, MLCs and MPs are now members of various monitoring committees for NRHM
activities. Many of them are now a days taking keen interest in NRHM activities. During last
year, It was proposed to organise one orientation camp plus guided tours to them in one of
the districts of each circle. Same program is being organised during this year.
As office bearers of Zilla Parishads will change, this program is being expanded then last year.
This scheme will be implemented through Deputy Director i/c circles.
As MLAs were busy in Panchayat Elections, the tour programs were postponed many times.
The plan was to conduct these programs at regional level but MLAs insisted to see facilities of
the district only. Total 6 tour programs were organised and 19 MLAs attended the program.
The program is completely revised this year. Budget provision is also reduced.

Budget required for this activity is as follows:
Table : - Guided tours for MLAs
Sir Particulars Unit cost No. of units
64
Rs. in Lakhs
Budget
required
1 Orientation material per batch 0.3 12 3.6
2 Lodging and boarding charges for MLA/MP 2 12 24
3 Expenditure of travel 2.4 12 28.8
4
Supervision charges and contingency to
Deputy Director i/c circle
1 12 12
Total 68.4

Year of starting
the
scheme/initiative
SECTION - B.9 : MAINSTREAMING OF AYUSH
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2009-10 645.2 1394.82 1240.53 1358.130
65
Rs. in Lakhs
Remarks
Indian Systems of Medicine & Homoeopathy (ISM&H) have proven strengths of treating
common and chronic diseases. With a view to make available the benefits of Ayurveda,
Unani, Siddha, Yoga & Naturopathy and Homoeopathy to the public at large, so that the
people can exercise their choice in accessing and specialized treatment centers of ISM&H in
the Allopathic hospitals. The objectives is to build bridges across medical systems by providing
general and specialized therapies of Ayurveda, Unani medicine, Siddha, Yoga & Naturopathy
and Homeopathy for utilization as an adjunct or better alternative to conventional medical
treatment. Similarly of Medicine & Homeopathy is a matter of concern as it has put the
credibility of these systems at stake. It has been felt that this situation needs to be addressed
with concerted efforts.
Following actions are taken for AYUSH scheme
• AYUSH facility – Ayurved, Homeopathy, Unani, Yoga and Naturopathy facilities are
started in all District Hospitals by appointing contractual doctors.
• 6 District Hospitals are provided AYUSH Wing (indoor, outdoor Panchakarma and
Ksharsutra facility and of AYUSH). For this AYUSH department grant is being utilized.
• AYUSH OPD and IPD facility started in 17 District Hospitals and some SDH and RH
• Ayurvedic and Unani Doctors are appointed on regular basis and 509 contractual
AYUSH doctors are appointed in Rural, Sub-District and District Hospitals.
Medicines are purchased through IPHS, RKS, DPDC and other available funds as
Maharashtra did not receive AYUSH medicine grants from GoI.
• Budget at state level will be utilized for IEC, Training, Contingency, innovatives and
salary as per requirement.
Plan of action – 2012-13
• This year ‘Suvarnaprashan Sanskar’ facility will be provided at few institutes as
an innovative.
• Also we have decided to start ‘Ayurved Gram’in selected grams on pilot basis.
PIP of AUSH scheme is in two parts as follows:

Part – A : Budget for Man Power for AYUSH specialists and staff under mainstreaming as well
as IEC and Training in AYUSH is submitted to Mission Flexipool in this section.
Part – B: Procurement of medicines, AYUSH equipment, instruments and civil works through
AYUSH funds. This part will be submitted to AYUSH department
Budget requirement
Budget is required for establishing AYUSH Centers in hospitals under mainstreaming,
establishment and functioning of District AYUSH cell and functioning of State AYUSH Cell. In
Maharashtra, AYUSH Coordinator will be appointed in 22 districts for AYUSH administration.
In 10 districts AYUSH officers are appointed as District AYUSH Officer in 2011-12.
Currently, training of AYUSH doctors is in various National Health Programs. They did not
have opportunity to get clinical training to update themselves in AYUSH. It is proposed to
provide training to these officers in Ayurvedic Colleges. Curriculum for the training will be
decided in consultation with Director (Ayurved). In addition to this, many of the allopathic
doctors are also taking interest in Ayurvedic issues. It is proposed to provide one introductory
training for such doctors.
Training under AYUSH
Training is important component of AYUSH. It is proposed to provide training of
mainstreaming to AYUSH doctors, as well as training in specialized subjects such as
Panchakarma, Ksharsutra. If additional budget is needed for these training, that will be met
from regular training budget.
It is also proposed to conduct training of Alopathic Doctors in basic AYUSH concepts and
commonly used remedies in AYUSH.
IEC/BCC under NRHM – Mainstreaming of AYUSH
It is important to provide information of AYUSH to community. It is proposed to conduct
AYUSH mela per district. No. may be increased as per demand and sanction from SHS.
Summary of budget requirement
Total requirement of Budget under AYUSH
Table – Budget requirement under AYUSH-2012-13
Sir Particulars Months
A Hospitals AYUSH Services
PG MO (one each
Ay/Ho/Un) at DH
1 (Salary PG MO- @
Budget
/unit
No. of
Units
66
Rs. in Lakhs
Total
budget
required
12 2.33 37 86.14

Sir Particulars Months
2
3
4
5
6
Rs.19,400)
PG MO (one each
Ay/Ho/Un) at DH
(Salary PG MO- @
Rs.19,400)
PG MO at WH
(Salary PG MO- @
Rs.18,000)
UG MO at DH/SDH /RH
(Salary of Graduate MO @
Rs. 15,120/MO/PM)
UG MO at DH/SDH /RH
(Salary of Graduate MO @
Rs. 15,120/MO/PM)
Pharmacist one at DH
(Salary @ Rs. 9180/ PM )
Y & N at DH
(Salary @ Rs. 7776/ PM )
Y & N at Vacant of DH
(Salary @ Rs. 7776/ PM )
Y & N at WH
(Salary @ Rs. 7200/ PM )
Budget
/unit
No. of
Units
67
Total
budget
required
5 0.97 35 33.95
5 0.90 8 7.56
12 1.8 495
5 0.75 79
898.13
59.72
12 1.10 24 26.44
12 0.93 12
5 0.39 12
5 0.36 8
11.20
4.67
2.88
Massagist cum Atendant
(Salary @ Rs. 7020/ PM)
Total of AYUSH Hospital
8 0.56 48 26.96
Services
Special budget for MO at
1157.64
PHC in Sindhudurg 12 1.68 36 60.48
B District AYUSH Cell
1
Dist. AYUSH Officer
(Salary @ Rs. 19400/ PM) 12 2.33 9 20.95

Sir Particulars Months
3
4
Budget
/unit
No. of
Units
68
Total
budget
required
DEO for AYUSH Cell
(Salary @ 10260) 10 1.03 33 33.86
TA to DAO & Co
coordinator
(AYUSH Centre*5000) 0.05 245 12.25
5 Contingency (DH*15000) 0.15 33 4.95
Total of District AYUSH
Cell 72.01
C State AYUSH Cell
AYUSH
IEC,Training,TA/DA,
innovative and
1
contingency and salary if
required
68
Total State level Budget 68
Grand total (A+B+C) 1358.13

Year of starting
the
scheme/initiative
SECTION - B.10 : IEC/BCC UNDER MISSION FLEXI-POOL
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2011-12 0 1251.41 1853.03 1439.03
69
Rs. in Lakhs
Remarks
In the developmental communication era IEC/BCC is playing very vital and strategic role and
especially in the field of reproductive and child health, IEC & BCC activities are plying equally
very important role. For generating demands regarding services available at grass root level
and to create awareness in community is a very hard task for health and family welfare
department.
SUBSECTION – B.10.1 : STRENGTHENING OF BCC/IEC BUREAU
In Maharashtra for planning, implementation and monitoring of IEC/BCC activities an
independent State Health IEC Bureau is established in the year 1996 which is headed by the
Deputy Director of Health Services, a Mass Media Specialist. Every district has a small IEC
unit of 2-3 officials functioning under the supervision of District Health Officer.
Planning, implementation and monitoring of various IEC/BCC activities under
Reproductive & Child Health Program as well as other various national health programs are
being carried out throughout the year through the State Health IEC Bureau. "Maharashtra
Arogya Patrika’ a monthly magazine in Marathi is being published and circulated regularly by
the State Health IEC Bureau for continuous health education to health providers and
community in the State. Parivartan Express, a very unique Audio Visual Van is run by State
Health IEC Bureau. Various activities such as health exhibitions, film shows are organized
throughout the State with the help of this Parivartan Express.
Table – Strengthening of IEC Bureau
Sir Particulars Unit cost
1
2
3
4
Hiring of IEC consultancy : Rs. 2.00 lakhs per
month X 12 months = Rs. 12.00 lakhs
Appointment of Communication expert to publish
all the works / schemes of NRHM.
Exhibition set for district media units: 33 districts
X Rs. 1.5 lakhs per district = Rs. 66.00 lakhs
Development of Information centre at IEC Bureau
= Rs. 10.00 lakhs
No. of
units
Rs. In Lakhs
Budget
required
12 1 12
3.5 1 3.5
1.5 33 49.5
10 1 10

Sir Particulars Unit cost
5
6
No. of
units
70
Budget
required
POL to Audio Visual Van 'Parivartan Express' for
state level exhibitions = Rs. 3.00 lakhs
3 1 3
POL to IEC van at districts = Rs. 1.00 lakhs X 33
districts = Rs. 33.00 lakhs
1 33 33
Total 111
SUBSECTION - B.10.2 : DEVELOPMENT OF STATE BCC/IEC STRATEGY
The State has developed on IEC/BCC strategy with focus on interpersonal communication,
print and electronic media, community media such as folk art, rallies, street plays, newspaper
advertisements as well as local need based IEC activities at district level.
No budget is requested for this activity for year 2012-13.
SUBSECTION - B.10.3: IMPLEMENTATION OF BCC/IEC STRATEGY
While implementing IEC/BCC Plan following issues will be focused.
• Message will be well designed to solve the identified health problems and
issues.
• IEC/BCC Messages, Material and media will be linked with programme objectives.
• Integrated approach will be adopted for implementing IEC/BCC activities.
• Programmes will be strictly monitored for timely dispatch of IEC material to proper
destination and its utilization
• Instead of mass media approach, IPC approach will be adopted for disseminate the
message among the rural masses.
• The district will be focal point for developing local specific IEC.
• Special training programme will be organized for developing the communication skills
of service providers and IEC personals.
• State will encourage the Best IEC practices.
• Role of different functionaries for implementation and supervision will be ensured.
• Decentralized and participatory approach will be adopted.
• Service providers at grass root level will be equipped with proper IEC material
methods.
and
• Media people as well as journalists will be encouraged with best awards.
• Health Melas will be organized for mass awareness.
• Mass publicity campaigns will be organized for declining the sex ratio.
Activities for B.10.3.1 to B.10.3.4
Inter personal communication

For behavioral change, Inter personal communication is very effective tool. For this purpose,
counseling and interactive sessions with ASHAs, ANMs, and Anganwadi Workers, group
meetings at village and block level, workshop for women groups, community leaders,
adolescent groups at block and district level has been proposed. 358 workshops at block level
(@Rs. 5000) and 33 workshops at district level (@Rs. 10000) total
Rs. 21.20 lakh are proposed for the IPC activities.
Community media - Folk Art:
For creating awareness regarding various health programs and projects, the activities like folk
art, Rallies, Street plays have been proposed. 300 folk programs @Rs. 4000 will be organized
in each district. Provision of Rs. 12 lakhs is made in the PIP.
Community media - Rallies:
On occasion of health days, fairs and campaigns, 5 rallies in each district @ Rs. 10000 will be
organized. Rs. 16.50 lakhs have been proposed for 165 rallies.
Outdoor media - print materials:
For the use of health providers and beneficiaries, the print material like folders, flash cards
and flip books are very useful. Folders and flash cards are very easy to carry and it can be
used in small groups. The flip books will be used by health workers for Inter personal
communication or group discussions. The issues like Mother and Child care, Immunization,
Breast Feeding, PCPNDT, NSV, JSSK. JSY, Institutional delivery, referral services, Nutrition, Age
at Marriage, Spacing methods will be sensitized through the print material. For creating
awareness and demand generates pictorial message will be given through flex banners,
hoardings and electricity bills. The message regarding JSY, NSV, PCPNDT, Immunizations, Age
at Marriage will be given through banners and these banners will be displayed at various
health institutions like District hospitals, RH, PHCs etc.. There are 162 hoardings in the
premises of health institutes and bus stands. Messages will be displayed on all the 162
hoardings. The message on electricity bill is one of the very useful medium which reach in
every house regularly. The message regarding PCPNDT will be given on 50 lakh bills in
selected districts. Following are the item-wise budgetary details:
• Folders - 1,00,000 folders x 10 subjects x Rs. 2.00 = Rs. 20.00 lakhs.
• Flash cards - 10,00,000 flash cards x 10 subjects x Rs. 1.00 = Rs. 100.00 lakhs
• Flip books - 5000 flip books x 3 subjects x Rs. 50.00 = Rs. 7.50 lakhs
• Flex banners (6' x 4' x 2') - 12,000 banners x 5 subjects x Rs. 120/- = Rs. 72.00 lakhs
• Messages on hoardings - Rs. 3100 x 162 hoardings = Rs.45.20 lakhs
Thus, a budget of Rs. 244.70 lakhs is proposed during the year 2012-13 for the above
publicity materials.
71

Electronic media:
To reach the masses, television and radio is the best option. The T.V. & Radio programs are
watched by all classes of community. Various programs like serials, dances and music, News,
discussions, interviews are telecasted and broadcasted for different target groups.
Considering the importance of T.V. & Radio following activities are proposed.
• Telecasting of TV spots : Rs. 60,000/- per telecast x 475 telecasts = Rs. 285.00 lakhs
• Broadcasting of Radio Jingles : Rs. 13,000/- per broadcast x 500 broadcasts = Rs.65.00
lakhs
Thus, a budget of Rs350.00 lakhs is proposed during the year 2012-13 for publicity through
electronic media.
Newspaper advertisements:
Newspaper is very popular and effective medium, through which health messages can be
reached up to different target groups. Pictorial advertisements will be published in
newspapers @ Rs. 20000/- per advertisement x 600 advertisements. Thus, a budget of Rs.
120.00 lakhs is proposed for this
activity.
Summary of budget requirement
Table – Budget required for Implementation of IEC/BCC strategy
Sir Activity
Rs. In Lakhs
Budget
1 Inter-personal communication 21.2
2 Community media (Folk art) 12
3 Community media (Rallies) 16.5
4 Print material 244.7
5 Electronic media 350
6 Newspaper advertisements 120
Total 764.4
SUBSECTION - B.10.4 : HEALTH MELA
For mass awareness regarding various health programs, health mela is the best opportunity.
We can provide health check-up services as well as awareness campaign in the same mela. In
Maharashtra, there are eight health circles. One health mela in each health circle will be
organized. Each Mela will be for the period 3 days. The mela will be organized in selected big
hospital premises or public ground. The facilities for health check-ups and diagnostic purpose
will be provided to community by specialists. Health exhibitions, film shows, folk programs
will be arranged in the mela. IEC material will be distributed to the beneficiaries.
72

Pre-publicity of the camp through banners, posters, Davandi, Radio publicity will be done.
Transport of public to the venue of Health mela, Remuneration of Private Specialist doctors (if
required) and mela expenditure will be required.
Rs. 8.00 lakhs X 8 circles = Rs.64.00 lakhs
SUBSECTION - B.10.5 :CREATING AWARENESS ON DECLINING SEX RATIO ISSUE
Declining sex ratio is one of the big challenge before health services in the state. State is
tackling this issue with creating awareness as well as implementations of law.
For creating awareness, the media like T.V., Radio, Newspaper, hoardings, messages
on electricity bills, Rallies, pictorial floats, banners, posters, exhibitions, folk program will be
utilized.
(1) Telecasting of TV spots : Rs. 60,000/- per telecast x 100 telecasts = Rs 60.00 lakhs
(2) Broadcasting of Radio Jingles : Rs. 13,000/- per broadcast x 46 broadcasts = Rs. 06.00
lakhs
(3) Messages on electricity bills - Rs. 1.60 x 50 lakh bills = Rs. 80.00 lakhs
(4) Newspaper advertising : Rs 15,000 X 100 advertisements = Rs. 15.00 lakhs
Thus, a budget of Rs 161.00 lakhs is proposed during the year 2012-13 for this
activity.
SUBSECTION - B.10.6 : OTHER ACTIVITIES
Awards for Journalists
Award will be honored to journalists for best press articles and stories on 'Mother and Child
Health' topic. For the award scheme, evaluation of articles will be done by expert committee.
and awards will be distributed in a special function at state level. Details of the award scheme
are as follows:
1) Selection procedure : Rs. 2.00 lakhs
2) Award distribution ceremony : Rs. 2.00 lakhs
3) Pre-publicity of award scheme : Rs. 25.00 lakhs
4) Prizes : Rs. 00.63 lakhs
( I prize : Rs. 25,000/- + II prize : Rs. 15,000/- + III prize: Rs. 10,000/- + IV prize : Rs.
1,5000/- + V prize : Rs. 5,000/-)
Thus. a budget of Rs. 29.63 lakhs is proposed for this award scheme.
73

Award to district for best performance in IEC :
Awards will be given to best three districts on performance basis in IEC. Evaluation will be
done on the performance of the year 2011-12 and the winner districts will be awarded with a
momento in the same function of journalists. Therefore budget is requested only for awards.
A budget of Rs. 2.00 lakhs is proposed for this purpose.
Exhibitions in major fairs in districts:
In each district, exhibitions, film shows will be arranged in the major fairs where more than 1
lakh people gathered. 5 exhibitions will be arranged per year. in each district. Thus 165
exhibitions will be arranged in 33 districts.
Rs. 20,000 X 165 exhibitions = Rs. 33.00 lakhs
Budget required for other activities
Total budget required for other activities is as mentioned in table below:
Table – Budget requirement for other activities
Rs. In Lakhs
Sir Particulars Unit cost No. of units
Budget
required
1 Awards for journalists 29.63 1 29.63
2 Award to district for best performance in IEC 2 1 2
3 Exhibitions in major fairs in districts
Printing of Maharashtra Arogya Patrika Magazine
0.2 165 33
4
and to provide it to Sarpanch, ASHAs, all health
institutes in the state (97,000 copies per month X
97
10 months) = 9,70,000 X Rs. 10 = Rs. 97.00 lakhs
Funds will be given to 6 tribal districts for printing
0.0001 970000
5 of IEC material in local tribal language = 6 districts X
16
Rs. 2.00 lakhs = Rs. 12.00 lakhs 2 8
6
Preparation of floats on the occasion of 15 th August
and 26 th January = Rs. 1.00 lakh X 33 districts =33
33
Lakhs
1 33
Total 210.63
74

Budget summary for IEC/BCC activities – 2012-13
Total budget required for the state considering implementation of above mentioned activities
is as follows:
Table – Budget required for IEC/ BCC activities - 2012-13
Rs. In Lakhs
Sr Activity Budget proposed
1 Strengthening of BCC/IEC Bureau 111
2 Development of State BCC/IEC Strategy 0
3 Implementation of BCC/IEC Strategy 764.4
4 Health Mela 64
5 Creating awareness on declining sex ratio 161
6 Other activities 210.63
Total 1311.03
75

Year of starting
the
scheme/initiative
SECTION - B.11 : MOBILE MEDICAL UNITS
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2008-09 1353.06 608.02 932.92 932.920
76
Rs. in Lakhs
Remarks
National Rural Health Mission, Framework for Implementation (2007-12) has mentioned
support to Mobile Medical Units in rural areas of the state. Objective of providing these units
is to take health care to the doorstep of the public in the rural areas, especially in underserved
areas. For states like Maharashtra, GOI has suggested MMU with diagnostic facilities.
Vehicles for all the 40 MMU have been received and MMU has started functioning. Work
done by MMUs in last two months is as follows:
Table : Work done by MMU in 2011-12
Sir Indicator
Work done
December 2011 Progressive
1 OPD 31358 148890
2 ANC Checkup 1748 6002
3 PNC Checkup 1088 2768
4 Urine test 1133 3276
5 Blood tests 2316 8856
6 BS for MP 729 2720
7 Sputum for AFB 323 893
8 VDRL Test 283 996
Recurring Cost per MMU
NRHM guidelines have suggested Rs. 19.87 Lakh /district /annum as recurring cost for MMU.
Recurring cost include salary of MMU staff and operational expenses. Salary of MMU staff is
proposed as follows:
Table : Salary of MMU staff
Rs. in Lakhs
Sir Name of the staff Monthly salary
Salary for 2012-
13
1 Medical Officer 0.3 3.6

Sir Name of the staff Monthly salary
Salary for 2012-
13
2 Staff Nurse 0.13 1.56
3 Pharmacist 0.1 1.2
4 Lab-technician 0.1 1.2
5 Driver (Dispensary vehicle) 0.07 0.84
6 Driver (passenger vehicle) 0.07 0.84
Total 0.64 9.24
MMU of Maharashtra have started functioning from July 2011. Considering the experience of
last 6 months, the recurring cost is calculated. MMU are getting very good response, so there
is substainal increase in recurring cost. It is requested to sanction the revised cost. Last year
recurring cost was for half year so it was less. Cost is increased in following areas:
1. There is slight increase in salary of staff as annual salary increase is 8% in
Maharashtra.
2. Recurring cost of vehicles increased as there is increase in Diesel prices and also now
the vehicles will be out of warranty.
3. Budget for medicines increased as OPD has increased by 150% then expected. This is
seen from the report of this scheme.
Each of the activity implemented by State is monitored from State level. Weekly performance
of all MMU is monitored from State level. Monthly report of all the visits on daily basis are
collected and analysed. Inventory of medicines, equipment and consulambles is also
monitored. For all these activities, we need monitoring cell. Therefore, it is requested to
continue the monitoring cell.
Medical officers and nurses of MMU need to be trained every year for refreshing the
knowledge and also to introduce them to various activities being introduced in the State.
Considering this, this activity may also be approved.
Considering the patient load of MMU and experience of SHS Maharashtra regarding
operational cost per MMU, budget as mentioned below is requested :
Table : Recurring cost of MMU : 2012-13
Sir Particulars Unit rate
No. of
units
Rs. In Lakhs
Budget
required
A Recurring cost of MMU
1 Salary of MMU Staff 9.24 40 369.6
1 Recurring cost of vehicles 6 40 240
2 Maintenance of equipment 0.72 40 28.8
3 Consumables 1.2 40 48
77

Sir Particulars Unit rate
No. of
units
78
Budget
required
4 Medicines 3.5 40 140
6 Reporting, stationary and meeting expenses 0.36 40 14.4
7 Overheads 2 40 80
Total 920.8
B MMU cell at SPMU
1 Salary of Program Officer 3 1 3
2 TA/DA to Program Officer 0.6 1 0.6
3 Salary of Program Assistants 1.26 2 2.52
4 Contingency at SHS including civil works 1.2 1 1.2
Total 7.32
C Training of MMU Staff 1.2 4 4.8
Grand Total 932.92

SECTION - B.12 : REFERRAL TRANSPORT
SUBSECTION – B.12.1& B.12.2 : PRE HOSPITAL EMERGENCY MEDICAL RESPONSE
(AMBULANCE) SERVICES (EMS)
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2010-11 4944.5 3076.28 10785.4 11301.400
79
Rs. in Lakhs
Remarks
Emergency Medical Services exists to fulfill the basic principles of first aid, which are to
Preserve Life, Prevent Further Injury, and Promote Recovery. This strategy developed for prehospital
trauma care is based on the Golden Hour Theory, i.e. that a trauma victim’s best
chance for survival is in well equipped hospital so the patient should be shifted to hospital
within one hour. Currently, ambulance services provide as a transport operation only, simply
to take patients from their location to the nearest medical treatment.
Considering the importance of establishment of pre-hospital emergency medical response, it
is decided to establish such service in Maharashtra.
1. Activities Completed
Following actions have been taken so far for this purpose:
• Proposal submitted to Government regarding establishment of services.
• Cabinet decision for establishment of pre-hospital ambulance services in state.
• AIIMS, New Delhi is appointed as consultant agency to establish the scheme in
state.
• Financial bid opened and negotiation with L-1 in progress.
2. Plan of action for 2012-13
During 2012-13 agency will be selected for delivery of pre-hospital emergency medical
care with the help of consultants. Services will be provided in the state in phased
manner.
Hospitals will be prepared in the areas as per recommendation of consultants. Help of
IPHS upgraded hospitals will be taken for this purpose. If required private health care
providers will also be considered. MIS system will be developed for the pre-hospital
emergency medical response services.
3. Requirement of Ambulance
This project is of total 937 ambulances. Out of these,247 Ambulance will be for
Corporation areas

and 690 Ambulance for rural areas of the state. Detailed year wise breakup of
Ambulance is
Mentioned below:
Table-Yearwise requirement of Ambulances
Sr.No Year NRHM GOM Total
ALS BLS Total ALS BLS Total ALS BLS Total
1 2012-
13
86 259 345 31 93 124 117 352 469
2 2013-
14
86 259 345 30 93 123 116 352 468
Total 172 518 690 61 186 247 233 704 937
Explanation for remarks on EMS
• Population coverage for the ambulances is 1.0 Lakh population in rural areas and 2.0 Lakh
population in urban areas. As NRHM supported ambulances will be plying in mainly rural
areas, they will cover 6.90 Crore population of the state.
• These ambulances will be provided to women for delivery in case of emergency only. Thus
mother in obstructed labour, heavy bleeding, etc. will be transported. However, planned
admission or transportation after delivery will not be carried out by the EMS ambulances.
• OPEX budget is for following activities:
o Procurement of ambulances – Rs. 32.3 Lakh for ALS ambulance (172 ambulances) and
Rs. 22.05 Lakh for BLS Ambulance (518 Ambulances).
o Software for the scheme and State Control Room – Rs. 1000.0 lakh.
• This scheme cannot be compared with JSSK, because under JSSK, we are providing transport
to women for delivery who are not in labour and for discharge of mothers also. Similarly for
neonates, services are provided after discharge through regular ambulances. Hospital to
hospital referral if it is not emergency will not be covered under EMS. Considering this, it is
clear that these two services are not duplication of services but are complementary to each
other.
Considering above explanation, it is requested to approve this activity.
1. Budget requirement for year 2012-13
Budget required is for three major activities. These are:
• Procurement of ambulances
• Recurring cost of ambulances (operational cost)
• Cost of establishment of the Central Station and Software
• Cost for establishment of monitoring mechanism
Detailed budget related information is as follows:
80

Financial bid of tender is opned.The L-1 rates are Capital cost:Rs.32.3 Lakh/ALS ambulance
and Rs.22 .05Lakh/BLS ambulance. Operational cost : Rs. 1.5 Lakhs/ALS ambulance per month
and Rs. 1.4 Lakh/BLS abundance/month.
During year 2012-13, total 468 Ambulances are proposed to be purchased. Out of these, 124
Ambulances are for Corporation areas and 344 Ambulances for Rural areas.
For Ambulances provided to Corporation areas, total expenditure of procurement of
ambulances and recurring cost will be borne by Government of Maharashtra.For Ambulances
of Rural areas, NRHM will bear 100% capital cost and 60% recurring cost and GoM will
bear 40% recurring cost. Recurring cost share of GoM will increase to 60% in 2013-14 and
80% in 2014-15.
Budget requirement as per abovementioned facts is submitted in table below:
Si
r
Table - Budget requirement of EMS – NRHM and GoM share – 2012 – 13
Rs. In Lakhs
Rate/unit cost NRHM GoM Total
Activity
NRH
M
GoM No Budget
Required
No Budget
Require
d
81
No Budget
Require
d
A Capital
Expenditure
1 ALS Ambulances 32.3 32.3 86 2777 31 1001 117 3778
(100 exp of NRHM
veh by NRHM and
100% exp of GoM
veh by GoM)
2 BLS Ambulances 22.05 22.05 259 5710 93 2050 352 7760
(100 exp of NRHM
veh by NRHM and
100% exp of GoM
veh by GoM
Total 345 8487 124 3051 469 11538
B Recurring
Expenditure
1 ALS-GoM
Ambulances
0 9 0 0 31 279 0 279
(100%
GoM)
Exp by
2 ALS – NRHM 5.4 3.6 86 464.4 86 309.6 774
Ambulance (60%
exp by NRHM &
40% exp by GoM)

Si
r
Activity
Rate/unit cost NRHM GoM Total
NRH
M
GoM No Budget
Required
No Budget
Require
d
82
No Budget
Require
d
3 BLS – NRHM 0 8.4 0 0 93 781.2 781.2
Ambulances
(100%
GoM)
Exp by
4 BLS – NRHM 5 3.4 259 1295 259 880.6 2175.6
Ambulances (60%
exp by NRHM &
40% exp by GoM)
Total 1759.4 2250.4 4009.8
Grand Total 10246.4 5301.4 15547.8
As mentioned in table above, budget required from NRHM side for procurement and running
of ambulances for year 2012-13 is Rs.10246.4 Lakhs.
In addition to ambulance services, budget will also be required for establishment of Central
Station, software and monitoring of the EMS. Therefore total budget required for the Prehospital
Emergency Medical Response Service for NRHM during the year 2012-13 will be as
mentioned in table below:
Table: Budget required for EMS from NRHM
RS. In Lakhs
Sr. No. Particulars Budget
Required
1 Contribution of NRHM- 1 st year (100 capital and 60% recurring) 10246.4
2 Budget required for software, establishment of control room and
incidental expenses (approximate)
1000
3 Budget required for appointment of one senior officer as
consultant and co-coordinator for EMS
4.80
4 Budget required for appointment of Program Officer (1) 2.88
5 Budget required for appointment of 2 Medical Officer (Rs.3.6 L x 2) 7.20
6 Budget required for appointment of Training Consultant (1),
Program Officer IT (1), Bio-medical Engineer (1), Mechanical
Engineer (1) for EMS (Rs.2.88 L x 4)
11.52
7 Budget required for appointment of 1 Accountant (Rs. 1.2) 1.20
8 Budget required for appointment of 2 Program Assistant (Rs. 1.2 L
x 2)
2.40
9 Budget required to for PEMRS cell establishment and consultancy
services
25.00
Total 11301.4

SECTION - B.13 : SCHOOL HEALTH PROGRAM
(Proposed in RCH Flex-pool)
83

SECTION - B.14 : PPP/NGOs
SUBSECTION - B.14.1 : NON-GOVERNMENTAL PROVIDERS OF HEALTH CARE (RMPs/TBAs)
(No budget requested)
SUBSECTION - B.14.2 : PNDT AND SEX RATIO
(Budget requested under RCH)
SUBSECTION : B.14.3.1: INVOLVEMENT OF PRIVATE SPECIALIST ORGANIZATION FOR
PROVIDING SPECIALISTS
The Activity has been deleted. PPP Cell is responsible for all the activites being implemented
in collaboration with private organisations. This cell is shifted to Program Management with
due explanation.
Subsection : B.14.3.2 : ORGANIZATION OF EPILEPSY CAMPS WITH THE HELP OF EPILEPSY
FOUNDATION MUMBAI
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed in
PIP 2012-13
Budget
Proposed in
NPCC
2011-12 0 15.9 68.2 53.900
84
Rs. in Lakhs
Remarks
Epilepsy is one of the chronic diseases with significant prevalence in school going
children's & in adults but very little attention is given as compare to other important disease
in the public health . More than 5000 students have been found having Epilepsy in the state
who requires specialist care to overcome this problem. Seven Epilepsy Camps were organized
at district places in the state during 2011-12.
The detail performance of Epilepsy camps conducted in 2011-12 is as follows.
Table – Performance of Epilepsy Camps conducted during year 2011-12
Sr.No District Hospital No of Neuro
physician or
epidemiologi
st present in
camps.
1 Sindhudurg District
Hospital,
Total No.
Of
epilepsy
patients
examined
& treated
No. Of EEG
(Electro
Encephalo
grams)
test done
No. of
patients
and
parents
given
counseling
by
psychologi
st
9 120 26 45

Sr.No District Hospital No of Neuro
physician or
epidemiologi
st present in
camps.
Oras
Total No.
Of
epilepsy
patients
examined
& treated
No. Of EEG
(Electro
Encephalo
grams)
test done
85
No. of
patients
and
parents
given
counseling
by
psychologi
st
2 Nashik District
Hospital
Nashik
15 167 58 35
3 Satara District
Hospital
Satara
19 376 57 50
4 Parbhani District
Hospital
Parbhani
14 155 46 40
5 Amravati District
Hospital
Amravati
14 399 55 60
6 Thane Sub–District
Hospital
Jawhar
6 183 40 41
7 Gondia District
Hospital
Gondia
9 588 117 35
Total 7 1988 399 306
There are many children and women suffering from Epilepsy. Stigma about this
disease prevents them to get proper care and treatment. Students suffering from Epilepsy are
particularly at disadvantages as early diagnosis and treatment will cure the disease and also
will not affect the academic performance of the child.
Considering above situation, following actions are proposed during the year 2012-13
• Campaign to educate the community about misconceptions about Epilepsy prevention
and treatment.
• Organization of eleven Epilepsy camps in the state for diagnosis & treatment of
Epilepsy in collaboration with Epilepsy Foundation Mumbai.
• To provide counselling to the epileptic patient and relatives.
• To provide OT, PT and speech therapy to epileptic patient.

Budget requirement
Budget will be required for following activities
• Transportations of the specialists
• Staying arrangements for specialists
• Incidental charges for the camp arrangement & Stationery for the camps.
• Medicines, consumables, etc.
• IEC
It is proposed to organize 11 camps in various districts of Maharashtra during 2012-13.
Detailed budget requirement is as follows:
Table -: Budget required for Epilepsy camps
86
Rs. In Lakhs
SR Activity Unit cost
No. of.
units
Budget
required
1 Travel charges to specialists and team 1 11 11
2 Staying arrangements for specialists 0.3 11 3.3
3 Arrangements of camps 0.25 11 2.75
4
Honorarium to EEG technicians OT, PT
and speech therapy technician
0.1 11 1.1
5 IEC for camps 0.5 11 5.5
6
7
Medicines and consumables for camps
and for regular treatment ( Regular camp
2.00 lakh and follow-up Medicine 1.00
lakh)
2.5 11 27.5
Diet facility to the patients (Tribal areas
only)
0.25 11 2.75
Total 6.2 53.9
B.14.3.3: PROVIDING TELEMEDICINE SPECIALTY NODE TO EPILEPSY FOUNDATION FOR FREE
CONSULTATION AND FOLLOW UP OF EPILEPSY PATIENTS
The scheme is not proposed as per GOI Comment

B.14.3.4: CAPACITY BUILDING AND ORGANIZATION OF EPILEPSY DAY
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed in
NPCC
New 0 0 25.6 21.600
87
Rs. in Lakhs
Remarks
Epilepsy is one of the important diseases of Public Health Importance. The prevalence of
epilepsy is an average one in thousand children & also quite common in adult populations
there are many new methods come for diagnosis & treatment. More than five thousand
school boys are dictated suffering of from Epilepsy in school health examinations. To treat
them properly & give regular follow-up, training of Paediatrician & Physician from district
hospital along with the nurses is proposed.
There could be many children & women suffering from Epilepsy. Stigma about this
disease prevents them to great a good care & service. There are many misconceptions
regarding Epilepsy in society. Considering above situation the following action is proposed
during the year 2012-13.
• Training of Medical Officer to improve the diagnostic skill
• Proper treatment to the epileptic patients by Health care provider
• Regular follow-up & proper management of the patients
• Improve the skill & Knowledge of nurses for patients care
• Create awareness in society regarding Epilepsy
• Organization of Epilepsy day in the state to create the awareness
The Epilepsy Foundation, Mumbai non -profit organization from Mumbai with a panel
of eminent neuro physician is willing to provide technical resource free of cost.
The budget provision for the capacity building of Paediatrician, Physician & other
Medical Officer including nurses is as follows.
Budget Proposed 2012-13
(Rs. In Lakhs)
No.
SR Particulars Unit cost of.
units
1. Organization of one day training to the
Medical Officer (Paediatrician &
Physician)
Budget
required
0.10 100 10.00

2. Organization of three day workshop for
hospital nurses
0.05 100 5.00
3. Organization of Epilepsy day & IEC 0.20 33 6.60
Total 0.35 21.6
B.14.3.5: HEALTH ADVISE CALL CENTER
Year of starting
the scheme/
initiative
2011-12
SUMMARY INFORMATION OF THE SCHEME / INITIATIVE
88
(Rs. In Lakhs)
Remarks
The Government of India accorded approval to set Health Advice Call Centre in
Maharashtra during 2011-12. The Objective of the Health Advice Call Centre is 24x7 medical
advices to health care provider for quick decision to provide smooth, effective and qualitative
health care. To begin with a Call Centre of 10 seats is to be set during the year.
The health advice is be given to caller who is dialling simply 3 digit toll free number
“104” from landline or any mobile phone. To begin with the call centre is rendering advice to
ANMs, ASHA worker, School Health personnel and Medical Officers of PHC & NGOs from
NRHM, It will guide health personnel’s for timely referral, proper intervention and
managements of the patients and effective implementation of National Health Programs. It
will work as an effective tool for disease surveillance and also in disaster management.
The Health Advice Call Centre will be fully functional from 23 January 2012.
The Health Advice Call Centre will be very useful for giving instructions to the Health
Care Provider during Epidemics and other various Health Campaigns.
The specialist’s advice by Paediatrician, Gynaecologist and Public Health Specialists
will be provided 24x7 to the caller.
Objectives:-
Budget
sanctioned for
year 2011-12
(in lakhs)
143
Budget proposed for
PIP 2012-13 (in
lakhs)
184.60
Budget
proposed to
NPCC (in
lakhs)
86.690
1) 24x7 free call for health information to health care provider.
2) Provide Medical advice on minor ailments.

3) To give guidance to the Medical and Paramedical Health Care Provider for School
Health Program (Examination & Treatment)
4) To give 24x7 Technical supports to Health Care Provider for smooth and effective
health care.
5) Provide Information to Health Care Providers for quick action in epidemic
outbreak, disaster, natural calamities and in major accidents.
6) Guidance to Health Care Provider for effective implementation of Various National
& State Health Program.
7) Provide Directory Information of hospitals/Institutes regarding various services /
Facility including Blood bank and Eye bank for proper and early referral.
8) Guidance to Mobile Medical unit , Medical officer & others staff
9) Guidance to NGO of sickle cell disease for effective implementation of program.
Linkages
1) Linkage with EMS
2) Linkage with Referral Transport
3) Linkage with other Help lines with health department.
Implementation Strategies:-
This project is implemented on turnkey basis. In first phase Call Centre of 10 seats to
be set. The service provider has established the call centre (control room), appointed the
manpower for this call centre, given training to them and has to run the call centre. The
service provider has developed all required software and provided hardware.
HMRI, Hyderabad is a service provider for Health Advice Call Centre. The MOU is done
with HMRI, Hyderabad on 11/10/2011.
The ownership of software, hardware and project vest Government of Maharashtra.
The call centre is being set at Pune Chest Hospital, Aundh, Pune. The call will be answered in
Marathi and English.
Budget required
The recurring expenditure will be for salary to staff, call charges and maintenance of the
system.
It is proposed that recurring cost for the year 2012-13, 60% of recurring cost will be borne by
NRHM and 40% by State Government. The share of NRHM in recurring cost will reduced from
60% to 40% in second year then it will reduce to 20% in third year. Considering this, budget
required for this scheme is as follows:
Table – budget required for Health Advice Call Centre 2012-13
89
Rs. In Lakhs

Type of
Budget
Total budget required for year 2012-
13
NRHM
Share
State Share Budget
Required
Remarks
Capital Cost 10 0 10 • Two seat to be added for
additional specialist physician &
surgeon.
Recurring
cost
• 100% capital cost contribution by
NRHM
76.69 19.17 95.86 • 80% of recurring cost
contribution by NRHM.
Total 86.69 19.17 105.86
• 20% of recurring cost is
contribution by State
Government.
Details of Recurring Cost of Health Advice Call Center (2012-13)
Rs. in Lakhs
Sr. Particulars Unit Cost No. of Units
1
2
3
HACC Recurring Cost
Service Provider Charges (As per
MOU)
Telephone Expenditure / Outgoing/
SMS Charges etc.
Workshops/Meeting/ IEC/contingency
expenditure
90
Budget
required
79.86 1 79.86
10.00 1 10.00
6 1 6
Total 95.86
SUBSECTION - B.14.4 : NGO PROGRAM : GRANT IN AID TO NGOs
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2007-08 516.5 284.4 247.800
Rs. in Lakhs
Remarks

The Government of Maharashtra is committed to improve the health care services for all with
particular focus on women & children living in the un-served and underserved areas in the
districts of the state.
Under National Rural Health Mission, RCH II has taken up steps to achieve objectives with
partnership of non-government organizations, like Mother NGO , Field NGOs ,& Service NGO
under NGO scheme. NGOs are playing a vital role in providing complementary &
supplementary services to Government.
The Service NGO scheme aims at strengthening the role of these NGOs not only in awareness
and demand generation but also the service delivery for contributing towards reduction of
Infant Mortality, Maternal Mortality , and Total Fertility.
Current Status of NGO Scheme
MNGO Scheme:
At present 2 MNGOs are working in two Districts i.e. Nandurbar & Gadchiroli. (Both Districts
are terrain and tribal districts.)
SNGO Scheme
Phase I
Sr.
No.
Present status of SNGO Scheme in Maharashtra:
District covered
No. Of PHCs
covered
No. Of Villages
covered
91
Populations
covered
1 06 22 484 4,95,332
PhaseII
In the year 2011-12, 8 NGOs are select for implementing Service NGO scheme as indicated
below.
Sr.
No.
District covered
No.of PHCs
covered
(Proposed)
No.of Villages
covered
(Proposed)
Populations
covered
(Proposed )
1 08 38 420 6,28,566

Activity Proposed for 2012-13
• For Service NGO scheme - Selection of NGOs in most difficult /Tribal areas in Gadchiroli,
Nandurbar, Nashik, Dhule, Bhandara, Gondiya, Chandrapur , Amravati , Beed and Yeotmal
districts.
• External Evaluation – Conduction of external evaluation of those MNGO/SNGOs who have
completed one year in implementation of various programmes under NGO scheme as per
GOI guidelines through external agency.
• Training for NGOs
• Quarterly meeting of NGOs
• Annual Workshop of NGOs
• Monitoring & Evaluation of the project(Internal )
Compliance of remarks of GoI
MNGO Scheme
Underserved areas of the district is identified and MNGO volunteers promote beneficiaries to
get the services from regular health service infrastructure. Thus, Field NGOs working under
MNGO take the children and pregnant women to Village health Nutrition Day for services.
This scheme is for three years and one MNGO is to be selected per district. This scheme
started in 2007 so the scheme is complete in almost all the districts except 2 districts in the
state.
SNGO Scheme
This scheme is for the area where there is no Government Hospital or available Govt Hospital
is not functioning properly.
Eight such hospitals have been identified in the state. These NGOs are required to conduct
baseline survey first and then start the services. Currently baseline survey is being
implemented.
Budget requirement for 2012-13
Table : Budget requirement for NGO Scheme
92
Rs. In Lakhs
Sir Activity Proposed
No.of
Units
Unit cost
Budget
required
1 MNGO SCHEME 2 15 30
2 SNGO SCHEME PHASE- (Existing NGOs) 7 15 105

Sir Activity Proposed
3
SNGO SCHEME PHASE- (New NGOs) Only for
Nandurbar, Gadchiroli, Nashik, Amravati,
Beed, Yavatmal, Chandrapur, Bhandara,
Dhule, Gondia)
No.of
Units
Unit cost
93
Budget
required
10 8.5 85
4 EXTERNAL EVALUATION
TRAINING TO NGOs (before & During the
9 1 9
5 project like Baseline, data software, Writing
project proposal, record keeping etc.)
19 0.2 3.8
6 Quarterly meeting 4 0.4 1.6
7 Annual workshop 1 2 2
8 Monitoring & Evaluation 19 0.6 11.4
Total 247.8

SECTION - B.15 : PLANNING, IMPLEMENTATION AND MONITORING
SUBSECTION - B.15.1 : COMMUNITY BASED PLANNING & MONITORING (CBPM)
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2007-08 292.22 292.1 241.10 234.320
94
Rs. in Lakhs
Remarks
Community based monitoring and planning of health services under NRHM is a participatory,
multi-stakeholder process for increasing accountability and responsiveness of public health
services while improving their implementation. This process was launched at state level in
Maharashtra in mid-2007. After a series of initiation, selection and capacity building
processes at state and district levels, field level implementation started in early 2008. Field
level implementation of Community monitoring in five districts of Maharashtra, initially on a
pilot basis, and then as a component of the State PIP, has now completed four years.
Significant expansion of these activities took place in two further phases, with addition of
new blocks and villages in five districts in mid-2009 and then addition of 8 new districts in
early 2011. Within the state wherever CBM has been implemented, the sense of ownership of
the public health services has definitely improved in the community. CBM has ensured
accountability through participatory monitoring and dialogue, has contributed to increasing
utilisation of public health facilities, and has induced various improvements in local health
services. Further since end-2010 Community based planning has also been initiated, wherein
community based processes are now informing local health planning, through people’s
participation and decentralised inputs.
With this background, the main focus of Community based monitoring and planning (CBMP)
activities in the period 2012-13 would be-
1. Partial phasing out of external inputs, maintenance of core monitoring activities and
development of community based planning in field areas of 5 districts where CBMP
process is being implemented at field level since early 2008.
2. Continuation phase including initiation of community based planning processes in
expanded areas of 5 districts where CBMP process is being implemented since mid-
2009; awareness and dissemination programmes in some additional areas beyond the
existing CBMP areas, in order to widen and expand the scope of Community based
monitoring and planning processes.

3. Completion of one cycle of community monitoring and consolidation of processes in 8
new districts of the State where CBMP activities have started in 2011.
4. Continuation of state level inputs for capacity building, coordination, financial
management, state level events and publication, as well as some wider dissemination
of Community based monitoring and planning process with emphasis on voluntary
activities.
Proposed coverage of community based monitoring and planning activities and plan of
action in the year 2012-13
Coordination of state level events, along with training, technical inputs and capacity building
inputs for NGOs at various levels would continue to be managed by SATHI as the existing
State Nodal NGO. Major activities in this year are planned as follows:
1. Partial phasing out of external inputs, maintenance of core monitoring activities and
development of community based planning activities in pilot phase areas of 5
districts
In 5 districts, Community based monitoring and planning process is being implemented in
certain areas since early 2008 where PHCs covered are 39 and under these PHCs total of 195
villages have been covered (this number is slightly lower than the initial 225 villages, since in
two blocks the process has been discontinued due to withdrawal of specific organisations
from these blocks).
The overall strategy would be for partial phasing out of external inputs by civil society
organisations in these areas, with lower scale of inputs but sustaining core community
monitoring activities. The emerging activity of community based planning which was initiated
since 2010 will continue to be developed. Financial inputs for these areas would be reduced
in scale to approximately half of the scale for the previous year (2011-12). The following
activities would be supported in these areas:
o Sustaining core Community monitoring activities with lower scale of external
support- The core community monitoring activities such as meetings of
Community based monitoring and planning committees at different levels,
selective data collection and periodic dialogue between VHSC members and
Health care providers would be continued. These activities would be supported
with lower level of resources given the overall strategy of partial phasing out of
external inputs in these areas. In continuation with data collection during
February- March 2011, the certain Public Hearings in Thane and Pune would be
conducted during April- May 2012.
o Orientation/training of newly elected PRI members who are part of monitoring
and planning committees at different levels- In the most of existing areas,
elections of PRI members at different levels are taking place, so training and
orientation workshops for newly formed VHSCs as well as elected PRI members at
different levels would be conducted.
95

o Activities for development of community based planning at village, PHC and RH
RKS, and block PIP levels- Based on initial experiences in 2010-11, workshops
would be conducted for RKS members as well as CBMP committees regarding
decentralised planning. The objective of these workshops would be to enable RKS
members to properly understand their role and responsibilities in planning the
appropriate use of various flexible funds at facility level, with a clear focus on
patient welfare and addressing issues identified through the community
monitoring process. Also activities for awareness and capacity building of
community members, VHSC and CBMP committees would be conducted regarding
local health planning and giving concrete suggestions for utilization of NRHM
flexible funds.
2. Consolidation of activities in expansion areas of 5 districts where CBMP process is
being implemented since mid-2009
Community based monitoring and planning process has been expanded in 14 blocks of 5
districts since mid-2009. In these areas, total number of PHCs covered is 33 and total of 245
villages as well as 93 Sub-Centers are covered by CBMP. The expansion has been taken place
at different levels, so considering this the following activities would be taken up in these
areas:
2.1 Along with core community monitoring activities, development of community
based planning activities- The core activities such as regular meetings of
monitoring and planning committees, next round of data collection, Jan Sanvad
/Jan Sunwais at different levels would be conducted. Activities like orientation
workshops for RKS committees, awareness and capacity building of community
members, VHSC and CBMP committees about monitoring and suggestions for
utilization of NRHM funds would be conducted in these expansion areas.
2.2 Orientation/training of newly elected PRI members who are part of monitoring
and planning committees at different levels- In the most of the expansion areas,
PRI elections at different levels are taking place hence training as well as
orientation workshops for members of newly formed VHSCs as well as newly
elected PRI members at different levels would be conducted.
2.3 Activities for facilitation of monitoring of Integrated Child Development Scheme
(ICDS) services-In this phase attempt would be to conduct activities for facilitation
of systematic monitoring of ICDS services such as analysis of information at
different levels for identification of issues related to ICDS, dialogue with concerned
ICDS officials at block and district levels. Further towards inter-sectoral convergent
action, visits of VHSC members to block level officials responsible for key health
related services like ICDS and Water supply would be organised.
2.4 Orientation of broader range of civil society organisations regarding Community
monitoring and planning – District level workshops would be organised with
participationofdiverse civil society organisations active in the district, regarding
community awareness building, collection of information on functioning of health
96

services, participatory dialogue and intervention in decentralised planning,
enabling more groups to develop community based action to improve health
services in their respective areas, while working on a voluntary basis. After
sensitization of dozens of new organisations regarding the CBM framework and
process, based on data collection by these organisations, in the coming year
participatory dialogue involving civil society stakeholders and Health providers
would be organized in the Ratnagiri, Latur, Parbhani , Osmanabad, and Solapur
(beyond existing CbM areas for last 2 districts .)
3. Development of Community based monitoring and planning in eight new districts-
In these new districts, the selection and approval of District and Block Nodal NGOs has been
completed and activities have been initiated during 2011. In these eight districts, total
number of PHCs covered are 48 and under each PHC five villages are covered i.e. total of 240
villages. Similar to earlier phase districts, in these districts key monitoring levels would be at
the Village, PHC, Block and District levels.
The following activities would be taken up in these districts and blocks in continuation of
current activities:
3.1 Activities for completion of first round of community monitoring-
In the period 2011-12 in 8 new districts, due to delay in approval of nodal organisations at
official level, only part of the cycle of community monitoring activities could be carried out. In
2012-13, the plan would be to complete the first round of Community monitoring activities at
different levels including completion of CBMP committee formation, data collection at PHC
and RH levels and Jansunwais / Jansanvad at block and district level. Further the second cycle
of monitoring would be started
3.2 Activities to involve and sensitise additional stakeholders and initiating
Community based planning at village and PHC/RH RKS levels -
Awareness and capacity building workshops would be conducted for different stakeholders
(PRI members, ASHAs), exchange programme would be organised in other districts,
orientation workshops would be held for RKS committee members, awareness and activation
programmes at community level and for members of VHSC and CBMP committees about
monitoring and suggestions for utilization of NRHM funds.
In this phase, taking all districts together, a total of 13 districts, 37 blocks, 120 PHCs and 680
villages would be involved in Community based monitoring and planning activities.
Further in the coming year a round of regional follow up workshops and dialogue events
would be organised in various regions of the state to promote wider awareness and to
encourage voluntary civil society activities for communitisation of health services.
4. Budget requirement-
Budget will be required for various CBMP activities focused in 13 districts as follows:
1. Budget for State level coordination and activities
97

Sr.
No.
Table A :- Budget Required for State Level Activities
Rs. in Lakhs
Budget Line items Budget Amount
1 State level Salary and Honorarium 32.98
2 Travel and field Expenses 2.07
3 State level Workshops, Training & Meetings 10.00
4 Office & Communication Expenses 1.20
5 Publications/process documentation 7.0
6 Overheads 6.39
Total 59.64
2. Budget for 5 districts pilot phase areas - partial phasing out of external inputs,
maintenance of core community monitoring and planning activities
Table B :- Budget Required for 5 Districts – pilot phase areas
98
Rs. in Lakhs
Sr. No. Budget Line items Budget Amount
1 Honorarium 6.3
2 Field Expenses 2.1
3 Workshops, Training & Meetings 7.3
4 Facilitation of Data Gathering, preparation of Report
cards
0.11
5 Jan Sanwad / Jan Sunwai 2.57
6 Office & Communication Expenses 0.13
7 Publication/process documentation 0.21
7 Overheads 2.25
Total 20.96
3. Budget for 5 districts for expansion areas since mid 2009
Table C :- Budget for 5 districts expansion areas
Sr. No. Budget Line items
Rs. In Lakhs
Budget Amount
1 Honorarium 27.54
2 Field Expenses 5.4

3 Workshops, Training & Meetings 16.97
4 Facilitation of Data Gathering, preparation of Report
cards
5 Jan Sanwad / Jan Sunwai 6.86
6 Office & Communication Expenses 0.47
7 Publication/process documentation 0.67
8 Overheads 7.37
Total 64.40
4. Budget for activities in 8 new districts
Table D :- Budget required for 8 new districts
Sr. No. Budget Line items
Rs. In Lakhs
Budget Amount
1 Honorarium 35.52
2 Field Expenses 6.72
3 Workshops, Training & Meetings 11.96
4 Formation/expansion of committees 7.74
5 Office & Communication Expenses 0.29
6 Facilitation of Data Gathering, preparation of Report
cards
3.36
7 Jan Sanwad / Jan Sunwai 9.36
8 Publication/process documentation 0.88
9 Overheads 9.10
Total 84.93
5. Summary of budget requirement
Table D :- Summary of Budget Requirement for CBMP 2012-13
Sr. No. Budget Line items
Rs. In Lakhs
Budget Amount
1 Budget for State Level activities
99
3.51
59.64

2 Budget for 5 Districts pilot phase areas 20.96
3 Budget for 5 Districts expansion areas 68.79
4 Budget for 8 new districts
100
84.93
Total 234.32
SUBSECTION - B.15.2 : QUALITY ASSURANCE
Quality Assurance program was initiated in the State during the year 2009-10 with support
from UNFPA. During the first phase 6 districts namely Ahmednagar, Aurangabad, Akola,
Chandrapur, Kolhapur and Raigad were taken. During the 2 nd phase in 2010-11 , 6 additional
districts namely Satara, Jalna, Wardha, Amrawati, Thane and Nashik were taken. During 3 rd
phase in 2011-12 , 6 more districts namely Buldhana, Jalgaon, Bhandara, Osmanabad,
Parbhani and Beed were taken.
The program will continue in year 2012-13 in all 18 districts with support from UNFPA. A State
Quality Assurance Cell will be created at State Level.
A) State Quality Assurance Cell :- It will be composed of following persons.
1. State Quality Assurance Nodal Officer
2. Full time Consultant Quality Assurance - (Qualification: Public health with 5 years of
experience in MCH)
3. Data entry Operator
A) Budget for State Quality Assurance cell is as follows.:-
Salary :- Salary of State Quality Nodal Officer will be supported by UNFPA. Budget for salary of
other persons is shown in State PIP.
Mobility Support :- One vehicle will be hired @ Rs.25000/- per month for consultants.
Office Expenditure & contingency :- Lump sum amount of Rs.5000/- per month. Thus total
amount of Rs.0.60 Lakhs.
Support for establishing QA Cell :- Lump sum amount of Rs. 1.00 Lakhs is kept for office
equipment and furniture.
Organization of meetings:- Lump sum amount of Rs.50000/- kept.
B) District Quality Assurance Cell :- It is composed of District Quality Assurance
coordinator and Data Entry Operator cum accountant.

Budget for District Quality Assurance Cell is as follows.
Salary :- Salary of District QA coordinators of 12 districts in 1 st and 2 nd Phase for 3 months will
be supported by UNFPA. Budget for remaining 9 months for salary and TA/DA will be from
State Budget in PIP. An amount of Rs. 42.12 Lakhs is kept for this purpose.
Budget for salary & TA/DA of district QA coordinators of remaining 6 districts in 3 rd Phase is
shown in State PIP. An amount of Rs.30.24 Lakhs is kept for this purpose.
Budget for salary of Data Entry Operator cum accountant for 18 districts is shown in State PIP.
An amount of Rs.21.6 Lakhs is kept for this purpose.
Office Expenditure & contingency :- Lump sum amount of Rs.3000/- per month. Thus total
amount of Rs.6.50 Lakhs for 18 districts.
Support for establishing QA Cell :- Lump sum amount of Rs. 0.50 Lakhs is kept for office
equipment and furniture for 18 districts.
Organization of meetings:- Lump sum amount of Rs.5000/- kept for 18 districts.
Detailed budget requirement is mentioned in table below
Table – Budget required for QA Cell
101
Rs. In Lakhs
Sr. No. Activity Unit Cost No of units
Total Budget Rs.
In Lakhs
A State level
State Quality Assurance Nodal
1 Officer (Salary by UNFPA) 6.6 0 0
2
Full time Consultant Quality
Assurance - (Qualification: Public
health with 5 years of experience
in MCH)
4.8 1 4.8
3 Data entry Operator 1.2 1 1.2
4
Mobility Support
2.5 1 2.5
5
6
Office expenditure & contingency
Support for establishing QA Cell at
State Level
0.05 12 0.6
1 1 1
7 Organization of meetings 0.5 1 0.5
Total for State Cell 10.6
B District Level
1 District QA Coordinators
0.36 12 38.88
2 (Contractual Position for 12
0.06 6 3.24
3
Districts which were taken up in
2009-10 & 2010-11 )
42.12

Sr. No. Activity Unit Cost No of units
Total Budget Rs.
In Lakhs
4 District QA Coordinators
0.36 6 25.92
5 (Contractual Position for 6 Districts 0.06 6 4.32
6 which were taken up in 2011-12 )
30.24
7
Office expenditure & contingency
0.03 18 6.5
8
9
Support for establishing QA Cell at
district Level
Organization of review meeting at
district level
0.5 18 9.0
0.05 18 0.9
Total of Districts cell 161.1
Total State & District 171.7
SUBSECTION - B.15.3 : MONITORING AND EVALUATION
Compliance of remarks
• State of Maharashtra has already started process of facility based reporting. Two meetings
with GoI are held during March 2012. It is expected that Maharashtra will start the GoI MIS by
May 2012.
• Basic data required for GoI MIS facility based reporting is being collected and scruitinised for
each facility in the state.
• Officer at state level identified and name communicated to GoI.
• This year MIS data is used for preparation of PIP. Identification of facilities for IPHS or other
strengthening, identification of delivery points, continuation of schemes, etc are all decided
based on MIS data of the facilities.
• All the meetings mentioned in the proposal are important for monitoring of the program and
providing fresh guidelines and mid time corrections. No. of meetings held in state are as
follows:
• District level meetings of Medical Officers for NRHM activities – 264
• State level monthly meetings held for district level staff – 104
• Special review meetings including meetings of DHO/CS/CEO ZP and senior officers – 103
• Meetings of higher officers (Deputy Directors and above) under Chairmanship of Additional
Chief Secretary (PH & FW) – 27.
• All these meetings proved very important for NRHM as field level difficulties were discussed in
meetings. All the new guidelines were discussed during these meetings and guidelines
changed accordingly.
Monitoring is regular collection, compilation and analysis of selected indicators of various
Programs to enable health managers to determine whether key activities are being carried
102

out as per the plan. It is carried out at service delivery unit through direct contact with health
workers as well as at the managing office by examining periodic reports. Monitoring provides
feedback to project manager in order to improve the operation plan and to take mid-course
corrective measures if necessary.
Evaluation of a program or of a component helps to assess the tracking/success/failure of any
program and also the reasons for the above. It is also necessary task at regular interval for
ongoing projects and at the end of the projects/initiatives and also before up scaling any
program initiative.
ACTIVITY - B.15.3.1 : MONITORING OF NRHM ACTIVITEIS (A+B+C components)
Monitoring and evaluation under health department is mainly carried out as follows:
• Regular MIS: The state has well-developed computerised web based system, which
includes all national health programmes. Fixed date schedule has been prepared for
data entry & feedback is given regularly to all the districts & the programme officers
from the Directorate level. Schedule of MIS and data flow is submitted below.
• Quarterly meetings of senior officers under chairmanship of Add. Chief Secretary at
Regional level.
• The Directorate holds regular annual meetings of all District Health Officers, Civil
Surgeons, Deputy Directors & programme officers & review is taken.
• Monthly meeting of Deputy Directors & Programme officers by the Directorate.
• At various levels like regional & district level concerned officers take regular meetings
for which fixed date schedule has been prepared. Similarly in each PHC monthly
review meetings are organised of all workers & supervisors for which fixed date
calendar has been prepared.
Program Monitoring and Evaluation Framework
The current monitoring system of Public Health Department has a major focus on quantitative
reporting on performance at various levels. This information is generated right from the subcenter
level up to state level. Each bureau/desk receives the information, which is analyzed
and correlated for checking correctness of data and synchronization of events. Annual
surveys are conducted for some items (e.g. eligible couple survey).
The dates of data collection, compilation, analysis and feedback are fixed. Total state report is
ready by 15 th of every month. Level wise MIS collection and dates of information submission
schedule is as follows:
103

Sir Level
Submitting
unit
Table : Flow of HMIS Information
To whom
submitted
1 Facility SC PHC
2 Facility PHC
3 Facility
4 District
5 District
6 District
RH/SDH/WH
/GH/DH
District MIS Cell
(DHO Side)
District MIS Cell
(Civil Surgeon
side)
Reports checked at District MIS
Cell by concerned supervisors
and MIS cell officers
District
HMIS Cell
• Circle MIS
Cell
• Bureaus –
related
reports
• Director
HMIS Cell
• NRHM Cell
MO Meeting is held at District
level by DHO and MS
RH/SDH/GH/WH meeting is
Date of
completion of
activity
Last day of
month
5 th of every
month
5 th of every
month
8 th of every
month
10 th of every
month
11 th of every
month
Remarks
SC ANM and MPW
submit SC report in
prescribed format – on
paper - to PHC on last
day of month in PHC
MIS meeting
Report entered in Web
Based HMIS Software
either at PHC or at
Block Office
Report entered in Web
Based HMIS Software at
RH / SDH / GH / DH
level
Checking the reports,
call back to Facility in
case of errors,
correction of errors.
This starts from 3 rd to
8 th of every month
District MIS report is
made accessible to
Circle offices, related
Bureaus, Director cell
and NRHM cell.
Compilation of reports
is responsibility of the
Director HMIS Cell.
Reports are discussed.
Review of work done
and plan for next
104

Sir Level
7 Circle
8
9
State
level
State
level
Submitting
unit
To whom
submitted
held by Civil Surgeon at District
level
DHO/CS DCP District level
officers meeting at circle level
Meeting of all Program Officers
by concerned bureaus to review
and plan – detailed review
Meeting of all Deputy Directors
and Bureau Chiefs
Date of
completion of
activity
12-13 of every
month
7 th to 15 th
every month
16 th of every
month
Flow of information of HMIS is as per the figure given below:
SUB CENTER
Figure : Flow of information of HMIS in Maharashtra
PHC RH/SDH/GH/WH
DISTRICT MIS CELL (Health Centers and Hospitals)
Remarks
month is decided.
Circle review and plan
for next month
Program Officers and
supervisors attend
meeting at state level.
This is specific for large
program like ASHA,
IPHS, RKS, School
Health.
Review of work done
and next month
planning.
Attended by Director of
Health Services,
Commissioner (FW) &
MD and ACS (PH & FW)
105

Data collected at SC level is in hard copy. HMIS is web based from PHC onwards.
Blue arrow indicate data flow and yellow arrow indicates feedback
In Maharashtra, components of the NRHM are monitored from various bureaus as mentioned
in table AND FIGURE above. These Bureaus are situated at Mumbai and Pune. Therefore each
bureau has separate monitoring unit for its components. Considering this, budget is
separately requested for RCH and FW Bureau as follows:
Plan of implementation 2012-13
Following activities are proposed for monitoring and evaluation for year 2012-13
1. Strengthening of MIS
All the BPMUs have been provided Computers and contingency to run the computers and
internet under NRHM. Following actions will be taken to strengthen the present MIS system:
• Revision, printing and dissemination of MIS formats consisting of all NRHM indicators
related to VHC, RKS, IPHS, AMG, etc. to VHCs, SHCs, PHCs, RH and all other reporting
units.
• Online/offline entry
DY. DIRECTOR I/C CIRCLE
DHS CELL / DIRECTOR OF HEALTH SERVICES
• Training of at least one member of reporting units in revised MIS formats
• Improving the quality of reporting
NRHM MIS CELL / COMMISSIONER (FW) & MD NRHM
• Monthly Institute wise review of all reporting units.
• Provision of computer and internet services to remaining PHCs, RH and districts.
106

• Establishment of data banks at all the district HQ to fulfill all the needs of district.
• Establishment of M & E Cell at district HQ and State HQ for concurrent monitoring
2. Review Meetings
Review meetings are very important for routine monitoring of the program. Review
meetings supported by good documents on progress of the program are important. During
year 2007-08, review meetings conducted by Additional Chief Secretary (PHD & FW) have
proved to be very effective. Considering this and the experience of these years, review
meetings are proposed & are being taken during year 2008-09 as below:
Table – : Review meetings proposed during 2010-11Rs. In Lakhs
Sir Meeting Frequency
1
2
3
4
5
6
7
DPM/DRCHO review meeting at HQ
by Mission Director
DAM meetings at HQ by Mission
Director
Three meetings of CEO ZP, DHO, and
CS, Deputy Director and Bureau
Chiefs by ACS (PHD) at divisional
headquarters (6 divisions × 3
quarters). Out of these, one will be
planning meeting and other two
review meetings. (Total attendance
is more than 120 persons)
Monthly meetings at district level.
One meeting per month will be
conducted for RCH/NRHM activities
at district level
Subject wise meetings of district
level supervisory staff , state level
officers, etc at divisional, bureau and
state level (ASHA, School Health,
IPHS, RKS, MCTS, JSSK, Sickle Cell,
Telemedicine, etc)
MS RH/SDH and THOs (8 circles × 2
meetings)
Review by Nodal Officers to allotted
Districts – Budget for travel/DA/Stay
of nodal officer
Budget
required
per
meeting
No. of
meetings
107
Budget
required
Monthly 0.9 12 10.8
Monthly 0.5 12 6
Every four
months per
circle
Once month
for all
districts
Monthly and
Bimonthly
4 18 72
0.05 396 19.8
0.5 48 24
Quarterly 1 16 16
One
meeting/
quarterly/dist
0.05 128 6.4

Sir Meeting Frequency
8
Review meetings at national level to
be attended by State level officers
Budget
required
per
meeting
No. of
meetings
108
Budget
required
As per need 12 0.5 6
Total 161
3. Staff for Monitoring and Evaluation
Very large data is being collected for RCH and NRHM activities at district level. Various new
schemes are coming up requiring new MIS indicators. Considering this, the MIS system at
state and district level is strengthened with the help of NRHM. One post of Statistical Officer
and 2-3 posts of Statistical Assistants and Statistical Investigators are sanctioned from State
Budget. Considering the quantum of the work increased after introduction of NRHM,
additional posts are sanctioned for M & E.
The Statistical Officer is overall in charge of the District M & E Cell. One person experienced in
HMIS is required to analyze and interpret the data and brief the DHO/CS about situation and
advice corrective measures. For this, one Public Health Specialist is appointed in the state for
every district. Statistical Investigators are appointed in districts depending upon number of
reporting units.
At state level, MIS consultant, Senior M & E Officer, statistical investigators and computer
specialists are appointed.
Considering the remarks for this activity, one Circular is issued to all the districts saying that
regular officer / supervisor should be responsible for each activity under NRHM. Contractual
staff will support the system and not replace or work as independent to regular system. One
workshop of RCH Officer and DPM regarding this is organized in third week of April to work
out details.
This year no new post is requested for M & E. All the posts mentioned are continued since
last 3 years. Details are as follows:
Table – : Staff required for Monitoring and Evaluation – 2012-13
Sir Particulars Unit cost
No. of
units
Rs. In Lakhs
Budget
required
A State Level
1
MIS Consultant (Public Health) (Rs.
45000/PM)
5.4 1 5.4
2 M & E Consultant -state level (0.38L/PM) 4.54 1 4.54
3 Sr. M & E Officer (28000/PM) 3.36 1 3.36
4 Stat. Investigator (4) Rs. 13500/SI/PM 1.62 4 6.48

Sir Particulars Unit cost
No. of
units
109
Budget
required
5 Travel and DA to SPOs 2.5 9 22.5
5 Computer specialists (2) Rs. 27000/PM 3.24 2 6.48
B District Level
3
District /Circle
24000/PM)
M & E Officer (Rs.
2.64 41 108.24
4 TA/DA to M & E Officer 1.2 41 49.2
5 TA to Statistical Officer 1.2 33 39.6
6 Stastical Investigator (2-4/dist) 1.26 98 123.48
Total 369.28
4. Other expenses
Budget is also required for printing of formats, contingency, office expenses, stationary,
equipment and maintenance of website of HMIS. Budget required for these activities is as
follows:
Table – : Other expenses in M & E – 2012-13
Sir Particulars Unit cost
No. of
units
Rs. In Lakhs
Budget
required
1 Workshop for revision of MIS formats 0.8 4 3.2
2 Printing of revised formats
I SHC formats (10579 SC × 24 formats) 0.002 10579 21.158
Ii PHC Formats (1816 PHCs × 24 formats) 0.006 1816 10.896
Iii Rural Hospital (455 RH × 24 Formats) 0.003 455 1.365
Iv District Hospital (23 DH × 24 Formats) 0.003 23 0.069
3 Trainings (one day hands on) 0.5 33 16.5
4 Contingency at district level 1.5 33 49.5
5
Contingency at state level (Mumbai +
Pune)
12 2 24
6 Creation and maintenance of Website 15 2 30
Total 156.688
5. Establishment of State Data Health Center
Objectives
1) To maintain programme wise web based/ non-based MIS data.
2) Feedback to state programme officers for data correction/ elimination of errors.
3) To provide outputs / report to State Programme Officers

4) Submit Information at State/ National level as a regular requirement as well as for meetings.
Required Infrastructure
1) Minimum 4000-5000 sq feet office space in a building is required to establish a SHDC,
containing Server room, Computer lab, Office rooms along with Officers cabin, record room,
gents/ladies toilets etc. (Server with specification and supporting system will be design by a
specialist like system analyst)
2) Facilities as a part of building such as Electricity, Fans, lights, electricity back-up etc.
3) Vehicle parking space for staff adjacent to Office.
4) Air-conditioning as per requirement for server room and computer lab.
5) Facilities: Internet / Internet, LAN / WAN, two telephone lines including intercom.
Roll of State Programme Officers
1) Follow up with field officers for online data entry work.
2) Obtain not web-based MIS report from field officers and submit consolidated reports to SHDC.
3) Correspondence for rectification of misleading/ wrong data based on validation output
received from SHDC.
4) Submit data finalization certificate to SHDC on monthly basis.
5) Maintain liaison with SHDC.
Manpower
Sr.
No.
1
Name of Post Qualificati
on
System
Analyst (For a
term of 2
years)
4 Statisticians
BE
(Comp/IT)
with SAP
specializat
ion
M.Sc.(stat
) with
Computer
knowledge
and
experience
in Health
Programm
e
Basic Functions (Job Description)
-Develop and plan hardware
system and software that will be
needed for each National Health
Programmed
-To integrate various software
currently being used for National
Health Programme
-To be responsible for all data
related activities of Data Centre
for various programme at
different levels.
-To access data to be sent to State
Programme Officer the validation.
-Finalization of reports after
corrective measures in validation
errors from State Programme
Officers.
-To provide information/ reports
required at various review
meeting held at State and
National level.
-To maintain liaisons with State
programme officers
No
Required
At
Mumbai
Centre
110
No
Required
At Pune
Centre
Will work for both
the centers at
Mumbai and Pune
2 2

Budget
Sr.
No
A) Salary
Name of
Post
No
Pune
Consolidated
Salary per
month (Rs)
Total
Budget
for a
year
Pune
Centre
No
Mumbai
Consolidated
Salary per
month (Rs)
Total
Budget
for a
year
Mumbai
Centre
(in lakh)
111
Grand
total
1
System
Analyst
1 0.5 5 0 0.5 0
5
2 Statisticians 2 0.2 4 2 0.2 4 8
Total 9 4 13
B) Allowances to Staff
TA and DA allowances for staff members Pune center Rs. 2.00 lakh, & Mumbai Center Rs. 2.00
lakh.
C) Material and Supplies
Sr.No Item
No.
Pune Centre Mumbai Centre
Unit
Cost /
Unit
(Rs)
Total
Budget
(In
lakh)
No.
Unit
Cost/
Unit
(Rs)
Total
Budget
(In
lakh)
Grand
Total
1
Desktop
computers
10 0.35 3.5 10 0.35 3.5
7
2 Laptops 2 0.4 0.8 2 0.4 0.8 1.6
3
Printer (One BW
one Colour)
2 0.5 1 2 0.5 1
2
4 Scanner (Big) 1 0.7 0.7 1 0.7 0.7 1.4
5
Furniture and
Lan system
1 10 10 1 10 10
20
6
Contingency ,
stationary
Server including
1 6 6 1 6 6
12
6 supportive
1 10 10 1 10 10
software
20
Sub Total of (C) 32 18 27.95 32 64

Total of Data Center
Sir Activity Budget requirement
1 Salary 13
2 Allowances to staff 2
3 Material and supplies 64
Total 79
Total budget requirement
Total budget required for Monitoring and Evaluation is as follows:
Table : Total budget required for Monitoring and Evaluation
Sir Particulars
Rs. In Lakhs
Unit cost
1 Meetings for monitoring of the activities 161
2 Manpower for Monitoring & Evaluation 369.28
3 Other expenses 156.688
4 Establishment of Data Center 79
Total 765.968
ACTIVITY - B.15.3.2 : COMPUTERIZATION OF HMIS, E-GOVERNANCE & E-HEALTH
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2007-08 258.4 220 1113.68 1113.680
112
Rs. in Lakhs
Remarks
Considering the volume of activities being carried out by Public Health Department, number
of persons involved and amount data generated in system, it has been decided to
computerize all the activities in the state step by step. Ultimate aim of the computerization is
to get real time data for all important indicators and enable the higher level managers to act
upon without any time lag.

Presently, following E-Governance activities are being carried out or in execution stage in the
state
• E-office introduced for the first time in Maharashtra at NRHM Mumbai. It has
started functioning well.
• Biometric attendance system in all health offices, PHCs and hospitals. Biometric
system is installed in all the Hospitals. Once it is functional, PHCs will be
introduced in the system.
• Development of ASHA software – ASHA software already developed. Information
of about 60000 ASHA in place. Software has helped to pay compensation to ASHA
in time.
• Hospital MIS software being established in State initially for 23 District Hospitals, 4
General Hospitals and 8 Women Hospitals. This software will completely
computerise the hospital functioning and will improve the efficiency of the system.
• Inventory management - Computerization of Medicine distribution system –
already started and providing good results. Now daily monitoring of all the
important medicines in all health facilities of state is possible. This has resulted
into saving of medicines from expiry, calculating correct demand, indications
before the medicine is out of stock.
• Computerization of Medical Equipment inventory – This software is also in
progress and is being prepared with the help of agency appointed by Department
of Information Technology, Govt. of Maharashtra.
• Fund transfer through E-banking to district level – already started in all the
districts, circle offices and training centres.
• Payment of cheques through e-banking – Cheques to venders and other personnel
are now being paid through e-banking.
• Tally ERP-9 Introduced at state, district and block level.
• GIS mapping with the support from UNICEF – GIS maps are being used for decision
making and presentation in the state.
• Use of MCTS software and HMIS software as per GoI guidelines.
• E-transfer – All the request transfers are now online. Officers interested in request
transfer will have to submit their request online to the Government. These
requests will be considered based on need and transfers will be made.
Considering the implementation of all the above mentioned activities in the state following
actions are proposed for year 2012-13 :
1. Creation of awareness among health officials for E-Governance: All the officers of
Health Department need to know the strengths of E-Governance and advances of
technology available for health related monitoring. If they understand the concepts
and benefits of E-Governance, then they will start monitoring from their own.
Considering this, now there is one session of senior IT expert regarding technologies
113

available for health. As these sessions are included in regular meetings, no additional
cost is required for this activity.
2. Expansion of E-Office to other State level Offices: E-Office is started in SHS office and
senior officers related to NRHM such as Director of Health Services, Additional Chief
Secretary (PH&FW), etc. The software is from NIC and installation, training,
handholding for one year, maintenance, etc. is being carried out by NIC. One
department of Directorate (Joint Director (Hospitals)) is also included in the scheme.
Now it is proposed to expand this scheme to all the state level offices in Mumbai,
Pune and Nagpur. These offices will require Computers, Scanners, cabling, etc. for
these offices. This is very important for Maharashtra as State level offices in the state
are situated in three different cities and at 8 different places.
3. Establishment and Expansion of Hospital Software : Maharashtra has 455 hospitals
and bed strength of these hospitals ranges from 30 beds to 550 beds. It is proposed to
completely computerise these hospitals in phased manner. Initially all District
Hospitals, all women hospitals and hospitals above 200 beds (General Hospitals) are
being computerised and later on 100 bedded hospitals will be included for
computerisation. The software for computerisation is prepared by Tata Consultancy
Services and will be procured from Maha-online a Government of Maharashtra
company. Budget required for this will be for software, computers, servers and LAN
and also for additional manpower for initial period till the system settles down.
4. Biometric Attendance System : Biometric Attendance System is introduced in the
state. Initially, all the offices from State to District level are covered and then the
Hospitals are covered. Now, it is proposed to cover all the Primary HealthCentres in
the state. This activity is separately mentioned in next chapter.
Budget requirement
As mentioned above, budget is required for procurement of software, hardware and
manpower. Budget required for each of the software system is as follows:
Table – Budget requirement for E-Governance
Sir Particulars Unit rate
No. of
units
114
Rs. In Lakhs
Budget
required
A Expansion of E-Office in State Offices
1 Payment to NIC for software 20 1 20
2 Procurement of Computers 0.4 214 85.6
3 Procurement of Scanners 0.8 36 28.8
4 Lan system 2 8 16
5 Internet connectivity 1.2 6 7.2
6 Computer specialist (one for one building) 2.64 6 15.84
7 Overheads 2 6 12
Total 165.44

Sir Particulars Unit rate
B
Establishment and Expansion of Hospital
Software
No. of
units
115
Budget
required
1 Payment to 'Maha Online for Software 300 1 300
2 Procurement of Computers 0.4 1240 496
4 Lan system 5 23 115
5 Internet connectivity 1.2 23 27.6
6 Manpower 2.64 6 15.84
7 DEO (4/hospital) (92) 1.2 92 110.4
8 Pharmacy Officer (2/Hospital) (46) 1.2 92 110.4
9 Overheads 1 23 23
Total 898.24
C
Other E-projects that will come up during 2012-
13
10 5 50
Grand Total 1113.68
SUBSECTION - B.15.3.3 : MOTHER AND CHILD TRACKING SYSTEM
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2006-07 0 1963.4 632.354
Rs. in Lakhs
Remarks
As per Govt. of India instructions, Mother and Child Tracking System (MCTS) e-mission mode
project under National e-governance plan is being implemented in the State. Exhaustive
attempts are being made to capture the data in MCTS. In Maharashtra, presently, rural data is
being captured and uploaded on MCTS web portal. Recently the State has also undertaken
the rash drive to correct the existing data of current year 2011-12 in MCTS. State has further
planned to capture the data from urban area for uploading in MCTS. State, Regional and
District level verification of MCTS Data is the core activity which is being implemented since
last few months. The State has also stressed on real time Data Entry in MCTS software for the
services delivered to beneficiaries. Review meetings are conducted at the State, Regional,
District and Block level regarding the progress of MCTS and utmost importance has been
given to update and validate the records in MCTS. The data of more than 13.50 lakhs
mothers and 8.50 lakhs children has been captured online on MCTS web portal so far.
Further, the data of 19 thousand ANMs and 59 thousand ASHAs has also been registered as

grass root health care providers in MCTS. In order to ensure quality RCH service delivery,
MCTS is the most effective monitoring tool . Keeping in view the wider spectrum of MCTS
activities, it is necessary to strengthen it at all level by providing some sort of support from
NRHM as indicated below:
(1) Printing and supply of MCTS Registers:
As per Govt. of India instructions, it is necessary to provide one RCH register (with Part-A for
eligible couple survey and Part-B for Mother and Child Tracking System) designed by Govt. of
India to each village and health facility (excluding Sub-centre) in the State . At present 43722
villages, 1816 PHCs, 367 Rural Hospitals/CHCs (30 bedded), 56 Sub-district hospitals (50
bedded), 24 Sub-district hospitals (100 bedded), 3 General Hospitals (200 bedded), 9 Women
Hospitals, 2 Regional Super Specialty Hospitals and 23 District Hospitals are existing in the
State (Total 46022). In order to provide the RCH Register to all these villages and health
facilities, a budget of Rs. 115.05 lakhs will be required during 2012-13 as indicated below.
Sr. No. Activity
1
Printing and Supply of RCH Registers to each
village and health facilities in the State
(2) Support for PHCs for preservation of records:
Unit
cost Rs.
Physical
Target
116
Amount
proposed
Rs. in lakhs
250.00 46022 115.05
Currently five types of work plans are being generated from MCTS web portal out of which
three (ANC, Delivery, PNC) are for mothers and two (Infant Immunization, Child
Immunization) are for children. Each health provider and Institution wise work plans are
generated and they should be preserved in respective files. The fundamentals of tracking
basically depend on 18 digit beneficiary ID. Out of which the first 13 digits of MCTS ID
(Separate for Mother and Child) are Unique for every Institution. It is a cumbersome
procedure to write all 18 digits ID on register as well as on beneficiary card by the health
provider. Hence, it will more appropriate to provide a 13 digits rubber stamp to each ANM so
that they can stamp the MCTS ID Number on Register and Beneficiary card simultaneously.
Considering the drainage workload and catchment area of PHCs it is proposed to provide Rs.
4000/- to each PHC exclusively for providing stationary and 13 digits rubber stamps to the
health providers, because, visibility of clear MCTS ID number on the beneficiary cars as well as
in the register will ensure to root the concept of tracking by ID in health system. Regarding
the stationary and rubber stamps for other institutions, it is proposed to incur the same from
the contingency available with them. Thus a budget of Rs. 72.64 lakhs (Rs. 4000.00 x 1816
PHCs) is proposed during the year 2012-13.

(3) Strengthening of State MCTS Cell:
Presently the MCTS activities are being monitored through a Cell established at State Family
Welfare Bureau, Pune which is manned by one Medical Officer on deputation basis and
supervised by one Assistant Director (FW). Keeping in view the heavy workload it is proposed
to strengthen the State MCTS Cell by providing following inputs during the year 2012-13.
Sr.
No.
Attribute Number
Monthly
remuneration Rs.
117
Total
amount Rs.
in lakhs
1 Statistical Investigator 2 9,600.00 2.30
2 Data Entry Operator
4 Computers, 2 printers, 4 UPS, 1
2 9,600.00 2.30
3
scanner, 1 laptop, 1 tablet PC,
furniture, utility software and other
contingency.
Hiring of vehicle for monitoring and
Lump sum 10.00
4
supervision activities in the field @
Rs. 25,000/- per month for 12
months.
25,000.00 3.00
Total 17.60
Thus, a budget of Rs. 17.60 lakhs is proposed during 2012-13 for this activity.
(4) Training of District staff in MCTS Activities:
MCTS Web Portal is dynamically changing & day to day updates are being incorporated. To
aware the recent changes on MCTS Web Portal to district, block and periphery level officers
as well as data entry operators, MCTS Online Web Portal training is proposed at every DTTC
and HFWTCs as indicated below:
a) Basic training – Basic training of MCTS data entry and operationalization of MCTS web
portal will be imparted to the newly appointed Data Entry Operators. Considering 50
trainee per district, an amount of Rs. 150/- per person is proposed. So the total budget
for basic training will (50 X 33 X Rs. 150) = Rs. 2.47 lakhs.
b) On-going training – To aware new things on MCTS web portal, on-going reorientation
training will be given to the Data Entry operators already appointed. 6 trainings are
proposed during 2012-13 considering one training at every two month. Considering 75
participants per district, an amount of Rs. 150 per person is proposed. So total budget for
on-going training will be (75 X33X Rs.150 X6) = Rs. 22.27 lakhs.

c) Hands on Training of all THOs at HFWTCs – Each Circle will conduct one day Hands on
Training of MCTS with GIS of all THOs in HFWTC. The training will be conducted twice in a
year . With 353 THOs and 200 Rs. per participant and 400 Rs per trainer ( two trainers at
each HFWTC) the total budgetary provision for same will be will be ( 353 THOs X Rs.200 X
2 ) + (12 Trainers X Rs.400 x 2) = Rs. 1.50 lakhs. The budget will be distributed to the
HFWTCs.
Thus, a total budget of Rs. 168.16 lakhs ( i + ii (a) (b) & (c) is proposed during 2012-13 .
(5) Review of MCH tracking activities
(a) State Level Workshop :-
It is proposed to organize a two days midyear MCTS review workshop. The participants for
this workshop will be the DHOs, Civil Surgeons, Medical Officers of Health of Municipal
Corporations, Municipal Commissioners, Chief Executive Officers of Zilla Parishads, Regional
Deputy Directors and other concerned officers. A budget of Rs. 5.00 lakhs is proposed during
2012-13.
(b) State Level Meetings:-
As MCTS has been initiated in urban & rural area, monthly review meetings of concerned
representatives from urban (MOH) & rural (DHO & CS) will be taken. Considering 100
participants (Representatives from DHO + CS + MOH) per meeting , Rs. 100 per participant is
proposed for lunch & Snacks. The total budget requirement for this will be (100 X 100 X 12 ) =
Rs. 1.20 Lacs.
(c) District Level Meeting : -
It is proposed to organize a monthly review meeting at district for review of block MCTS
activities. A budget of Rs. 1000/- per meeting per month is proposed for meeting the
expenses of tea, snacks etc. Thus, a budget of Rs. 12000/- per district will be required during
2012-13. So for 33 districts, the total budget will be Rs. 3.96 lakhs required. Thus, a budget of
Rs. 3.96 lakhs is proposed during 2012-13.
(d) State Project e-Mission Team (SPeMT) Member meetings:-
As per GOI instructions State Project e-Mission Team (SPeMT) Members should meet at least
once in a month to take review of progress of MCTS in the State. Rs. 1000 per meeting is
proposed as contingency . So total budget for SPeMT member meetings will be 1000 X 12 =
Rs. 0.12 lakhs.
(e) District Project e-Mission Team (DPeMT) Member meetings:-
As per GOI instructions District Project e-Mission Team (DPeMT) Members should meet at
least once in a month to take review of progress of MCTS in the State. Rs. 1000 per meeting is
proposed as contingency. So total budget for DPeMT member meetings will be 1000 X 12 X
33 = Rs. 3.96 Lacs.
Thus, a budget of Rs. 12.75 lakhs (1 to 4) is proposed during 2012-13.
118

(6) Monitoring Data collection & Data Quality
MCTS Data Collection through standard Android Telephony (voice data uploading on web
based central server & data entry by accessing voice data) :
An innovative project has been proposed with technical support from UNICEF & RIDDHI,
Private Software Company for MCTS Data Collection & data entry. In order to implement this
innovative project, it is necessary to have an android based voice data capturing software
preinstalled in GPRS enabled Android Handsets with the ANMs & PHC Medical Officers. The
captured MCTS data will be recorded in preformed voice data format which will be sent
through GPRS to web based central server from which it can be accessed at the data entry
points and MCTS data entry can be done in real time fashion. The PHC level Data for other
Parameters e.g. Daily OPD count, Delivery Count etc. will be sent through GPRS enabled
Android handset available at PHC level. It is, therefore, proposed to provide one GPRS
enabled Android handset to each ANM and MO PHC . The financial implications required for
this purpose are shown as below:
(a) Procurement of Android mobile handset with GPRS connectivity:
Sr.
No.
1
Item
Unit cost
Rs.
Physical
target
119
Total
amount Rs.
in lakhs
Provision of Android Handsets to all tribal
SC and 10% nontribal SC (2055+853=2908)
and all tribal PHCs and 10% of nontribal
PHCs (315+150=465). Total Android phone
requirement is 2908+465=3373
6300.00 3373 212.499
Total 212.499
(b) Training on Android telephony:
i) State level training – Initially it is proposed to train 2 trainers per district at State
level for data uploading through GPRS enabled Android mobile handset. For 33
districts, the total trainees will be 66. A budget of Rs. 1.32 lakhs (Rs. 2000.00 x 66
participants including organization cost) is proposed for this purpose during 2012-13.
ii) Block level training – All ANMs & PHC functionary staff will be trained at block level
training. Expenditure of Rs. 5000 per block is proposed to train and hands on demo for
all ANMs & Medical Officers in Taluka. Hence total budget for same will be 353 x Rs.
5000.00 = Rs. 17.65 lacs.

Thus a total budget provision for Material Procurement & Training in this Standard Android
Telephony innovative for MCTS data capturing will be Rs. 231.469 lacs.
(7) Establishing of State Level MCTS Call Center:
It is proposed to establish a dedicated State level MCTS Call Centre for verification of MCTS
data telephonically from the state level. For this purpose, 5 lady call assistants, 5 telephone
lines, 5 computers with internet connection will be required. The financial implications
required for this purpose will be as follows:
Sr.
No.
Description Number Monthly
remuneration
Rs.
120
Total Amount
Rs. in lakhs
1 Lady Call Assistants 8 9,600.00 7.68
2 5 computers, internet, furniture, and 5
telephone lines
Lump sum 5.00
3 Recurring expenditure Lump sum 2.00
Total 14.68
Thus, a budget of Rs. 14.68 lakhs is proposed during 2012-13.
Sr.
No. Activity
Summary budget
Unit cost
Rs.
Physical
target
Rs. In Lakhs
Amount
proposed
Rs. in lakhs
1 Printing and supply of MCTS registers 0.0025 46022 115.055
2 Support for PHCs for preservation of records 0.04 1816 72.64
3 Strengthening of State MCTS Cell 17.6 1 17.6
4 Training of District Staff 168.16 1 168.16
5 Review of MCH tracking activities 12.75 1 12.75
6 Monitoring Data Collection & Data quality 231.469 1 231.469
8
Establishing of State Level MCTS Call
Centre
14.68 1 14.68
Total 632.354

SUBSECTION – B.15.3.4 : STRENGTHENING OF SUPERVISION AND MONITORING SYSTEM
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2006-07 258.4 220 484.4 484.140
121
Rs. in Lakhs
Remarks
The state has established the Health Management Information system for easy monitoring
and data retrieval. This helps in Monitoring and supportive supervision of health institutions.
Such an attempt to automate the records of health institutions would help, in the long run, to
reduce the workload of maintaining physical records and in compilation and collation of data
generated. This would also facilitate timely reporting of data as well as analysis and
interpretation of various data generated. In the future, such an initiative can pave way for
attempting emerging trends in medicine like telemedicine.
Support is required to establish and maintain the E-Governance system which is submitted in
this chapter.
Plan of action
It is also proposed to support the program offices directly involved in the NRHM activities. Six
old and three new important Disease Control Programs get funds as per PIP. However some
program offices such as Nursing, Hospitals, Primary health institutions actually implement
important activities of program but are not directly provided funds. Therefore it is proposed
to provide funds to these institutions along with the peripheral health institutions.
Public Health Department have ambulances and supervisory vehicles. It is proposed to
computerize the total history of all vehicles and improve the proportion of on road vehicle in
the state.
It is also proposed to provide one data entry operator, one accountant and one statistician to
all the disease control program cells to strengthen the management of the programs.
As there will be large scale computerization from State as well as NRHM funds, there is need
off training all the staff of health department and also need to develop computer labs at each
district HQ for data entry, checking the entered data, follow up of the data submitted by the
districts and hands on training to supervisory staff of PHCs and CHCs. Therefore it is proposed
to develop one Computer Laboratory for each of the district HQ. The Computer Lab will be
established in one room – preferably the HTT building and if not possible then in DTT building.
This lab will be under control of HMIS Cell of the district.

Budget requirement
Budget is required for establishment of Computer Laboratory, internet facility, salary of
support staff required for supervision provided to the program officers and related facilities
to all the concerned Program Officers at state level.
Budget required for this purpose is as follows:
Table – : Budget requirement for strengthening MIS and supervision
Rs. In Lakhs
Sir Particulars Unit cost
1
2
Replacement of old computers and maintenance
of existing computers in all the State level
offices
Establishment of Data Bank for online HMIS in
District
No. of
units
122
Budget
required
12 8 96
i Procurement of Computers (6 per district) 0.3 198 59.4
ii
Procurement of Heavy Duty Printers (2 per
district)
0.3 66 19.8
iii LAN System 2 33 66
iv Civil Works 5 33 165
3
Provision of one DEO, one accountant and one
statistician to collect and compile program data
to 6 program offices + one accountant for
payment of meetings at SHS (19 persons)
1.26 19 23.94
4 Support to program offices 6 8 48
5 Support to MIS section of Directorate 6 1 6
Total 484.14

SUBSECTION - B.15.3.5 : ESTABLISHMENT AND FUNCTIONING OF GRIEVANCE CELLS
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2010-11 27.81 38.4 42.84 42.840
123
Rs. in Lakhs
Remarks
Many times complain are received by SHS and districts regarding various shortfalls in
activities implemented under NRHM. Presently, these complain are entertained by concerned
officers and dispatched to concerned districts for further action.
Considering the importance of grievance redressal, one grievance cell at SHS Mumbai and one
each at Deputy Director Circle HQ have been established in 2010-11. These cells will continue
to work during the year 2012-13.
Composition of the cell at Deputy Director i/c circle office will be as follows:
• Deputy Director i/c circle or his representative
• One NGO representative, preferably the CBM NGO of the city
• One retired judge or senior journalist of the city
This committee meets once a week. One person is appointed from Social Work or Journalism
background full time to coordinate the mattes. He/She will register the complaint, get the
information collected from concerned department and inform the complainant.
Non-official members will be paid Rs. 500/visit + local travel charges.
Compliance of remarks on grievance Cell is as follows:
• During the year 2011-12, Grevence cell received total 291 complaints. All these complaints
were processed. Out of these, action completed in 131 complaints and action in process in
160 complaints.
• Lot of complaints are received regarding grievances against regular staff. Such complaints are
tracked till enquiry is made and enquiry report is sent to DHS for further action. Enquiry has
been started against 13 officers due to constant follow up of the Grevence Cell.
• Currently, grievance Cell is also entrusted responsibility of tracking the news appear in local
newspapers.
• Telephone charges are doubled due to increase in follow up of the complaints to district and
state HQ. This is good indication.

Budget requirement
Budget required for grievance cell is for telephone and Grievance Redressal Officer. Budget
will be required to one state cell and one cell each for 8 circle offices in state. Total budget
required is as follows:
Table - : Budget requirement for grievance cell
Sir Activity Unit cost
No. of
units
Rs. In Lakhs
Budget
required
1 Telephone charges 0.48 9 4.32
2 Salary of GR Officer 2.4 9 21.6
3 Salary of DEO to GR Officer at state 1.26 2 2.52
3 TA/DA to nonofficial members 1.2 8 9.6
4 Contingency 0.6 8 4.8
Total 42.84
124

SECTION - B.16 : PROCUREMENT
Procurement procedure inn Maharashtra is transparent. Procedures adopted by Maharashtra
are as follows:
Procurement methods
Procurement in Maharashtra takes place by following methods
1. Medicine Procurement from State Government Budget and from activities under
Mission Flexi pool through State Government Rate Contact. From April 2012, this
purchase will be made through Open Tender System (Two envelop system).
2. Medicine procurement where there is no RC through tender system (two envelop
system).
3. Medicine procurement from RCH funds and from DCP funds through one tender
system only by following World Bank procurement procedure.
4. There are no rate contracts for equipment. Therefore equipment are procured
through only open tender system. For State and MFP funds 2 envelop system is used
and for RCH and for RCH and DCP funds World Bank Procurement Procedure (one
envelop) system is used.
5. Computers, printers and UPS procured either through DGS & D RC or State DIT RC
whichever is cheaper for required specification computer.
6. Furniture and some selected item procurement through Government Rates fixed by
Industries Department in concurrence with Finance Department of Government of
Maharashtra.
Procurement agency
As per NRHM Guidelines, Maharashtra has established one dedicated Procurement Cell in the
state. This cell is headed by officer at the level of Joint Director. He/she is supported by
Deputy Director (Procurement) and two Assistant Directors of procurement. This cell is
supported by contractual technical staff paid from NRHM funds.
Tender system
E-tendering system is used for all the tenders. Instrument/equipment are tested by expert
panel usually from senior Professors from Government Medical Colleges from Mumbai, Pune
and Aurangabad. Laboratory tests, chemical tests are performed in accredited laboratories
wherever necessary.
Approval of tenders
• Firstly approval for procurement of goods is given. For this, demand for particular
item, budget provision, specifications and which method of procurement is being used
is checked and approval is given.
125

• Once the tender process is completed and financial bids are opened, total record is
submitted to Committee under Chairmanship of ACS (PH & FW). Members of
committee include Secretary (Finance), Secretary (Industries) and CSPO. Joint Director
(Proc) is member secretary of committee. Procurement order is given only after the
approval of committee.
• Payment is made only after getting original receipts from the consignee. No advance is
paid if not mentioning in Tender.
Funds for procurement of medicines
Source of funds for medicines with approximate budget are mentioned below:
1. State government funds for PHCs and SCs – Rs. 32 Crores
2. State Government funds for Hospitals – 57 Crores
3. State Government funds for DCPs – 14 Crores.
4. GoI funds for RCH activities – Rs. 70 Crores
5. GoI funds for PHCs and Hospital under IPHS – 19 Crores.
Total funds availability – GoM funds Rs. 103 Crores + GoI funds Rs. 89 Crores = total Rs. 192
Crores.
Above figures do not include the medicines particularly Anti-snake venom, Anti rabies vaccine
and emergency medicine through Cess Funds of Zilla Parishads as these figures are not
collected at state level.
Procurement for year 2012-13
In order to provide quality RCH services, it is necessary to ensure the availability of essential
drugs and equipment at all health facilitates. Following equipment, drugs and supplies are
proposed under Maternal Health, Child Health and Family Planning during 2012-13.
Sl. No. Activity
Unit cost
Rs. in
lakhs
Physical
targets
126
Amount
Proposed
Rs. in
lakhs
B 16.1 Procurement of Equipment
B 16.1.1 Procurement of equipment : MH
Operationalize Comprehensive Abortion
1 Care services (including MVA / EVA
and Medical Abortion) at health Center
64.38
Sub-total for Maternal Health 64.38
B 16.1.2 Procurement of equipment : CH
1
Mannequin (Baby Model for NSSK
training)
0.060 208 12.50
2
Kelly Forceps for PPIUCD for District
and Women Hospitals (3 sets for each
0.0045 93 0.42

Sl. No. Activity
Unit cost
Rs. in
lakhs
Physical
targets
127
Amount
Proposed
Rs. in
lakhs
institute)
Sub-total for Child Health 12.92
B 16.1.3 Procurement of equipment : FP
1
NSV kit (@ 10 kits per district &
corporation)
0.03375 560 18.90
2 Printing of R3(6000) & R4(6000) registers 0.00150 12000 18.00
Sub-total for Family Planning 36.90
B 16.1.4 Procurement of equipment : IMEP 0 0 0
B 16.1.5 Procurement of others
Support for ARSH Counselors at District
1
HQ- Procurement of 1 Computer with
printer, scanner & UPS at 33 District HQ
ARSH Clinics @ Rs. 50000/- per clinic
Printing of 400 Training modules for
0.50 33 16.50
2 Medical Officers of newly selected blocks
for CBA activities under ARSH
Printing of 1600 Training modules for
0.001 400 0.40
3 ANMs/LHVs of newly selected blocks
for CBA activities under ARSH
Printing of 5250 Training modules for
0.0005 1600 0.80
4
ASHAs & 5250 training modules for
AWWs of newly selected blocks for CBA
activities under ARSH
Printing of new record keeping registers
0.0003 10500 3.15
5
and formats, Stock keeping, Outreach
activity registers as provided by GoI @
Rs. 2000/- per clinic (140 ARSH Clinics)
Register & format for 850 ANMs to be
0.02 140 2.80
6 continued in 222 Municipal Council area
@ Rs. 500 per ANM (Municipal Councils)
0.01 850 4.25
Sub-total for Other(ARSH & URBAN)
School Health
Purchase of Height & weight
27.90
7 measurement scale for calculation of BMI
at state level
0.03 440 13.20
8 Software for Database at state level 20.00 1.00 20.00
9 Laptop Purchase 0.35 853 298.55
Sub-total School Health 331.75
Total for equipment (B 16.1) 473.85
B 16.2 Procurement of Drugs and supplies
B 16.2.1 Drugs & supplies for Maternal Health
1 Sub-center Kit-A (Rural) 0.11 10579 1163.69
2 Sub-center Kit-B (Rural) 0.07 10579 740.53

Sl. No. Activity
3
4
5
6
7
8
Essential Obstetric Care drug kit for
PHCs
SBA drug kit for PHCs (658 – 24x7
PHCs/54 PHCs in HFD
SBA drug kit for CHC/FRU (369 CHCs,
74 SDH) (In HFD 50)
SBA drug kit for DH/WH/OH (23 DH, 9
WH, 4 OH) (In HFD 3)
Emergency Obstetric Care drug kit for
FRUs (184 CHC FRU, 23 DH, 9 WH, 4
OH= 220 ) (in HFD 21)
Sub-center kit –A+B (Urban ) 112 Health
Posts) (Municipal Corporations)
Unit cost
Rs. in
lakhs
Physical
targets
128
Amount
Proposed
Rs. in
lakhs
0.21 1816 381.36
0.24 658 157.92
0.24 443 106.32
0.24 36 8.64
1.50 220 330.00
0.18 112 20.16
9 SBA kit for Maternity Homes (Urban) 0.24 64 15.36
10
Emergency Obstetric Care Drug Kit for
Maternity Homes (Urban)
1.50 64 96.00
11
SBA drug kit for DH/WH/OH (23 DH, 9
WH, 3 OH)
Drug kit for RTI/STI (Kit-1) ( for 658-
0.24 35 8.40
12 24X7 PHC & 456 CHC/SDH/WH (54
PHC/50 CHC in HFD)
Drug kits for RTI/STI (Kit 2) ( for 658
0.00025 25208 6.30
13 24X7 PHC & 456 CHC/SDH/WH (54
PHC/50 CHC in HFD)
Drug kits for RTI/STI (Kit 3) ( for 658
0.00010 66728 6.67
14 24X7 PHC & 456 CHC/SDH/WH (54
PHC/50 CHC in HFD)
Drug kits for RTI/STI (Kit 4) ( for 658
0.00032 14828 4.74
15 24X7 PHC & 456 CHC/SDH/WH (54
PHC/50 CHC in HFD)
Drug kits for RTI/STI (Kit 5) ( for 658
0.00040 2966 1.19
16 24X7 PHC & 456 CHC/SDH/WH (54
PHC/50 CHC in HFD)
Drug kits for RTI/STI (Kit 6) (For 658
0.00030 7414 2.22
17 24X7 PHC & 456 CHC/SDH/WH (54
PHC/50 CHC in HFD)
Drug kits for RTI/STI (Kit 7) ( for 658
0.00049 29657 14.53
18 24X7 PHC & 456 CHC/SDH/WH (54
PHC/50 CHC
RPR test kits ( for 658 24X7 PHC & 456
0.00049 1483 0.73
19 CHC/SDH/WH (54 PHC/50 CHC in
HFD)
RTI-STI- drug kits for link workers
0.00060 12677 7.61
20 Drug kits for RTI/STI (Kit 1) 0.00025 16296 4.07
21 Drug kits for RTI/STI (Kit 2) 0.00010 43140 4.31

Sl. No. Activity
Unit cost
Rs. in
lakhs
Physical
targets
129
Amount
Proposed
Rs. in
lakhs
22 Drug kits for RTI/STI (Kit 3) 0.00032 13899 4.45
23 Drug kits for RTI/STI (Kit 4) 0.00040 479 0.19
24 Drug kits for RTI/STI (Kit 5) 0.00030 19024 5.71
25 Drug kits for RTI/STI (Kit 6) 0.00049 1984 0.97
26 Drug kits for RTI/STI (Kit 7)
HIV whole blood test kits 613000 kits for
0.00049 1984 0.97
27
estimated 613000 ANCs in districts. Total
no. of kits 76680 for 69710 ANCs from
HFD
Supply of safe delivery kits 7275 kits for
estimated 1455 HIV positive del. in PHC
0.00025 674300 168.58
28 & in case of HFDs 486 safe del. Kits
required for estimated 97 HIV positive
del. In PHCs.
Printing of consent forms & laboratory
0.0025 7275 18.19
29
forms each for testing of pregnant
mothers estimated no. 613000 @ Rs.70/for
100 forms
Treatment of Severally anemic mothers
0.00070 674300 4.72
30 by Parental Iron treatment to pregnant
mothers
0.005 16912 84.56
31
Supply of Sanitary Napkins to JSY
beneficiaries in Rural Institutions
0.0005 340647 170.30
32
Operationalise Comprehensive Abortion
Care services MMA drug kits
0.00088 31719 27.91
Sub-total for Maternal Health (1 to 33) 3567.30
B 16.2.2 Drugs & supplies for Child Health
Drug kit for Sick New Born and
1 Child/Neonatal Resuscitation for all
PHCs
Emergency drug kit for New Born and
2
Child for 24x7 PHCs
Drug kit for Sick New Born and Child for
3
FRU/CHCs
Emergency drug kit for newborn and
4
child for FRUs
Drug kit for Sick newborn and child for
5
DH, WH and GH.
Emergency drug kit for newborn and
6
child for DH, WH & GH
Drug kit for sick newborn and
7 child/neonatal resuscitation for Urban
Health Posts
Drugs required for mass De-worming
8
and Vitamin A supplementation
0.047 1816 85.40
0.081 658 53.30
0.041 220 9.02
0.183 220 40.26
0.083 34 2.81
0.337 34 11.45
0.047 218 10.25
- - 330.00

Sl. No. Activity
Unit cost
Rs. in
lakhs
Physical
targets
130
Amount
Proposed
Rs. in
lakhs
Sub-total for Child Health ( 1 to 8) 542.49
B 16.2.3 Drugs & supplies for Family Planning
1 Inj. Lignocain 1% 30 ml vial Rs. 16.00 137500 22.00
2 Inj. Pentazocin 1ml Amp Rs. 3.55 387500 13.75
3 Chromic Catgut 10 (box of 10 pieces) Rs. 300.00 8250 24.75
4 Autoclave Strips (boxes) Rs.459.00 10000 4.59
Sub-total for Family Planning (1 to 4) 65.09
B 16.2.4 Supplies for IMEP
General drugs and supplies for health
B 16.2.5 facilities
1
2
3
4
5
Procurement of iron folic acid tablets for
adolescent boys and girls & School
teachers, AWWs (No. of beneficiaries,
*52, + 20 percent of it , *0.60 paise)
Procurement of Albendazole tablets for
adolescent boys and girls
(No. of beneficiaries* 2, + 10 percent of it
*0.60 paise)
Procurement of Sub-center Kit A @ Rs.
11000 for 59 HP & Kit B @ Rs. 7000 for 59
HP total of Rs. 18000 per HP (Municipal
Councils)
Procurement of Kit A & B for 850 Urban
ANMs
Sub-total for general drugs (ARSH &
URBAN)
School Health medicine Purchase at State
Level
0.000006 9707038 1837.99
0.000006 9707038 128.13
0.18 59 10.62
0.18 850 15.30
1992.04
0.83 440 365.20
Total for drugs and supplies (B16.2) 6532.12
Grand total (B16.1 + B16.2) 7005.97
Summary Table Procurement RCH
Sr.No. Activity Budget Rs. Lakhs
B 16.1 Procurement of Equipment

Sr.No. Activity Budget Rs. Lakhs
1 Maternal Health 64.38
2 Child Health 12.92
3 Family Planning 36.90
4 ARSH & URBAN 27.90
5 School Health 331.75
Sub Total Procurement of Equipment 473.85
B 16.2 Procurement of Drugs and supplies
1 Maternal Health 3567.30
2 Child Health 542.49
3 Family Planning 65.09
4 ARSH & URBAN 1992.04
5 School Health 365.20
Sub Total Procurement of Drugs and supplies 6532.12
Total RCH Procurement 7005.97
SECTION - B.17 : PNDT ACTIVITIES
(Covered under Component A – RCH Flexipool)
131

SECTION - B.18 : REGIONAL DRUG WAREHOUSE
SUBSECTION - B.18.1 : STATE PROCUREMENT MANAGEMENT
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2007-08 1321.2 599.6 783.12 783.720
132
Rs. in Lakhs
Remarks
Timely supply of good quality drugs as well as logistics management is of critical importance
in any health system. Maharashtra state is completely reorganizing the procurement set up
within the state and is in process of revision of existing procurement policy.
Procurement strengthening plan f – 2012-13
Salient features of the procurement of goods and services in state are as follows:
• Currently medicine and equipment are partly procured at state and partly at district
level. As Procurement Division of the state is now fully functional all the purchases in
2012-13 will be by Procurement Division of the state.
• E-tendering software and Inventory control software is introduced in the state. This
has enabled to get precise information about stock situation of every drug and
equipment and also in procurement.
• Demand generation, distribution of drugs and stock position is completely
computerized. Data entry is made at PHC level onwards.
• Medicines purchased will be stored in Regional and District warehouses. Therefore 8
warehouses at regional level and 33 warehouses at district level will be strengthened.
• Currently there are two warehouses in each district. One for DHO (for PHCs) and one
for CS (for DH and CHCs). Now onwards, only one warehouse will be constructed in
District Hospital premises. This will save in manpower and security requirements and
will be easy for monitoring.
• All the Pharmacies in Public Health Department offices are now connected by web for
inventory control. This system will be strengthened further.
• Medicines will be purchased by E-tender system only.
• Medicines required in very small quantity and of minimal cost (requirement less than
Rs. 1000/institute in year) and medicines of short expiry (e.g. adrenaline) will only be
purchased locally. All other medicines will be purchased from central level.
• State level Procurement Cell, Regional and district stores, etc. will be supported under
NRHM.

• Daily stock of important medicines is being monitored in the state.
• One Procurement Verification Officer is appointed since 2009-10. This person visits all
the stores at Districts and major blocks and verifies the stock register, assures whether
the stock book is maintained, all NRHM purchases are entered in registers, etc.
Budget requirement – 2011-12
Budget requested in this PIP is for currently functioning system, i.e. for divisional and district
warehouses. Considering the above plan, budget required for procurement plan of
Maharashtra state is as given below:
Table - : Procurement Plan of Maharashtra state : 2011-12
Sr Particulars Unit cost
No. of
units
Rs. In Lakhs
Budget
required
A State Level Activities
Sr. Procurement Consultant (Medical
1
Postgraduate with at least 3 years experience in
Procurement and trained at reputed agency in
World Bank Procurement Procedure)
Procurement Consultant (Pharmacy postgraduate
5 1 5
2
with at least 3 years experience in procurement
and Trained at reputed agency in World Bank
Procurement procedure)
Salary of Procurement Officer (medicines (2),
3.6 1 3.6
1 Equipment (2) and Other goods (1) at state
procurement cell
3.4 5 17
2
Salary of procurement assistant /Pharmacist at
state procurement cell (6)
1.26 8 10.08
3 Quality Assurance Officer 2.6 1 2.6
5 Contingency to Procurement Cell 15 1 15
6
Travel and Daily allowances to State Procurement
Officers for pre-dispatch inspection and meetings
20 1 20
B Circle and District Level activities
1
Repairs and new construction of Circle
warehouses
12 8 96
2
Repairs and new construction of District
Warehouses
13 33 429
3 Pharmacist to DHO/CS and Circle warehouses 1.26 74 93.24
4 Contingency to circle and district warehouses 1.2 74 88.8
5 Procurement Verification Officer (Rs. 25000/PM) 3.4 1 3.4
Total 783.72
133

SECTION - B.19 : NEW INITIATIVES / STRATEGIC INTERVENTIONS / PROJECTS
SUBSECTION - B.19.1 : MEDICAL SERVICE BACKUP FOR PALKHI SESSIONS
(PUNE, SATARA AND SOLAPUR DISTRICTS)
Activity deleted as per decision
SUBSECTION - B.19.2 : BIOMETRIC ATTENDANCE FOR HEALTH STAFF
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2010-11 201.88 632.52 550.12 397.120
134
Rs. in Lakhs
Remarks
Presence of health staff is important to provide health services. Many times serious patients
get delayed treatment because concerned staff is not available. Therefore, it is essential to
monitor the arrival and leaving of health staff in hospitals/PHCs and concerned
establishments. Three districts in Maharashtra, Thane, Akola and Wardha have implemented
biometric attendance system on pilot basis. Attendance and timeliness of health staff in these
districts have improved significantly. Based on experience of these districts, it is proposed to
extent this scheme to all the PHCs, RHs and District Hospitals of the state.
Salient features of the scheme will be as follows:
• Biometric attendance is being installed in all the offices and health facilities except
THO office and PHCs this year. These places will be covered in 2011-12.
• The staff including senior officers will be required to put thumb impression on the
device at the time of arrival and at the time of leaving the hospital. The device will
keep record of arrival and departure.
• The biometric device will be connected online with central server at district level and
state level.
• District information will be available on line to CEO ZP, DHO and Civil Surgeon at
district level and Director of Health services and ACS (PH & FW) at state level.
• Special efforts with the help of experts will be made in PHCs where there is no
internet connection available for submitting information. These PHCs are not more
than 10% in state.
• Central server for HMIS will be sued for this purpose.
Compliance of remarks

• Biometric Attendance system is being used for basically two types of staff. One is office staff
having fixed duty hours from 9.45 AM to 5.30 PM and health facility staff having changing
duty system.
• Regarding office staff, the system has started showing results within one month. As this
system records impression of fingers, the person has to come to office in time. This is now
being linked to salary software from 1.4.2012. After that every absentee will be treated as
LWP unless certified by controlling officer.
• Regarding clinical staff like doctors, nurses and support staff who have changing duties, there
is some problem at operational level particularly in bigger hospitals. These problems are being
sorted out with the help of IT experts.
• Total data of the district is received at district, regional and state HQ. This data is reviewed.
Even senior officers are called by Hon. ACS (PH) for their explanation if they are consistently
late to office.
• Except at 2 places in the state, the machine was well accepted by staff. No mischief was done
bt staff to make the machine out of order.
• We expect that because of timekeeping by doctors and nurses, accessibility will be improved
which will finally improve quality of health care delivery. However, till today no systematic
study is done for this.
• For year 2012-13, the expansion will be in PHC where problem of regular attendance is much
more serious.
Considering above fact, it is proposed to approve this scheme.
Budget requirement
Budget will be required for following purposes
• Biometric device
• Staff for monitoring
Computers and internet facility is already available in PHC and all hospitals, therefore there is
no request for budget for these items.
Detailed budget requirement is as follows:
Table -: Budget required for biometric attendance in health institutions
Sr Activity Unit cost
No.of
units
135
Rs. In Lakhs
Budget
required
1 Biometric equipment in PHCs and THO offices 0.3 1246 373.8
2 One Computer Manager at DHS 3 1 3
3 Computer Assistants one in each circle and 4 at DHS 1.26 12 15.12
4 Contingency, internet stationary at circle HQ 0.5 8 4
6 Contingency at state HQ 1.2 1 1.2
Total 397.12

SUBSECTION - B.19.3 : PREVENTION OF SICKLE CELL DISEASE
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2010-11 1698.47 1914.33 1815.26 1815.250
136
Rs. in Lakhs
Remarks
Sickle Cell Disease (SCD) is a hereditary disorder mostly found in tribal communities,
scheduled castes & other backward communities. Prevalence is more in malaria prone areas.
Although it is observed throughout the state, some of the geographical areas have high
prevalence rate of carriers which is more than 8% and sufferers are found to be more than
0.5%. According to various studies, 19 districts in Maharashtra are found to be high prevalent
districts. These include Thane, Nashik, Nandurbar, Amaravati, Gondia, Gadchiroli, Nagpur,
Chandrapur, Wardha, Bhandara, Yavatmal, Dhule, Nanded, Jalgaon, Washim, Akola,
Aurangabad, Buldhana, Raigad & Hingoli is added as few patients are found there also.
The disease is hereditary & there is no cure for the disease. SCD is one of the major
reasons of recurrent episodes of infection, malnutrition and death in young children in high
prevalence areas. Identification of carriers & sufferers is necessary in all high-risk districts
giving emphasis on health education and marriage counseling. Therefore prevention &
control program for SCD is implemented in all tribal & high prevalent districts.
1. Objectives of the program
Objectives of Sickle Cell Disease Control Program are as follows:
• To create awareness in the community about the disease, diagnostic services,
management & other aspects of SCA.
• To identify carriers and counsel them for prevention of Sickle cell disease in next
generation.
• To improve the awareness of the government functionaries in these areas.
• To establish laboratory facility for screening the disease at PHC& laboratory facilities
for screening & conformation at RH, SDH & DH.
• To make available treatment at various levels from PHC to DH.
2. Progress during 2011 - 12
Progress of SCD Program in state during year 2011-12 is as follows:
• SCD Program is being implemented in 19 districts.
• Training of health staff and laboratory technicians is completed in 19 districts.

• Solubility testing started in all the PHCs included in project. 73 Electrophoresis test
centers are established in 19 districts.
• Distribution of cards based on status of individual started in all project districts.
• Marriage counseling started in all districts.
• MIS in place for all project districts.
• Procurement of solubility test kits for all project districts and electrophoresis machines
for new districts.
• NGOs selected and started working in 10 high prevalence districts under this project.
• ASHA and Health workers like ANM, HA, MPW are involved in 9 districts having low
prevalence of Sickle Cell Disease.
• Capacity of RH/SDH improved to treat complicated cases.
• 73 Electrophoresis testing centers are established.
• Quality Control in screening test (Solubility test) and Electrophoresis test is monitored
stringently.
• Day care centers are established in 13 District Hospitals and 2 Women Hospitals.
Year wise Physical Performance
Physical Progress
Year Total test performed Total Disease Total Carrier
2007-08 15310 - -
2008-09 68590 - -
2009-10 421246 1120 11275
2010-11 1181862 3191 24984
April 2011 to
January 2012
2559863 2813 31656
Total 4246871 7124 67915
137

Role of Government Medical Colleges
• 8 Medical Colleges are identified in the project areas.
• Each Medical Colleges is attached to two-three districts.
• Each district is attached to the nearest medical college.
• Medical colleges are helping in routine electrophoresis testing as well as
training of medical officers & Lab Technicians.
• Medical Colleges are also supporting for treating the complicated cases &
providing specialized treatment like Hip replacement, Neonatal screening,
Prenatal screening.
• Role of Medical Colleges will be expanded for quality control in Sickle Cell
testing.
• Medical Colleges will routinely examine 5% of negative & positive samples
quarterly.
• They will also inspect the Electrophoresis centers in their districts at least once
in a year.
3. Plan of action 2012-13
• Extinction of Sickle Cell Disease Control Program to a new districts i.e. Hingoli.
• More focus on Quality Control issues.
• Testing, card distribution and Marriage counseling of all boys and girls above
15 years age in rural areas of project districts.
• Liaison with Medical Colleges for training, research, treatment of complicated
cases & quality control of Sickle Cell tests.
• More emphasis on IEC with implementation of Sickle Cell Week in December.
• Strengthen the Day Care Centre.
• Establish well equipped Lab at District Hospital and Women Hospital.
• Arrange regular camps for Sufferer patients.
• ASHA sensitization work shop.
• NGO evaluation.
Health institutes involved in SCD Control Program during year 2012-13 are as follows:
Table - : Institutes involved in SCD Control Program
Sir Type of institutions Total in state
No. included in
SCD program
1 PHC 1809 947
2 RH/SDH 474 240
138

Sir Type of institutions Total in state
No. included in
SCD program
3 District Hospitals 23 14
4 Woman Hospital 10 4
5 Medical Colleges 16 8
Total 2332 1213
4. Budget requirement for year 2012-13
Budget will be required for following activities:
a. Peripheral health institutions
Patients will come to peripheral health institutions for laboratory investigations and
treatment. Medicines and equipment will be purchased at state level therefore not
mentioned for peripheral health institutions.
Table –: Budget required for peripheral health institutions
Rs. In Lakhs
Sir Particulars Unit cost
No. of
units
139
Budget
required
1
Laboratory consumables & Medicine to
PHCs 0.15 947 140.85
2
Lab Consumables & Medicine
Electrophoresis testing centre
to
0.15 75 11.25
3 Lab consumables & Medicine to RH/SDH 0.05 165 08.25
4 Contingency to PHC 0.10 947 94.70
5
Contingency to Electrophoresis testing
centre 0.10 75 07.50
6 Contingency to RH/SDH 0.10 165 16.50
7 Contingency to Block level 0.10 209 20.90
Total 299.95
NGO Districts.
Almost all people with Sickle Cell anemia have painful carises at some point in
their lives. Some have a crisis less than once a year. Others may have fifteen or more
crises in a year. Some of the complications of Sickle Cell Anemia are Splenic
(Sequestration) Crisis, and Infections like Pneumonia, Meningitis, influenza, and
hepatitis, Acute Chest Syndrome, Delayed Growth and Puberty in Children, Stroke, Eye
Problems, Gallstones, Pulmonary Arterial Hypertension (High Blood Pressure) and
Multiple Organ Failure.

Therefore the only alternative to control the diseases is frequent counseling
for regular treatment to prevent crisis and counseling for marriage to prevent
transmission of gene to next generation which is the prime role of NGO.
The Physical Performance of NGO districts.
Sr.
No.
District
Total
Solubility
Test
performed
Total IEC
Done
Total
Carrier
Total
Sufferer
1 Thane 463884 5563950 2848 235
2 Nashik 300465 1864278 1146 30
3 Nandurbar 601867 4447773 20993 1955
4 Gondia 287901 739504 2142 396
5 Gadchiroli 331238 382775 5958 1047
6 Nagpur 308477 104743 2507 285
7 Wardha 207749 842787 3081 250
8 Chandrapur 317254 879574 6838 1095
9 Bhandara 222567 2469205 4833 200
10 Yavatmal 402049 1003785 13969 767
11 Dhule 216292 118876 1384 606
Total 3659743 18417250 65699 6866
Considering high no. of Carrier and Sufferers in these districts it is very
important to follow up these Carriers and Sufferers for regular treatment (monthly
basis), frequent prenatal counseling, and early diagnosis and to adapt Healthy habits
to prevent crisis etc.
As the only way to prevent disease is only counseling Considering all above
factor the NGO's were appointed in these high prevalence’s, tribal and LEA districts
like Gadchiroli, Chandrapur, Gondia, Bhandara etc.
Role of NGO in Sickle Cell Program
To Create Awareness about Sickle Cell Disease in community.
To prepare IEC in local language and distribute.
Arrange meetings and testing camps in villages, Schools, Colleges and Ashram Schools
etc.
To motivate community for Solubility test.
To distribute color coded cards after testing. (Red-Sufferer, Yellow-Carrier, White-
Negative)
To register Sickle cell Sufferer and Carrier.
Home visits to Carriers for premarital counseling.
Home Visits to Sufferers for regular treatment.
140

To Counsel Sickle Cell Sufferer and Carrier (Sufferers to be counseled for regular
treatment on monthly basis Premarital Counseling of Carriers and relatives every 2
months.)
To Counsel Pregnant mother for early registration and prenatal diagnosis.
No. of NGO's appointed:-
(Thane, Nashik, Nandurbar, Gondia, Gadchiroli, Nagpur, Chandrapur, Bhandara, Wardha,
Yavatmal, Dhule district)
Sr.
No.
1
2
Sr. Districts No. of NGO's
appointed
1 Thane 1
2 Nashik 1
3 Nandurbar 1
4 Gondia 1
Remarks
5 Gadchiroli 2 As this is a total tribal high
focus and LEA district
6 Nagpur 1
7 Wardha 1
8 Bhandara 1
9 Chandrapur 1
10 Yavatmal 2 It is big, tribal district having
16 blocks.
11 Dhule 1
Total 13
NGO selections:
On an average one NGO is selected per district by District Health Society depending
upon the size of district.
NGO are appointed by giving advertisement in local newspaper.
JAT and TAC committees are formulated to scrutinizes to applications
Budget for NGO (Total budget for 13 NGOs)
NGO districts - Grant in AID to NGOs
NGO districts - Grant in AID to NGOs Place of work No. of
Unit
Salary of Project Manager (Rs.9000+1000
TA/DA) Rs. 10000*12 m)
Salary of DEO cum Accountant (Rs.6000*12
m)
District Head
quarter
District Head
quarter
141
Unit
Cost
Total
13 1.20 14.10
13 0.72 8.46

3
4
Salary and TA/DA of NGO Supervisor
(Rs.7000+1500 TA/DA)Rs.8500*12 m *Block)
Salary and TA/DA of Community Volunteer
(Rs. 4000 + 500 TA/DA) Rs.4500*12* m)
Block Head
quarter
PHC Head
quarter
109 1.02 104.38
518 0.54 260.37
7 MIS and TA/DA (Rs.10000) - 13 0.10 1.30
8 Overheads (Rs.3000*per PHC) - 518 0.03 15.54
9
IEC (Rs.5000*per PHC)(This budget is
calculated in District level budget)
NGO districts - Grant Total
Role and responsibility of human resource provided to NGO.
- 518 0.05 25.90
• Role of PHC volunteer (Salary and TA/DA of Community Volunteer Rs.4500/- pm)
1. Selected NGO has one community volunteer for each PHC.
2. They create awareness of disease in the PHC area.
3. These volunteers visits households and schools and motivate target population to get
tested for Sickle Cell Disease.
4. Tested persons are issued cards (White-normal, Yellow-Carrier and Red-Affected) by
NGO after counseling.
5. All Carriers and affected persons are registered at PHC, and counseled periodically for
marriage and treatment by NGO volunteers.
6. They give home visit to each Sufferer every month and Carriers every two months.
7. Frequent visit to pregnant mothers.
• Role of Taluka supervisor (Salary and TA/DA of Taluka Supervisor Rs.8500/- pm)
1. Taluka Supervisor appointed at block level. He monitor 5/6 PHC in his each block.
2. To monitor Electrophoresis centre in that Taluka.
3. To plan the testing camps at village, schools and sub center level along with PHC, MO.
4. He/She monitors availability of Cards, IEC materials, other consumables etc in all
PHC’s in the block.
5. He/She supervises the testing camps in the blocks.
6. He/She ensures that all positive blood samples are sent to electrophoresis centers.
7. He/She supervises white, yellow, red cards are distributed as per electrophoresis test
results.
8. He/She supervises for all Sufferer and Carrier are counseled for regular treatment and
pre marriage counseling.
9. He/She send Sickle Cell patients to speciality centers.
10. He/She monitors training of PHC volunteers.
• Role of Project Manager (Salary and TA/DA of Project Manager Rs. 10000/- pm)
1. Project Manager appointed at district level. He/She monitor to each district.
2. To monitor Electrophoresis centre, in district.
3. He/She Collect and compiled data and send it to State level.
142
404.15

4. He/She monitors availability of Cards, IEC materials, other consumables etc. in all
block’s He/She supervises the testing camps in the blocks.
5. He/She ensures that all positive blood samples are sent to electrophoresis centers.
6. He/She supervises white, yellow, red cards are distributed as per electrophoresis test
results.
7. He/She ensures that all Sufferer and Carrier are counseled for regular treatment and
pre marriage counseling.
8. He/She monitors training of all volunteers and block supervisors.
9. Coordinate with district administration for training, funding and reporting.
10. Attend monitoring meetings at PHC and State level.
• Role of Data entry operator cum Accountant (Salary of DEO cum Accountant
Rs.6000/- pm)
1. To maintain the book of accounts.
2. To maintain the vouchers, purchase bills.
3. To maintain records all PHC level volunteers and block level supervisors.
4. To compile data and prepare reports and submitted to district as well as State.
5. To prepare line list of Sufferers and Carriers.
b. NGO District level budget
Sickle cell disease control program will be monitored from district level. The NGO supervision
will also be done from district level. Budget required at district level include NGO charges, IEC,
District Cell budget and contingency.
Detailed budget requirement is shown in table below:
Table: District level budget requirement for NGO districts
Rs. In Lakhs
Sir Particulars
1
2
Unit
cost
No. of
units
143
Budget
required
NGO involvement (Institutes covered in
dist.) 0.8472 477 404.15
Salary & TA, DA of Lab Technician in
Electrophoresis testing centre 1.2 40 49.20
3 Salary & TA, DA of SCD Coordinator
Salary of Lab Tech. in DH/WH (Day Care
1.86 10 20.46
4 Centre)
Salary of Counselor in District Hospital
0.54 10 5.40
5 (Day Care Centre)
Lab Technicians for Peripheral institute
0.60 10 6.00
6 (PHC) 0.78 9 7.02
7 Contingency to District 1 11 11.00
8 Support to DH/WH (Lab consumables 1.50 10 15.00

Sir Particulars
9
10
&Contingency/renovation of day care
room )
Unit
cost
No. of
units
144
Budget
required
Procurement of test kits (Solubility &
Electro & Medicine) 2 11 22.00
Celebration of Sickle Cell Week in
PHC/RH/SDH/DH/WH 0.042 661 27.87
11 Health Camp for Sufferer 0.05 418 20.90
Consumables to HPLC machine
12 (Nandurbar, Wardha, Gadchiroli) 5 3 15.00
13 IEC (per PHC/RH/SDH/DH/WH) 0.05 477 33.05
Total 637.05
* Gadchiroli, Gondia and chandrapur districts are high prevalence for Sickle Cell Disease. They
are also high focus LEA tribal population majority districts. The Model in these districts may
change from NGO to additional support staff like one Taluka supervisor per two talukas and
one lab. Technician and one volunteer per 4 to 5 PHCs depending upon the district demand.
Non-NGO’s Districts
(District covered Amravati, Jalgaon, Nanded, Washim, Akola, Bhuldhana, Aurangabad, Raigad
and Hingoli)
As these are low prevalence districts it was decided to implement program through
existing health infrastructure by giving remuneration to them. Decision to implement Sickle
Cell Disease Control Program either through NGOs or ASHA and Health functionaries is taken
at State Health Society.
ASHA’s are trained for community mobilization and creating awareness regarding
Sickle Cell Disease. ANM/MPW is trained for basic Solubility testing and collecting samples for
Electrophoresis during camp. HA from PHC will help in transporting Solubility test kits,
sending samples for Electrophoresis and collecting reports of Electrophoresis testing. Record
will be kept by ASHA, ANM and HA at sub center and PHC respectively.
The Physical Performance of NGO districts.
Sr.
No.
District
Total Solubility
Test performed
1 Amravati 135318
Total IEC Done Total Carrier
399369
Total
Sufferer
1342 166
2 Jalgaon 147082 442427 239 16
3 Nanded 34806 124413 29 4
4 Washim 49556 42402 99 12
5 Akola 81962 22210 385 37

6 Buldana 42500 758697 105 16
7 Aurangabad 67243 75738 2 4
8 Raigad 28661 51770 15 3
9 Hingoli Proposed in 2012-13
Total 587128 1917026 2216 258
Role of Health functionaries in Non-NGO's districts:
• ASHA Compensation (Per test Rs. 5/-, Card distribution Rs. 20/-, Village
meeting Rs.50/-, Group meeting Rs. 40/-, Follow up of patients Rs. 15/-)
ASHA is trained for Sickle Cell Disease and is utilized for community
mobilization for testing and creating awareness.
ASHA is trained for distribution of Colour coded cards and counselling for
marriage and regular treatment.
ASHA gives home visits to Carriers and Sufferer for pre-marital counselling and
follow up for regular treatment in order to prevent crisis.
They arrange meeting with Self Health Group, adolescent’s age group
minimum 6 meeting in a year and Gram sabha 4 in a year for giving
information to community.
Visit Sickle Cell pregnant mother for early registration and prenatal diagnosis
counselling.
ASHA ensures that the total population in her jurisdiction will get information
on Sickle Cell.
• ANM Remuneration (Per test Rs. 4/-, blood samples collection and Counseling
Rs. 40/-,
On Arogya Seva Satra day ANM will perform testing on patients mobilized by
ASHA (minimum 25 patients per satra) after Quality Control of test kits.
ANM will keep record of all tested for Solubility test and those who are found
positive
ANM will be help ASHA in distributing white cards.
ANM will collect blood samples of all positive Solubility samples and 3%
Negative samples.
ANM will keep record of tests performed during satra and samples sent for
Electrophoresis.
She will keep follow up of samples sent to Electrophoresis centre.
She will counsel the Sufferer and Carrier and distributes cards.
She will visit Sufferer and Carrier in her sub centre area.
• Health Assistant. (Transport of sample to PHC Rs.50/-, Transporting sample to
Electrophoresis center Rs. 200/-, Monitoring at PHC level Rs. 100/- pm)
HA will transport Solubility kits, Consumables and EDTA bulbs required for
Sickle Cell testing from PHC to Arogya Seva Satra.
HA will bring back samples of positive Solubility test and 3% Negative samples
for Electrophoresis to PHC.
145

Sr.
No.
1
2
3
4
5
He will transport positive Solubility test samples from PHC to Electrophoresis
testing centers and bring back the report of Electrophoresis.
He will keep record of all Electrophoresis samples, Carriers and Sufferers.
He will be responsible for reporting to THO.
He will help the Medical Officers from PHC to examine each Sufferer once in a
month and Carrier in marriage age group once in 6 months.
The block Sickle Cell assistant will supervise all these activities and will be
responsible for collecting data from PHC and submitting to Sickle Cell
Coordinator. He should remain present for each Arogya Seva Satra.
Health workers districts budget
Non NGO districts
ASHA Remuneration
Non NGO districts
Test compensation to ASHA
(Rs.5/test)(Rs. 300*per ASHA)
Monthly meetings with adolescents
(Rs.240*per ASHA) (6 meeting in year)
Gram Sabha
Rs.50 for 4 sessions(Rs200*per ASHA)
Card distribution
(Rs.20*per ASHA)
Follow up visits
(Rs.15*per ASHA*3 m)
Remuneration to ANM/HA
No.
of
Unit
Unit
Cost
146
Total
ASHA 14263 0.00300 42.79
ASHA 14263 0.00240 34.23
ASHA 14263 0.00200 28.53
ASHA 14263 0.00020 2.85
ASHA 14263 0.00045 6.42
6 Testing for ANM Rs.4/test(Rs.240*ASHA) ASHA 14263 0.00240 34.23
7
Councelling and collection of sample (ANM)
(Rs.40*ASHA)
ASHA 14263 0.00040 5.71
8
9
10
Transport of sample to PHC (HA)
(Rs.100*ASHA)
Transporting sample to Electrophoresis center
(per PHC*2000)
Incentive to HA/LHV for monitoring
(per PHC*1200)
Non-NGO districts - Grant Total
ASHA 14263 0.00100 14.26
PHC 429 0.02000 08.58
PHC 429 0.01200 5.00
182.60

Sir Particulars
Table - Non-NGO District level budget
Unit
cost
No. of
units
Rs. In Lakhs
Budget required
1 Involvement of ASHA district 0.41534 470 182.60
2
Salary & TA, DA of Lab Technician in
Electrophoresis testing centre 1.2 35 39.48
3 Salary & TA, DA of SCD Coordinator 1.86 9 15.75
4 Salary of Taluka Sickle Cell Assistant 0.90 105 99.03
6
Salary of Lab Tech. in DH/ WH (Day Care
Centre) 0.54 8 4.32
7
Salary of Counselor in District Hospital
(Day Care Centre) 0.60 8 4.80
8 Contingency to District 1 9 8.50
Support to DH/WH (Lab consumables &
Contingency/renovation of day care
9 room )
Procurement of test kits (Solubility &
1.50 8 11.00
11 Electro & Medicine)
Celebration of Sickle Cell Week in
2 9 17.00
12 PHC/RH/SDH/DH/WH 0.042 544 22.91
13 Health Camp for Sufferer 0.05 22 1.10
14 ASHA Sensitization (1 camp in year) 0.001 14263 14.26
15 IEC (per PHC/RH/SDH/DH/WH) 0.05 544 27.20
c .State level
Total 447.95
SCD program implementation will be controlled from state level. Important activity to be
done from state level is provision of Solubility & Electrophoresis test kits & Electrophoresis
Machine to districts. Trainings will be carried out by regional training centers. Budget for
training will be covered in training budget. Budget required for remaining activities at state
level is as follows:
Table: - Budget required at state level
Sir Particulars Unit cost
No. of
units
Rs. In Lakhs
Budget required
1
Equipment (Electro., Centrifuge, HPLC
machine), consumables 35 2 70.00
2 IEC & Evaluation of NGO state level - - 119.30
147

Sir Particulars Unit cost
No. of
units
Budget required
3
Solubility test kit, Electrophoresis test kits
& Consumables 0.08 1250 100.00
4 Salary of Quality Control Officer 5.40 1 5.40
5 Salary of Program Officer 3.445 2 6.89
6 Salary of Program Assistant 1.36 2 2.71
7 Contingency at state level 2 1 2.00
9 State level Sickle Cell Week 0.01415 1414 20.00
10
Training for L.T., ANM, MPW, LHV, S.N &
ASHA etc. in districts. 2 20 40.00
11 Support to GMC 8 8 64.00
Total 430.30
a. Summary of SCDCP requirement
Total requirement of SCD Control Program is mentioned in table below:
Table- : Summary of Budget Requirement – SCD Program
Rs. In Lakhs
Sir Level Budget required
1 Peripheral Health Institutions 299.95
2 District level budget for NGO district 637.05
3 District level budget for Non-NGO district 447.95
4 State level budget requirement 430.30
Total 1815.25
SUBSECTION - B.19.4 : TELEMEDICINE PROJECT
Year of
starting the
scheme/
initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2011-12
Budget
proposed for
PIP 2012-13
Budget
proposed
to NPCC
2007-08 340.02 328.72 328.720
Remarks
148
Rs. in Lakhs
Installation of Telemedicine
equipment in DH/SDH,
Specialist facilities and no.
of patients increased with
Multivideo Conferencing
Equipment.

Telemedicine is a rapidly developing application of clinical medicine where medical
information is transferred via telephone, Internet or other networks for the purpose of
consulting, and sometimes remote medical procedures or examinations. Telemedicine may
be as simple as two health professionals discussing a case over the telephone, or as complex
as using satellite technology,Internet with Static IP and video-conferencing equipment to
conduct a real-time consultation between medical specialists in two different places.
Telemedicine Centers in Maharashtra
In Maharashtra, all the 23 District Hospitals, 4 Sub-District Hospitals are connected with
telemedicine network since 2009-10. During 2010-11, telemedicine facility is extended to 30
SDH/RH (one per district except Mumbai). These facilities are called patient node. Thus,
currently there are 27 + 30 = 57 patient nodes in the state. These nodes seek expert services
from 6 specialty nodes, out of which 3 are situated in Mumbai, and one each at Pune,
Aurangabad and Nagpur.
Plan of action for year 2012-13
During year 2012-13, new tele-opthalmaolgy telemedicine center will be opened. Existing
centers will be strengthened and their utilization will be improved. Following actions are
proposed during 2012-13.
• Further strengthening the existing Specialist and District patients nodes(Includes Multi
Video Conferencing System)
• Increasing the utilization of centers with the help of private practitioners.
• Adding digital telemedicine equipment to existing centers to improve their quality of
work
• Strengthening the SDH nodes and making them functional.
• Strengthening the management system of telemedicine project.
• Increasing CME’s for Medical and Paramedical staff.
• Innovative activity like including pilot project of teleopthalmology.
Budget requirement for 2012-13
Budget is required for following purposes:
Table – Budget required for Telemedicine Centers
(Rs. in lakhs)
Sir No. Particulars
Unit
Cost
No. of
units
Budget
required
1
Salary & TA/DA of Telemedicine
Consultant
4.13 1 4.13
2 Salary & TA/DA of Project Coordinator 3.00 1 3.00
3 Salary & TA/DA of Program Assistant 1.37 1 1.37
4
Salary & TA/DA of Facility Manager for
Old Districts & Specialist Centre
1.92 33 63.36
149

Sir No. Particulars
5
Salary & TA/DA of Facility Manager for
Sub- Districts
Unit
Cost
No. of
units
Budget
required
1.92 30 57.60
6 Accountant for Specialist Centre 1.152 1 1.15
7 Honorarium to Doctors – Specialist node 0.003 14000 42.00
8 Honorarium to Doctors – Patient node 0.001 14000 14.00
9 AMC of Telemedicine equipment 0.20 33 6.60
Contingency to Specialist & Patient nodes
10 ( including Civil works & other
maintenance)
0.10 63 6.30
11 Contingency to State Level
Procurement of additional equipment to
Specialist & patient nodes of
2.50 1 2.50
12 telemedicine centers (Equipments,
Multivideo camera, pilot project teleopthalmalogy)
21.67 3 65.01
13 Training to Patient node/Specialist node 5.00 1 5.00
14 Connectivity expenses 0.90 63 56.70
15 Total 328.72
150

B.20 : HEALTH INSURANCE SCHEMES
(No proposal submitted for year 2012-13)
151

B.21 : RESEARCH, STUDIES AND ANALYSIS
Two operational research topics of operational research importance are submitted for
approval. National Rural Health Mission, Directorate of Health Services and Senior Faculty of
Medical Colleges are involved in these research projects. Detailed description of the projects
is as follows :
The research studies submitted in this chapter are proposed by the teams in which retired
Vice Chansler of Maharashtra University of Health Sciences, retired Professors and Deans and
also Directors of Research Institutes are included. Remarks on these researches were shown
to the team. The team has opined that, these studies are Maharashtra specific and they will
definitely benefit for identifying high risk infants and their management. Considering this, it is
proposed to sanction these studies.
SUBSECTION - B.21.1 : PACKAGE OF NEONATAL CARE BY ASHA (PNC BY ASHA)
Year of starting
the
scheme/initiative
Introduction:-
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
New 0 0 20.890 12.898
152
Rs. in Lakhs
Remarks
Nearly 27 million babies are born in India every year and 1 million of them die before
they complete four weeks of life. The neonatal mortality in India is 44/1000 LB. It is higher in
rural areas as compared to urban area (49 rural Vs 27urban/1000 live births 1 ) NFHS II Survey
has shown that Maharashtra has a neonatal mortality rate 37/1000 live births with urban &
rural distribution of NMR as 41 and 31 respectively for 1000 live births 2 .
Infant mortality is decreasing but there is no significant reduction in neonatal
mortality. 45% of the neonatal deaths occur by 48 hours of birth 3 , the causes being birth
asphyxia, trauma, problems related to prematurity and LBW and congenital malformations.
For prevention of mortality within first 48 hours, good ANC care and quality obstetrical
services are essential. Early registration of pregnancies and provision of antenatal services
through existing health care services is emphasized under RCH II. JSY is being implemented
for encouraging women to accept institutional deliveries. At present it is estimated that 90%
of the deliveries in Maharashtra are hospital/health center deliveries. NSSK is being
implemented all over Maharashtra to improve and render standardized newborn care
immediately after birth. UNICEF has been providing support and expertise for training of

irth attendants at all levels. All these initiatives are expected to reduce the mortality of the
newborn within 48 hours of birth.
Under RCH II program and IMNCI strategy, the health workers are expected to pay
visits to Low Birth Weight (LBW) babies and Normal Birth Weight (NBW) babies at least 6 and
3 visits respectively. But in practice these visits are not feasible for ‘Health Worker Female’
(ANM) due to heavy work load. One ASHA worker is identified for 1000 population i.e. 200 to
250 houses. Considering their level of education, ability to learn new skills, availability and
acceptability these women activists can be entrusted with the neonatal care after 48 hours
which is crucial for neonatal survival but not satisfactory in the existing rural health care
practice.
The causes of neonatal mortality after 48 hours are neonatal infections, feeding
problems, hypothermia, hypoglycemia etc. in a preterm and LBW baby these problems are
more common. ASHAs can identify a baby who is doing well and a baby who is not doing well
(At Risk) with specific training such as signs and symptoms of infection, Kangaroo Mother
Care for LBWs, correct technique of breast feeding, identification of inadequacy of breast
feeds, helping &counseling mothers to acquire breast feeding skills.
Growth monitoring is an objective parameter for knowing baby’s wellbeing. The
pediatricians can find out expected weight of the baby on given day during neonatal period
from the knowledge of birth weight and the mathematical formula based on birth weight of
the baby. All babies initially lose weight, become equal to birth weight and then start gaining
weight. Although these phases are dependent on genetic and environmental factors to some
extent, birth weight is the most important determinant provided adequate feeding is
ensured.
Existing growth monitoring charts are based on monthly growth monitoring. Under
IMNCI weekly charts are available for identifying babies with low and very low weight for
age 5 .
Weekly Chart under IMNCI
153

These charts cannot be used for daily growth monitoring of the baby. Daily growth
monitoring charts for neonatal period were prepared by past graduate students of preventive
and social medicine of Pune University 6, 7 . Based on these growth curves and existing
mathematical formula with used by paediatricians 8,9,10 , we have developed a colour coded,
birth weight specific daily growth monitoring charts. Use of these charts do not require any
complicated formulate for calculating expected weight of the baby provided the birth weight
of the baby is known. Retrospective prediction of birth weight is possible with 80% accuracy
by birth weight specific growth velocity curves during early neonatal period 11 . Since 90% of
births will be available for these hospital born babies for remaining 10% babies born at home
retrospective prediction of birth weight can be undertaken by ASHAs after training. Under
field conditions, the visits although specified on specific day after birth, can actually take
place on different day hence daily growth monitoring charts are useful.
Four patterns of growth monitoring charts are developed, use of which can be taught
to ASHAs for neonatal growth monitoring. Considering a Birth Rate of 15/1000 population,
one ASHA will have 15 births in 1000 population covered by her. There will be 5 LBWs & 10
NBWS. She will required to pay 5 visits to LBW on day 3,7,14, 21 and 28 and 3 visits to NBW
on day 3,7 and 28 as per IMNCI guide lines 12 . Thus in one year the ASHAs will be required to
undertake 25 visits for LBWs and 30 visits for NBWS totaling to 55 visits i.e. about once a
week visit.
Foot Length is related to Birth Weight. Colour Coded Foot Caliper can be used to
access ‘At Risk’ baby comparison of readings by Foot Length Caliper and birth weight will be
undertaken. Foot length can be taken on 3 rd day also as it remains unaffected till 7 th day.
If identification of babies ‘At Risk’ can be done, domiciliary care is provided in relation
to feeding of the baby and referral of ‘At Risk’ baby and monitoring of growth is done on
colour coded birth weight specific growth monitoring charts, we would achieve more gain in
weight of the baby, prevent future SAM & MAM and reduce the mortality in neonates after
48 hours for which at present no specific measures are being available.
With these objectives in mind a research is planned for provision of package of services for
neonates after 48 hours with the help of ASHAs
154

Goal – To improve survival and growth of neonates after 48 hours of birth.
Specific Objectives –
1) To train ASHAs in identification of ‘At Risk’ neonate.
2) To train ASHAs in accurately weighing the baby on electronic weighing machines.
3) To train ASHAs in using colour coded birth weight specific daily growth monitoring charts.
4) To train ASHAs in using Colour Coded Foot Length Caliper
5) To train ASHAs in providing domiciliary care to babies ‘At Risk’ and counsel the mothers.
6) To train ASHAs in timely referral of ‘At Risk’ babies.
Research Methodology –
The study will be under taken by Krishna Institute of Medical Sciences, Deemed University,
(KIMSDU) Karad. (KIMSDU is situated in Satara District) The study will be conducted in two
adjacent districts of Western Maharashtra namely Satara and Kolhapur.
The duration of study will be 18 months as follows –
1) Preparatory phase – 3 months. During the three months procurement of equipment,
developing and printing of formats, preparation of training material and training of ASHAs,
their supervisors and concerned PHC Staff will be undertaken. Strategy will be developed for
collection compilation and Analysis of the data.
2) Implementation phase – 12 months Data Collection, Supervision and monitoring will be
done.
5% of babies included in the study will be cross checked by home visits and all entries in the
proforma including weight of the baby will be verified.
3) Analysis, Interpretation and report writing – 3 months.
Study Design – Community Based Interventional Study.
Study Area – Inclusion Criteria
1) PHC situated in rural area with approachable roads.
2) All ASHAs are identified and functioning.
3) All posts of PHCs are filled in.
Exclusion Criteria
1) PHC in close vicinity of cities and periurban areas.
Two randomly selected eligible PHCs from each District.
Control Area – Matching PHCs from same Taluka for each selected PHCs for study.
Matching will be done for following characteristics
i) Socio cultural background.
ii) Availability and accessibility to secondary and tertiary health care facilities.
iii) Estimated proportion of LBW.
Sample Size Calculation – It is assumed that babies receiving package of domiciliary neonatal
care will weight on an average 50gm more than babies from control area.
n = 2 (Zα/2 + Z1-β) x SD 2
d
155

= 2 (1.96+ 1.28) x 290 2
50
= 706.28 = 707
Therefore at least 707 babies in control and 707 babies in study group together from both the
Districts.
Package of Services to be provided to study population.
Over and above the routine care given to Mothers & babies under RCH II program and IMNCI
strategy under NRHM following package of services will be rendered.
I) Identification of ‘At Risk Baby’ criteria of ‘At Risk Baby’.
1) Any baby with birth weight

2) Colour Coded Foot Length Caliper (Annexure 2)
Package of Services to be provided to Control population.
The routine care will be given to Mothers & babies under RCH II program and IMNCI strategy
under NRHM.
Assumption
300 Electronic weighing machines were supplied by State Health Systems Resource Centre
(SHSRC) Pune from the grants received under NRHM to Pune, Satara and Kolhapur districts
for the Project conducted by Krishna Institute of Medical Sciences Deemed University,
entitled “Field Testing of Appropriate Technology Tools for monitoring of slow progress of
labour and growth of LBW Babies below 2500gm at PHC/RH Level”
These weighing machine will be made available for this proposed project to Krishna Institute
of Medical Sciences Deemed University which will be given to ASHA workers and field
monitoring staff. The machines will be standardized and if found inaccurate will be replaced
and repaired. Hence all the machines are requested to be made available.
Gantt Chart showing Activities under Project
Sir
No
Activities 1 2 3 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3
1 Procurement of
equipment
2 Developing and
printing of formats
3 Preparation of
training material
and training of
ASHAs
4 Undertaken by
supervisors and
concerned PHC
staffs
5 Development of
strategy for
collection,
compilation and
analysis of the
data
6 Data collection of
12 months
7 Supervision and
monitoring
157

8 Cross check of 5%
babies
9 Analysis and
interpretation
10 Report writing
Budget requirement
Budget requirement for the project is as follows:
BUDGET FOR PROJECT- PACKAGE OF NEONATAL CARE BY ASHAs
Project Work
500 AWWs in study area
100 AWWs in control area
Project Work
Study Area
1 lac population-100 ASHAs
1500 Births - BR 15/1000 population
LBW 500 births x 5 visits x Rs.25 = Rs. 62,500 (5 visits to LBW)
NBW 1000 births x 3 visits x Rs.25 = Rs.75,000 (3 visits to NBW)
Control Area
1 lac population-100 ASHAs
1500 Birthsx2=3000
LBW 500 births x 2 visits x Rs.25 = Rs.25,000
NBW 1000 births x 2 visits x Rs.25 = Rs.5,0000
5% check total weighing episode (Sample checking)
Study-275/5500
Control- 150/3000
Total weighing episode 425 x Rs.25=Rs.10,625
Training
KIMS Team
3 trainees x 3 days x 2 dist x DA 500= Rs.9,000
Local trainer
DLO x DA 300 x 12 visits x 2 Dist =Rs.7,200
Block/PHC Supervisors
Sup 4 x Rs.150x 12visits x2 Dist=Rs.14,400
TADA at trainers ASHAs/ Supervisors
ASHAs /Sup 210x Rs.150x3days=Rs.94,500
Working Lunch and snacks for participants
210 x Rs.100x 3 days= Rs.63,000
Training materials for trainees
210 x Rs.100 = Rs.21,000
POL for training 200km x Rs.10x 3 daysx2 Dist =Rs.12,000
158

Field monitoring supervision & guidance
POL considering 10 visits per month by SRO
Average 150 km per visit travel distance
150km x 10 visits x 12 months x 2 SRO x 10 per km charges= Rs.36,0000
DA to SRO
10 visits x 15 months xRs.1000x 2 dist = Rs.3,00,000
PHC level ASHA supervisor forms checking
Birth in study area 1500
Birth in control area 1500
Total births 3000 x Rs. 10 = Rs.30,000
Material & Logistic supply
1. Stationary files, proforma printing including weighing charts
1500 x Rs. 25 = Rs. 37,500 for study area
1500 x Rs. 10 =Rs. 15,000 for control area
2. Foot length calipers
225 x Rs. 100 = Rs.22,500
3. Measuring scale, rubber, pencil, sharpener,etc
210 x Rs. 15 = Rs.3,150
4. Project kit bag for ASHAs/Sup/DLS/DLO
225 x Rs. 100 = Rs. 22,500
5. Contingency: Telephone, postage, courier, Xerox ,office stationary-
Rs.15,000
6. Statistical analysis - Rs.30,000
7. Report Writing - Rs.10,000
TOTAL BUDGET= Rs. 12,89,875
SUBSECTION - B.21.2 : MULTICENTRIC BIRTH COHORT TO STUDY THE ANTHROPOMETRIC
MEASUREMENTS OF CHILDREN IN MAHARASHTRA AND THEIR SOCIOEDMOGRAPHIC
CORRELATES
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
New 0 0 39 39.000
Principal investigator : Dr.Uday Bodhankar 1 , Dr Abhay Chowdhary 2
159
Rs. in Lakhs
Remarks

Co- principal investigators : Dr. Satish Pawar 3 , Dr. Archana Patil 4 , Dr Pramila Menon 5 , Dr
Leena Dhande 6
Other investigators : Dr. Shanshank Dalvi 7 , Dr. Jayant Shah 8 , Dr. Yashwant Patil 9 , Dr.M.S.
Rawat 10
Dr. Nita Hatkar 11 , Dr. Sandeep Bavdekar 12 , Dr. Ashok Rathod 13
Advisors : Rajalakshmi Nair 14 , Dr Mrudula Phadke 15
A joint collaborative project from Directorate of Health Services, National Rural Health
Mission, Medical Colleges & Maharashtra University of Health Sciences
1, 5, 7 - Maharashtra University of Health Sciences, Nashik, 2 – Haffkine Research Institute,
Mumbai , 3 – National Rural Health Mission, 4 – Directorate of Health Services, 6,10,11,12,13
– Government and Corporation Medical Colleges Maharashtra, , 8, 9 – Pediatricians, BPNI,
Pvt. Medical Colleges, 14, 15 - Special Invitee and Experts.
Introduction :
WHO has conducted a multicentric multicounty study in which the anthropometric
measurements of children reared in optimal conditions (non-smoking mothers, exclusive
breast feeding…. ) in various countries like Ghana Oman, USA., India, Brazil, Norway have
been pooled together to formulate new growth charts and then the z-scores with percentiles
to classify malnutrition. As per these scores, 6.4%of Indian children get classified as having
severe acute malnutrition (SAM ).
Growth potential of children in developed and developing countries is likely to be different
though the WHO new growth charts show that infants under optimum conditions grow
similarly irrespective of country of origin or ethnic background. This difference in growth
potential may be due to various factors like genetic potential, diet, family sizes and
intrauterine influence. The question that arises is, is it appropriate to have the same growth
standards for different countries? This question can be answered only when we have
anthropometric measurements recorded for full term normal infants in the country under
consideration and compare these with the corresponding measurements in those from
developed nations. To begin with we are forming a birth cohort in Maharashtra, India and we
propose to study their anthropometric measurements with a plan to do similar studies in
various States of India.
In addition to this ,it has been observed that two important anthropometric measurements
i.e. wt for age and wt for ht. which have been operationally used in the field by ANM/AWW
and Medical Officers respectively often create difficulty in accurate diagnosis of SAM. This is
because ANM & AWW undertake wt. for age measurement. When the baby is referred on
the basis of above as SAM or MAM, the situation with the Medical Officer who uses wt. for
ht. as the criterion becomes ambiguous. Some babies classified as SAM may not be so while
160

using wt. for ht. and vice-versa. Therefore, we also feel the need to validate these two
indicators vis-à-vis the third one i.e. the midupper arm circumference (MUAC).
Aims and Objectives :
Primary -
1)To obtain anthropometric data from infants and children from Maharashtra.
2) To evaluate the utility and diagnostic efficacy of wt for age, wt for ht and MUAC in infants
and children to detect SAM
Secondary -
3) To assess renal, immunological, biochemical and hepatic functions in babies detected to
have malnutrition and correlate anthropometrically.
Review of literature :
Studies have been done in other developing and developed countries on anthropometry of
children aged 0-5 years, WHO study, NFHS data, studies looking at factors influencing growth
potential of children in different countries. What happens to growth of Indian kids reared in
India initially and later in developed countries. Is the growth of children born to Indian
parents in developing countries comparable to their native counterparts? Some studies done
in India by Dr. Khadilkar show a different picture compared to WHO new growth charts.
Methods :
This is a multicentric study that will be conducted in Government Medical College hospitals
and private nursing homes, primary health centers, rural, sub-district hospitals in various
cities and towns of Maharashtra so as to cover families from varied socio-economic
backgrounds. We shall recruit 10000 women from different wealth quintiles. We will form a
birth cohort recruiting babies after due informed consent of the mothers taken in last
trimester of pregnancy. Along with this longitudinal study a cross sectional study will be
undertaken to study anthropometry of infants of various months as they attend the
immunization clinics of the hospitals. Longitudinal study would be on 1000 infants and 9000
infants from birth to 3 years of age will be studied cross sectionally.
Duration of study :
Data collection - 6 months for cross sectional study. 2 years for longitudinal study. Data
analysis- 3 months, paper writing- 6 months, dissemination- 6 months
Post funding Timeline
Activity 3mths 6 9 12 18 24 36
Meeting of all investigators and CRF development + + +
161

workshop
Recruitment of ROs and ANMs +
Training of Ros and ANMs +
Procurement of equipment +
Piloting of CRF +
Data collection- enrollment, follow-up + +
Data analysis + +
Paper writing +
Dissemination of data +
Sample size- per center and total. For each center, 1000 women from different wealth
quintiles.
Inclusion criteria will be as follows-
1. Mother willing to deliver and follow up at study site for 3 years
2. Mother not indulging in active smoking
3. Mother willing to comply with IYCF principles i.e. initiate breast feeding within ½ hour
of birth in normal and within 4 hrs of birth for caesarean section, breast feed
exclusively for 6 months, introduce complementary foods at 6 months and continue
breast feeding till 2 years.
4. Mother willing not to formula feed the baby or bottle feed the baby
5. However mothers who adapted different feeding practices will be included and put in
a separate category while analysing.
Exclusion criteria will be as follows :
1. Babies born preterm.
2. Babies with Genetic Syndromes congenital malformations.
3. Babies with overt cardiac, respiratory, renal, neurological, gastrointestinal l,
endocrinolocal or any other disease.
The babies will be subjected to anthropometric measurements at birth, at 6,10,14 weeks,
9 months, 12 months, 15-18 months, 24 months, 36 months. Those written in italics are
home visits rest are immunization visits. In case a patient does not come for scheduled
immunization visit, she will be given a reminder for the same. The following
measurements will be recorded - weight, length till 2 years followed by height, MUAC,
upper arm length, fore arm length, OFC, U/L segment ratio, triceps and infraspinatus skin
fold thickness and chest circumference. In case a baby is found to be in the SAM or MAM
category, immediate treatment will be given at nearby VCDC, CTC, Medical College OPD,
indoor – Hospital. Blood will be collected for renal hepatic immunological (IgG, IgA, IgM
interleukins etc.) and biochemical tests.
Demographic data of family will be entered in Case report form. We will follow WHO
definitions for exclusive breast feeding, TICF, TIBF, bottle feeding etc.
162

Team- Pediatricians, anthropologists, trained research officers, social workers, ANMs,
statistician, data entry operators
Financial Implications –
Non- recurring -
Weighing balance, tapes (MUAC) caliper identical at all centers. Rs.15,000/- per center.
Rs.1,50,000/- at 10 centers.
Recurring –
Travel Rs. 20,000/- per center every year.
Rs. 2,00,000/- for 10 centers for 1 year.
Stationery Rs.1,00,000/- for all the centers
Staff- Research Assistant- (MBBS or MD) nurse or ancillary helper Rs. 20,000/- per month
Rs.24,00,000/- per year.
Cost for investigations (Chemicals, Lab kits) Rs.10,00,000/-
Contingency Rs.50,000/-
Total Expenditure -
Rs.39,00,000/-
163

Year of starting
the
scheme/initiative
B.22 : ESTABLISHMENT AND FUNCTIONING OF SHSRC
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
164
Rs. in Lakhs
Remarks
2008-09 100 100 100 100.000 No change
NRHM is conceived as a decentralized district planning led sector program. Such programs
require resource teams at sub district, district, state and national level, that are fully
conversant with principles of decentralized planning and assessment of people’s needs. As a
consequence, State Health Society needs technical and management support from
established professionals in the field. This is required to drive change and reform in planning,
implementation and monitoring of health sector programs in general and family welfare
programs in particular.
The State Health Resource Centre (SHRC) is conceived primarily as an agency/institution that
is responsive to and available for providing technical assistance to Centre/States and districts
for building their capacity in improving service delivery in the health sector.
1. SHRC Units:
The SHRC will have the following units:
1. Public Health Unit, covering Public health activities for improvement in health care
delivery
2. Social Development Unit, covering civil society partnerships, gender empowerment,
community mobilizations sub units.
3. Financial Management Unit including procurement specialists, fiduciary reform
specialists, health insurance specialists.
4. Human resource management unit including training specialists in several areas.
5. Planning, Research and Documentation Unit, including MIS and e-governance
6. IEC, Social Marketing and Public Private Partnership Unit.
It is proposed to appoint 6 Senior Consultants as head of each unit and one additional senior
consultant as public health expert.
1.1. Support Unit

Support staff of the SHRC will be headed by Resident Assistant Director or Resident
Consultant. This person will look after day to day functioning of the SHRC. He/she will keep all
the facilities of SHRC in working condition and arrange for all the administrative activities
required for smooth functioning of the SHRC.
2. Budget requirement 2012-13
Budget Requirement for SHRC will be on following heads:
3. Salary and daily allowances
Budget required for salary and daily allowances is as follows:
Table – : Budget requirement for salary and daily allowances
165
Rs. In Lakhs
Sir Particulars Unit cost No. of Units Total cost
1 Salary of Executive Director 9 1 9
2 Salary of Sr. Consultants 6 4 24
3 Remuneration
consultant
to Short term 6 1 6
4 Salary of Asst. Director/R. Consultant 4.8 1 4.8
5 Administrative Officer 2.4 1 2.4
7 Librarian 1.2 1 1.2
8 Statistician 1.2 1 1.2
9 Data Entry Operator 1.2 2 2.4
10 Steno 1.8 1 1.8
13 Travel cost for officers and staff 12 1 12
Total 64.8
4. Total budget requirement
Total budget required for establishment and starting of functioning of SHSRC is mentioned in
table below:
Table – : Budget requirement for SHSRC : 2012-13
Sir Particulars Unit cost No. of units
Rs. In Lakhs
Budget
requirement
1 Computer and other office equipment 0.5 4 2
2 Salary of Staff 64.8 1 64.8
3 Cleaning, sweeping, security 3.6 1 3.6
4 Evaluation studies and reports 5 4 20
5 Other expenses including renovations and
repairs
9.6 1 9.6
Total 100

SECTION – B.23 : SUPPORT SERVICES
SUBSECTION : B.23.1 : SUPPORT STRENGTHENING NPCB
National Program for Control of Blindness is included in Component – D of the PIP. However,
activities which are very important for the program and not permissible as per NPCB
guidelines are included in this chapter. Following activities are proposed for year 2012-13
ACTIVITY : B.23.1.1 : OPERATIONALIZATION OF SUPERSPECIALITY HOSPITAL FOR CHILD EYE
CARE
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2011-12 120 29.88 29.880
166
Rs. in Lakhs
Remarks
GoI has approved Rs. 120.0 Lakh for Strengthening of Superspeciality Hospitals on the lines of
Shankara Netralaya Chenni for the treatment of Neonatal, Infant and Child Eye Diseases.
Accordingly, Superspeciality Hospital Amravati, Government Medical College Aurangabd and
BJ Medical College Pune are selected for this purpose and equipment required for this
purposes also being provided to these institutions.
This facility being provided is being utilized for children with eye diseases identified by
Medical Officers during Anganwadi visit and School Health Examination Program. Out of the
three institutions above, two are functioning Medical Colleges. Trainee doctors for Child Eye
Diseases are available at Aurangabad and Pune but not available at Amravati. Therefore, it is
proposed to provide trained doctors and staff through NRHM for this purpose.
Trained doctors and budget required for this activity is as follows:
Table – : Budget requirement for operationalization of Superspeciality hospital Amravati
Rs. In Lakhs
Sir Activity Unit cost
No. of
units
Budget
required
1 Per operation charges to Specialist 0.05 300 15
2 Support staff for operations (2 persons) 1.44 2 2.88
3 Consumables required per operation 0.03 300 9

3 Contingency 3 1 3
Total 29.88
ACTIVITY : B.23.1.2 : PROVISION OF HIRED VEHICLES TO OPHTHALMIC SURGEONS FOR
CATARACT OPERATIONS
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
New 12.9 12.900
167
Rs. in Lakhs
Remarks
Cataract operations are most important activity for prevention of blindness. In Maharashtra,
government agencies are performing about 1.4 lakh operations every year. The number of
operations is not increasing significantly as compare to number of cases available and
facilities being provided. Considering this, Cataract camps at designated SDH are being
performed. For this, GoI – NPCB has provided vehicles to surgeons. As these vehicles are now
very old, it is becoming very difficult for doctors to travel to peripheral institutions and
conduct camps.
GoI has provided Rs. 125/cataract operation for mobility support. But this budget is to be
utilized for patient transport. Therefore there is no budget for travel to Surgeon and his / her
team to SDH.
Considering this, it is requested to provide budget for hiring of suitable vehicle to Ophthalmic
Surgeons for operations.
Budget required for this activity is as follows:
Table – : Budget requirement for mobility support to Ophthalmic Surgeons
Rs. In Lakhs
Sir Activity Unit cost
No. of
units
Budget
required
1
Hiring of vehicles for Cataract operation
camps for districts where government
vehicles are condemned. (six camps per
district for 27 districts)
0.05 162 8.1
2 POL for vehicles which are on road 1.2 4 4.8
Total 12.9

ACTIVITY : B.23.1.3 : PROCUREMENT OF OPHTHALMIC EQUIPMENT FOR CATARACT
OPERATIONS
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
New 0 00 413.05 413.050
168
Rs. in Lakhs
Remarks
Ophthalmic equipments being provided to hospitals under the NPCB. However, at many
paces the microscopes are old and non-functional now. Budget available with the NPCB is not
sufficient. In addition to this, Maharashtra has started ophthalmic operations at selected
SDH/GH and Women Hospitals.
Some ophthalmic equipment are important for treatment of eye diseases but are not being
provided under NPCB. Therefore, it becomes very difficult to provide quality services to poor
patients. These equipment need to be provided from other sources.
Therefore it is requested to provide Ophthalmic Equipment in addition to NPCB provisions as
follows:
Sir Activity Unit cost
No. of
units
Budget
required
A
Equipment sanctioned under NPCB but
needed for providing to new hospitals
1 Pheco-Emulsification Machine 8 6 48
2 Operating Microscope 10 8 80
3 Keratorefractometer 3 8 24
Total
Equipment not in the list of NPCB budget
152
B requires for quality patient care for
District Hospitals
1 Ophthalmic OT table 0.85 23 19.55
2 Air Purifier 0.5 23 11.5
3 Non-contact Tonometer 4 23 92
4 I-Chart 0.5 23 11.5
5 Auto perimeter 5.5 23 126.5
Total 261.05
Grand Total 413.05

SUBSECTION : B.23.2 : SUPPORT STRENGTHENINGMIDWIFERY SERVICES UNDER MEDICAL
SERVICES
(No Budget requested)
SUBSECTION : B.23.3 : SUPPORT STRENGTHENING NVBDCP
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2011-12 0 306.99 169.470
169
Rs. in Lakhs
Remarks
Sr.
No.
Component Amt required in Lakh
1 Malaria Link Volunteers 37.6
2 Strengthening Of Research Cum Training Centre,
Nagpur
9.89
3 strengthening of Zonal Office Nagpur 37.89
4 Purchase of ACT & RDT for the year 2012 - 13 84.09
Total 169.47
1. Malaria Link Volunteers (MLVs)
To reduce time lag between blood smears collection & examination MLVs are
proposed in the district Gadchiroli at sub-center. MLV will collect B.S. collected by MPWs
every day & transport these collected B.S. to PHC same day. Report of B.S. examined at PHC
will be handed over to MLVs. This activity will help to minimize time lag between collection
of B.S , examination & treatment.
Total No. of sub centers in Gadchroli district – 376
MLVs will be appointed from June to March = 10 months
Salary 1000/MLV = 376 X 1000 X 10 = 37.60 Lakh
2. PROPOSAL FOR STRENGTHENING OF RESEARCH CUM TRAINING
CENTRE, NAGPUR UNDER NVBDCP NRHM PIP 2012-13.

The Research cum Training Centre, Nagpur is the only State Level Training Centre under
NVBDCP Maharashtra State for filariasis. Filariasis is the main problem in all the districts in
this zone. Training on Filariasis and Vector Borne Diseases is arranged regularly throughout
the year for various cadres from all the districts in Maharashtra state. Strengthening is
necessary for effective functioning of the Centre.
At present, the center is situated in old building in Deputy Director's campus. Considering the
load of various trainings, following are proposals to strengthen the training center.
1) One post of Data Entry Operator on contractual basis.
2) Renovation of the Training center.
3) Provision of Classroom Furniture
4) Provision of office material as Xerox machine, fax, computer, printer etc.
5) Provision of training material as laptop, projector, exhibition models etc.
1) Data Entry Operator on contractual basis:
This office has to organize trainings of various cadres from different districts. A large
database of training status of various cadres is to be maintained. For this purpose no separate
Data Entry Operator or computer assistants available in this office. So it becomes difficult to
collect data timely and arrange accurately and organize trainings. So it is suggested to sanction
one post of DEO to Zonal office on contractual basis.
Details of honorarium :
Rs.8000pm x 8 months = 64000/-
2) Renovation of the Training center.
The classroom and Office is situated in old building which needs to be renovated. Approximate
cost for classroom and Office renovation Rs. 5.00 lakhs.
3) Provision of Classroom Furniture
Comfortable sitting arrangement needs to be provided for trainees. Approximate cost for 30
wooden table and chairs Rs. 1.5 lakhs.
4) Provision of office material as xerox machine,fax, computer, printer etc.
Provision of office material as xerox machine,fax, computer, printer etc.
Cost of Rs. 1.50 lakhs
.
5) Provision of training material as laptop, projector, exhibition models etc.
There are various trainings organized at this Training center. There are no training equipment
and exhibition models with this training center. To organize various trainings, it is suggested to
provide following training aids.
Provision of training material & Equipment such as laptop, projector, exhibition models etc.
Cost of Rs. 1.25 lakh
………………………………………………………………………………………
170

APPROXIMATE BUDGET REQUIRED FOR RESEARCH CUM TRAINING
CENTRE, NAGPUR
1) Data Entry Operator on contractual basis: = Rs. 0.64 lakh
2) Renovation of the Training center = Rs.5.00 lakh
3) Provision of Classroom Furniture = Rs.1.50 lakh
4) Provision of office material as xerox machine, fax, computer, printer etc
= Rs.1.50 lakh
5) Provision of training material as laptop, projector, exhibition models etc
= Rs.1.25 lakh
TOTAL = Rs. 9.89 lakh
3. PROPOSAL FOR STRENGTHENING OF ZONAL OFFICE NAGPUR UNDER
NVBDCP NRHM PIP 2012-13
Zonal Office, Nagpur (Assistant Director of Health Services, (Malaria), Nagpur) is
monitoring & supervising the vector borne diseases in 6 districts viz. Bhandara, Chandrapur,
Gadchiroli, Nagpur, Gondia &, Wardha.
These districts are more prone for Malaria, Filaria, Dengue, Chandipura, Chikungunya
& J.E. In Last 3 years malaria is in increasing trend in Gadchriloi, Chandrapur & Gondia
districts. Remaining districts are also vulnerable for the disease.
Since last 2 to 3 yrs. the cases of Chandipura Encephalitis are increasing in the district
of Bhandara, Nagpur and Chandrapur. The mortality of Chindipura encephalitis was more in
these districts.
Filariasis is also prevalent in Chandrapur district. Maximum number of cases of filarial
hydrocele & Lymphatic Filariasis are found in Chandrapur district which is highest in
Maharashtra state. There are cases of filarisis in all other districts.
The epidemics of Chikungunya were also notified in these districts and even today
sporadic cses of Chikungunya are also occurring in these districts.
Considering the load of above diseases it needs continuous monitoring and supervision
form the zonal office. Following are proposals to strengthen the zonal office.
1) One post of Data Entry Operator on contractual basis.
2) Extension of the Zonal Office building
3) Provision of warehouse.
4) Provision of office material as computer printer etc.
5) Provision of training material as laptop, projector etc.
6) Entomological kits and material & equipment of the zonal entomologist.
1) Data Entry Operator on contractual basis:
This office is providing technical support to the districts. Data regarding various
diseases from the DMOs/ FOs is being collected compiled and analyzed and need to be sent
higher officers. As Jt.DHS Pune, NVBDCP HQ, ROH & FW Pune for this purpose no separate
171

Data Entry Operator or computer assistants available in this office. So it becomes difficult to
collect data timely and analyze accurately and send it in the HMIS Formats. So it is suggested
to sanction one post of DEO to Zonal office on contractual basis.
Details of honorarium :
Rs.8000pm x 8 months = 64000/-
2) Extension of the Zonal Office building There is no separate office building for zonal
office. At present zonal office is occupying few small rooms in the building of Filaria Control
Unit Office. Due to lack of space it is difficult to provide separate chamber for Zonal
Entomologist. Even the room is not available for Laboratory. So it is suggested that budget
may be provided for extension of the existing building.
Approximate cost :
Extension of Zonal Office …. Rs. 25.00 lakh
3)Provision of warehouse :
There is no separate warehouse for storage of medicine & insecticides which is
supplied from state level. This may result in damage or theft of the material. So it is suggested
that the separate warehouse may be provided.
Construction of Warehouse …. Rs. 10.00 lakh
4) Strengthening of office :
Provision of material such as computer, Laser printer, UPS, etc.
Cost Rs. 0.50 lakh
5) Provision of training aids:
There are various trainings organized at Zonal level. There are no training equipment
with this office. To organize trainings at zonal as well as at district levels, it is suggested to
provide following training aids.
Provision of training material & Equipment such as laptop, projector etc.
Cost of Rs. 0.75 lakh
6) Entomological kits and material & equipment of the zonal entomologist :
There are 2 posts of Zonal Entomologists in this region. The Entomological kits
have not been provided. It is suggested to supply 2 entomological kits to this region.
Approximate Cost Rs. 0.50 lakh each x 2 kits = 1.00 lakh
APPROXIMATE BUDGET REQUIRED FOR ZONAL OFFICE, NAGPUR
1) Data Entry Operator on contractual basis = Rs.0.64 lakh
2) Extension of the Zonal Office building and = Rs.25.0 lakh
3) Provision/construction of warehouse = Rs.10.0 lakh
4) Provision of office equipment like computer printer etc. = Rs. 0.50 lakh
5) Provision of training aids like laptop, projector etc. = Rs. 0.75 lakh
6) Entomological kits for two zonal entomologists = Rs. 1.00 lakh
Total 37.89
172

4. CASH ASSISTANCE REQUIRED UNDER NRHM FLEXI FUND TO PURCHASE OF ACT & RDT
FOR THE YEAR 2012 – 13
Sr.
No
SUBSECTION : B.23.4 : SUPPORT STRENGTHENING RNTCP
S.
No
.
1
2
Name of the
District
Budget Head
Civil works:-
Establishment/Renova
tion of DTCs in 8
districts Akola,
Nanded, Jalna, Hingoli,
Sindhudurg, Washim,
Akola corp and
Amravati corp.
Establishment or
renovation of training
facility with hall and
hostel facility
Artesunate 50 mg + Sulphadoxine
Pyremethamine (500+25mg)
Yearly
Requiremen
t
Amount
Propose
d (Rs in
Lakhs)
25 %
Requiremen
t
Amount
Approve
d
(Rs.in
Lakhs)
280 280
Cost Yearly
Requiremen
t
Justification/R
emarks
Approved as
the provision
for
maintenance is
Rs 4500/
annum per DTC
for existing
DTCs.
Malaria Rapid Diagnostic Test
25 %
Requiremen
t
1 Gadchiroli 7395 1849 231094 84896 21224 938101
2 Chandrapur 12789 3197 399656 97233 24308 1074425
3 Thane 5142 1286 160688 192399 48100 2126009
4 Raigad 3795 949 118594 69031 17258 762793
5 Mumbai
Municipal
Corporation
4800 1200 150000 221526 55382 2447862
Total 33921 8480 106003
1
665085 166271 7349189
Total Cost Rs.1060031 + 7349189 = 8409220/-
Comments/Justificati
on from the States (
please also mention
the amount with
clear justification
under each head)
173
Proposed
Amount in
Lakhs
280
200 200 Approved 200
Cost

S.
No
.
2
3
4
Budget Head
Laboratory
strengthening:-
Strengthening of IRL
Pune for Liquid Culture
Travel expenses to Coinfected
to visit ART
Centre
Travel expenses to
MDR TB suspect to
DTC
Amount
Propose
d (Rs in
Lakhs)
Amount
Approve
d
(Rs.in
Lakhs)
40 0
25 25
30 30
Justification/R
emarks
Not approved
as the liquid
culture
strengthening
of Pune IRL is
already in
RNTCP lab
scale up plan.
Comments/Justificati
on from the States (
please also mention
the amount with
clear justification
under each head)
11000 coinfected
patients expected to
travel to ART centre
for treatment
initiation; scheme
already initiated this
year and requires to
be continued to pass
the benefit of early
ART treatment
initiation and prevent
mortality due to comorbidity.
The Scheme is
already initiated in
this year and requires
to be continued.
Maharashtra with all
districts under PMDT
with Criteria B will
have around
estimated 20,000 TB
suspects annually;
with Rs. 150 average
cost for each patient
174
Proposed
Amount in
Lakhs
0
25
30

S.
No
.
5
6
Budget Head
Air-borne infection
control
Additional
investigations -
Thyroid function test,
CT-Thorax etc.
Amount
Propose
d (Rs in
Lakhs)
Amount
Approve
d
(Rs.in
Lakhs)
110 110
30 30
Justification/R
emarks
Comments/Justificati
on from the States (
please also mention
the amount with
clear justification
under each head)
travelling to DTC will
need around 30 lakh.
Medical colleges /
District hospitals with
provision for MDR TB
hospitalization and
decentralized
management of MDR
TB patients will
require up gradation
and AIC measures -
11 places @ Rs.10
lakh per site; Similarly
35 TB wards in district
hospitals needs AIC
measures @ 5 lakh
per ward
The Scheme is
already initiated in
this year and requires
to be continued.
Specialized
investigations not
available in the
government hospital
especially for the
MDR patients needs
to be done from
private sector.
Approximately 4000
MDR TB patients
requiring such
investigations at an
average cost of
175
Proposed
Amount in
Lakhs
110
30

S.
No
.
7
8
Budget Head
Strengthening of the
Laboratory - C&DST
Computer & Printer
for 41 Medical
Colleges
Amount
Propose
d (Rs in
Lakhs)
Amount
Approve
d
(Rs.in
Lakhs)
135 135
20.50 20.50
Justification/R
emarks
Comments/Justificati
on from the States (
please also mention
the amount with
clear justification
under each head)
Rs.750 per head
C&DST labs up
gradation for
decentralized services
at Sewri TB hospital,
GMC Yeotmal, Dhule,
Solapur, Sangli &
Aurangabad - 6 labs
@ 45 lakh per lab
Already completed
the procurement in
the financial year
2011-2012
176
Proposed
Amount in
Lakhs
Total 1460.5 1420.5 810.00
SUBSECTION : B.23.5 : CONTINGENCY SUPPORT TO GOVERNMENT DISPENSARIES
(Budget not requested)
SUBSECTION : B.23.6 : OTHER NDCP SUPPORT PROGRAMS
Following are the proposals submitted by other NDCP programs for support
135
Nill

ACTIVITY : B.23.6.1 : RENOVATION OF OCCUPATIONAL THERAPY AND KITCHEN
DEPARTMENT IN 4 REGIONAL MENTAL HOSPITALS – 2 nd PHASE
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2011-12 500 153 153.000
177
Rs. in Lakhs
Remarks
Introduction:-
This project is approved by NRHM in 2011-12 and provided budget of Rs. 500.0 Lakh. This
budget is being utilized as per the sanctioned proposal and budget required for year 2012-13
is submitted for approval.
Occupational therapy (O.T.) in Mental Hospitals play a key role in rehabilitation of the
patients and is being widely recognized all over the world. This is an advanced way to
prepare the mentally affected patient, psychologically and physically to meet the demands of
his / her future occupational life in the society. This methodology particularly helps in case of
chronically ill mental patient. Strengthening of Occupational therapy (O.T.) departments in
Four Regional Mental Hospitals is being undertaken for rehabilitation of the patients
recovering from mental disorders.
Aims and Objectives
1) To provide basic unskilled work to various types of mentally ill patients to keep them
occupied in meaningful activities.
2) To provide skilful work activities to the patients who are stable and have achieved some
level of normalcy, so that they develop self - esteem, self- confidence and are well
prepared for discharge from hospital.
3) To Provide skilful activities through specific training to a selected group of patients to
produce saleable products which will generate revenue so that patients can be given some
incentives as an encouragement for their further progress in the society .
4) To provide agro based activities to the selected ones which will help to utilize open
cultivable land in the campus of RMHs, the product (crop or vegetable/ fruits) can generate
revenue.
5) To maintain innovative projects like bakery, cane baskets, carpentry, power loom,
tailoring department, canteen facility for the patient by the patient assisted by staff
members.

6) To maintain recreational activities, music therapy section, physical fitness section and
others sports activities with the help of staff members so that patient - staff association and
an emotional bond is created between them for an effective hospital management.
7) To maintain “Day care centre” for continuation of rehab process in discharged as well as
out patients to help them take part in various activities creating better job opportunities.
Activities undertaken in 2011-12
This task was achieved through up-gradation of occupation therapy department (for
indoor patients), and establishment of Day care centers (for outdoor patients) through
following activities.
1. Appointment of skilled personnel
Appointment of skilled personnel of following categories is being done at Pune, Thane,
Ratnagiri & Nagpur Mental Hospitals on contractual basis by a committee under the
chairmanship of Deputy Director Health Services, Pune, Thane & Nagpur Circle respectively.
Table - Contractual skilled personnel for four Mental Hospitals
Sr.No. Designation Pune Nagpur Thane R'giri
Total man
power
1 Occupational Therapist 5 2 1 1 9
2
Tailor Cum Fashion Designer
Instructor
4 1 1 2 8
3 Carpenter Instructor 1 1 2 1 5
4 Weaver 3 1 4 8
5 Screen printing Instructor 2 1 1 4
6 Craft Teacher 4 3 1 8
7 Yoga Teacher (Dance & Music) 2 2
8 Marketing Coordinator/Executive 1 1 2
9 Gardner 2 1 2 5
10 Activity Bio product Data keeper 1 1 2
11 Beauty parlor trainer 1 1
12 Driver 1 1 2
13 Activity Assistance Staff 6 15 2 23
14 Wielder 1 1
15 Administration Manager 1 1
16 Clinical Psychologist 1 1
17 PSW 1 1
18 Counselor 1 1
19 Sales & Marketing Manager 1 1
20 HR Manager 1 1
178

Sr.No. Designation Pune Nagpur Thane R'giri
Total man
power
21 Psychiatric Nurse 1 1
22 Agriculture assistant 2 2
23 Multi Purpose Vocational Instructor 1 21 1 23
24 Rota Machine operator 1 1
Total 33 15 54 11 113
2. Procurement of Equipment
Following Equipment are being procured centrally by procurement cell & by a committee at
Regional Mental Hospitals following Government procurement guidelines.
Sir
No Name
A Carpentry Section
Table – Procurement of Equipment
Quantity
Pune N'pur Thane R'giri
1 Wood Cutter 2 1 2 1
2 Planner Machine (Randa Machine) 1 1 1 1
3 Grinder Machine 1 1 2 1
4 Drill machine 1 1 1 1
5 Spray Painting machine 1 1 2 1
6 Files(Flat & Round (50:50) 12 4 24 0
7
Files MARPHA (Flat & Round 6
no.each)
12 0 0 0
8 Carpenter Table 0 0 2 2
B Tailoring Section
1 Sewing Machine, Heavy Duty 20 3 3 2
2 Cloth cutter machine 4 2 2 0
3 Storage Racks 4 0 0 0
4 Pico machine 1 0 2 2
5 Tailoring scissors 25 12 10 0
6 Laundry Iron with Table 0 0 1 0
7 Tailoring Cutting Table 0 0 2 2
C Screen Printing
1 Screen Printing machine 2 1 0 0
D Craft Activities
1 Paper Plate Making Machine 1 0 1 1
2 Door Mat Making Machine(coir base) 1 0 0 0
3 Envelope paper cutter 1 2 0 0
E Physical Rehabilitation Unit
179

Sir
No Name
Pune
Quantity
N'pur Thane R'giri
1 Short wave Diathermy 2 1 1 0
2 Shoulder Wheel 2 1 1 0
3 Pedo cycle 4 1 1 0
4 Static cycle with energy functions 6 1 1 0
5 Lumbar traction 2 0 1 0
6 wheel chairs 4 1 0 0
7 walker 4 2 0 0
8 Ultra Sonic 0 0 1 0
9 Interferential Therapy 0 0 1 0
10 Continuous Passive motion(U/L) 0 0 1 0
11 Reaction Time 0 0 1 0
12 Treadmills 0 0 1 0
F Sports and Games Therapy
1 Badminton Rackets 90 6 100 0
2 Shuttle cocks 50 24 50Box 0
3 Volleyball 40 6 40 0
4 Carom boards 15 4 30 0
5 Cricket bats 30 4 5 0
6 Tennis ball 100 24 100 0
G Library Facilities
1 500 Books(on different Subjects) 500 500 0 0
H Gardening Activity
1 Water Jar 85 6 50 20
2 Khurpya 85 24 0 20
3 Fawada 34 4 30 10
4 Kudal 40 4 30 10
5 Tikaw 10 4 10 5
6 Gardner Scissor 40 6 30 5
7 Popat scissor 10 2 10 3
8 Lawn machine 1 2 1 0
9 Koyata 10 6 4
10 Sarni/khurpi 10 12 10 3
11 Water pipe 1000Ft. 6
As
required 100Ft.
I Health Fitness Centre
1 Roller Walker 6 0 0 0
2 Lats Pully 2 0 0 0
3 Twister 4 0 0 0
180

Sir
No Name
Pune
Quantity
N'pur Thane R'giri
4 Pect Deck 3 0 0 0
5 Leg press 3 0 0 0
6 Leg Ext./Curl 3 0 0 0
7 Abking pro 4 0 0 0
8 Dambells 20 0 20 0
9 Cycle 4 0 0 0
10 Yoga mats 125 0 0 0
11 Stepper 2 0 0 0
12 Theraballs 2 0 0 0
13 Bench Press 4 0 0 0
14 Weight Cuffs 8 0 0 0
J Day Care Centre
1 Spiral Binding machine 1 0 1 0
2 Lamination machine 1 0 1 0
3 Comb binding machine 1 0 0 0
K Leather Activity
1 Leather Sewing machine 1 1 0 0
2 Leather punching machine 1 1 0 0
L Miscellaneous
1 Computer with backup 10 4 15 3
2 Printer and Scanner 4 4 0 0
3 Printer and Scanner with Xerox 0 0 1 0
4 Laser Jet Printer 0 0 2 0
5 Computer Table 10 4 15 0
6 Steel cupboard 22 10 25 3
7 Digital Camera 1 0 0 0
8 Handy cam 1 0 0 0
9 DVD player with Speaker 3 0 1 1
10 Speaker 0 0 10 0
11 Television Set 6 3 1 1
12 Water cooler 4 3 0 0
13 Showcase with Glass 2 3 3 1
14 Notice Board 2 3 5 0
15 Chair(Plastic) 120 120 100 20
16 Activity Table 0 0 5 0
17 Office Table 0 4 6 0
18 Basic Musical Equipment set 0 0 1 Set 0
19 Air Conditioner 0 0 3 0
20 Assessment Bed() 0 0 4 0
181

Sir
No Name
Pune
Quantity
N'pur Thane R'giri
21 File Making Machine 0 1 0 1
22 Welding Machine 0 1 0 0
23 Rota Printing Machine 0 1 0 0
24 Film making machine 0 0 0 1
3. Provision of Raw material
Raw material required for the Rehabilitation activities like handicrafts, screen printing,
drawing, tailoring etc is being procured by the Regional Mental Hospitals following
procurement guidelines and RKS approval
4. Renovation and repairs of the existing structures
Renovation and repairs to the Occupation Therapy department and Day care center of
Regional Mental Hospitals is being undertaken by the public works department of
Government of Maharashtra after technical approval by the engineering wing of State
NRHM.
5. Data automation with the help of hospital software.
Computer software is being developed for updating the outdoor and indoor patients’
record of Four Regional Mental Hospitals. This will help to track the patients for follow
up.
The project needs to be continued in 2012-13 for supporting the rehabilitation of indoor as
well as outdoor patients recovering from mental disorders. Budget provision for following
recurring activities will be required.
1. Continuation of contractual staff
2. Provision of Raw material
3. Operational expenses for the State Mental Health Cell & 4 Regional Mental Hospitals
4. Maintenance of Data Automation Software
Budget Provision
Sr.
No
Manpower on
contractual basis
Table – State level Monitoring Cell
No. of
staff
Monthly salary Yearly Budget (Rs)
1 Psychiatrist 1 Rs. 50,000/- 6,00,000/-
2 Data Entry Operator 1 Rs. 10,000/- 1,20,000/-
3 Office Stationery -- -- 50,000/-
Sub Total 7,70,000/-
182

Sr.No. Designation
Table – Human resources for RHM Pune
No of
personne
l
Salary/person
/month (in
thousand Rs.)
Rs. In Thousands
Total
salary for
1 month
183
Budget
for 1
yrs.
1 Occupational Therapist 5 15 75 900
2
Tailor Cum Fashion Designer
Instructor
4 5 20 240
3 Carpenter Instructor 1 5 5 60
4 Weaver 3 5 15 180
5 Screen printing Instructor 2 5 10 120
6 Craft Teacher 4 5 20 240
7 Yoga Teacher (Dance & Music) 2 5 10 120
8
Marketing
Coordinator/Executive
1 15 15 180
9 Gardner 2 5 10 120
10 Activity Bio product Data keeper 1 5 5 60
11 Beauty parlor trainer 1 5 5 60
12 Driver 1 5 5 60
13 Activity Assistance Staff 6 5 30 360
Sr.No. Designation
Total 33 85 225 2700
Table – Human Resource for RMH Thane
No of
personnel
Salary/person
/month
Total
salary
for
1 month
Budget
for 1
yrs.
1 Occupational Therapist 1 15 15 180
2
Tailor Cum Fashion Designer
Instructor
1 5 5 60
3 Carpenter Instructor 2 5 10 120
4 Weaver 4 5 20 240
12 Driver 1 5 5 60
13 Activity Assistance Staff 15 5 75 900

Sr.No. Designation
No of
personnel
Salary/person
/month
Total
salary
for
1 month
184
Budget
for 1
yrs.
15 Administration Manager 1 15 15 180
16 Clinical Psychologist 1 15 15 180
17 PSW 1 15 15 180
18 Counselor 1 15 15 180
19 Sales & Marketing Manager 1 15 15 180
20 HR Manager 1 15 15 180
21 Psychiatric Nurse 1 15 15 180
22 Agriculture assistant 2 10 20 240
23
Multi Purpose Vocational
Instructor
21 5 105 1260
Total 54 160 360 4320
Sr.No. Designation
Table – Human Resource for RMH Nagpur
No of
personnel
Salary/person
/month
Total
salary
for
1 month
Budget
for 1
yrs.
1 Occupational Therapist 2 15 30 360
2
Tailor Cum Fashion Designer
Instructor
1 5 5 60
3 Carpenter Instructor 1 5 5 60
4 Weaver 1 5 5 60
5 Screen printing Instructor 1 5 5 60
6 Craft Teacher 3 5 15 180
7 Marketing Coordinator/Executive 1 15 15 180
8 Gardner 1 5 5 60
9 Activity Bio product Data keeper 1 5 5 60
10 Wielder 1 5 5 60
11
Multi Purpose Vocational
Instructor
1 5 5 60
12 Rota Machine operator 1 5 5 60
Total 15 80 105 1260

Sr.No. Designation
Table – Human Resource for RMH Ratnagiri
No of
personnel
Salary/person
/month
Total
salary
for
1 month
185
Budget
for 1
yrs.
1 Occupational Therapist 1 15 15 180
2
Tailor Cum Fashion Designer
Instructor
2 5 10 120
3 Carpenter Instructor 1 5 5 60
4 Weaver 5 0 0
5 Screen printing Instructor 1 5 5 60
6 Craft Teacher 1 5 5 60
7 Gardner 2 5 10 120
8 Activity Assistance Staff 2 5 10 120
9
Multi Purpose Vocational
Instructor
1 5 5 60
10 Rota Machine operator 5 0 0
Total 7 60 65 780
Sr. No.
Name Of
Material
1 Envelop Paper
2
3
4
Seeds and
Fertilizers
Sanitary Napkin
Raw Material
Moti & Imitation
Jewelry
Raw Material for RMH Pune
Quality Quantity Cost
brown
paper
best seeds
best
cotton &
paper
workable
5 Painting Material Durable
6
Utensil Washing
Powder
ISI Mark
7 liquid Soap ISI Mark
8 Shampoo ISI Mark
9
Cloth Washing
Powder
ISI Mark
bundle as
required
as
required
as
required
as
required
as
required
as
required
as
required
as
required
as
required
Mode Of
Procurement
Time
Line
10000 Local market 1 mth
10000 Local market 1 mth
24000 Local market 1 mth
36000 Local market 1 mth
30000 Local market 1 mth
250000 Local market 1 mth
250000 Local market 1 mth
100000 Local market 1 mth
400000 Local market 1 mth

10
11
12
Sr. No.
Sr.
No.
1
2
3
4
Handkerchief
and Scarves
Embroidery Raw
Material
Tooth Powder
Raw Material
Name Of
Material
Drawing & Craft
Material
Raw Material for
looms - Thread
Agarbatti raw
material
Seasonal
activities like
Rangoli, Utane,
workable
coats
material
ISI Mark
as
required
as
required
as
required
Total 1410000
Raw Material for RMH Thane
Quality Quantity Cost
ISI Mark
as
required
100000 Local market 1 mth
100000 Local market 1 mth
100000 Local market 1 mth
Mode Of
Procurement
186
Time
Line
200000 Local market 1 mth
Std. 1000 kg 200000 Local market 1 mth
Std.
Std.
5 Decorative laces Std.
as
required
as
required
as
required
Raw Material for RMH Thane (continued)
Name Of Material Quality Quantity Cost
6 Electric welding rods Std.
7
8
9
10
11
Medicinal herbs and
plants
Sanitary napkin raw
material
Raw material for fabric
and warli painting
Raw material for
decorative paper bags
File making raw
material
Std.
Std.
Std.
Std.
coats
material
as
required
as
required
as
required
as
required
as
required
as
required
Total 1535000
Raw Material for RMH Nagpur
100000 Local market 1 mth
500000 Local market 1 mth
150000 Local market 1 mth
Mode Of
Procurement
Time
Line
10000 Local market 1 mth
25000 Local market 1 mth
100000 Local market 1 mth
100000 Local market 1 mth
100000 Local market 1 mth
50000 Local market 1 mth

Sr.
No.
1
2
3
Name Of Material Quality Quantity Cost
Screen printing
material
Basic material and
threads for weaving
dept.
Raw material for
Paper plate, door
mats, envelop
Std.
Std.
Std.
4 Seeds and fertilizers Std.
Sr.
No.
as
required
as
required
as
required
as
required
Total 800000
Raw Material for RMH Ratnagiri
Name Of Material Quality Quantity Cost
Mode Of
Procurement
187
Time
Line
20000 Local market 1 mth
270000 Local market 1 mth
450000 Local market 1 mth
60000 Local market 1 mth
Mode Of
Procurement
Time
Line
1 Electric welding rods Std. as required 10000 Local market 1 mth
2 Decorative laces Std. as required 50000 1 mth
3 Agarbatti raw material Std. as required 45000 Local market 1 mth
4
Seasonal activities like
Rangoli, Utane, Rakhi
Std. as required 175000 Local market 1 mth
5 Drawing & Craft material Std. as required 150000 Local market 1 mth
6
7
8
File making raw material
Raw material for
Std. as required 50000 Local market 1 mth
decorative paper bags
Medicinal herbs and
Std. as required 25000 Local market 1 mth
other plantation Std. as required 20000 Local market 1 mth
Budget requirement
Total 525000
Budget requirement for second phase of the project is as follows:

Table – Budget requirement for 2 nd Phase of Mental Health Project
Implementing Unit
HR
Raw
material
Operational
expenses
Mental Health Cell DHS 7.20 0.00 0.50
RMH Pune 27.00 14.10 0.50
RMH Thane 43.20 15.35 0.50
RMH Nagpur 12.60 8.00 0.50
RMH Ratnagiri 7.80 5.25 0.50
188
Rs. In Lakhs
Maintenance of
Data
Automation
software
A B
10.00
Sub-total 143.00 10.00
Total (A+B) 153.00
ACTIVITY : B.23.6.2 : LEPTOSPIROSIS PREVENTION AND CONTROL PROGRAM
Introduction
Due to rapid ecological changes during the past decade many zoonosis have emerged
and resulted into epidemics causing significant morbidity and mortality in human beings.
Leptospirosis is one of the diseases which predominantly occur in coastal region. The
conditions that are required for maintenance and transmission of the leptospirosis are the
presence of saline soil, adequate moisture and reservoir / carrier hosts.
Leptospirosis occurs as a result of amplification and transmission of infectious agents.
The severity of leptospirosis disease varies from mild to rapidly fatal. Mild forms are often
misdiagnosed or ignored and severe forms are characterized by hepatic involvement, Acute
Renal Failure and Hemorrhagic Syndrome. Early Case Detection, Accurate diagnosis,
Appropriate and Timely treatment reduces the morbidity and mortality due to diseases.
At present there is no control program for Leptospirosis in the country. As a New
Initiative in the 11th five year plan a pilot project for prevention and control of Leptospirosis
started in Gujarat, Kerala & Tamilnadu in 1st phase And Maharashtra &Karnataka in 2nd

Phase. In year 2011-12, The pilot project was implemented in Thane, Raigad, Ratnagiri and
Sindhudurg costal districts of Maharashtra state.
Govt. of India is not going to fund this project from year 2012-13. Leptospirosis is one
of the diseases that are monitored under IDSP program. As per the discussion in PIP Meeting
held in Lonavala from year 2012-13 this project will be funded by NRHM.
Problem statement -
Thane, Raigad, Ratnagiri and Sindhudurg are the costal districts of Maharashtra state.
Leptospirosis , zoonotic disease is endemic in this region but in the sporadic form. The cases
previously diagnosed of leptospirosis in this region were seen of hepatic involvement. But in
year 2010-11, the cases appeared in outbreak form with clinical course of disease changed
showing the pulmonary involvement in patients leading to rapid death due to fast
deterioration of patient.
So Leptospirosis is the one of the major public health problem in these districts which
has to be deal urgently.
STATEMENT SHOWING INFORMATION OF LEPTOSPIROSIS CASES
Year
Sr.
No.
Districts / Corporation 2009- 10 2010- 11
2011- 12
(up to 4.02.12)
A D A D A D
1 Gr. Mumbai Corp. 448 38 271 17 125 6
2 Thane 0 0 3 0 54 3
3 Thane Corp. 0 0 0 0 2 0
4 Mira-Bhayandar Corp. 5 0 0 0 2 1
5 Navi Mumbai Corp. 0 0 0 0 5 0
6 Kalyan Corp. 0 0 0 0 3 0
7 Raigad 0 0 252 24 28 5
8 Ratnagiri 14 0 26 6 138 9
9 Pune 10 1 10 0 0 0
10 Kolhapur 5 0 0 0 0 0
11 Sindhudurg 9 1 181 25 92 4
12 Nagpur 0 0 3 1 0 0
Total 491 40 746 73 449 28
Note:- A = Attack, D =Death.
189

Epidemiological Data for 2010-11 & 2011-12
Sl.
No
.
Name of
district
Suspecte
d cases
2010-11 2011-12
Blood
sample
s
tested
Positiv
e cases
Death
s
Suspecte
d cases
Blood
sample
s
tested
Positiv
e cases
1 Thane 5 5 3 0 109 115 54 3
2 Raigad 495 495 252 24 88 78 28 5
190
Death
s
3 Ratnagiri 124 124 25 6 138 139 138 9
4 Sindhudur
g
2029 1156 179 25 4101 4100 92 4
Total 2653 1780 459 55 4436 4432 312 21
Objectives:-
To reduce morbidity and mortality due to leptospirosis.
Strategies :-
1) Early detection of Cases and identification & Strengthening of diagnostic laboratories
• Identification of
diagnosis services
laboratories for strengthening leptospirosis
• Training of Doctors,lab-technicians and paramedical staff in
laboratory diagnostic technique.
• Procurement of Kits.
• Diagnostic facilities to make available up to PHCs with Eliza test
facility at district hospital.
2) Strengthening of patient management facilities.
a) Development of trained manpower
- Training of Medical and Paramedical personnel on various aspects on control of
leptospirosis.
b) Development of uniform guidelines.
- Uniform guidelines to be formulated , printed and distributed to pilot areas.
3) Intersectoral coordination
- Intersectoral coordination meeting of Health, veterinary and Agriculture.
4) IEC -to create awareness in the general public.
- IEC material to developed and provided to create awareness in the general public in
the form of posters, banners, board etc.

Financial Requirement for Leptospirosis:
Sr. No.
Financial Proposal for prevention & control of Leptospirosis (2012-13)
Cash assistance required under NRHM Flexi fund
Component
(Sub- Component)
Financial
Requirement (Rs.
in Lakhs)
Functional head
as per NRHM
1 Training of MO and Staff 8.00 Flexi Fund
2
Laboratory Strengthening Activity
1. leptospirosis diagnostic kits
( Rapid test + Eliza kits)
33.40
2. Eliza reader and Washer
25
3 Medicine 43.50 Flexi Fund
4 IEC 9.00 Flexi Fund
5
191
Flexi Fund
Referral transport by Ambulance- POL
6.00
Flexi Fund
Total 124.90 Flexi Fund
Statement showing the Budget requirement District-wise for year 2012-13
for Leptospirosis Prevention And Control
Sr.N
o
Name of
District
Component (Sub- Component )
Laboratory
Strengthening
Traini
ng of
MO
and
Staff
leptospir
osis
diagnosti
c kits
( Rapid
test kits
+
Eliza
Read
er
and
Wash
er
Medici
ne
IEC Referral
transport
by
Ambulan
ce- POL
Tot
al
(Rs in Lakhs)
Allocati
on
from
NRHM
Flexi
Fund
Stat
e
Fun
d

Eliza kits)
1 Thane 2.00 11.90 10.00 11.75 0 0 35.6
5
2 Raigad 2.00 6.80 5.00 8.00 3.0
0
3 Ratnagiri 2.00 8.80 5.00 6.75 3.0
0
4 Sindhud
urg
2.00 5.90 5.00 17.00 3.0
0
192
35.65 0
0 24.8 24.8 0
0 25.5
5
25.55 0
6.00 38.9 38.9 0
Total 8 33.4 25 43.5 9 6 124.
9
ACTIVITY : B.23.6.3 : PIP FOR STATE BUREAU OF HEALTH INTELLIGENCE AND VITAL
STATISTICS
124.9 0
To strengthen all activities under this bureau, strong monitoring and evaluation is essential.
Considering this aspect PIP for the year 2012-13 has been prepared. In this plan emphasis has
been given on training, monitoring and evaluation, publication of various annual reports and
printing of Birth and Death forms, conduction of statistical evaluation studies and building
construction/renovation. Detailed plan of action is furnished below.
1 Printing
1.1 State Level
1.1.1 For printing of annual reports: Civil Registration System , Survey
of Causes of Death and Medical Certification of Causes of Death,
expected expenditure Rs 1 ,00,000 has been proposed.
1.1.2 Survey of causes of Death (Rural) Scheme is being implemented
in one selected village of every primary health center. For the
training of MO,ANM,MPW working under this scheme, printing
of training modules and guidelines of the scheme Rs 2,00,000/- is
proposed.
1.1.3 Printing of Registration of Birth and Death Act 1969 booklet is
proposed. Expenditure of Rs 25,000 is expected.
1.2 District Level
1.2.1 Printing of Birth and Death formats, form No 1 Birth reporting
form, form no 2 Death reporting form, form no 3 Still birth

2 Monitoring and Evaluation
reporting form, monthly summary report of Birth, Death and Still
birth form no 11, 12 and 13 Rs. 32,41,200/- expenditure is
needed.
1.2.2 According to the directives from Government of India,
Standardized birth and death certificates are to be issued to all
rural units. For this printing of form no 5 (birth certificate) and
form no 6 (death certificate) RS. 7, 18,880/- is proposed.
1.2.3 Printing of Form no 4 and 4a under Medical Certification of
Causes of Death to be provided to districts is essential for which
Rs. 3,16,680/- is proposed.
1.2.4 SCD scheme is implemented in all the Primary Health Centers.
One village from each Primary Health Centre is selected under
this scheme. Out of 1818 PHCs in the State 1813 are working
under this scheme. The information on Births, Deaths, Still Births
and Causes of Deaths is collected every month by this office. It is
the responsibility of this office to provide prescribed formats of
reporting to the PHCs. For printing of these forms funds required
budget is Rs. 11, 02,500/-.
2.1.1 The data entry of Block level is expected to be done in newly
developed software by NIC Pune. For this purpose new Server for
HIVS Bureau is required. Rs. 5, 00,000/- is the expected
expenditure.
2.1.2 a) Under Survey of causes of Death scheme®, for ascertaining
cause of death, two physician per district will be authorized and
they will be expected to ascertain every cause of death under
this scheme in their district. An honorarium of Rs. 25/- per
physician per death is planned. For this RS. 11, 50,000/-
expenditure is expected.
b) Under SCD scheme Health worker (M/F) are required to visit
fortnightly to the selected village for collecting sign and
symptoms of deceased before death from their relative. Hon. Of
Rs 25/- per death to health worker is proposed. For 2300 deaths
under SCD scheme Rs. 5, 75,000 are proposed.
2.1.3 a) Appointment of one programmer is need for NIC developed
software for taking output of various combinations of variables
under civil registration system. Estimated expenditure of Rs 1,
193

3 IEC
4 Training
2.1.4 Deleted
80,000 /- is needed for contractual appointment of one
Computer (software) programmer in the financial year 2012-13
for a period of nine months.
b) Data entry of Birth and death registration of urban units is
done at State level at HIVS bureau. On an average data entry of
10 lakh urban births and 3.5 lakh urban deaths are expected per
year. As existing staff is not able to complete the data entry in
stipulated additional manpower is required. Hence, appointment
of 10 data entry operators is proposed. For this financial
assistance of Rs. 8, 64,000/- is required for a period of
nine months.
2.1.5 For statistical analysis of Medical Certification of Causes of
Death, software needs to be developed. Rs. 1, 00,000/- is
expected for this purpose.
2.1.6 Deleted
3.1.1 IEC plays an important role in giving information to various
provisions under this act to public at large. Coverage of Death
registration appears to be low due to non registration of deaths
under 6 years of age. Focus of IEC on registration of deaths under
6 years of age is the need of hour. Rs. 6, 60,000/- expenditure is
required for this publicity.
4.1.1 Under civil registration events like Births, Deaths and Still Births
that occur are filled in prescribed forms. On the basis of this
forms various statistical tables are generated which are used for
future planning purpose. NIC, Pune has developed software for
data entry of these forms. Training at block level is proposed for
which an amount of Rs. 3, 76,000/- is required.
4.1.2 To ascertain the causes of death under SCD scheme, training of
three selected / authorized physicians per district is proposed.
For these 4 batches, State level TOT will be conducted. 100
participants will be trained. This will require budget of Rs. 1,
194

40,000/-.
Total budget required for HIVS is Rs. 102.5 Lakhs
ACTIVITY : B.23.6.4 : IDSP ADDITIONAL BUDGET FROM NRHM MISSION FLEXIPOOL
1. Procurement of Lab equipment for District Priority Lab Nashik/Beed –
(Proposed in District PIP)
Under IDSP, GoI has planned to develop 50 District Priority Labs in entire country.
Two of these DPL labs are from the State, District Hospital Lab Nashik & Beed. Though under
IDSP these labs have received some of important lab equipment, as per district’s request there
is requirement of other deficient equipment which should be procured on priority to develop
these labs as Public Health Labs. DPL Nasik has proposed Rs. 20 Lakhs under additionalities
in its' District PIP.
3. Developing State IDSP Cell:-
At present, State IDSP Cell is situated at Joint Director of Health Services
Office, New Central Building, Pune -1. As per the norm, six contractual staff positions are
approved at State IDSP Cell but the present accommodation of the Cell is inadequate &
congested. New State IDSP Cell can be developed at Vishrantwadi Office. For new proposed
office infrastructure, project requires Rs. 10.00 Lakhs from NRHM flexipool.
4. EPIDEMIC PREPAREDNESS:- Workshop for Rapid Response
Teams:-
• Aim :- Capacity building of concerned officers regarding epidemic
Preparedness & outbreak investigation.
Table( N):-
• Training Load:-
State RRT 6 Officers 06
DSO 1 /District 033
RRT 4 /District 132
DMO 1/ District 33
195

Surveillance Officers of
municipal Corporations
In charge of District
Public Health Lab
1/ corporation 23
1/ DPHL 30
Total 247
• Technical Committee For Workshop:-
Jt.Director, of Health Services (MF&WBD)
Jt.Director of Health Services (TB/Leprosy)
Deputy Director, State Public Health Lab
Faculties from PSM, Medicine, Pediatrics & Microbiology department.
Principal HFWTC
Epidemiologists HFWTC
Senior Training Consultant, NRHM
State Surveillance Officer, IDSP
• Topics to be covered:-
1. Fundamentals Disease surveillance
2. Case Definitions of epidemic prone diseases
3. Role of laboratories in disease Surveillance
4. Lab sample collection & Transportation.
5. Generating early warning signals (EWS)
6. Outbreak - Definition, Triggers, management, investigation
7. Epidemic preparedness
8. Analysis of disease surveillance & outbreak data.(Data management)
9. Community involvement & media management
• Duration of Workshop -- 3 days
• One Workshop at every division (Total 8 Workshops) 30 participants /
Workshop.
Table( O):-
• Estimate of Expenditure:-
Sr.No. Particulars Amount
1 TA of participants Rs.1000/participants Rs.30,000/-
2 DA Rs 500/day/participant Rs.45,000/-
3
Rs.1500/participants
Tea & Food Rs 300/participant/day Rs.27,000/-
196

4 Training material Rs 200/participant Rs.6,000/-
5 Honorium to Faculties Rs 1000/Lecture x Rs.12,000/-
12
6 Miscellaneous Expenses Rs.10,000/-
Total Rs.1,30,000 X 8 Rs.10,40,000/-
Total budget required for IDSP support is Rs. 40.40 Lakh
ACTIVITY : B.23.6.6: SUPPORT REQUIRED FOR ROUTINE IMMUNIZATION
1) Construction of Regional / District Vaccine & Cold Chain Store (RVS)/(DVS) –
As per EVM Suggestions there must be standard RVS / DVS for proper storing of
vaccines & suitable working room for cold chain technician at regional & district / MC
level. GOI has approved the model plan for RVS/DVS as per WHO norms. Post of cold
chain technician is sanctioned to every district but there is no provision for office and
the space required for keeping the tools, spare parts etc. and creating environment for
suitable working place. Construction of one room for cold chain technician will solve the
problem of inadequate space and will facilitate the functioning of cold chain. It is
therefore proposed to sanction Rs. 80,27,523/- (Received proposals of district Nasik @
Rs 3377523/- & Bhandara @ Rs 4650000/- from district infrastructure NRHM section. )
2) Contractual appointments of Cold- Chain Technicians - Presently 34 cold chain
technicians’ posts are sanctioned at district level. Out of 35 districts 12 districts are
geographically large and having large number of institutions having ILR/DF facility.
It is very difficult for 1 cold chain technician to attend all the calls within time. Also
fourteen districts are having corporation area within them. For this purpose the
identified districts need additional cold chain technician on contract basis for smooth
functioning EVM assessment recommendation. To fill the vacant post , the districts
identified are BMC(2), Thane, Aurangabad, Nasik, Pune, Ahmadnagar, Nagpur,
Solapur, Nanded, Kolhapur, Amravati, Jalgaon (Total - 13).Also 12 posts of cold chain
technicians are vacant. Hence it is proposed to sanction 25 posts of cold chain
technicians for next year. The proposed honorarium is Rs. 12000 per month on
contract basis. Proposed essential qualification for these posts is ITI & NCTVT
Refrigeration/Air Conditioning. The proposed activity is new & may take 2 months
for sanction and appoint of these technicians Hence the honorarium is proposed for
197

only 10 months. The expenditure required for this activity Rs. 30.00 lakh
(12000x10x25). The activity was proposed under NRHM additional ties in last year but was
not sanctioned.
3) Contractual appointment of Pharmacist - In the State WIC and WIF facility is
available at State head quarters and at present handling of vaccines & distribution is
done by Health Supervisor/Health Assistant.. EVM assessment has recommended
appointment of pharmacist at state vaccine store. Presently the post of pharmacist at
State head quarter is not sanctioned. The pharmacist is required for handling vaccine,
distribution and keeping inventory control. For this purpose appointment of 1
Pharmacist on contract basis @ Rs. 15,000 per month is proposed on contract basis.
Proposed essential qualification for this post is B-Pharmacy with computer literacy .
The budget required will be Rs 1.80 Lakhs (15000x12x1). The activity was proposed under
NRHM additionailties in last year but was not sanctioned.
WIC/ 5, [[
4) WIC/WIF Maintenance - There are 16 WIC & 5 WIF working in the State at
various 11 places like State/Divisional/District headquarters. These places
require budget for maintenance which is not available under RI PIP. Generator
repairs, POL for generator and minor repair is needed at these places to maintain
cold chain for 24 Hrs. There is Load shedding at regional level 5 to 10 Hrs approx
at regional level. It is proposed to sanction Rs. 1 lakh per year for WIC/WIF
maintenance at 11 places. The budget proposed Rs. 1.00 x 11 = 11.00 lakhs. The
activity is newly proposed under RI PIP in last year but was not sanctioned.
5) Spare parts for cold chain maintenance - The supply for spare parts required for
maintaining cold chain equipments is not regular. As per Govt. of India guidelines
cold chain sickness rate should be less than 2%. The budget is proposed to procure
essential and fast moving spare parts at State level and to distribute in time to
regional and district level to repair breakdown equipments. It will help state to
reduce breakdown percentage and reduce down time. Ultimately it will maintain
potency of vaccine. For this activity proposed budget is Rs. 20 lakhs. The activity
was proposed under RI PIP in last year but was not sanctioned. Hence this year proposed
under NRHM additionalities .
6) Wireless data logger- (State Hq vaccine store )
Maharashtra is among 10 states which have been recommended by MOHFW and
UNICEF where the loggers are introduced. For installation of this system dedicated
198

oad band internet connection with STATIC / fixed Global IP address is required.
BSNL offers this type of connection ( Fi Bro 1 (1 MBPS Speed, unlimited download,
one static IP) costs 2999 /- per month as fixed monthly charges.) Hence the operational
cost is Rs. 2999 X 12 = 35988. The activity is implemented in last year and the
wireless data loggers started working online from 27 th Nov. 2011 onwards. The data
logger is monitoring temperature of cold room on 24X7 basis with readings every 30
minutes. This will help in improving cold chain capacity of the state. The activity was
proposed under RI PIP in last year but was not sanctioned. Hence this year proposed under
NRHM additional ties.
7) Wireless data logger- (Regional Hq vaccine stores )
At 8 regional level & 2 district level e.g. Chandrapur & Parbhani there are 14
WIC & 3WIFavailable, EVM assessment recommendation / suggestion is that provide
wireless data loggers facility to all WIC/WIF The outcome of the activity will be
monitoring of the temperature of cold room on 24X7 basis with readings every 30
minutes. This will help in improving cold chain capacity of the state For installation of
this system dedicated broad band internet connection with STATIC/ fixed Global IP
address is required. BSNL offers this type of connection (FiBro 1 (1 MBPS Speed,
unlimited download, one static IP) costs 2999 /- per month as fixed monthly charges.)
Hence the operational cost is Rs. 2999 X 12X17 =Rs. 611796/-,
Also requires (one dedicated computer, printer, UPS, Internet connection etc.)
approx cost @Rs. 50000/-X10 V.S.=Total approx cost Rs.5.00 Lakh.
Approx. cost of (each Data logger, Software, Receiver, Router etc)@Rs50000/- X17
WIC/WIF.=Total approx cost Rs.8.50Lakh.
Total budget proposed is activity Rs. 1961796/- i.e. approximately 20.00 lakhs.
8) Retrofitting of CFC WIC into Non CFC- (Regional /District Hq vaccine stores )
At 4 regional level e.g. Nasik, Aurangabad, Akola, Kolhapur & 2 district level
e.g. Chandrapur & Parbhani there are 6 WIC working on CFC units, EVM assessment
recommendation / suggestion is that retrofit CFC units into Non CFC units The
outcome of the activity will be replacement of CFC units. Approx. cost of retrofitting is
@Rs. 100000/- X 6WIC X 2Units = Total Cost Rs 12 Lakh.
9) Alarm & Hooter System for WIC/WIF - (State/Regional /Dist. Hq vaccine store )
There are 16 WIC & 5 WIF working in the State at various 11 places like
State/Divisional/District HQ,EVM assessment recommendation / suggestion is that these
199

WIC/WIF requires Alarm & Hooter System. The outcome of the activity will be extra
attention for handlers & safety of vaccines. Approx. cost of retrofitting is @Rs. 25000 X 16 WIC
X 5 WIF= Total Cost Rs 5.25 Lakh.
Total Budget: 180.33
ACTIVITY : B.23.7: Hematology Program
Hemophilia and Thalassemia are inherited blood disorders and have no cure, hence
they are included together in this program.
Hemophilia is a group of genetic bleeding disorders in which the body’s ability to
control coagulation is impaired. It is caused by the absence of certain clotting factors in the
blood. Prolonged bleeding may occur after trauma or sometimes spontaneously. Prolonged
bleeding in the brain or inside joints can be fatal or permanently debilitating. It affects almost
only males. Hemophilia is a lifelong incurable disorder but it can be managed by repeated
blood component therapy. Hemophilia cannot be prevented. Genetic counseling,
identification of carriers through molecular genetic testing, and prenatal diagnosis are
available to help individuals understand their risk of having a child with hemophilia. Education
and timely treatment is essential for this disease.
Hemoglobin is the protein that enables red blood cells to carry oxygen. Thalassemia is
a hereditary hemoglobin disorder. In Thalassemia reduced quantities of hemoglobin is
produced. This is associated with severe anemia with rupture of the red blood cells.
Thalassemia major is a serious disease in which the child becomes dependent on blood
transfusions. Since there are no detailed epidemiological studies; it is not possible to predict
the prevalence of Thalassemia in Maharashtra. Identification of carriers and sufferers is
necessary, giving emphasis on health education and marriage counseling to prevent this
disease in the next generation.
Objectives of the hematology program
Objectives of the hematology program are as follows:
• Capacity building of all health functionaries for example MO, ANM, MPW, ASHA etc.
• Strengthening of diagnostic and treatment centers
• Strengthening supportive departments like blood bank and establishment of
physiotherapy center
• Provision of technical manpower
• To create awareness in the community about these diseases
200

The program will be implemented through the establishment of Hematology Centers at 4
districts. Diagnosis, treatment and support services will be provided and the centers will be
integrated with Rajiv Gandhi Jeevandayee Arogya Yojana for further specialized treatment.
Activities planned for 2012-13
Activities planned for the year 2012-13are as follows:
• It is proposed to establish 4 Hematology Centers:
Table - Centers identified
Sr. District Center
1 Nagpur Women’s Hospital
2 Amravati District Hospital
3 Pune Sassoon General
Hospital, B.J.M.C.
4 Nashik District Hospital
• However these districts are tentative and may be changed depending on availability of
technical manpower.
• Existing health infrastructure in 4 districts:
Sir District PHC RH/SDH MO ASHA
1 Nagpur 58 11 122 1688
2 Nashik 103 28 115 3532
3 Amravati 56 13 87 2068
4 Pune 96 24 204 3293
Total 313 76 528 10581
• Provision of trained technical manpower to all 4 centers as well as manpower at
district and state level for monitoring and evaluation.
Physician, Pediatrician and Pathologist should be taken from existing staff.
This is a new initiative which is to be implemented for the first time in
Maharashtra with the help of the Government of India. As this is a new initiative it is
strongly recommended to appoint Hematology co-ordinators in the districts to
monitor the program. Monitoring will include data collection as per the population,
the patients as well as Hematology Program personnel. In the initial stages coordinators
will implement and manage the program as a separate entity in the district.
They will also be responsible for monitoring the effective training of all the personnel
in this program.
201

Medical officer may not be appointed at state level. However, one
program officer and one program assistant should be appointed at state level.
State level personnel will be responsible for monthly reporting and effective program
implementation. New patients of Thalassemia and Hemophilia will be issued ID cards
prepared in co-ordination with district and State level and central data base will be
maintained. They will also be responsible for forwarding names of beneficiaries with
income less than Rs. 150000/- per annum to Rajiv Gandhi Jivandai Arogya Yojana.
These responsibilities cannot be given to the existing staff. Budget has been adjusted
accordingly including TA/DA of state level personnel.
Table - Manpower required for Hematology Center
Sr. Center Sr. Post No. of
Unit
1 Hematology
Center
Unit
cost
202
Rs. In Lakhs
Amount
1 Physician 4
2 Pediatrician 4
3 Pathologist 4
4 Medical Officer (MBBS) 8 1.80 14.40
5 Hematology Technician 4 0.60 2.40
6 Counselor 4 0.60 2.40
7 Staff Nurse 4 0.60 2.40
8 Physiotherapist 4 1.20 4.80
Total 26.40
2 District level 1 Salary and TA/DA of Hematology
Coordinator
4 0.87 3.48
Total 3.48
3 State level 1 Salary of Hematology Program
Officers
1 1.44 1.44
2 Salary of Hematology Program
Assistants
1 0.58 0.58
3 Contingency for TA/DA of
Medical Officer and Hematology
Program Officers
- 0.20 0.20
4 Total 2.22
Grant Total 32.10
• Services to be offered at the Hematology center are as follows:
1. Laboratory services for diagnosis of all three diseases
2. Treatment of these diseases

3. Day care facilities including investigation, examination by all specialists, blood
transfusion etc.
4. Supportive services such as dentist, physiotherapy etc.
5. Health education and counseling including genetic counseling for those in the
marriage and reproductive age group
• Investigations to be offered at Hematology Centre Laboratory are as follows:
Table – Test to be performed
Sr. Test
1 Hb, CBC with RBC indices
2 Peripheral Smear
3 Hemolytic profile 1 NESTROFT for Thalassemia
2 Reticulocyte Count
4 Hb. Electrophoresis for Thalassemia
5 HPLC
6 Coagulation profile for Hemophilia 1 PT-INR
2 aPTT
3 Mixing studies-for inhibitor
patients.
4 Factor assay
• Equipment and budget required is as follows:
Table –: Equipment and Budget required for routine Hematological workup
Sir Equipment Unit cost No. of units
Rs. In Lakhs
Budget required
1 Cell Counter - 3 part 3.50 2 7.00
2 Microscope binocular 0.30 4 1.20
3 Electrophoresis machine 0.60 4 2.40
4 Purchase of Reagents for 1.00 4 4.00
above tests
Total 14.60
203

Table –: Equipment Budget required for diagnosis of Hemophilia
Rs. In Lakhs
Sir Equipment Unit cost No. of units Budget required
1 Semi-automated coagulometer 5.00 4 20.00
2 Centrifuge Machine 0.20 4 0.80
3 Water bath for incubation 0.50 4 2.00
4 Reagents 0.50 4 2.00
Total 24.80
Table –:Budget required for diagnosis of Thalassemia
Rs. In Lakhs
Sir Equipment Unit cost No. of units Budget required
1 HPLC Machine only Nashik (to be
purchased at State level)
35.00 1 35.00
2 Reagent 2.00 4 8.00
Total 43.00
Table –: Additional Budget required
Sir Particulars Unit cost No. of
Rs. In Lakhs
Budget
units required
1 Laboratory consumables 0.50 4 2.00
2 Laboratory renovation 1.0 4 4.00
3 Essential Medicines 0.50 4 2.00
4 Support to Blood Bank 1.00 4 4.00
5 Establishment of Physiotherapy Centre 1.50 4 6.00
6 Establishment for Day Care Centre/up
gradation (min 4 beds)
1.00 4 4.00
7 Contingency for equipment, stationery,
consumables, up gradation, repair etc
1.50 4 6.00
Total 28.00
• Hemophilia is treated by replacement of coagulation factors
204

Sr. Factor
Table –: Annual budget required for Factors for Hemophilia patients
No. of
patients
Annual
requirement of
factor/patient
(Units)
1 VIII 200 10000
2 IX 60 10000
3 FEIBA 12 10000
Total
requirement
factor/annum
(Units)
2000000
600000
120000
Price or
unit of
Factor
(Rs.)
205
Rs. In Lakhs
Total
Amount
(Rs.)
9 180.0
16 96.00
40 48.00
Total 324.00
Sr.
No.
• Training will be provided to health functionaries in all 4 districts and intensive training
will be provided to hematology center staff
Category of
OFFICERS/STAFF
1 Specialist
(Physician,
pediatrician,
pathologist
2 MBBS MOs at
Hematology
center/
3 Support staff of
Hematology
center
4 Medical officers of
PHC/RH/SDH
5 ASHA(Workshop)
Total
training
load
No. of
days
Total
batches( Per
batch 30
participants)
Rs. In Lakhs
Expected
Budget for
one batch
Total
expected
budget
12 10 1 2.07 2.07
9 10 1 2.07 2.07
16 5 1 1.03 1.03
528 1 18 0.21 3.73
10581 1 0 0.00 10.58

Total Budget
• IEC materials will be provided at all PHC/RH/SDH/DH and Hematology Centers
Table –: IEC
20.6 19.47
Sir IEC
Unit cost No. of units
Rs. In Lakhs
Budget
required
1 IEC 0.03 393 11.79
Total 11.79
ASHAs will provided IEC to Gram Sabha, 4 sessions per year. For this ASHA will be given
incentive at the rate of Rs. 50/- per session which has been budgeted under General incentive
for ASHAs.
As this is a combined program for Hemophilia and Thalassemia, depending on the number of
patients for each disease, the budget may be interchanged and utilized from different heads
for diagnosis, treatment and IEC as required.
Table- : Summary of Budget Requirement – HEMATOLOGY Program
206
Rs. In Lakhs
Sir Level Budget required
1 Manpower required for Hematology Center 32.10
2
Equipment and Budget required for routine
Hematological workup
Equipment Budget required for diagnosis of
14.60
3 Hemophilia 24.80
4 Budget required for diagnosis of Thalassemia 43.00
5 Additional Budget required
Annual budget required for Factors for Hemophilia
28.00
6 patients 324.00
7 Training 19.47
8 IEC 11.79
Total 497.76

B.23.8 SHORT TERM CERTIFICATE COURSES FOR MEDICAL OFFICERS IN PUBLIC
HEALTH DEPARTEMENT
INTRODUCTION
Public Health Department has a good network of health institutions which delivers basically primary &
secondary health care. Primary health care is provided by sub centers & primary health centers. For
secondary care there are Rural Hospitals which have 30 beds & are expected to provide specialty
services in three specialties. There are 50 bedded & 100 bedded Sub District Hospitals with
respectively five and eight specialties. At district level there are District Hospitals with fourteen
specialties.
To provide specialty care at these hospitals specialist posts are created. In addition to these regular
posts there is provision of appointing specialists on contractual basis with laid down terms &
conditions.
OBJECTIVE
At the end of training course Medical Officer should be able to deliver effective medical care following
appropriate current medical practices in defined specialilty like Medicine, Pediatrics, Anesthesia,
Psychiatry etc.
NEED FOR SHORT TERM TRAINING COURSES
• Presently proportion of vacancies in the specialities like Pediatrics, Medicine & Anesthesia is
about 60%
• Specialists are not willing to join rural areas although appointed by the department due to
various reasons like payment, basic amenities, lack of education facilities etc.
• Those who join the department are not continuing & proportion of leaving the job is
significant.
• Necessary infrastructure has been developed at hospital level however it is not optimally
utilized due to shortage of specialists.
• Requirement & availability of specialists is as below:
o Total posts of specialists sanctioned: 511
o Out of that posts filled: 144
o Total number of vacancies: 367
Therefore to fulfill the requirement of department of providing appropriate specialty services it is
proposed to start short term training courses in all required specialties initially this will cover
Pediatrics & Medicine & in due course other subjects will be included as per need. In addition to this
training will also be imparted to MOs & some paramedical staff in disciplines like Bio chemistry,
Microbiology & Radiology.
METHODOLOGY
• It is proposed to appoint Dr Mrudula Phadke as a Training Consultant (Chairperson) for
planning, implementation of these training courses.
207

• It will be a certificate course & the certificate will be given by the Directorate of Health
Services & this will be only for working in the health facilities of health department & not for
general practice outside the department.
• Trainees: These will be identified MBBS Medical Officers who are already working in the
department & are willing to work at least for five years in the department after completion of
training course. MOs will be deputed for this training course either at identified Medical
College or District Hospital for 6 months. These identified MOs need to be given incentive in
the form of priority for PG diploma or degree courses & also preference in posting.
• Duration: It will be six months.
• Curriculum: This will be prepared as per the requirement of the department based on the
clinical services expected to be delivered at the respective hospital level. This will be
developed by the experts in the corresponding field.
• Training methodology: this will cover.
o Training lectures to cover theoretical aspects by videoconference.
o Theory of practical
o Hands on training in the wards of Medical Colleges & DHs
o Journal club, clinics, case presentation, seminars & etc
o Theory & practical examination during the training the training period & at the end of
course.
o MOs will attend theory lectures in morning session by videoconference method & in the
afternoon will work in wards, will attend journal/ case presentation/ seminars etc. either
in Medical College or in DHs as orders given.
o In addition to this, there will be three contact programs in which all trainees will have
class room lecture session.
• Training place: Training will be given at following sites depending on the availability of trainers
and also clinical cases:
o Medical Colleges both government & private as per willingness. Consent of Medical
Education department needs to be taken for the same.
o District hospitals: Initially few DHs like Nasik, Ahmad nager will be included as training
places & after evaluating their usefulness additional DHs will be covered.
o Private hospitals
• Trainers: Trainers & resource persons will be identified by the consultant, form Medical
Colleges and also private practitioners. They will be identified based on their experience,
expertise & most important will be willingness to work.
• Training material: Training Material will be developed by experienced teaching faculties/
experts in that field & will be distributed to all the trainee Medical Officers.
BUDGET
Budget for each will be required for various activities as below:
208

A. Training expenditure
No Activity Rate Budget
in lac
1. Preparation of training curriculum, listing of essential Rs. 1 lac per training Rs. 1.0
skills, time table etc
course
2. Remuneration for trainers
a. For theory sessions (there will be about 5-10 trainers. Rs. 5000 for each Rs. 12.0
They will take one session per week. Total 24 sessions session* 24 sessions* 10
of each trainer)
trainers
b. For practical & hands on training (There will be about 5- Rs. 10,000 per month* Rs. 7.20
12 trainers from local district.)
12 trainers* 6 months
3. Contingency funds for printing training material,
conduct of examination etc.
- Rs. 5.0
4. Office expenses for consultant Rs. 50,000 per month Rs. 3.0
TOTAL Rs. 30.20
B. Video Conferencing expenditure
No Activity Rate Budget in lac
1 Facility of video conferencing - Rs. 10.0
TOTAL Rs. 10.0
ACTION EXPECTED TO BE TAKEN
• Approval of the proposal by Government & appointing Chairperson Dr. Mrudula Phadke
& also designate one senior officer from the Directorate as Chief coordinator.
• Development of videoconference facility in Mumbai at Directorate of health services.
• Technical aspects :
o Development of curriculum, training calendar & preparation of training material.
o Identification of training sites.
o Finalisation of trainers.
• Sanction of budget
• Identification of Medical Officers
• Consent of Medical Education department for involvement of Medical Colleges as well as
their faculty members.
It is expected to start the training course from 1 st April 2011 by completing all the official
procedures.
Total Budget: 40.20
209

SECTION – B.24 : SPECIAL SCHEMES FOR TRIBAL AND LEFTIST EXTREMISM AFFECTED AREAS
Maharashtra has 15 tribal districts out of which 5 are sensitive and six are leftist
extremism affected districts. Considering the health problems of these areas and nonavailability
of trained staff to provide the health services, specific schemes are proposed for
these areas. Schemes in Part –A are related to all the tribal areas of the State. However more
focus is given to districts with remote tribal areas. Part – B of this Section is related to special
schemes and activities proposed for high focus districts namely: Nandurbar, Gondia and
Gadchiroli.
Following schemes are proposed for tribal and leftist extremism areas.
PART – A : SCHEMES FOR ALL TRIBAL AREAS OF THE STATE
SUB-SECTION – B.24.2 :MAHER SCHEME
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2008-09 66 66 76 76.000
210
Rs. in Lakhs
Remarks
Tribal areas have hilly terrain. Many of the tribal padas do not have pukka roads. Even if
pukka roads are available, there is no reliable transportation system for transferring pregnant
women in labour to nearby PHC. This is important cause of high maternal and neonatal
mortality. It is not economical to provide vehicles at each tribal pada, nor it is feasible to
develop emergency vehicle system as there is no mobile phone coverage in remote tribal
areas and landlines are out of order for prolonged time.
In such situation, if one room is build in PHC premises where pregnant woman will get
admitted one week before her due date, all abovementioned problems will be solved. She
can be daily checked by Doctor of PHC and can be transported to suitable referral center if
any complications are detected during waiting period or during labour. Following facilities are
being provided in ‘Maher Scheme’
• One room of 5×5 meters
• One sanitary block (Toilet and bathroom)
• One kitchen ota with smokeless chulha
• One solar water heater system on roof of the room

‘Maher’ will be maintained by local Self Help Group. When mother is admitted, mother, her
young child and one relative will be provided food three times a day. It is proposed to provide
Rs. 125/- per mother per day to SHG for this purpose. Currently Maher rooms are being
constructed in 30 PHCs in the state, mostly in tribal and leftist extremism affected areas of
Vidharbha region.
Currently the scheme is being implemented in 60 PHCs OF Leftist Extremism affected and
tribal areas. It is proposed to continue the program in same PHCs.
Compliance of remarks
Currently Maher is established at 60 places out of which it is functional at 37 places.
Remaining places will be functional within next three months. In functional 37 places, total
1859 mothers have benefited from this scheme. Once other centers are functional, the
number of beneficiaries will increase.
c. Budget requirement 2012-13
Budget required for 2010-11 is for existing centers as well as new centers. Detailed budget
required is as follows:
Table – : Budget distribution for Maher Scheme
Sir Particulars Unit cost
No. of
units
Rs. In Lakhs
Budget
required
1 Construction of Maher room (spillover) 2 23 46
2 Maintenance cost to SHG per delivery 0.005 6000 30
Total 76
SUB-SECTION – B.24.4 : VOLUNTEER TO TRIBAL AND LEFTIST EXTREMISM AFFECTED PHCS
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2008-09 24.6 24.6 24.6 12.240
211
Rs. in Lakhs
Remarks
Tribal population does not accept the health services from institutions as expected. Different
language, different culture and different understanding about various diseases, etc. are
important reasons for this. Considering this, it is proposed that one local volunteer, who

knows the local language and can understand the concept of positive health can be appointed
as Volunteer in tribal PHC. This volunteer will welcome the patients, direct them for case
papers, and inform them about the instructions given by doctor and nurses and give simple
public health messages.
Based on experience of the state, volunteer scheme is modified and now requested only for
Melghat region as it was existing in this area since last 4 years through local funds. Under this
scheme, 34 volunteers are appointed 2/health facility in all PHCs and Hospitals of Melghat.
These Volunteers help the doctors and nurses to provide treatment, inform patient about
importance of treatment, minimize LAMA, accompany the patient to higher center in case of
referral. Currently these Volunteers are paid Rs. 3000/PM from local / volunteer funds.
District has requested the honorarium to be increased to Rs. 5000/PM, however, this increase
will be considered after evaluation of the scheme by Public Health Department. Therefore,
presently Rs. 3000/PM is reqested for the Volunteer. If the evaluation comes to be positive
then honorarium will be increased to Rs. 5000/PM.
Budget requirement
Budget required per Volunteer will be Rs. 36000/volunteer/year and for 34 volunteers the
budget is 34×0.36 = 12.24 Lakh.
Table – : Budget required for Volunteer to tribal PHCs of Melghat region – 2012-13
Rs. In Lakhs
Sir Particulars Unit cost No. of units
Budget
required
2 Honorarium (Rs. 3000/ PM) 0.36 34 12.24
Total 12.24
Honorarium to Volunteer will be increased to Rs. 5000/PM once the evaluation is received
SUB-SECTION – B.24.5. : MOBILITY SUPPORT
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2008-09 728.3 496.6 670.3 670.300
212
Rs. in Lakhs
Remarks
Transport is required to transfer emergency patients and women in labor in health
institutions. Transport of delivery patients from village to health institutions for scheduled or
emergency transfer is available with support of RCH funds. Referral plan of all the villages are
being made.

Mobility support is also required to officers for supervision in tribal areas of the state. There
are 70 tribal blocks in state to supervise the tribal PHCs. The Block Health Officers require
vehicles to supervise the work of tribal PHCs.
Compliance of remarks
Supervisory work of the officers supervising NRHM works has increased many fold. As each
health facility is being monitored from district and state level, lot of information is being
collected and officers are also travelling to health facilities to go through the discrepancies.
We have submitted proposal for hiring of vehicles to district officials through RCH. This costs
about Rs. 3.0 Lakh per officer in one year. Currently cheaper supervisory vehicles available on
RC costs about 4.5 Lakh. Thus, this cost will be cleared within one and half year. Considering
life of vehicle for 12 years, this will be really beneficial to the SHS. Cost on driver and POL will
be borne from regular budget of State Government. It will not have any impact on the NRHM
budget. Considering this, it is requested to sanction this proposal along with the supervisory
vehicles.
Budget for repairs is required almost every year to ambulances. Currently available state
government budget is inadequate and is not sufficient to fulfill the increase in demand. In
tribal areas, roads are not good so that increases the maintenance. Other maintenance
activities required routinely include, preventive maintenance, tyre, batteries, etc.
Considering the situation above, budget as requested below is proposed for tribal and LEA
areas:
Budget requirement 2011-12
Budget proposed for providing mobility support is as follows:
Table – : Budget required for ambulance service in PHC/RH/SDH - 2009-10
Rs. In Lakhs
Total
Sir Institution No. of units Unit price budget
required
1 New PHC ambulances 32 5.4 172.8
2 New RH/SDH/DH Ambulances 16 7.6 121.6
3 Repairs of existing ambulances 315 0.5 157.5
4 Supervisory vehicles 42 5.2 218.4
Total 670.3
213

SUB-SECTION – B.24.6 : SOLAR BACK-UP SYSTEM FOR TRIBAL AREAS
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2008-09 622.5 595.5 595.5 192.000
214
Rs. in Lakhs
Remarks
There is severe electricity problem in state. IPHS health institutions require continuous power
supply. Therefore solar backup system is proposed for all the IPHS health institutions in tribal
areas.
Special system has been developed in the state with the help of Government College of
Engineering Pune for health facilities. This system can provide power to all the equipment in
PHC for 24 hours.
Same system will be used for tribal areas. This year, it is proposed to try solar back up system
for selected Rural Hospitals. Budget required for this system is as follows:
Compliance of remarks
All the PHCs in tribal areas are covered now so there is no need of grants for tribal PHCs.
However, this year, grant is requested for hospitals which fulfill criteria of delivery point.
List of hospitals included is submitted in Annexure.
Budget required for solar power backup
Budget required for solar power backup is mentioned below:
Table – :Budget required for solar power backup
Sir Type of institute Cost per unit No. of units
Rs. In Lakhs
Total cost
2 Solar Backup – RH 32 16 192
Total 16 192
Considering the importance of un-interrupted power supply, it is proposed to add new health
institutes for solar power if there is saving in other activities.

SUBSECION B.24.7 : MOBILE MEDICAL UNITS FOR TRIBAL DISTRICTS
Activity deleted as per remarks.
SUBSECTION - B.24.8 : ORGANIZATION OF SPECIALIST MEDICAL & DENTAL CAMPS
THROUGH MEDICAL COLLEGES IN TRIBAL HOSPITALS
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2008-09 127.44 231 250.2 250.200
215
Rs. in Lakhs
Remarks
Maharashtra has 455 hospitals of various bed strengths. Almost all of these hospitals are well
equipped with wards. Operation theater, labour rooms and equipment. However, because of
shortage of specialist by almost 50%, these hospitals are not in positions to provide specialists
care. Considering this situations, it is proposed to arrange specialist camps in sub-district
hospitals particularly the SDH/ Rural Hospital in tribal areas. Specialists of at least 8 specialties
will be visiting the hospitals and provide specialist services.
Specialists involved in the camps: Medicine, surgery, pediatrics, OBGY, ENT, Orthopedic, Skin
& V.D , Anesthesia and Dental faculty.
Sixty Specialty Medical & Dental Camps were organized during 2011-12. Patients
referred by Primary Health Center were examined, diagnosed & given the treatment. Average
2000 patients examined in each camp & more than average 50 major surgeries were done in
each camp. The patients detected in School Health Examinations, sickle cell program,
malnourished children, gynecological & pregnant mother with BOH were examined & given
proper treatment.
During 2012-13, Sixty Medical & Dental Camps are proposed in tribal Sub- District/
Rural hospital with the help of medical colleges/multi-specialty hospitals
Organization of the camps will be done as follows:
1. All the PHCs and hospitals in areas will be informed in advanced regarding the camp
date & places where camp to be organized.
2. PHCs /CHCs will screen the patients and send them to SDH on the day of camp.
3. SDH will be selected on following criteria:
a) Tribal SDH
b) Well-constructed OT with all necessary equipment
c) Laboratory with facility of all basis investigations
d) Blood storage centre
e) adequate nursing staff

4. Medical college & Dental College in the region will be identified for Specialist services
in the camps.
5. Medical College specialists will halt at SDH for 4 days on first day screening of Patients
will be done on second and third day operations and surgeries will be conducted. On
the fourth day post-operative care will be provided.
Proposed Budget
Budget will be required for following activities
• Transportation of the specialists
• Incentive to specialists
• Staying arrangements for specialists
• Incidental charges for the camp arrangement
• Medicines, consumables, etc.
It is proposed to organize 60 specialty camps in the state. Camp wise expenditure may change
depending upon number of patients attended & Surgeries performed in the camps.
Table -: Budget required for specialists camps through Medical colleges in tribal areas
(Rs. In Lakhs)
SR Activity
1 Honorarium to Senior specialists @ Rs. 2000/
day & Rs.1500/- for Jr. Specialist
2 Hiring of vehicles to transport 16 specialists to
SDH and back (4 day)
Unit cost
(single
camp)
No. of.
units
(Total 60
camps)
216
Budget
required
1.12 60 67.20
0.30 60 18.00
3 Staying arrangements for specialists 0.30 60 18.00
4 Arrangements of camps & office expenses 0.45 60 27.00
5 Medicines and consumables for camps 1.50 60 90.00
6 Transportation of patients 0.25 60 15.00
7 IEC 0.25 60 15.00
Total 4.17 250.2

SUBSECTION - B.24.9 : PILOT PROJECT TO REDUCE IMR IN MELGHAT REGION (DIST.
AMARAWATI) OF MAHARASHTRA
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2008-09 115.81 96.72 81.92 81.920
217
Rs. in Lakhs
Remarks
As per SRS, IMR of Maharashtra is 33/1000 live births. However, it not equally distributed
throughout the state. There are some pockets which indicate almost double the IMR of state
average. One of such pockets is Melghat. Currently, estimated IMR of Melghat is around
60/1000 live births which is highest in the state. Lot of measures have been carried out since
last 10 years. However after initial reduction, IMR is not going down since last 3-4 years.
Considering this situation, a pilot project is being submitted for this area to reduce IMR.
1. Peculiarities of Melghat region
• Reserve forest (Tiger reserve), very dense with very low population density.
• Communication facility underdeveloped.
• Because of low density of population, geographical distance from PHC is very long. For
example, 6 villages of one PHC are situated 150 KM from PHC HQ. This leads to very
difficult situation in contacting the families.
• People do not prefer to go to health institutions. Instead they go to local quacks.
• Language of local tribes is different (Korku). Very few Tribes can understand Marathi
language.
2. Findings of infant deaths
• Causes of infant mortality are same : LBW/immaturity, diarrhea, ARI.
• Almost all infant deaths are within first 6 months of life.
• Family members ignore the health of child very often. They do not take ill child
immediately to doctor for treatment.
• Proportion of home delivery is 90%, which is slowly increasing because of active
intervention of ASHA.
• All the PHCs in Melghat are well equipped to treat the children but very few families
take the benefits of these facilities.
3. Positive findings in recent times
• People have accepted ASHAs very well. ASHAs are now bringing mothers for ANC
check-up and delivery. ANC check-up has increased but delivery is taking some time to
increase.

• Local volunteer appointed has proved very useful. He/she can talk to patients to
consume medicines given in PHC and also convince mothers in local language and
persuade them to stay in PHC for 2 days after delivery.
• PHCs in the area are provided all required equipment in neonatal care and MOs are
trained.
• There is one CHC and one SDH in area. One pediatrician is available in these centers.
Considering the above situation and development in recent times, project as mentioned
below is submitted for approval:
4. Pilot Project
Following activities will be carried out in this project
• ASHA will monitor nutrition of mother particularly anemia by colour coded finger caps
provided to her. If mother is anemic then FS will be provided to mother. These tablets
will be consumed by mother in front of ASHA.
• ASHA will motivate the mothers to get delivered in PHC or hospital. If not possible
then ASHA will arrange for delivery by trained person, will judge the risk of new born
by measuring the foot length of child and classify the child based on the foot length
equipment.
• ASHA will be trained to monitor daily the health of child for up to 6 months of life. She
will check following five parameters:
o Whether child is breast feeding?
o Do the child have fever?
o Do the child have diarrhea?
o Do the child have running nose?
o Respiratory rate of child is normal or not?
• This volunteer will monitor 7-8 children per day.
• After child birth, one card will be issued in the name of child. Volunteer will daily
record her findings in the card. At the end of 6 months, the card will be deposited in
PHC. In case of referral, Volunteer will take card to PHC.
• In case answer to any of the above question is yes, Volunteer will immediately inform
the Special Squad MO about health of child. Special Squad will arrive in village, check
the child and if required bring the child to nearest PHC or CHC for further treatment.
• Volunteer will be given one Mobile Phone (in 50% area there is coverage) or wireless
devise to contact the MO.
• Special squad will consist of MO of PHC one nurse from PHC and one local volunteer
(to be appointed). Special squad will be provided one ambulance.
• As there are very long distances between health institutes, ambulance will be
equipped with baby warmer, oxygen cylinder, neonatal resuscitation kit, IV facility,
etc.
5. Extent of the project
218

Total Melghat area having 11 PHCs, 2 CHCs and one SDH.
Compliance of remarks
• In this project, 10 important signs/symptoms that can be verified by ASHA are included. ASHA
has to check these with child daily and inform the doctor in case of any danger sign. As all
these signs and symptoms are already existing in Module – VI of ASHA, it was decided to hold
till training of this module is complete. There was delay because of this decision.
• This project was shown to UNICEF consultants. They suggested addition of pediatrician to the
project. However, as this is very interior area, no pediatrician applied for the post in spite of
advertisement twice. Therefore post of pediatrician is dropped in PIP 2012-13. Now it has
been planned to appoint experienced doctor (MBBS/BAMS) with salary ranging from Rs.
20000 to 40000/PM)
• Till date, 347 children (0-6 months) are registered for the project. Special two day meeting is
organized for this project in first week of May. Implementation is expected to improve after
the meeting.
6. Budget requirement
Considering the present experience of local Block Medical Officers, there will be 5-6 calls per
PHC for sick children to be examined. Thus, ambulance will travel for approximately 150 KM
in a day.
Budget will be required for following purposes:
• Remuneration to ASHA for each visit to child (Rs. 3/visit) considering she will spend
about 1 hour for this work.
• Remuneration to ASHA to accompany the child to hospital – Rs. 75/day – minimum
one day
• Honorarium to local volunteer who accompanies the ambulance to convince the
family to accept treatment
• Ambulances with equipment
• Driver, POL, maintenance for ambulance.
Services of MO, medicine and PHC level treatment will be provided under regular finds.
Total budget required is submitted in table below:
Table -: Budget required for Special IMR reduction project
Sir Activity Unit cost
1
Remuneration to ASHA @ Rs. 5/visit. ASHA will
make average 6 visits daily (approx 2100 visits in
one year) for 350 ASHA
No. of
units
219
Rs. In Lakhs
Budget
required
0.054 350 18.9

Sir Activity Unit cost
2
ASHA to accompany child to hospital @ Rs.
100/day. 5000 visits
No. of
units
220
Budget
required
0.001 5000 5
3
Provision of important gadgets such as
communication device, thermometer, foot length
caliper, finger caps, etc. to ASHA
1 11 11
4
Honorarium to local volunteer cum driver @ Rs.
6000/Driver/month in 11 PHCs
0.72 11 7.92
5
POL and maintenance of ambulance considering
100 KM run/day
2.4 11 26.4
6
Contingency including travel and other allowances
to experts
0.3 11 3.3
7 Important medicines to ASHA 0.02 350 7
8
Appointment of one experienced person as
supervisor for implementation of the program
2.4 1 2.4
Total 81.92
SUBSECTION - B.24.10 : COORDINATION CELL FOR TRIBES IN SELECTED LEA & TRIBAL
DISTRICTS HOSPITALS
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2008-09 28.8 29.52 24.600
Rs. in Lakhs
Remarks
Peripheral health institutions (SCs, PHCs, CHCs, etc.) have to refer patients to District
Hospitals in emergency. Majority of the District Hospitals are 300 bedded and above. These
hospitals have different sections for registration, laboratory checkup, X-ray, medicines, etc.
Tribal patients do not understand the language and there is delay in getting all the formalities
done. Because of such environment, patients are not willing to stay in hospital and many of
the times insist for discharge even if the condition of patient is critical.
Considering such situation, one pilot project was organized in District Hospital Amravati for
patients from Melghat tribal areas. Six persons from hospital were pooled to form one cell
with one telephone line. All the doctors in Melghat were informed about the Cell and
telephone number. Now the doctors call the Melghat Cell in District Hospital at the time of

eferral. Patients health condition, required treatment and expected time of arrival is
communicated. One Cell member takes the responsibility and informs the Casualty MO to call
concerned specialists. When patient arrives, the Coordinator of Cell accompanies the patient
till emergency is over from registration to laboratory and report collection. After emergency
is over, the patients are asked to contact the cell in case of any difficulty in hospital. During
the stay in hospital ell member visits the patient twice daily for any difficulty. Transport
arrangement is also made if required after discharge.
The cell in Melghat has increased the inflow of tribal patients from 38 per month to 73 per
month. Proportion of referred patients actually arriving the hospital has increased from 58%
to 81% and AMA discharge has reduced to only 2 patients in December 2010 as against 10-12
patients per month during last year. Because of this response, Coordination Cell is now
established in all the 6 Sensitive tribal districts which also include two LEA districts of state.
Same activity will continue this year.
Compliance of remarks
One pilot project at DH Amravati has shown that if tribal patients are provided support then
their stay in hospital improves. This project is based on the findings of this pilot study.
This project was started in 6 districts : Amravati, Gadchiroli, Gondia, Thane, Nashik and
Nandurbar. Out of these, this did not start in Gondia and started very late in Thane. District
wise performance of the project is as follows:
Table – Performance of Coordination cell at DH
Sir Name of district Performance Remarks
1 Thane 620 Started in December
2011
2 Nashik 17694
3 Nandurbar 878
4 Amravati 921 From Melghat area
only
5 Gondia 0 Not started. Dropped
in year 2012-13
6 Gadchiroli 7149
Considering above performance, Gondia is discontinued from the scheme. Budget required
for remaining centers is mentioned below.
No new centers is proposed in 2012-13.
Budget requirement
Budget will be required for following purposes
221

• Salary of supervisor and coordinators
• Furniture for the desk
• Telephone line
• Mobile charges for the supervisor and coordinators
• Incidental charges
Detailed budget requirement will be as follows:
Table -: Budget required for tribal cell in District Hospital
Sir Activity Unit cost No. of units
222
Rs. In Lakhs
Budget
required
1
Salary of Tribal Cell Supervisor @ Rs. 8000/PM
for 10 months
0.96 5 4.8
2
Salary of Coordinators (4) @ Rs. 6000/PM for 10
months
2.88 5 14.4
3 Telephone line for help desk 0.36 5 1.8
4
Mobile charges to all desk members @ Rs.
200/PM for 10 months (no instrument charges)
0.12 5 0.6
5 Contingency 0.6 5 3
Total 24.6
SUBSECTION - B.24.11 : INTEGRATION OF PALLIATIVE CARE IN JAWHAR TRIBAL BLOCK DIST
THANE
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2008-09 13.5 13.5 13.500
Rs. in Lakhs
Remarks
Palliative Care is a multi disciplinary approach to alleviate the suffering of patients
with chronic life limiting illnesses, and their families. It is aimed at improving the quality of life
through relief of physical, psychosocial and spiritual suffering. The palliative care is required
in terminal period of cancer, neurological and cardio respiratory discusses.
For year 2011-12, the project is being implemented in a Jawhar tribal block of Thane district
with the technical support and help from Tata Memorial Hospital and Research Centre,
Mumbai.

Goal
To integrate palliative care into the exciting health care system in the jawhar block of
Thane district.
Objectives:
• Training health care professional including physicians, nurses and medical and
social workers (at the block and the primary health centre level) in palliative care
so that they are able to identify patients requiring palliative care and are able to
deliver appropriate holistic care to such patients.
• Training the outreach health workers such as ASHA workers, ANMs etc, in basic
palliative care principles and practice, so that they can identify patients in the
community who require palliative care and deliver basic care in the patients home
or in the community.
• Ensure the availability of morphine and other opioids at the block level.
• Increase the awareness in the community about palliative care.
• Ensure access of children with life limiting conditions to appropriate pediatrician
Palliative care facilities.
Performance in 2011-12
• The training of Health Care Provider in Palliative Care is as follows
Medical officers – 38, Nurses- 51,
ASHA- 223, Medical Social worker – 1 &
Paramedics – 3
• Total patients under Palliative Care - 271
Cancer Patients - 18, HIV Patients- 5, Resp. diseases & T.B patients-43, Cardio
vascular diseases- 4, Mental retardation & cerebral palsy- 24 , leprosy- 11,
Others- 171
• Palliative Care diagnostic Camps conducted - 6
Action plan
• Establishment of Palliative Care Cell at the Sub-district hospital / Rural Hospital
containing one Medical Officer, one Nurse and one Medical Social Worker.
• Training of health care professionals including physicians, nurses and medical
social workers at the block and the primary health centre level in palliative care.
The training will be delivered by the palliative care team at Tata Memorial Centre
(TMC), Mumbai. Training will be conducted at Tata Memorial Centre as this will
give the trainees an opportunity to observe the working of the palliative care team
at TMC. The duration of each training session will be two weeks.
• Training the outreach health workers such as ASHA workers, ANMs etc. The
palliative care team at Tata Memorials Centers (TMC), Mumbai, will carry out the
training. Besides the palliative care team from TMC may also conduct training on
223

site so as to reinforce appropriate knowledge, skills and attitudes and to identify
and gaps.
• Data collection and monitoring will be carried out throughout the project so as to
capture the numbers of patients accessing palliative care services and the follow
up, use of opioids and care in the terminal phase.
• Evaluation of the program at baseline and on a monthly basis.
Expected outcomes
• Improved care for patients with life limiting diseases and their families.
• Access to appropriate pain relief medications, including morphine.
• Developing a model program for palliative care which can be applied across other
districts in the state.
Future Plans
• Activities:-
Expand the project activity in Tribal Block of Nashik District.
Establishment of Palliative Care Cell at the Sub-district hospital/ Rural
Hospital containing one Medical Officer, one Nurse and one Medical
Social Worker to provide palliative care.
The Palliative care team will make frequent visits to PHCs and
households of patients registered under palliative care.
Budget proposed for 2012-13
Table – Budget requirement for palliative care Project
( Rs. in Lakhs)
SR. NO Activity Total Cost
1 Training of Health Care professional & Training Material 1
2 Support to faculty member from Tata Memorial Centre
for travel & DA
3 Medicines & Logistics 3
4 Incentives for ASHA workers & other Health Care
Provider
5 Referral of Patients 1
7 Salary of Contractual medical social worker & Medical
officer
9 TA of Palliative care Cell 1
224
1
2
3.50

10 IEC 1
Total 13.5
The Total Budget required for the project is 13.5 lacs. The project will be implemented in
collaboration with Palliative care department Tata memorial centre, Mumbai.
SUBSECTION – B.24.12 : ESTABLISHMENT OF NUTRITIONAL REHABILITATION CENTERS IN
TRIBAL AND LEA BLOCKS
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
2008-09 41.4 92.16 92.160
225
Rs. in Lakhs
Remarks
Introduction –
A Nutrition Rehabilitation Centre (NRC) is a facility based care center, for the
management of Severely Malnourished Children. In NRC malnourished Children are admitted
with defined admission criteria. They are kept under observation and provided with medical
and therapeutic care. In addition focus is on improving the skills of mothers on complete care
and feeding. Training of Nutrition Rehabilitation to Health and ICDS Functionaries is also
undertaken in NRC.
In Maharashtra 6 NRCs have been established at Gondia, Gadchiroli, Dharni
(Amravati), Thane Nandurbar and Nashik.
A) Objectives
- To function as apex institute for malnutrition.
- To provide institutional care for children with severe malnutrition.
- To promote physical, mental & social development of children with severe
malnutrition.
- To build capacity of primary care givers in the home based management of
malnourished children.
- To train the medical and paramedical staff regarding management of malnourished
children in the facilities and their household care after discharge
B) Situation Analysis
NRC Weekly Report for week ending 26.12.2011

Sr.
No.
1
Name of NRC No.of
children
admitted
in the
week
GH
Gadchiroli
Progressive
No.of
children
admitted
No.of
children
admitted
at the end
of week
No.of
children
cured since
beginning
of NRC
(Aug 2011)
2 29 4 18
2 WH Gondia 3 53 8 45
3 SDH Dharni 5 23 9 14
4 GH Nashik 0 20 1 17
5
GH
Nandurbar
5 5 5 0
6 GH Thane 8 15 9 6
Total 23 145 36 100
C) Proposed Budget for 2012
Remarks
(LAMA -5,
Medical
Transfer 2
Table - Nutrition Rehabilitation Centres Budget Estimates for One NRC
Rs in Lakhs
Sr.
Item
No.
A Human resources
Contractual ANM
@ Rs
9000/each/pm
Part time Sweeper
@ Rs. 1500/pm
Number
required
Cost
estimate/month
Annual Remark & Justification
2 0.18 2.16 Newly Proposed - 1) As
proposed in expert
committee meeting on
30th April 2011 at
Nagpur 2) During
monitoring visits to the
NRCs it was observed
that separate ANMs are
necessary for NRC
1 0.015 0.18 Rs 500/- increase in the
payment proposed in
expert committee
meeting on 30th April
2011 at Nagpur as it is
difficult to get sweeper
at Rs 1000/-
226

Sr.
No.
Item
Contractual Cook
@ Rs
3500/each/pm
Contractual
Attendant @ Rs
3500/each/pm
Contractual NRC
Coordinator @ Rs
7000/each/pm
B Medicines
Medicines
Electrolytes &
Minerals
(Potassium,
Magnesium, Zinc
& Copper
supplement), Iron
& Folic Acid,
Albendzole, Anti
Amoebic drugs,
Multi Vitamin
syrup, K-ReSoMal,
Syrup Kesol-20 by
EISEN etc.
C Diet of Children
@Rs. 25/Day &
Parents @ Rs
60/Day (Per day
10 Children
D Wages Lost @ Rs
60/Day
E AWW Honorarium
@ Rs 150/ Child x
20 Children/pm
for bringing child
for admission into
NRC
Number
required
Cost
estimate/month
1 0.035 0.42
2 0.07 0.84
1 0.07 0.84
Annual Remark & Justification
0.01 0.12 Routine medicines
should be used from
hospital store.
Medicine not available
in store ,only that
medicines should be
purchased
0.255 3.06
0.18 2.16
0.03 0.36 *Annual 240 Children
As proposed in expert
committee meeting on
30th April 2011 at
Nagpur
227

Sr.
No.
Item
Transportation
cost to AWW for
bringing child @
Rs.200X10
children
Transportation
cost to mother @
Rs.200X10
children
Number
required
Cost
estimate/month
Annual Remark & Justification
0.02 0.24 *Annual 120 Children
As proposed in expert
committee meeting on
30th April 2011 at
Nagpur. If Govt. vehicle
is used for
transportation, charges
for transportation will
not be admissible
0.02 0.24 *Annual 120 Children
As proposed in expert
committee meeting on
30th April 2011 at
Nagpur. If Govt. vehicle
is used for
transportation, charges
for transportation will
not be admissible
F Stationary 0.06
G Event
Management
(Celebration of
Health days etc)
0.06
H Printing, Xeroxing,
Photo etc.
0.06
I AWW Honorarium
@ Rs 200/ Child
for follow up of
the child
discharged from
NRC program for 1
year, admissible
only if child does
not become SAM
and certified by
concerned MO
PHC
0.04 0.48 Annual 240 Children
AWW Honorarium
@ Rs 100 x 4
0.08 0.96 Annual 240 Children
228

Sr.
No.
Item
follow up x 20
Children/month
Transportation
charges for
AWW@Rs
200/visit x 4 visits
x 10
children/month
Transportation
charges for
mother@Rs
200/visit x 4 visits
x 10
children/month
Diet of Child,
mother and AWW
@Rs. 75 for 3
persons 4 follow
up visits/ childx20
children/month
diet to be
provided from
NRC
J Training Cost
J Training Cost -
One day trg of Dist
hospital, Rural
hospital & PHC
Mos & Staff Nurse
regarding NRC
(resource persons-
Pediatrician and
NRC coordinator
Number
required
One
batch
per
month (
Batch
size 30)
Cost
estimate/month
Annual Remark & Justification
0.08 0.96 Annual 120 Children As
proposed in expert
committee meeting on
30th April 2011 at
Nagpur If Govt. vehicle
is used for
transportation, charges
for transportation will
not be admissible
0.08 0.96 Annual 120 Children As
proposed in expert
committee meeting on
30th April 2011 at
Nagpur If Govt. vehicle
is used for
transportation, charges
for transportation will
not be admissible
0.06 0.72 Annual 240 Children. As
proposed in expert
committee meeting on
30th April 2011 at
Nagpur
0.03 0.36 360 trainees annually
229

Sr.
No.
Item
working in NRC)
. One day Trg of
AWWs, ANMs
regarding home
management of
SAM children to
be conducted at
PHC level during
meeting)
k Soap, hair oil and
contingent
expenses
Total Recurring
Cost
Number
required
Cost
estimate/month
Annual Remark & Justification
0.12 As proposed in expert
committee meeting on
30th April 2011 at
Nagpur
15.36
Note- If Govt. vehicle is used for transportation, charges for transportation will not be
admissible
Total Budgetary Requirements for 6 NRCs = 15.36 x 6 = Rs 92.16 Lakhs
SUBSECTION – B.24.13 : ESTABLISHMENT OF MEDICINE WAREHOUSE AT SELECTED PLACES
IN TRIBAL AREAS
Year of starting
the
scheme/initiative
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Budget
sanctioned
for year
2010-11
Budget
sanctioned
for year
2011-12
Budget
proposed
in PIP
2012-13
Budget
Proposed
in NPCC
0 1742.23 150 150.000
230
Rs. in Lakhs
Remarks
Warehouse are required for storage of medicines. Some tribal areas of the state are far away
from the district HQ. It requires almost a day to reach these places because of distance and
condition of roads. In Mansoon it becomes very difficult to reach these places in most of the
July and August month.
Considering above problem; it is prepared to build good quality warehouse one each at
Semadoh (Melghat), Adivasi (Gadchiroli) & Dhadgaon (Nandurbar)

Each of the warehouse will be 100 Sq. feet with modern storage of system. Budget
required for warehouse is Rs. 50.0 Lakhs/warehouse. Total budget required is Rs. 1.5 Cr.
SUB-SECTION –B.24.14: TELEMEDICINE IN TRIBAL AREAS
SUMMARY INFORMATION OF THE SCHEME/INITIATIVE
Telemedicine are being provided to all the districts in the Maharashtra state. However as
Nandurbar and Gadchiroli districts, being leftist extremism affected, more number of
Telemedicine Centre are proposed for their districts. Therefore it is proposed to provide 1
centre for Nandurbar districts and 3 centers for Gadchiroli districts.
Considering the underserved area, backwardness and difficult terrain, it is proposed to
provide additional 4 Rural/Sub -districts –Taloda Dist. Nandurbar, Sironcha Dist. Gadchiroli,
Dhanora Dist. gadchiroli and Jawhar Dist Thane for telemedicine over and above the
sanctions under NRHM.
Considering the proposal above, total budget required will be as follows:
Year of starting
the scheme/
initiative
Budget proposed for
PIP 2012-13 to Preappraisal
committee
Final budget
proposed to
NPCC
2012-13 32.45 32.450
Remarks
231
Rs. in Lakhs
Budget revised as per need of
program
Telemedicine is a rapidly developing application of clinical medicine where medical
information is transferred via telephone, Internet or other networks for the purpose of
consulting, and sometimes remote medical procedures or examinations. Telemedicine may
be as simple as two health professionals discussing a case over the telephone, or as complex
as using satellite technology,Internet with Static IP and video-conferencing equipment to
conduct a real-time consultation between medical specialists in two different places.
Telemedicine Centers in Maharashtra
These nodes seek expert services from 6 specialty nodes, out of which 3 are situated in
Mumbai, and one each at Pune, Aurangabad and Nagpur.
Performance of telemedicine centers in Maharashtra
In Maharashtra, fourteen specialties are started for opinion under telemedicine. So far 22456
patients (Up to Feb 2012) have been referred to Medical College Hospital sand opinion
received for 22325 patients.
Total 14 CME organized through telemedicine center for specific issues like sickle cell disease,
epilepsy, school health patients, etc.
Plan of action for year 2012-13

During year 2012-13, new telemedicine center will be opened. Following actions are
proposed during 2012-13.
• Increasing the utilization of centers.
• Adding digital telemedicine equipment to new proposed centers to improve their
quality of work
• Expansion RH/SDH nodes and making them functional.
• Strengthening the management system of telemedicine project.
• CME’s for Medical and Paramedical staff.
Budget requirement for 2012-13
Budget is required for following purposes:
Table – Budget required for Tribal Telemedicine Centers
(Rs. in Lakhs)
Sir
No.
Particulars Unit Cost
No. of
units
232
Budget
required
1 Construction & renovation of room 3 4 12
2
Salary & TA/DA of Facility Manager for
New tribal rural/Sub - district hospitals
0.86 4 3.45
3 Honorarium to Doctors – Patient node
Contingency to Patient nodes
0.001 1000 1
4 ( including Civil works & other
maintenance)
0.1 4 0.4
5
Procurement of additional equipment to
tribal patient nodes of telemedicine
centers (Telemedicine Equipments, video
Conferencing camera, Software, etc)
3 4 12
6 Connectivity expenses 0.9 4 3.6
Total 32.45

Chapter 25
SCHEMES FOR HIGH FOCUS DISTRICTS
Schemes under this chapter are all specific for three high focus districts. They are different
from schemes of tribal areas of other districts or schemes for other LEA districts.
Drawings and primary estimates of all the construction works will be submitted before NPCC.
This is because PWD is busy with year end works and response from High Focus districts
requires some time.
1. NANDURBAR DISTRICT
Nandurbar district is 100% tribal district in North Maharashtra. High ranges of Satpuda
Mountain ranges and Narmada river along with backwaters of Sardar Sarovar has made more
than 30% of the villages very remote and not accessible by road. This is one of the important
reasons for poor performance of the districts in health indicators. Considering the situation of
the district, following activities / schemes are proposed for Nandurbar district.
a. Health Shelter
In blocks of Dhadgaon and Akkalkuwa, many of the health facilities and also villages are at
such a remote place that health worker need to travel up to 45 Kilometers on foot to reach
remote villages from his/her HQ. This makes extremely difficult for them to travel to these
remote villages. There are no homes, schools or other places to stay overnight for the staff.
Considering this peculiar situation, it is proposed to build pre-fabricated shelter homes at
places where the villages are more than 25 KM from HQ of the health worker. Ten places in
these blocks have been identified for such shelter homes.
Shelter will be two rooms of 150 sq. feed one for male staff and one for female staff, one
kitchen of 50 sq. feet and one toilet block of 50 sq. feet. Total shelter will be of 400 sq. feet.
Local SHG or ASHA will be given responsibility to maintain the shelter. She will be paid Rs.
3000/PM towards maintenance and provision of food. Food charges will be borne by
concerned health worker.
List of facilities where health shelter is required is submitted in annexure
Budget requirement
Budget required for shelter is for construction of shelter, maintenance and contingency for
keeping drinking water, etc.Detailed budget requirement is as follows:
233

Table – Budget requirement for Health Shelter
Sir Activity Unit cost
1
Construction of Health Shelter including one
borewell for water supply (one time)
No.of
units
234
Rs. In Lakhs
Budget
required
12 10 120
2 Maintenance by SHG/ASHA 0.36 10 3.6
3
Other maintenance charges (Drinking water,
electricity, drainage, etc.)
0.36 10 3.6
4 Furniture grant (one time) 0.5 10 5
Total 132.2
b. Wireless contact
Major part of interior areas in the district is not approachable by any means of
communication including mobile phones and BSNL wireless network. Therefore it is proposed
to provide one wireless set to each of the SC in interior areas. The base of the wireless
network will be at district level. Message for ambulance to shift mother in labour, critically ill
child and epidemics are expected from this system. System will be procured by following
procurement procedure. Budget required for this activity will be as follows
Table – Budget requirement for Wireless contact system
Sir Activity Unit cost
No.of
units
Rs. In Lakhs
Budget
required
1 Wireless set 0.5 56 28
2 Base station at Nandurbar 5 1 5
3 Salary of operator at Nandurbar 1.2 1 1.2
4 Contingency including civil works, stationary, etc. 0.5 1 0.5
Total 34.7
c. Floating Dispensaries and Floating ambulances
About 50 villages of Nandurbar district are completely isolated due to Backwaters of Sardar
Sarovar. These villages have mountain on one side and back water on other side. Government
of Maharashtra is providing health services to theses villages by floating dispensaries. These
dispensaries visit all the villages on fixed days and provide services. Only the post of Medical
Officer and Driver are approved by Government. These dispensaries are providing good
services, however, in case of emergency, particularly the delivery case or critically sick child,

they have to discontinue the service and take the patient back to Health Facility for
treatment. This leads to major disruption of services to remaining villages and irregularity in
service provision.
Distance between floating dispensary and bank of river changes every time and patients need
to travel in water to reach dispensary. This becomes very difficult for the patients particularly
the pregnant women. In addition there is no place for patients to wait till the Floating
dispensary approaches the villages. Therefore, one clinic room is proposed at each stop of the
dispensary.
Considering the above condition, it is proposed to provide additional essential staff and space
to Floating Dispensary and three Floating Ambulances to this areas so that these ambulances
can be called to shift pregnant women, critically ill neonates and other sick persons. The
ambulance will be called through wireless contact system.
Budget required for this activity is as mentioned in table below:
Table – Budget requirement for Floating dispensaries and Ambulances
Sir Activity Unit cost
No.of
units
235
Rs. In Lakhs
Budget
required
A Floating dispensary
1 Pharmacist (one per dispensary) 1.2 2 2.4
2 ANM 1.44 2 2.88
3 Laboratory Technician 1.2 2 2.4
4 Construction of clinic (Fibre - 400 sq. feet) 12 16 192
5 Maintenance of clinic by local ASHA 0.36 16 5.76
6 Solar light system and water supply 3 16 48
4 Assistant 0.96 2 1.92
5 Medicine 0.5 2 1
6 Additional POL 0.5 2 1
Total Floating dispensary 257.36
B Floating Ambulance
1 Procurement of Floating Ambulance 20 3 60
2 One Driver 0.48 3 1.44
3 One ANM in ambulance 0.72 3 2.16
4 One Assistant 0.36 3 1.08
5 Total Floating Ambulance 64.68
Grand Total 322.04
Considering the time required for procurement, salary of staff for Floating ambulance is
requested for six months only.

d. New Construction / repairs of quarters of RH/SDH and PHCs in remote areas
Areas in Nandurbar are so interior that there is no facility for staying of the health staff in the
village. Presently provided quarters require large repairs and also not adequate. It is proposed
to repair the existing quarters and to build quarters for one driver, two nurses and one
attendant in each of the hospital and PHCs.
Budget required for this activity is as follows:
Sir Activity
Table – Budget requirement for Civil Works
Unit
cost
units
236
Budget
required
A Repairs of the quarters
1 PHC quarters 17 14 238
2 RH Quarters 52 4 208
Total Repairs 446
B New Construction of quarters
1 PHC quarters 55 6 330
2 RH quarters 55 4 220
Total new construction 550
Grand Total 996
Summary Part B: Nandurbar District Schemes:
Rs. In Lakhs
Sr.No. Activity Budget required
1 Health Shelter 132.2
2 Wireless contact 34.7
3 Floating Dispensaries and Floating ambulances 322.04
4 New Construction / repairs of quarters of RH/SDH and
PHCs in remote areas
2. GONDIA DISTRICT:
Construction under Health Facility:
996
Total 1484.94

Construction of Separate LAB Room in Rural Hospital
Laboratory services are one of the major services required to cater prompt healthcare
services. The present laboratory room in RH is not spacious. it is needed to construct
there separate Laboratory room at each RH.
Construction Of NICU in RH
Stabilization of Newborn is to be started at RH. There are no separate wards for
Newborn care at some RH. Thus construction of NICE for proper management of
Newborn illness is required.
Construction of Dharamshala Building at RH
Gondia has poor road connectivity so easy transport services are available all the
time. Relatives of patients prefers to stay close to their sick relative. Thus, for
convenience to stay of such relatives coming from different localities is essential.
Herewith proposed budget is for construction of DHARMSHALAS for relatives at 10
health facilities.
Construction of nursing school building in BGW hospital campus
There is no separate nursing school building in Gondia District Hospital. Thus a
building of Nursing school for proper operationalization of school is proposed for
Gondia at BGW Women Hospital Campus.
Quarters:
Construction of MPW quarter in sub center building in highly naxal affected blocks
(Deori, Salekasa, Arjuni/ Mor.)
MPW and ANM works at sub centre to cater health services .In the difficult and naxal
affected area there is always scarcity of transportation. Thus to cater the services
round the clock one of the MPW/ANM is expected to reside at Sub centre premises.
Thus construction of MPW quarter is required at such area.
Construction of Staff Quarter in RH
There is no staff quarters available at RH,Amgaon of Gondia district .To cater the
services round the clock staff should reside in the campus of Hospital. Thus quarters
for these staff at Hospital vicinity is proposed.
Construction of Staff Quarters in WH,DH & RH
237

Residential Quarter for Hospital employees. With a view to provide 24 hour health
services to the patients attending RH . The health staff need to available in hospital
premises because of non availability of residential quarter most of the employees in 3
RH stay outside the premises and they are not in position to render quick services to
the needy patients.
Construction of Staff Quarters in PHC
With a view to provide 24 hour health services to the patients attending PHC . The
health staff need to available in hospital premises. But because of non availability of
residential quarter most of the employees in 4 PHCS stay outside the premises and
they are not in position to render quick services to the needy patients.
Compound Walls for Health Facility
Construction of Compound Wall At S.C.
Compound wall having height 1.5mtr with grill work on top constructed from bricks &
RCC Structure. Most of the SC’s in Gondia district are located in difficult, forest,
remote & naxal affected area. So for the protection from stray animals and antisocial
elements it is essential to construct compound wall to each SC in the district.
Construction of Compound Wall At PHC
Most of the PHC’s in Gondia district are located in difficult, forest , remote & naxal
affected area. So for the protection from stray animals and antisocial elements it is
essential to construct compound wall to each PHC in the district.
Construction of Compound Wall At PHU
Most of the PHU in Gondia district are located at difficult places , forest ,remote and
naxal affected area. So for the protection from stray animals and antisocial elements it
is essential to construct compound wall to each PHU in the district.
Preliminary estimates and drawings are requested to district. Will be submitted before
NPCC meeting.
Table: Budget required for Gondia under Special Action Plan
Section Activities No. Of Unit
Cost per
Unit
238
Total
Budget
1 Construction of Separate LAB Room in RH 5 9 45
2 Construction Of NICE in RH 10 10 100
3 Construction of Dharamshala Building at RH 15 10 150

Section Activities No. Of Unit
Cost per
Unit
239
Total
Budget
5
Construction of MPW quarter in sub center
building in highly naxal affected blocks (Deori,
Salekasa, Arjuni/ Mor.)
39 9 351
6 Construction of Staff Quarter in RH 1 100 100
7 Construction of Staff Quarters in WH,DH& RH 3 60 180
8 Construction of Staff Quarter in PHC 4 22.35 89.4
10 Construction of Compound Wall At PHC 4 7.5 30
1 .Gadchiroli District:
Compliance of remarks
Total 1045.4
Mobile unties proposed here are not regular MMU. These units have been procured by
District Collector Gadchiroli from LEA funds provided by GoI as per the decision during
meeting of Hon. Union Home Minister. There are six vehicles, two dental units, two
ophthalmic units and two pathology units. Response of the community is also very good.
However, now it has been informed by Collector that there is no budget for continuation of
the scheme so this can be budgeted from NRHM. These vehicle worth over Rs. 1.0 cry with
equipment are currently lying unused. If this budget is provided then services can be stated
with these vehicles. In entire LEA area of Gadchiroli, there is no pathology lab or dentist
available except for DH Gadchroli and SDH Aheri.
Considering above fact, this proposal may be approved.
A. Operationalization of Mobile Units
Gadchiroli district is completely LEA area and length of the district is about 350 KM. Except for
DH Gadchiroli and SDH Aheri, there is no availability of dentist, pathology unit or the
Ophthalmological unit. Considering this, six mobile units have been supplied under IAP to
Gadchiroli districts. These include 2 Dental Units, 2 Pathology Units and 2 Ophthalmologist
units. However, these units are not functional due to non-availability of funds for manpower
and operational expenses. As no such services are available in periphery, these units are
extremely essential for the district. Considering this, it is proposed to support these units
from Mission Flexi Pool. Budget required for these units is as follows:
Table – Budget required for operationalization of Mobile Units
Sir Particulars
Unit
rate
No. of
units
Rs. In Lakhs
Budget
required
A Mobile Dental Unit (2)
1 Salary of Dentist (Rs. 20000/PM) 2.4 2 4.8

Sir Particulars
Unit
rate
No. of
units
240
Budget
required
2 Salary of Dental Technician (Rs. 12000/PM) 1.44 2 2.88
3 Salary of Attendant (Rs. 6000/PM) 0.72 2 1.44
4 Salary of driver (Rs. 8000/PM) 0.96 2 1.92
5 Medicines and consumables (Rs. 1.2 L/year) 1.2 2 2.4
6 POL 1.2 2 2.4
7 Overheads 1 2 2
Total 17.84
B Mobile Ophthalmic Unit (2)
1 Salary of Ophthalmic Officer (Rs. 14000/PM) 1.68 2 3.36
3 Salary of Attendant (Rs. 6000/PM) 0.72 2 1.44
4 Salary of driver (Rs. 8000/PM) 0.96 2 1.92
5 Medicines and consumables 0.6 2 1.2
6 POL 1.2 2 2.4
7 Overheads 1 2 2
Total 12.32
A Mobile Pathology Unit (2)
1 Salary of Doctor (Rs. 25000/PM) 3 2 6
2 Salary of Laboratory Technician (Rs. 12000/PM) 1.44 2 2.88
3 Salary of Attendant (Rs. 6000/PM) 0.72 2 1.44
4 Salary of driver (Rs. 8000/PM) 0.96 2 1.92
5 Lab consumables 6 2 12
6 POL 1.2 2 2.4
7 Overheads 1 2 2
Total 28.64
Grand Total 58.8
B. Construction
Construction of Women Hospital at Gadchiroli is required.
District Hospital bed occupying rate is around 120 to 140, There is no private Health
Facility in this District & Hence People in this district solely Dependent on the District
Hospital for Health Care, Patient also coming from adjacent District like Chandrapur,
Bhandara & Chhattisgarh State. Considering
In the total patient load of this district the no. of Women coming for delivery is high
for that Separate Women Hospital required.

New construction of Ware House
A large quantity of medicine is supplied to PHCs and Hospitals as this is special focus
district. At present there is no sufficient and convenient storage facility available for
storage of this huge quantity of medicines and consumable. It is proposed to construct
one Warehouse in the premises of District Hospital for both the DHO and Civil
Surgeon. Thus construction of new warehouse at District level is proposed for safe
storage and distribution of Medicine and consumables.
Construction of Dharmashala at DH
As DH is the only place to receive specialty care in district, large number of tribal
patients attends the DH and SDH Aheri daily. These poor patients do not have any
facility to stay. As monsoon of this area is very strong, patients are at very much
hardship. Therefore it is proposed to construct shelter (Dharmashala) for poor
patients one each at Gadchiroli and Aheri. This will consist of two halls one kitchen
room with platform and two sanitary blocks (separate for men and women).
New construction of MPW Quarter at Sub Centre
One ANM and a MPW are appointed at sub centre to cater basic health care at village
level. One of these is supposed to be available on 24 hrs. basis for serving the
population. Thus construction of MPW quarters at well-performing subcentres are
proposed in the special action plan.
New construction of Medicine store Room at Primary Health Centre
PHCs are catering health services in the form of OPD as well as IPD(6 beds or
more).Availability and storage of medicine is very important at the PHC itself. At
present 32 PHCs in the district haven’t their medicine store. Therefore, construction of
32 medicine store rooms are required in these PHCs.
New construction of 20 Bedded EYE Ward at District Hospital
Gadchiroli District hospital caters various specialty services to rural population. There
is no separate ward for ophthalmology patients in this hospital. Ophthalmology
patients need to stay in the hospital for cataract surgeries and in case of ophthalmic
emergencies. Separate 20 bedded eye ward is proposed for this purpose.
New construction of Trauma Ward at District Hospital
Gadhchiroli is tribal and naxalite affected area. Naxalite activities used to occur in this
district which leads to large no. of trauma emergencies . To handle these emergencies
241

at present no separate trauma ward in DH. All these emergencies comes to DH ,hence
trauma ward construction is proposed.
New construction of Nursing School & Hostel Building at District Hospital
At present ANM schools is running in the campus of DH but haven’t separate building
.There is a requirement of construction of Nursing school building as well as Hostel for
the students of this school in campus of DH.
New construction of Type- IV Quarter at District Hospital
DH Gadhchiroli is a big health facility and a large no. of Class IV employees works for
the hospital. Residence quarters for these employees are less as compare to no. of
employees .So to accommodate all class IV employees additional 18 quarters are
needed.
Table: Budget required for Gadchiroli under Special Action Plan
Sir Name of Activities/initiative Unit cost
1
2
3
5
6
7
8
9
14
No. of
units
242
Rs. In Lakhs
Budget
required
New Construction of Women Hospital at
Gadchiroli (partial cost)
500 1 500
New construction Hospital Training Center
(Partial grant)
100 1 100
New construction of Ware House at District
Health Officer
90 1 90
New construction of MPW Quarter at Sub
Center
8 10 80
New construction of Medicine store Room at
Primary Health Center
4 15 60
New construction of 20 Bedded EYE Ward at
District Hospital
100 1 100
New construction of Trauma Ward at District
Hospital and Dharmashala
115 1 115
New construction of Specialist Room at District
Hospital
15 5 75
New construction of Type- IV Quarter at District
Hospital
22 18 396
Total 1516

C. Mobility Support
As this district is totally naxalite affected, there is no sufficient public transport system. The
distances of health facilities are also very far off. Therefore it is proposed to provide
Ambulances and supervisory vehicles to PHCs, Hospitals and Blocks. Requirement of vehicles
is as follows:
Table – Budget required for Mobility Support
Sir Name of Activities/initiative Unit cost
No. of
units
243
Rs. In Lakhs
Budget
required
1 Ambulances to PHC 5.5 6 33
2 Ambulances to RH/SDH 7.5 4 30
3
Supervisory vehicle to District Officials (DHO
and CS side)
5.2 5 26
5 Supervisory vehicles to Block Health Officer 5.2 10 52
6 Blood bags supply vehicle 5.2 1 5.2
Total 146.2
D. Total budget required for Gadchiroli district
Total budget required for special plan of Gadchiroli district is mentioned below:
Table – Total Budget required for Gardchiroli District
Rs. In lakhs
Sir Activity/scheme Budget proposed
1 Operationalization of Mobile Units 58.8
2 New Construction / repairs 1516
3 Mobility Support 146.2
Total 1721
Summary of budget required for Special Action Plan of High Focus districts
Total budget required for special action plans of high focus districts is mentioned in table
below:

Table – Summary budget required to High Focus Districts
Sir District Budget Required
244
Rs. In lakhs
1 Nandurbar 1484.94
2 Gondia 1045.4
3 Gadchiroli 1721
Total 4251.34

MAHARASHTRA
NATIONAL RURAL
HEALTH MISSION
PIP 2012-13
Page | 1

Sr.no Components
Component wise PIP 2012-13
Amount
Proposed to
NPCC
Approved
by NPCC
Additional
Budget
requested
Total
budget
A RCH 510.74 403.69 53.41 457.09
B MFP 869.40 358.44 590.23 948.67
C RI 32.54 42.44 2.94 45.39
requested Remark
Revised as per
discssussion
during 6-8
June.
Original MFP
PIP is of Rs.
769.39 Cr.
Requirement of
high utilization
hosptials (B.15,
Rs. 179.28 Cr
added as per
discussion)
Revised as per
new guidelines
D1 NIDDCP 0.3 1.47 0 1.47 No Change
D2 ISDP 4.6 4.17 0 4.17 No Change
D3 NVBDCP 12.57 20.65 0 20.65 No Change
D4 NLEP 4.33 4.13 0 4.13 No Change
D5 NPCB 39.14 20 0 20.00 No Change
D6 RNTCP 55.04 55.29 0 55.29 No Change
Page | 2

Sr.no Components
Amount
Proposed to
NPCC
Approved
by NPCC
Additional
Budget
requested
Total
budget
requested Remark
Infrastructure
Maintenance 300 356.05 0 356.05 No Change
Total 1828.66 1266.33 646.58 1912.91
Page | 3

PART – B : MISSION FLEXIPOOL
SECTION - B.1: ACCREDITED SOCIAL HEALTH ACTIVIST (ASHA)
A trained female community health worker called as Accredited Social Health Activist (ASHA) is
being provided to tribal as well as non-tribal areas in the approximate ratio of one per 1000
population.
B.1.1.1 : Selection and training of ASHA
Approved and Accepted.
B.1.1.2 : ASHA Drug Kit Medicine
Approved and Accepted.
B.1.1.3 : Incentive to ASHA
Approved for incentive as per the list attached. Accepted.
B.1.1.4 : Awards to ASHA
Approved and accepted.
B.1.1.5 : Support Mechanism for ASHA
All the activities at State and District Level are approved. Regarding Block Level activities, Block
level contingency is approved whereas Salary TA/DA of Block Community Mobiliser is not
approved. At PHC level, TA/DA to ASHA facilitator not approved, Honorarium to MO not
approved and contingency at PHC level not approved.
Regarding the activities which are not approved, PHC level decision of not approving activities
such as TA/DA to ASHA facilitator and Honorarium to MO is acceptable. Therefore it is not
submitted in revision. However, GoI has not approved Salary and TA of Block Community
Mobiliser of non-tribal block which need to be reconsidered. This activity is resubmitted with
explanation below:
Salary and TA of Block Community Mobiliser.
Budget requested : Rs. 100.0 Lakh, Remarks of ROP : Not Approved
GOI was requested Rs. 100.0 Lakh. However, total amount approved is Rs. 30.0 Lakh. Presently
Block Community Mobilisers are working in tribal blocks only. These are 60 blocks. It is
proposed to appoint Block Community Mobiliser in another 40 non-tribal blocks. If criteria
Page | 4

mentioned in ROP are to be applied, budget required for this activity will be Rs. 50.0 Lakh as
mentioned in table below:
Budget Requirement for Salary of Block Community Mobiliser in Non-tribal areas
Sir Particulars
Budget
/ unit
Total
Units
Budget
required
2 Block Community Mobiliser (salary + TA/DA) - Tribal 0.5 60 30
Block Community Mobiliser (salary + TA/DA) - Non-
Tribal
0.5 40 20
Block total 50
As discussed during the meeting of 7-8 June 2012, the non-tribal blocks with high IMR are
selected. List of selected blocks is submitted as Annex – B.1.1
B.1.2 : Strengthening of ASHA Resource Centre
There are approximately 60,000 ASHAs functioning in the state. ASHA program's success
depends on strong supportive system. For this purpose ASHA Resource Centre (ARC) plays very
vital role. In Maharashtra ARC is attached to SHSRC and Senior Public Health Consultant in
heading the ARC. As per GOI letter dated 15 th March 2011 entire team of ARC needs to be
recruited for the effective supervision of the program in the State. Therefore, following
structure and budget is proposed for strengthening of ASHA Resource Centre.
No Category
1
Project Manager
(Sr. Public Health Consultant)
SUBSECTION - B.2.1 : CHC
Approved
Unit cost
in Rs. In
lakhs
No of units
Total cost in Rs.
In lakhs
0.5 1 5
Total 6
SECTION - B.2 : UNTIED FUNDS TO HEALTH INSTITUTIONS
Page | 5

SUBSECTION - B.2.2 : PHC & APHC
Out of Rs. 452.50 Lakh requested, Rs. 426.53Lakh approved for PHC. Accepted.
Out of Rs. 198.75 Lakh requested, Rs. 186.83 Lakh approved for PHC. Accepted.
SUBSECTION - B.2.3 : Sub Center
Out of Rs. 1056.60 Lakh requested, Rs. 1011.27 Lakh approved for Sub-Center. Accepted.
SUBSECTION - B.2.4 : UNTIED FUNDS TO VHC
Out of Rs. 3967.44 Lakh requested, Rs. 3548.61 Lakh approved for VHNSC. Accepted.
SUBSECTION - B.3.1 : CHC
Approved
SUBSECTION - B.3.2 : PHC & APHC
-B.3 : ANNUAL MAINTENANCE GRANTS (AMG)
Out of Rs. 807.0 Lakh requested, Rs. 737.03 Lakh approved for PHC. Accepted.
Out of Rs. 240.0 Lakh requested, Rs. 218.28 Lakh approved for APHC (PHU). Accepted.
SUBSECTION - B.3.3 : Sub Center
Out of Rs. 828.60 Lakh requested, Rs. 768.69 Lakh approved for SC. Accepted.
SECTION - B.4 : HOSPITAL STRENGTHENING
SUBSECTION - B.4.1.1 : UPGRADING HEALTH FACILITIES TO IPHS
Page | 6

Remarks of GoI in RoP : Approval Pended. State to provide detailed breakup of the cost
components as there is lack of clarity on the cost components for which the funds are to be
utilized.
Detailed break up of cost components and procedure adopted by GoM to arrive at gaps and
converting gaps to budget requirement is submitted in this chapter. Information already
provided regarding criteria for selection of health facility, Steps in up gradation, number of
institutions upgraded by 31.3.2012, IPHS Evaluation system, Utilization of IPHS facility, more
emphasis on burn ward and Dialysis this year, implementation of Book Your Bed (BYB), etc. are
not mentioned here as this is already mentioned in PIP.
GoI has specifically mentioned about Up gradation of health facilities to IPHS in NRHM
Framework for Implementation. GoI has given time line for this and also given formats for gap
calculation in these guidelines. As mentioned by GoI, these standards have been fixed by a high
powered task group through a consultative process with states and other experts. IPHS is novel
concept to fix bench marks for infrastructure including building, manpower, equipment, drugs,
etc. Most importantly they define the level of services each health facility expected to provide.
Under RCH-II, upgradation of PHCs as 24×7 PHCs and CHC as FRU is being attempted to provide
emergency services to mothers and children. IPHS Upgradation activity in Maharashtra is being
carried out as per the guidelines of GoI in NRHM Framework and IPHS Guidelines for Health
facilities.
Salient features of cost calculations are:
• Cost calculation is based on annual survey of each of the health facility.
• Provision from state funds, provision from other sources including other schemes
of NRHM, provision from user fees and other local grants, etc are substracted from
annual requirement of facility and only gap is paid from IPHS funds.
• Gap is calculated for human resource, medicine, equipment, physical infrastructure
and support services separately and annual plan submitted by the facility is
scruitinised at district and state level.
• Identified gap is converted into budget and only required budget is released.
Budget requirement varies from facility to facility depending upon load (e.g.
deliveries, OPD, IPD, etc). Budget requrested is average of the requirement.
Detailed explanation of Cost components, their break up and how the gap is calculated is
submitted below:
How the cost is calculated for IPHS Upgradation
Page | 7

Government of India has published IPHS Guidelines for Sub Center, PHC, CHC and Hospitals as
per beds (51-100, 101-200, 201-300 and 301-500). In these guidelines, GoI has defined essential
services for each type of health facility.
Following steps have been carried out to identify the gaps and to convert the gaps into budget
requirement.
a. Basic Information
1. External Facility Survey is carried out during 2008-09 and 2009-10 with the help of
External Agency. Format provided in NRHM Framework for Implementation 2005-2012
were used for the survey.
2. Gaps in providing essential services to each type of facility as per IPHS were identified.
Meetings of Medical Officers, Medical Superintendents, RCH Officers and Civil Surgeons
were conducted to disseminate the findings. The gaps were converted into budget
requirement.
3. State level workshop was carried out under Chairmanship of Hon. Additional Chief
Secretary (PH & FW) for overall picture of the State. In this meeting, health facilities to
be upgraded were shortlisted by applying criteria of availability of building, OPD, IPD,
deliveries and emergency load.
4. It was decided in the workshop that as per GoI guidelines for IPHS upgradation, all the
designated PHCs will be first upgraded to 24×7 PHCs and all the Hospitals will be first
upgraded to FRU.
5. Accordingly, gaps related to PHCs (9 services) and FRU (10 services) were identified from
external survey and process of Upgradation started.
b. Planning for year 2012-13
Initially for two years, planning was carried out by IPHS cell in the district and only budget
was proposed in District Plans. However from 2011-12 onwards, each of the health facility
plan was prepared by the district and submitted to State Health Society IPHS Cell. For year
2012-13, detailed plans are prepared at Facility level, scrutinized first at district and then
state level.
The detailed activities carried out are as follows:
1. One committee was established at state level of officers such as Joint Director (T), Joint
Director (Hospitals), Joint Director (SC-PHC) and Senior Consultant IPHS.
2. Detailed format with eight sections was prepared by committee and circulated to all the
districts.(Format enclosed as Annex – B.4.1)
3. At the district level, two day workshop of annual assessment of health facility was
undertaken. Annual plan was prepared based on pre-tested format and committee of
District RCH Officer, RMO (Outreach) and IPHS Coordinator scrutinized the format.
Page | 8

4. These plans were again checked by State level committee and final approvals were
given.
c. Budget calculations for year 2012-13
Following actions were taken for calculation of budget for IPHS upgradation of health facilities
a. As mentioned in GoI Guidelines, annual survey of each IPHS Institutions is done. One
separate format for annual survey is devised based on the GoI format. Each of the IPHS
health facility has to fill up the format. This format is checked at district and state level
and budget is released only after finalization of format.
b. Budget was requested for Hiring of Manpower (Table -2), Procurement of Medicine
(Table-3), Procurement of Equipment (Table -4), Maintenance of Equipment (Table-5),
Physical Infrastructure (Table-6), Support services (Table -7) and Miscellaneous services
(Table-8). All these requirements are summarized in Table -1.
c. For each category, annual requirement, supply from government, supply from other
sources if any and gap was identified. Unit price of each unit required was calculated
and finally budget required for fulfilling of the gaps was calculated.
d. Exercise as mentioned above is carried out for all the health facilities included in IPHS
Upgradation. Considering the number and small requirement in SC, monitoring of
upgradation of SC is done at District level. However from PHC onwards total monitoring
is done from State level. Annual plan of each facility is around 15 pages. We have
prepared detailed plans for 658 PHCs and 220 Hospitals. Total plans come to 13174
pages. Therefore this is submitted in separate CD. To get an idea, plan of PHC and
hospitals one in each category is submitted as Annex – B.4.2.
Budget requested in the PIP was submitted as average of all the requirements. However,
detailed budget requirement have been calculated for each health facility before submitting to
GoI and was available in the Society. This detailed budget along with physical requirement is
submitted for approval.
1. Table - 1 : Requirement of Manpower : Manpower requirement include Specialists,
Nurses and Paramedical Staff. Requirement of manpower is enlisted as per IPHS. Staff
available is recorded and gap is identified. Salary of this staff is calculated. Range of
salary is communicated to all the District Societies and RKS. Actual salary is fixed by RKS
depending upon qualifications (degree/diploma), experience of the doctor and number
of days of OPD and Surgery. (Detailed circular sent to districts is annexed ; (Annex –
B.4.3). Staff presently working under IPHS is given in table below:
Table – IPHS Staff availability as on 1.4.2012
Sr. No. Speciality On Contract (IPHS)
Page | 9

Sr. No. Speciality On Contract (IPHS)
1 Specialists 607
2 Lab Technician (PHC+Hospitals) 634
3 Staff Nurses 1375
4 Data Entry operator/Accountant (PHC+Hospitals) 847
5 IPHS Coordinator 28
6 Statistical Investigator (IPHS Coordinator) 15
7 Data Entry operator (IPHS Coordinator) 31
Total 3537
Out of the staff above, post of Statistical Investigator and DEO at district level are discontinued
in year 2012-13. Also 342 Accountants at PHC and Hospitals are discontinued. Remaining staff is
continued. The DEO cum Accountant are engaged in account of health facility and also entering
data for MCTS and other online software.
Break up of Specialists appointed as on 1.4.2012 in IPHS designated hospitals is submitted in
the table below.
Table – Specialists appointed in IPHS upgradation hospitals.
Sr. No. Specialty On Contract (IPHS)
1 Surgeon 74
2 Physician 46
3 Gynecologist 89
4 Pediatrician 95
5 Anesthetist 120
6 Ophthalmic Surgeon 8
7 ENT Surgeon 7
8 Dermatologists 4
9 Orthopedics 13
10 Radiologist 17
11 Dentist 119
Page | 10

Sr. No. Specialty On Contract (IPHS)
12 Public Health Manager 9
13 Psychiatrist 6
Total Specialists 607
Summary of budget required for Manpower to IPHS health facilities is submitted in table below:
Table – Budget required for Manpower to upgrade health facilities to IPHS
Rs. In Lakhs
Sr. No. Type of facility
No. designated for up
gradation
Budget requested by the facilities
1 PHC 658 1245.69
2 RH 110 1386.95
3 SDH – 50 51 848.61
4 SDH – 100 23 503.91
5 WH 9 246.60
6 GH 4 152.26
7 DH 23 894.61
Total 878 5278.64
Detailed budget required for each health facility is submitted as Annex B.4.4A for Hospitals and
Annex B.4.4B for PHCs.
2. Table – 2 : Medicine Requirement
Budget for medicine is provided through following source:
i) State Government Medicine Grants
ii) User fees charges collected in hospitals
iii) Other schemes of NRHM
iv) Remaining through IPHS funds as gap filling.
State Government has developed list of medicines required for health facilities by establishing
committee of experts. This committee considered WHO essential drugs list, IPHS Medicine List
and Lists of medicines recommended by various GoI program experts. This list is updated
periodically and latest updated list is published by Government Order on 30.4.2012. List
submitted as Annex B.4.5.
Page | 11

State Government has approved budget for medicines to health facilities as per the criteria
given below:
Table – Medicine Budget from state grants
Sr Type of Health Facility Tribal areas Non-tribal areas
1 Sub-Center 0.12
2 Primary Health Center 1.2 1.6
3 Rural Hospitals 4.0 6.0
4 Hospitals with

Sr. No. Type of facility
No. designated for up
gradation
Budget requested by
the facilities
5 WH 9 427.92
6 GH 4 423.87
7 DH 23 1233.39
Total 878 8007.80
Detailed budget required for each health facility is submitted as Annex B.4.4A for Hospitals and
Annex B.4.4B for PHCs.
3. Table -3 : Equipment / instrument requirement
IPHS Guideline have identified essential services and also equipment required for services to be
provided by that particular health facility. This list of equipment changes with type of facility.
List of equipment for each facility is circulated to all IPHS designated health facility in the state.
Instruments already available are subtracted from the list. Equipment which can be repaired is
considered as available. Specialty specific equipment, (e.g. C-arm for orthopaeditian, Dental
chair for dentist) are not included in plan unless we get specialist and technician if required.
Thus, requirement of equipment and instrument is directly dependent on availability of
manpower.
Similar to medicines, gap of instrument and equipment is identified. Unit price of equipment is
decided and the gap is converted into budget.
Budget required for equipment / instrument procurement by the state in 2012-13 for IPHS
designated health facilities are submitted in table below:
Table – Budget required for equipment / instruments to upgrade health facilities to IPHS
Sr. No. Type of facility
No. designated for up
gradation
Rs. In Lakhs
Budget requested by the
facilities
1 PHC 658 537.94
2 RH 110 831.91
3 SDH – 50 51 509.58
4 SDH – 100 23 251.96
5 WH 9 284.89
6 GH 4 84.27
7 DH 23 2001.18
Total 878 4501.74
Page | 13

Detailed budget required for each health facility is submitted as Annex B.4.4A for Hospitals and
Annex B.4.4B for PHCs.
4. Table -4 : Maintenance of equipment
As per GoI IPHS Guidelines, every equipment if out of order should be repaired within 30 days.
Considering this following actions have been taken regarding maintenance of equipment.
i. All the equipment will have two year warranty at the time of purchase.
ii. All the equipment users will have address of the person to whom they should contact
in case the equipment is out of order.
iii. Maharashtra state has 8 Health Equipment Maintenance Units in the state. Each unit
visits one block once in month and repairs the equipment. This unit repairs all minor
equipment and major equipment such as all types of autoclaves, shadow less lamps,
centrifuge machines, suction machines, etc.
iv. Advanced equipment like C-Arm, CT Scan, Sonography, high end X-ray machine, are
entered into contract with manufactures for maintenance.
All the districts are instructed to keep the equipment and instrument of IPHS health facilities
functional. Budget required for AMG and other minor issues is first claimed from Government
budget, then from user fees and lastly from IPHS funds.
Separate format is given for identifying gaps and converting the gaps into budget requirement.
Summary of budget requirement for instrument / equipment is submitted in table below:
Table – Budget required for maintenance of equipment / instrument to upgrade health
facilities to IPHS
Rs. In Lakhs
Sr. No. Type of facility
No. designated for up
gradation
Budget requested by the facilities
1 PHC 658 213.32
2 RH 110 118.86
3 SDH – 50 51 89.23
4 SDH – 100 23 42.33
5 WH 9 18.47
6 GH 4 9.39
7 DH 23 154.44
Total 878 646.03
Detailed budget required for each health facility is submitted as Annex B.4.4A for Hospitals and
Annex B.4.4B for PHCs.
Page | 14

5. Table – 5 : Physical infrastructure
GoI IPHS Guidelines have identified areas required for each type of facility and also about
support services (Laundry, kitchen, etc.) and quarter. Gap for these areas is identified and
physical infrastructure is requested. Here also budget received from State Government and
other sources is subtracted and only gap budget is requested to GOI.
One register is kept at Facility and district level to avoid duplication of the civil works. One page
of this register is for each building. This helps to avoid duplication of the works from different
sources. As this data will be voluminous, at state level this monitoring is done with the help of
software called as ‘Construction Tracker’.
Budget required for physical infrastructure is submitted in table below:
Table – Budget required for physical infrastructure to upgrade health facilities to IPHS
Sr. No. Type of facility
No. designated for up
gradation
Rs. In Lakhs
Budget requested by the facilities
1 PHC 658 3453.24
2 RH 110 2242.95
3 SDH – 50 51 1705.03
4 SDH – 100 23 1177.42
5 WH 9 751.51
6 GH 4 167.41
7 DH 23 2665.01
Total 878 12162.56
Detailed budget required for each health facility is submitted as Annex B.4.4A for Hospitals and
Annex B.4.B for PHCs.
6. Table – 6 : Support services
Support services include Security services, Kitchen services, Cleaning services, laundry services,
etc. Normally budget from state government is provided for these services. However, at some
places, this budget is not sufficient due to high patient load. This gap is only filled in from IPHS
budget. Budget required for these services is mentioned below:
Table – Budget required for Support services to upgrade health facilities to IPHS
Sr. No. Type of facility
No. designated for up
gradation
Rs. In Lakhs
Budget requested by the
facilities
1 PHC 658 466.56
Page | 15

Sr. No. Type of facility
No. designated for up
gradation
Budget requested by the
facilities
2 RH 110 248.68
3 SDH – 50 51 151.51
4 SDH – 100 23 112.83
5 WH 9 94.82
6 GH 4 52.76
7 DH 23 272.61
Total 878 1399.77
Detailed budget required for each health facility is submitted as Annex B.4.4A for Hospitals and
Annex B.4.4B for PHCs.
7. Table – 7 : Other requirements
Other requirements which are not mentioned in Table – 1 to 6 but are essential to keep the
hospitals to IPHS standards are mentioned here. This includes expenses on un-interrupted
electrical supply, water supply, etc. For this also the guidelines says that first regular state
budget followed by user fees should be used. IPHS budget is to be used only when these budget
are not available or insufficient.
Budget required for this activity is submitted in table below:
Table – Budget required for other requirements to upgrade health facilities to IPHS
Sr. No. Type of facility
No. designated for up
gradation
Rs. In Lakhs
Budget requested by the facilities
1 PHC 658 559.56
2 RH 110 185.90
3 SDH – 50 51 193.50
4 SDH – 100 23 212.77
5 WH 9 39.29
6 GH 4 41.14
7 DH 23 312.72
Total 878 1544.87
Detailed budget required for each health facility is submitted as Annex B.4.4A for Hospitals and
Annex B.4.4B for PHCs.
Summary of total budget required for IPHS upgradation is submitted in table below :
Table – Summary of Budget required upgrading health facilities to IPHS
Rs. In Lakhs
Page | 16

Sr. No. Type of facility
No. designated for up
gradation
Budget requested by the
facilities
1 PHC 658 8956.36
2 RH 110 6779.53
3 SDH – 50 51 4536.03
4 SDH – 100 23 2940.90
5 WH 9 1863.50
6 GH 4 931.11
7 DH 23 7533.96
Total 878 33541.41
Detailed budget required for each health facility is submitted as Annex B.4.4A for Hospitals and
Annex B.4.4B for PHCs.
Once the state budget is made available to state in April and also once PIP is approved by GoI
which will give idea of other sources of funds, total Plans of the health facilities are revised by
calling the meetings of MO/MS, Store in charge and Pharmacist to finalize the Plan. During
finalization, GoI guidelines given for that year are also considered.
This year budget required for IPHS up-gradation is Rs. 335.41. Considering the limitation for PIP
size, Executive Committee of NRHM Maharashtra allotted Rs. 109. Cr for IPHS. Considering this,
the budget will be finalized for all the health facilities once it is approved by the GoI.
Impact of NRHM, criteria for selection, plans for this year and other minute details are already
submitted in PIP. Therefore they are not mentioned again here. Final budget required for state
remains same as mentioned in table below. The figures mention here are average amount
required after revising the budget demand of each facility.
Budget requirement
Considering above factors and based on the IPHS guidelines, one Planning Format was prepared
by SHS and distributed to all the districts. Plans received from the districts are analysed and
only the health facilities fulfilling Delivery Point criteria or with potential of improvement in
delivery services have been included in the upgradation list. We have ready plans for each of
the facility in the state. SC plans are kept at the level of District Society and all the plans for PHC
and higher health facilities are scrutinized by Quality Assurance wing of the SHS.
Once the budget is approved by GoI, one day workshop of all facilities (circle wise) is
conducted. Till that time, GoM funds and other activities are also known. Plans revised as per
availability of GoM funds and funds from other (particularly RCH activities) and plans are
finalized.
Although we have detailed plans of each facility, the budget required is mentioned as average
of these facilities.
Budget required for up gradation for year 2012-13 is as follows:
Page | 17

Table -: Budget required for up-gradation of health institutions as per external facility survey
Rs. In Lakhs
Sir Type of facility
No. of facilities
included for
IPHS
Upgradation
Average
Budget
required per
unit
Total budget
required
1 SC 1521 0.25 380.25
2 PHC 658 6 3948
3 RH 110 20.15 2216.5
4 SDH – 50 51 24.3 1239.3
5 SDH – 100 23 41.7 959.1
6 GH – 200 4 72.5 290
7 WH - (300 +) 2 72.6 145.2
8 WH - (200-299) 2 54.9 109.8
9 WH - (

• Some private medical institutions / organizations are willing to appoint specialists on
yearly basis.
Details of these areas are as follows:
Table – Special Focus Hospitals in Maharashtra
Sir District Names of RH/SDH Total No. Remarks
1 Gadchiroli SDH Aheri, RH
Sironcha, RH
Bhamragad, RH
Dhanora, RH Etapalli
2 Amravati
(Melghat area
only)
SDH Dharani, RH
Chikhaldara, RH
Churni
3 Nandurbar RH Akkalkuwa, RH
Dhadgaon, RH Molgi
5 Very remote and LEA affected
areas. Except Dhanora, all other
more than 100 KM away from
DH. No specialist facility
available since establishment.
3 Very remote reserve forest area.
Very high IMR and MMR. No
specialty services available.
3 Very remote area within
Satpuda mountain range and
Narmada river. No specialties
available since establishment.
High IMR and MMR.
Performance of special focus hospitals
Deliveries conducted in these hospitals for last three years is mentioned in table below. These
hospitals do not have specialists. After appointment of specialists, these hospitals will further
improve their performance.
Table : No. of deliveries conducted in Special Focus Hospitals
Sr. No.
Name of the
District
Name of the
institute
No. of Deliveries
2009-10 2010-11 2011-12
SDH Aheri 279 247 341
RH Sironcha 82 136 142
1 Gadchiroli RH Bhamaragad 26 18 31
RH Dhanora 95 106 116
RH Etapalli 10 38 81
2 Amravati SDH Dharni 483 487 532
Page | 19

Sr. No.
Name of the
District
3 Nandurbar
Name of the
institute
Budget required for special focus Hospitals
No. of Deliveries
2009-10 2010-11 2011-12
RH Chikhaldara 61 38 46
RH Churni 104 78 48
RH Akkalkuwa 199 185 203
RH Dhadgaon 594 798 845
RH Molgi 122 190 190
Total 11 hospitals have been included as special focus hospitals in the state. These are very
remote hospitals, without availability of specialists, far away from District Hospitals and with
very high IMR and MMR.
Salary of human resource to these hospitals was requested under RCH Flexi pool and repairs
and main building and quarters requested under Mission Flexi pool. GOI has approved salary of
Specialist Rs. 369.6 Crores for the specialists.
These are very small places without any staying arrangement in the village or city. Therefore
package declared to these doctors include rent free quarters. Considering this, plan is
submitted to establish laboratories, repair OT, labour room BSU and repairs of quarters.
Table above clearly show that these hospitals are well utilized. If additional inputs are given
then cesarean section and other important services can also be started in these hospitals.
As per discussion on 6-8 June 2012, budget requirement is recalculated. Duplication of budget
requested for Blood Bank / Blood Storage Unit is deducted and budget completely revised.
Hospital wise budget requirement for construction work is as follows:
Sr District
Table – Hospital wise requirement of budget for special focus hospitals
Rs. In Lakhs
Name of the
hospital
Laboratory
and blood
bank
equipment
Repairs and new
construction
Main
building
Quarters
Total
1 Gadchiroli SDH Aheri 0 11 45 56
RH Sironcha 9.4 22.5 111 142.9
RH Bhamragad 8.4 19.3 74 101.7
RH Dhanora 6.2 17.8 88 112
RH Etapalli 5 21 63 89
Page | 20

Sr District
Name of the
hospital
Laboratory
and blood
bank
equipment
Repairs and new
construction
Main
building
Quarters
Total
2 Amarawati SDH Dharani 0 16.8 113 129.8
RH Chikhaldara 3.7 9.5 34 47.2
RH Churni 3.7 7 106 116.7
3 Nandurbar RH Akkalkuwa 8.4 23 147 178.4
RH Dhadgaon 8.5 19.5 123 151
RH Molgi 3.7 14.1 54 71.8
Total 57 181.5 958 1196.5
Considering the clarification given above, GoI is requested to reconsider its decision and
approve this activity. Rs. 1196.5 may be approved for strengthening of 11 special focus
hospitals in the state.
SUBSECTION - B.4.1.3 : ESTABLISHMENT OF SNCU
Remarks of ROP : Approval pended. State to submit equipment audit of existing equipment and
resubmit the plan as per gap analysis.
Maharashtra State is establishing SNCU as per IPHS at 34 Hospitals in these States. GoI in its
guidelines for establishment of SNCU has identified equipment, instrument and support
services for these SNCU.
Presently NICU is functional at small scale all these places and establishment of full-fledged
SNCU is in progress. Beds of SNCU are based on number of deliveries criteria provided in SNCU
guidelines. These beds have increased from 198 beds to 557 beds. Instrument and Equipment
required for each of SNCU as per IPHS norms published by GoI are identified, presently
available instrument and equipment were deducted from this and finally only gap is being
proposed for procurement. Total 32 types of equipment are required for SNCU. No. of
equipment are 5238. Out of these 1001 equipment are already available and 4237 equipment
need to be purchased.
As per discussion with Child Health Division, detailed equipment wise requirement as per
norms, current availability and actual requirement is calculated for each equipment in table
below. SNCU wise list of equipment availability and requirement is submitted as Annex – B.4.5.
Sr.
No
Table – Requirement of equipment for SNCU in Maharashtra
Name of Equipment
No.
Required
as per
norm
No.
Available
No. to
be
Procured
Unit
Price (in
Lakh)
Rs. In Lakhs
Total
Cost (In
Lakh)
Page | 21

Sr.
No
Name of Equipment
A Major Equipment
No.
Required
as per
norm
No.
Available
No. to
be
Procured
Unit
Price (in
Lakh)
Total
Cost (In
Lakh)
1 Infant Warmer 742 200 542 0.53 289.75
2 Phototherapy Unit 271 101 170 0.47 80.33
3 Pulse Oxyimeter 271 29 242 0.79 191.79
4 Syringe Pump 138 28 110 0.36 39.38
5 Monitor 42 0 42 1.20 50.40
Total
Small
1464 358 1106 3.36 651.64
B Instrument/Equipment
1 Laryngoscope Set 271 54 217 0.02 3.80
2 Manual resuscitator 94 43 51 0.03 1.53
3 Pump,Suction,Portable 94 37 57 0.03 1.43
4 Pump,Suction,foot operated 94 32 62 0.04 2.28
5 Suture instruments 94 22 72 0.02 1.08
6 Oxygen Hood 271 60 211 0.10 21.53
7 Thermometer Clinical, digital 536 77 459 0.00 1.42
8 Scale baby electronic 188 27 161 0.05 8.05
9 Stethoscope Neonate 536 51 485 0.00 0.81
10
Sphygmomanometer,
electronic
271 5 266 0.03 6.65
11 Light, Examination 271 18 253 0.01 2.53
12 Hub Cutter syringe 94 31 63 0.02 1.23
13 Basin Kidney 188 39 149 0.00 0.10
14 Tray dressing 188 54 134 0.00 0.07
15 Stand Infusion 46 19 27 0.01 0.26
16 Infantometer 46 5 41 0.02 0.62
17 Autoclave, Steam 46 4 42 0.08 3.25
18 Laundry Washer dryer 46 1 45 0.12 5.40
19 Centrifuge 46 0 46 0.19 8.74
20 Glucometer 136 45 91 0.01 0.68
21 Split AC 46 1 45 0.30 13.50
22 Refrigerator 110 Lit. 46 6 40 0.10 4.00
23 Voltage Stabilizer (25-50 K.V.) 46 6 40 0.25 10.00
24 Computer With Printer 46 6 40 0.48 19.26
Page | 22

Sr.
No
Name of Equipment
No.
Required
as per
norm
No.
Available
No. to
be
Procured
Unit
Price (in
Lakh)
Total
Cost (In
Lakh)
25 Generator 25-50 KV 34 0 34 3.04 103.43
Total 3774 643 3131 4.93 221.66
Grant Total A + B 5238 1001 4237 8.29 873.30
Considering the services above and guidelines of GoI for SNCU establishment and functioning,
budget required for SNCU under MFP is as follows:
Sir Type of institute
Table – Budget required for SNCU
Average
cost per
SNCU
No. of
units
Rs. In Lakhs
Total
cost
1 Larger equipment as per GoI list 19.2 34 651.64
2
Minor equipment and instrument as per GoI
List
6.5 34 221.66
3 Maintenance of Equipment 3 34 102
4 Cleaning services 2.37 34 80.64
5 Security Services 1.78 34 60.48
6 Laundry Services 0.4 34 13.6
7 Contingency 1.2 34 40.8
Total 1170.82
Considering the explanation submitted above, budget of Rs. 1170.82 Lakh is requested for
approval.
B.4.2 : STRENGTHENING OF DISTRICT, SUB-DISTRICT HOSPITALS, CHCs, PHCS.
Budget not requested.
SUBSECTION - B.4.2.1 : UN-INTERRUPTED POWER SUPPLY TO FACILITIES
Un-interrupted power supply to health facilities (Solar Photovoltaic System) is requested at
B.4.2.1 for non-tribal and also at B.24.6 for tribal hospitals. GoI has approved this activity for
non-tribal areas (Rs. 660.0 Lakh) and not approved for tribal hospitals (Rs. 512.02 Lakh0. As per
discussion during 6-8 June Meeting at Delhi, the activity of Supply of Solar Photovoltaic System
to Tribal Hospitals (B.24.6) is now shifted to Section B.4.2.1. In addition to this, in activity for
budget required for monitoring cell of Photovoltaic system (A.8.1.9), there is remark that this
may be requested from MFP. Accordingly, this budget is also requested from MFP. This may be
approved as follows:
Page | 23

B.4.2.1 A : Uninterrupted power supply to Solar Health Facilities – Non tribal areas
Budget requested : Rs. 660.0 Lakh. Budget Approved : Rs. 660.0 Lakh. Accepted.
B.4.2.1 B : Uninterrupted power supply to Solar Health Facilities – Tribal Hospitals (CHCs/SDH)
There is severe electricity problem in state. IPHS health institutions require continuous power
supply. Therefore solar backup system is proposed for selected IPHS Hospitals (CHCs/SDH) in
tribal areas. Hospital will be selected on the basis of performance of hospitals in indicators such
as Delivery, IPD, OPD and Cesarean Sections performed during 2011-12.
Special system has been developed in the state with the help of Government College of
Engineering Pune for health facilities. This system can provide power to all the equipment in
PHC for 24 hours.
Same system will be used for tribal areas. This year, it is proposed to try solar back up system
for selected Rural Hospitals. Budget required for this system is as follows:
Compliance of remarks
All the PHCs in tribal areas are covered now so there is no need of grants for tribal PHCs.
However, this year, grant is requested for hospitals which fulfill criteria of delivery point.
Budget required for solar power backup
Budget required for solar power backup is mentioned below:
Table – :Budget required for solar power backup in tribal area hospitals
Rs. In Lakhs
Sir Type of institute Cost per unit No. of units Total cost
1 Solar Backup – RH 32 16 192
Total
192
Considering the importance of un-interrupted power supply, it is proposed to add new health
institutes for solar power if there is saving in other activities.
B.4.2.1 C : Solar back up monitoring Cell
So far, solar back up is provided to 330 PHCs and 5 Hospitals since last three years. All these
systems are provided with simcards which daily send message about condition of the solar
system. Information of all the centers is collected at one place in Mumbai, daily it is analyzed
and the message is given to the Supplier for systems under warranty and Maintenance Agency
for the systems which are now under maintenance contract. Daily 6-7 messages are received.
These messages are communicated to concerned agency and also follow up is made for timely
repairs.
Page | 24

Same cell is also has responsibility of getting demands from District Societies, corrections in any
required, floating tender, analyzing the tender, getting sanctions and assisting the Procurement
Department to issue the orders. Solar cell also monitors the establishment of Solar system in
selected health facility.
Solar cell is established in 2009-10 and is functional currently at SHS Mumbai.
Budget required for solar cell is as follows:
Table – Budget required for Solar Back UP monitoring Cell
Rs. In Lakhs
Sir Type of institute Cost per unit No. of units Total cost
1
Salary of Program Officer for
Support
2.88 1 2.88
2 Salary of DEO for support 1.2 1 1.2
Total
4.08
SUBSECTION - B.4.2.2 : QUALITY ASSURANCE IN IPHS FACILITIES
The activity of Quality Assurance was mentioned in PIP guidelines of GoI in 2010-11. That time
this activity was submitted and got approval also. However, activity could not be implemented
as Technical Support Partners could not be appointed. Therefore this was again requested in
PIP of 2011-12 and again got approval. It took long time to clear the pre-conditions and NGOs
selected so the activity started in October 2011. Now MoU is made with four Technical Support
Partners and NHSRC and this is fourth month they have started work.
Work of Quality Assurance is being carried out in stages as per guidelines issued by NHSRC in
2011. NHSRC has also given guidelines for percentage of payment at each stage as mentioned
in table below:
Table – Guidelines of NHSRC for payment of Technical Support partners
Sr Stage Description % of Payment to be
made
1 I Submission of 15 copies of “As is report” with gaps 15%
2 II Preparation and distribution of training and process
manual to all the concerned staff of hospital
15%
3 III Implementation of all quality system documents 30%
4 IV Pre-certification audit and closure of all nonconformities
20%
5 V Completion of final audit 20%
Total 100%
Page | 25

Presently all the TSPs have completed first stage and they are in the second stage. Therefore, if
to be discontinued, they have to be paid payment up to second stage.
Payment of the Technical Support Partners as per NHSRC guidelines and MOU will be as per
table submitted below:
Sr. No. Name of TSP
Table – Budget need to be distributed to TSP
1 st installment
15%
2 nd
installment
15%
Training
expenses
Rs. In Lakhs
Total
1 HOSMAC 70.968 70.968 8.4 150.336
2 ACME 38.8245 38.8245 6.9 84.549
3
MEDICA
SYNERGIE
34.7235 34.7235 6.68 76.127
4 OCTAVO 61.5255 61.5255 7.6 130.651
Total 206.0415 206.0415 29.59 441.663
The reports prepared by TSPs will be utilized for further improvement in quality services.
Remaining part of ISO certification will be carried out under IPHS Up gradation.
SCHEME - B.4.2.3 : BARRIER FREE ENVIRONMENT IN HOSPITALS
GoI has not approved this activity. It is proposed to drop this activity as per remarks of GOI.
SUBSECTION - B.4.4 : LOGISTICS MANAGEMENT AND IMPROVEMENT
SCHEME - B.4.4.1 : MOBILITY SUPPORT
As per remarks of ROP, this activity is submitted a comprehensive plan in Chapter B.12 :
Referral Transport.
Page | 26

SCHEME - B.4.4.2 : EQUIPMENT MAINTENANCE AND REPAIRS
Mobility support for HEMR unit is shifted to Mobility Support under NRHM. GoI has rejected
appointment of technical consultants for repairs of instrument and equipment. This decision is
accepted. No additional budget requested under this head.
SCHEME - B.4.4.3 : DISABILITY WORKSHOPS AT DISTRICT HOSPITALS
Approved activity
SCHEME - B.4.4.4 : MODERNIZATION OF HOSPITAL KITCHEN
Approved activity
SCHEME - B.4.4.5 : PUBLIC HEALTH ESTATE MANAGEMENT CELL
Need of Public Health Estate Management Cell
Most of the health facilities in Maharashtra are constructed on land either donated by donor or
on government land.
There is need to update the record of land of health facilities in the state for following
reasons
• Infrastructure development
• To make availability of land for constructions of the new health facility.
• To remove the encroachment on health facility.
• To update the records of land of health facility.
Many of these lands are not in the name of health department. In some facility the
boundaries are not cleared.
Considering the above fact, Public Health Estate Management Cell is established in state
Health society & at regional places in the Deputy Director Health office during 2011-12. The
State Health Society, Maharashtra Mumbai have already established four Public Health Estate
Management Cell in the state & remaining five will be established till March 2012.
Present position of PHEMS
PHEMS was approved in 2011-12. Advertisement was given for filling up of posts in July 2011.
Cell started functioning from September 2011. Position of filling up of posts in the state as on
1.4.2012 is as follows:
Page | 27

Table – Position of posts filled in as on 1.4.2012
Sr. No. Designation No. of posts
No. in position
on 1.4.2011
1 Senior Estate Manager 8 5
2 Junior Estate Manager 9 8
3 Program Officer at state level 1 1
4 Program Assistant 9 9
5 Travel & Mobility 9 9
6 Office Contingency 9 9
7 Office equipment& Furniture 9 9
Total
All these officers have started working and have collected valuable records for health
department. Total performance of this cell in year 2011-12 (7 months) is mentioned in table
below:
Table - Performance of Public Health Estate Management Cell (September 2011 to
March2012)
Sir Name of the
circle
No of
health
institutes
visited
Record
Updated
Encroach
ment
Removed
Land made
available for
construction
1. Pune 194 451 0 0
2. Aurangabad 206/65LL 87/61L 2
3. Nagpur 275 122 0 0
4. Latur 311 168 0 01
If this cell continues then it can work more efficiently this year. It is expected that this cell will
be able to get records of all existing health facilities. Considering the load, it is proposed to
continue this activity for next three years.
Page | 28
7

Considering the remarks of RoP, budget is requested only for existing staff. Therefore it is
requested to sanction the budget as proposed.
Sr.
No.
Table : Budget required for Estate Management Cell during 2012-13
(Rs. In Lakhs)
Designation
No. of
posts
No. in
position on
1.4.2011
Budget
per post
Budget
required
1 Senior Estate Manager 8 5 3.6 18
2 Junior Estate Manager 9 8 2.4 19.2
3
Program Officer at state
level
1 1 3 3
4 Program Assistant 9 9 1.2 10.8
5 Travel & Mobility 9 9 5 45
6 Office Contingency 9 9 0.6 5.4
7 Office equipment& Furniture 9 9 0.5 4.5
Total 16.3 105.9
It is requested that this activity may be approved and budget of Rs. 105.9 Lakh may be
sanctioned.
SCHEME - B.4.4.6 : IPHS MONITORING WING
There are many aspects which need to be monitored closely for upgrading the hospitals and also for
providing quality services. All these things should be done as per findings of External Facility survey.
Thus there is need of closely monitoring structure for timely upgrading of hospitals.
Out of the total budget requested under Mission Flexi pool, more than 20% budget is requested for
IPHS. Thus this is extremely important program as mother and child services will not be accepted by
community unless the health facility is in good condition. Considering the importance of program and
need to closely monitor this, IPHS monitoring system is established at district, divisional and state level.
IPHS monitoring system at district level is mentioned in IPHS chapter. In this section, IPHS monitoring
system at state and district level is mentioned. These units have been established in 2009-10 and have
been proved to be very useful.
Responsibilities of IPHS Wing at District level is as follows:
• Screening the data of health facilities for inclusion of facility in IPHS. Recommending names of
facilities with data support.
• Support to MO PHC / Medical Superintendent in planning health facility up gradation. Filling up
of gap formats and editing the formats.
Page | 29

• Monitoring for filling up of identified gaps. One separate file is maintained for each health
facility in district and gap filling is monitored on monthly basis.
• Supporting district for procurement of medical equipment, maintenance of medical equipment
and decision about out of order equipment.
• Monitoring the functional status of medical equipment in the IPHS facilities of the district.
Coordination with Health Equipment Unit for scheduling the visit of HEMR Units and informing
this to MO PHC.
• Monitoring mobility support to PHCs and Hospitals. Providing mobility support budget to health
facility. Monitoring referral transport under JSSK.
• Monitoring support services such as electricity either through express feeder or through Solar
Photovoltaic system.
IPHS Coordinator is only Biomedical Engineer available at District level in Public Health Department.
He/she is posted at CS office so she can discharge above mentioned duties appropriately.
Therefore same is to be continued for next year.
Considering the comments on IPHS wing, post of Consultant – IPHS is discontinued. Mobility support
required for IPHS Consultant and contingency is also discontinued. At district level, post of DEO and
Statistical Investigator is also discontinued. Therefore out of 5 posts, only one post is continued for year
2012-13.
As per discussion with Maternal Health Division during 6-8 June 2012 meeting, Consultants under RCH
Office will be included in the Cell for monitoring of quality improvement in the services offered by
Health Facilities. No new staff is recommended but staff appointed for Quality Assurance will be reoriented
for this activity and both the cells will work in close liaison.
Present position of the staff
IPHS Wing is in position since 2009-10. No. of staff approved for this wing since last three years is 92
persons as mentioned in second column of table below. Out of these, 87 persons were working in the
cell on 31.3.2012. As per discussion, 45 persons are discontinued or absorbed somewhere else and now
staff of 42 persons is requested under the scheme. Staff retained is experienced and is supporting the
health system for implementation of this program. Request for staff to be continued in 2012-13 is as
follows:
Sr Name of post
Table – Proposed IPHS Staff as on 31.3.2012
No.
approved
No. in
position on
31.3.2012
No
proposed
in 2012-
13
1 IPHS Coordinator at district level 33 33 33
2 IPHS Consultant at Circle level 9 8
0
3 State Senior IPHS Consultant 1 1 1
4 Data Entry operator at Circle level 8 8
0
Remarks
Post
discontinued
Post
discontinued
Page | 30

5
Data Entry Operator at District
level
33 29
6 IPHS Supervisors at state level 4 4 4
7 Salary of DEO (4) 4 4 4
Total 92 87 42
Considering the above fact, detailed budget requirement is as follows:
Budget requirement
0
Post
discontinued
Total manpower is revised. Initially budget required for State-Circle and District IPHS wings was Rs.
440.88 Lakh. Now it is revised to Rs. 181.65 Lakhs which is 60% reduction.
Budget requirement is as follows:
Table - : Budget requirement for IPHS Wing
Sr Name of post Unit cost
No. of
units
Rs. In Lakhs
Total
budget
1 Salary and TA/DA of IPHS Coordinator 3.9 33 128.7
Stationary, internet, office maintenance,
2 photocopying, AMC of office equipment, etc at
District Office)
0.75 33 24.75
3 Salary of State IPHS Consultant 6 1 6
4 Salary of IPHS Supervisors (4) at SHS 3.6 4 14.4
5 Salary of DEO (4) 1.2 4 4.8
6 For civil works, renovation, repairs, furniture 3 1 3
Total 181.65
SECTION - B.5 : NEW CONSTRUCTION, RENOVATION AND SETTING UP OF HEALTH FACILITIES
New construction, repairs of health facility infrastructure in Maharashtra is carried out by two
agencies. Infrastructure Development Wing is established to carry out construction work of
buildings of PHC/PHU and Sub-Centers. Contractual Junior Engineer, Deputy Engineer and
Executive Engineers are appointed in this wing. This wing is headed by Superintending Engineer
who is regular SE from PWD. In addition to this, Executive Engineers of PWD also supervise the
work of IDW engineers wherever necessary.
No additional charges are levied on the works done by IDW wing.
Page | 31

New construction of Hospitals, Nursing Schools and Regional Warehouses is carried out by
Public Works Department of Government of Maharashtra. PWD claims 5% Centage charges for
all works done and it is included in estimate provided by PWD.
Both the wings – IDW and PWD use DSR for making estimates.
For specified works such as construction of SNCU or construction of Audiometry Room, PWD
hires special architect for planning. Architect is selected from approved panel of PWD and
payment to architect is made as per approved government rates. Fees of architect are included
in estimate provided by PWD.
Considering the volume of work being done in Health Department and time bound program of
NRHM funds, PWD has appointed Chief Engineer Aurangabad as Nodal Officer for Health
Department works. Positive difference with PWD is observed after appointment of Nodal
officer.
One new software ‘Construction Tracker’ is introduced in Maharashtra state for all health
department constructions. The work is registered in the system immediately after awarding
administrative approval. Work is tracked till possession. It is proving very useful to the state for
timely completion of construction.
SUBSECTION - B.5.1 TO B.5.3 : NEW CONSTRUCTION AND RENOVATION OF SUB-CENTERS,
PHCs AND CHCs
A) Spill Works:-
Spill works are those works which started before 31.3.2012 i.e. last year and could not be
completed in same financial year. Precaution is taken to not to start new work in last three
months of the year so that spill cost remains within the limits. This year due to water scarcity,
civil works could not be completed within given time in some areas of the state. This has
increased the spill cost.
There are 190 Spill works pertaining to Repairs Works (Spill Cost Rs. 458.79 Lakhs) and 161 spill
works pertaining to New Construction (Spill Cost Rs. 3154.56 Lakhs). The total spill cost comes
out to be 3613.35 Lakhs. All these works are sanctioned works of last year.
Budget required for spill works as per type of facility is submitted in table below:
Table-(A) – Budget required for spill works
Sr. No. Type of work Facility No. of works
Rs. In Lakhs
Budget
required
1 Repair works Sub-Centre 87 135.32
Page | 32

Sr. No. Type of work Facility No. of works
Budget
required
PHC 103 323.47
RH/SDH 0 0.00
DH 0 0.00
Total 190 458.79
2 New Works Sub-Centre 122 1153.46
PHC 39 2001.10
RH/SDH 0 0.00
DH 0 0.00
Total 161 3154.56
Grand total All facilities 351 3613.35
As these works are ongoing works and this is a committed expenditure, this may be approved.
List of works is attached as Annex B.5.1
B) New Construction works Proposed in 2012-13:-
1. PHCs:- New construction of PHCs 10 No’s and Quarters at 31 PHCs are proposed, (
Amounting to Rs. 1475.00 Lakhs )
GOI Remarks:- Approval pended. Need to submit fresh plan. Approval will be
given on the basis of performance e.g. Delivery points.
Justification for Approval:- Fresh plan is submitted now on the basis of
performance e.g. Delivery points. Hence the activity may be approved.
2. SHCs:- New construction of 25 SHCs are proposed, ( Amounting to Rs. 450.00 Lakhs )
GOI Remarks:- Approval pended. State to provide break up on the ones existing
in rented buildings and the ones that are completely new constructions. If
existing in rented building state to provide details of functionality such as
delivery load, OPD/IPD and bed occupancy rate.
Justification for Approval:- Building status for all the works is mentioned now (
i.e. Whether the institute is working in rented building or a new
construction.) All the relevant information about rented
building is also given. Hence may be approved.
Table-(B) – Budget required for New works
Rs. In Lakhs
Page | 33

Sr. No. Type of work Facility
No. of
works
Unit Cost Budget required
1 New Construction Sub-Centre 25 18.00 450.00
PHC+
Quarters
41(10+31)
New
construction 10
PHCs @ 72 L
(31 Qtrs.)
1475.00
RH/SDH(CHC) 0 0.00 0.00
DH 0 0.00 0.00
Total 66 1925.00
The list of the facilities proposed for new construction is submitted as Annex – B.5. – II
Table-(C) – Budget Approved for Upgradation works
Rs. In Lakhs
Activity
proposed
Unit cost
(in lakhs)
Physical
Target
Amount
Proposed
(in lakhs)
Amount
Approved
(in lakhs)
Remarks
Repairs/ Upgradations
DH
11 325.00 325.00 Approved as per
SDH
CHC
PHC
SHC
15
57
304
475
204.00
658.25
1997.66
1284.14
204.00
658.25
1997.66
1284.14
list provided by
State. State to
ensure that work
will be completed
this year and no
further grants
Total
862 4469.05 4469.05
will be given
from new year
for these facilities
Table– Total Summary (For A)Spill Work, B) New Construction, C) Repairs/Upgradation)
Rs. In Lakhs
Activity proposed
Physical
Target
Amount
Approved
(in lakhs)
Amount
Proposed
(in lakhs)
A)Spill works 351 0.00 3613.35
B)New Construction 66 0.00 1925.00
C)Repairs/ Upgradations 862 4469.05 4469.05
Total 1279 4469.05 10007.40
Remarks
Requested in
revised PIP
Requested in
revised PIP
Already
approved
Page | 34

From Proposed total PIP of Rs. 10007.40 Lakhs only repairs/ upgradation works amounting
Rs. 4469.05 Lakhs is approved. Spill works and New Construction works of Rs. 5538.35 Lakhs
are proposed for approval of GOI.
The list of the facilities proposed for new construction is submitted as Annex – B.5. – II
SUB-SECTION - B.5.4 : SETTING UP OF INFRASTRUCTURE DEVELOPMENT WING
As per remarks, shifted to Program Management Section and approved.
SUBSECTION - B.5.5 : GOVERNMENT DISPENSARIES AND OTHER RENOVATIONS
No budget requested
SUBSECTION - B.5.6 : CONSTRUCTION OF BLOCK HEALTH OFFICE
Maharashtra had requested budget for three activities. These are Repairs of BPMU/DPMU, new
construction of BPMU / DPMU in non-tribal areas and new construction of BPMU/DPMU in
tribal areas. This proposal is revised. New construction of Block Office in tribal areas only is
requested and repairs of BPMU in tribal and non tribal areas is requested in this chapter. It was
also discussed to support construction of DPMU at 10 places in the state where there is no
space for Civil Surgeon to sit as the District Hospital is handed over to Medical Colleges. This
activity is shifted to B.5.12 : Strengthening of Program Management Unit.
As per discussion, proposal for quarters to BPMU staff is also dropped.
Budget required for strengthening of BPMU is as submitted below:
Budget requirement
Budget required for this activity is as follows:
Table – Budget requirement for Civil Works in BPMU
Sir Particulars Unit cost No. of block
1
Repairs of BPMU in tribal and non –
tribal areas. (Cost mentioned in average
of total demand + Spills of one BPMU in
Nagar Dist)
Rs. In Lakhs
Budget
required
12.4 14 173.6
Page | 35

2
New Construction of BPMU in tribal and
LEA areas
28 6 168
Total 341.6
SUBSECTION - B.5.7 : MAJOR CIVIL WORKS FOR OPERATIONALIZATION OF FRU
State government has established Women Hospitals at Gadchiroli and Nanded. Gadchiroli is
being constructed completely newly whereas, in Nanded, district administration has given one
hospital constructed for Guruta gaddhi (religious ceremony) organized last year in Nanded.
Both these hospitals are planned to be operationalized as FRU as large number of deliveries are
expected at both these places.
Approval for Gadchiroli is already received and Rs. 2.2 Crores handed over to PWD Maharashtra
from NRHM grants. Remaining grants need to be released this year. Gynaec ward of Gadchiroli
is always overcrowded and requires floor beds. Current rate of 300 deliveries per month at
Gadchiroli is expected to increase by 50%. We are expecting about 450-500 deliveries per
month in WH Gadchiroli once it is established. The district administration has allotted central
space to this hospital. Total estimate of the WH Gadchiroli is Rs. 13.2 crores. Currently we have
released Rs. 2.2 Crores. Out of reaming 11 Crores, Rs. 5.0 Crores will be required during this
year. Establishment of Women Hospital in Gadchiroli will improve the service availability.
Similarly, State Government has established Women Hospital at Nanded. Currently, deliveries
are taking place @ 600-700 PM in Government Medical College Nanded. However, the college
is being shifted to Vishnupuri which is around 12 KM from city. This will increase the load of the
Women Hospital by many fold. It is expected that about 600 deliveries will take place per
month in Women Hospital Nanded. It is proposed to repair the existing WH building, establish
the SNCU, and repair the labour rooms and Operation theaters.
Budget required for these activities is as follows:
Table – Budget required for WH Nanded and WH Gadchiroli to establish as FRU.
Rs. In Lakhs
Sir Activity Unit cost
No. of
units
Budget
requirement
1 WH Gadchiroli
i
Second installment
construction of WH
to PWD for
500 1 500
2 WH Nanded
i Repairs of main building, provision of lift 37 1 37
ii Extension of wards (2 wards of 30 beds) 58 1 58
Page | 36

Sir Activity Unit cost
No. of
units
Budget
requirement
iii Repairs of Labour rooms 2.6 2 5.2
iv Repairs of 2 OTs 3.1 2 6.2
v Establishment of SNCU 72 1 72
vi Establishment of Blood Bank 14 1 14
Total of WH 192.4
Grand total 692.4
SUB-SECTION - B.5.8 : MAJOR CIVIL WORKS FOR OPERATIONALIZATION OF 24×7 PHCs
Covered in IPHS Upgradation. Therefore deleted from this activity
SUBSECTION - B.5.9 : CIVIL WORKS TO OPERATIONALIZE INFECTION MANAGEMENT AND
ENVIRONMENT PROTECTION PLAN
Not approved therefore deleted.
SUBSECTION - B.5.10 : STRENGTHENING OF TRAINING INFRASTRUCTURE
Remarks of RoP : Approval Pended. State to submit detailed plan.
Budget is required for maintaining the buildings of training institutes (minor civil works and
furniture), construction or extension of training institutes and for provision of training aid and
equipment.
i) Mainenance of training institutes
Regarding minor civil works and furniture, this grant is utilized for civil maintenance work of
buildings and hostels. This is because, load of training institutes has increased and budget
available through regular resources is not sufficient. For example, during last year, total 16261
persons trained in HTT and 510516 persons trained in DTT. This increases the pressure on
existing system and this requires changes. This budget is utilized on following aspects:
• Repairs or replacement of tables, chairs, boards and other furniture as per need.
• Repair or replacement of beds, mattresses, study tables in hostel and other hostel
furniture
• Plumbing services repairs
Page | 37

• Electrical services repairs, replacement of geezers, water coolers, etc
• Repairs and maintenance of drainage system
For above mentioned activities, first regular budget is used and then NRHM budget is used.
Considering the load of training for year 2012-13 and availability of budget from regular budget,
budget for minor civil works is requested as follows:
Table – Budget required for maintenance of training institutes
Sir Activity
Average
Unit cost
No. of
units
Rs. In Lakhs
Budget
requirement
i District Training Center 3 33 99
ii Hospital Training Center 2 23 46
iii HFWTCs and PHI 15 8 120
iv BTCs 1 8 8
Total 273
ii) Construction or extension of training institutes
In Maharashtra there are total 33 DTT approved. However, out of these, DTT building is
available in only 30 districts. It is proposed to construct remaining three DTTs at Gondia, Hingoli
and Washim.
Similarly for HTT, currently only 14 HTT have its own building. Remaining HTT does not have
building. Out of these, HTT at Gadchiroli, Beed and Ratnagiri has available space. Therefore HTT
building is requested for these three HTTs.
Considering the load of HFWTC and PHI, it is proposed to expand the training institutes as per
requirement. Current hostel of 3 stories of PHI is proposed to expand by 2 more floors.
Similarly, HFWTCs at Nagpur, Amarawati, Pune and Aurangabad needs extension of hostels.
Budget required for each of these institutes as per block estimates is requested. Nutrition
Training Center is functional in Maharashtra since 1978 in SIHFW campus Nagpur. Considering
the problem of malnutrition, this center is provided with new responsibilities. Budget is also
required for extension of the Nutrition Training Center of Nagpur. For works above 1.0 Crore,
once the administrative approval to design is obtained, drawings will be submitted to GoI.
Facility wise requirement of construction is submitted in table below:
Table – Facility wise requirement of budget for construction
Rs. In Lakhs
Page | 38

Sir Type of institute
Cost per
unit
No. of
units
Total cost
1
District Training Center at Gondia, Hingoli and
Washim
210 3 630
2
Hospital Training Center at Gadchiroli, Beed
and Ratnagiri
195 3 585
3 Remaining construction of HFWTC Kolhapur 100 1 100
4 Remaining construction of HFWTC Thane 175 1 175
5 Extension of Hostel at PHI Nagpur 226 1 226
6 Extension of Hostel at HFWTC, Pune 172 1 172
7 Extension of Nutrition Training Center 98 1 98
Total 1986
Although the budget required for this activity is Rs. 1986 Lakh, budget of Rs. 1029.0 lakh will be
required this year for construction as proposed in PIP. Remaining budget will be requested in
year 2013-14.
iii) Provision of required training aid and equipment
All the training centers now a day require LCD Projector, IDP, Lap top and other training aid.
Training center wise requirement of training aid is as follows:
Sir Activity
Table – Provision of Training Aid and equipment
Average
Unit cost
No. of
units
Rs. In Lakhs
Budget
requirement
1 District Training Center 1 33 33
2 Hospital Training Center 0.5 23 11.5
3 HFWTCs and PHI 3 8 24
5 BTCs 0.5 7 3.5
6
Library for training institutes and data
management center
2 8 16
Grand Total 88
As mentioned in the remarks, detailed plan is submitted. It is requested to approve the
proposal.
iv) New Construction of Colde Chain Equipment Training Center at Pune.
Page | 39

Immunisation division, MoHFW has proposed to establish a National Cold Chain, Vaccine,
Logistics Management Resource Center at New Delhi. Present training Center of Government of
Maharashtra for Cold Cjhain Equipment will be designated as Cold Chain Equipment Training
Center. Government of India MOHFW by letter No. M – 11014/1/2010-CC&V dated 27.7.2011
directed to Director, NIHFW New Delhi to establish CCE Training Center thorugh PIP of
Maharashtra. UNICEF is providing technical support to the project. Formal MOU is signed
between GoI and GoM for this institute.
As per the discussion of State Health Transport Organisation and Immunization Divion of GoI,
the budget for traning center will be as follows:
Table – Budget required for establishment of CCE Training Center Pune.
Rs. In Lakhs
Sr Name of the Subject Approximate Cost
A Non-recurring cost
1
Complete renovation work and infrastructure strengthning of
existing training center building. 90
2 Construction of new hostel building in SHTOcampus 1000
3 Vehicle provision 30
Total Non-recurring 1120
B Recurring cost
1 Staf salary 95
2 Operational expenses 105
Total - Recurring 200
Grand total 1320
Out of above mentioned activities, only non-recurring activity will start this year, and for this,
SHTO Pune has requestd Rs. 300.0 Lakh budget for year 2012-13.
SUBSECTION B.5.11: CONSTRUCTION AUDIT
Remarks of ROP : Not approved
In NRHM, execution of civil works pertaining to state sector Buildings (i.e. District
Hospitals, Sub District Hospitals and CHCs) is done by State PWD and execution of works
pertaining to Zilla Parishad sector i.e. PHCs and SCs is done by Infrastructure Development Wing
(IDW) established in every district. As far as State PWD is concerned there is a separate wing
called “Vigilance and Quality Control Wing” for monitoring the quality of works being executed
by PWD. But for the works executed by IDW there is no independent quality assurance wing.
Page | 40

Hence it is decided to get the quality control work (pertaining to IDW works) done by
appointing a separate agency at State level for “Third party evaluation.” The State Executive
Committee also sanctioned the proposal for appointing a separate agency for third party
evaluation in the E.C. meeting held on 22-12-2011.
The scope of the work for “Third Party Evaluation” is decided on the basis of system existing in
“Sarva Shiksha Abhiyan” in Education Department and it is as below :
1. The consultant / representative (Engineer) shall visit each site of work for minimum
four times during the construction of work. These visits shall be when the construction work is
at Excavation level, at plinth level, at beam / slab level and at completion stage for issue of
completion certificate.
2. The consultant, at his own cost, shall check the quality of the materials brought on the
site of work and ensure that the materials are in accordance with the specifications generally
prescribed for the work. The laboratory test results of the materials tested is submitted to
district CEO, ZP.
3. consultant should remain present in the co-ordination / review meeting to be held at
State level or at District level once in a month or earlier as required (at no extra cost.)
4. As per the intimations, the consultant or his authorized Engineer should accompany to
the IDW Engineers when they take site visits / organize meetings at District level.
5. If any deviation in design / construction or compromise in quality is observed during the
site visit of consultant, it should be immediately reported to CEO, ZP at district level and SE,
IDW, Mumbai for further action.
6. Consultant shall organize with his own arrangement and equipment, at his cost, a one
day workshop to impart training to District IDW Engineers at mutually agreed suitable place at
district. The expenses towards the TA & DA of participants except the consultant) will be borne
by NRHM. A suitable place will be made available free of cost to consultant for arranging such
training program.
7. The consultant shall appoint two Engineers (Minimum Qualification B.E. Civil) for each
district. If the no. of works in any district is more than 500 then an extra Engineer for 250 works
should be appointed.
8. Consultant shall submit monthly report about the general progress of the works (for
each work).
9. Consultant should suggest the remedial measures to be carried out if any defects are
noticed, during construction.
10. Consultant should suggest the ways and means for economical construction. (To reduce
the cost of construction without affecting quality of work.)
11. Consultant should suggest methodology “to check and ensure the quality of work done”
(by IDW Engineer) and check the work quality accordingly.
12. Consultant shall not issue any instructions directly if in his opinion it is found necessary
to change specifications or modify design. The same shall be brought to the notice of regional
Executive Engineer and SE, IDW, Mumbai.
Page | 41

13. The consultant shall have minimum 3 years’ experience in the field of civil works of
similar magnitude to that of the works covered in the proposed project.
14. Consultant shall have to prepare “Manual for good construction practices” and
“Checklist” covering all the items to be executed as per the estimate and furnish it to IDW,
Engineers.
15. After the work is completed consultant shall issue completion certificate as per format
approved by SE, NRHM, Mumbai.
The procedure for appointing such agency at state level is in progress and it is expected
that the agency will be fixed up to the end of March 2012. Hence provision for the above
activity is necessary in PIP 2012-13.
Provision is done on lump sum basis i.e. @ 2.0% of the total budget for civil
construction. The total budget for civil construction (i.e. Mission flexipool + Minor civil works
for FRUs and 24 x 7 PHCs) is 88.66 + 2.25 + 6.03 = 96.94 Crores.
Hence budget required for third party evaluation of civil works is :-
2.0 % x 9694 (Lakhs) = 194 Lakhs.
SUBSECTION B.5.12: STRENGTHENING OF PROGRAM MANAGEMENT UNIT
Maharashtra had requested budget for three activities. These are Repairs of BPMU/DPMU, new
construction of BPMU / DPMU in non-tribal areas and new construction of BPMU/DPMU in
tribal areas. This proposal is revised.
In Maharashtra, 10 district HQ do not have District Hospital or any building or structure for
office or quarters. It is becoming very difficult to keep total DPMU staff at one place in these
places. Civil Surgeon is also not having any office or quarters to monitor the program. As NRHM
is now entering second phase, it will be very useful for districts to build own office at these
places.
This activity was again discussed during 6-8 June 2012 meeting. It was advised that one DPMU
complex may be developed in each of the 10 Medical Colleges. Ground floor of the complex will
be medicine store of around 3000 Sq feet and first floor will be office of the Civil Surgeon and
other DPMU staff of the district. Accordingly budget is requested for this activity as follows. All
remaining activities are discontinued.
Budget requirement
Budget required for this activity is as follows:
Table – Budget requirement for BPMU/DPMU
Rs. In Lakhs
Page | 42

Sir Particulars Unit cost
1
No. of
block
Budget
required
New Construction or repairs of DPMU in
10 districts.
96 10 960
Total 960
SUBSECTION B.5.13: STRENGTHENING OF NURSING SERVICES
Given the current problem of availability of trained nurses in the state, NRHM seeks to try a range of
innovations and experiments to improve the position. These include strengthening of Nursing/ANM
training schools and colleges to produce more paramedical staff, special batches of tribal students in
private nursing schools, providing scholarships and loans to poor students to complete course in rural
areas, higher salary, etc.
Sr
Table – : Requirement of nursing staff and current capacity of nursing schools
Health institute and
nursing staff/inst.
No. of
institutions
Requirement of staff Training capacity
Regular Contra. Total of govt. Schools
1 SHC – 2 ANMs 10579 10579 10579 21158 940
2 PHC – 1 LHV 1816 1816 1816 3632 225
3
4
PHC – 3 Staff Nurses
RH – Staff Nurse
1816
453
0
2718
5448
1359
5448
4077
360
Plan for year 2012-13
Considering the importance of availability of trained nursing staff to achieve the objectives of NRHM,
various steps are proposed to be taken to increase the availability of trained nurses in the state.
Important steps to be taken during year 2011-12 are mentioned below:
• Strengthening of all nursing schools as per MNC norms
• Repairs or New construction of nursing schools or hostels wherever necessary
• Repairs or new construction of annex buildings
• Public Private Partnership
Budget requirement for year 2012-13
As need of nurses has increased many fold after introduction of NRHM, admission capacity of all the
Nursing Schools is increased two or three folds. This has resulted into increase in requirement of basic
facilities such as classrooms, hostels, annex buildings (places of field practice), addition of books, models
and teaching aid as per MNC norms, etc. Major part of the requirement is being borne by state
government, however, gaps are being filled under NRHM for specific matters. Budget requested by
District Societies is submitted below as average budget requirement for the construction work of
Nursing schools.
As discussed in 6-8 June meeting, GoI is independently providing budget to Nursing Schools. Budget
provision of GoI outside the NRHM budget is as follows:
Page | 43

• Rs. 50 Lakh for strengthening of nursing schools at Latur and Kolhapur.
• Training material to three new nursing schools (Pusad, Sindhudurg, Washim) – Rs. 8.36 Lakh
• Construction of Main building, hostel and annex building of new Nursing Schools (Pusad,
Sindhudurg, Washim) – Rs. 42.53 Crores.
As mentioned above, budget is provided for five nursing schools. These schools are not proposed budget
for civil works under this activity.
Budget will be required for following purposes:
Table – : Budget required for strengthening of nursing services
Sr Particulars Unit price
No. of
units
Rs. In Lakh
Total
budget
required
1 Repairs of Annex building 6 31 186
2 New construction of annex building 55 3 165
3 Repairs and new construction of main building 44 4 176
4 Repairs and new construction of hostel building 27 8 216
Total 743
SUBSECTION B.5.14: CONSTRUCTION WORK IN HIGH FOCUS DISTRICTS
As per discussion with GoI officials, shifted from B.25 to Construction section (B.5)
1. NANDURBAR DISTRICT
Nandurbar district is 100% tribal district in North Maharashtra. High ranges of Satpuda
Mountain ranges and Narmada River along with backwaters of Sardar Sarovar has made more
than 30% of the villages very remote and not accessible by road. This is one of the important
reasons for poor performance of the districts in health indicators. Considering the situation of
the district, following activities / schemes are proposed for Nandurbar district.
a. New Construction / repairs of quarters of RH/SDH and PHCs
Areas in Nandurbar are so interior that there is no facility for staying of the health staff in the
village. Presently provided quarters require large repairs and also not adequate. It is proposed
to repair the existing quarters and to build quarters for one driver, two nurses and one
attendant in each of the hospital and PHCs.
Budget required for this activity is as follows:
Table – Budget requirement for Civil Works
Page | 44

Sir Activity
A Repairs of the quarters
Unit
cost
units
Budget
required
1 PHC quarters 17 14 238
2 RH Quarters 52 4 208
Total Repairs 446
B New Construction of quarters
1 PHC quarters 55 6 330
2 RH quarters 55 4 220
Total new construction 550
Grand Total 996
2. GONDIA DISTRICT:
Construction of MPW quarter in sub center building in highly naxal affected blocks
(Deori, Salekasa, Arjuni/ Mor.)
MPW and ANM works at sub center to cater health services .In the difficult and naxal
affected area there is always scarcity of transportation. Thus to cater the services round
the clock one of the MPW/ANM is expected to reside at Sub center premises. Thus
construction of MPW quarter is required at such area.
Construction of Staff Quarter in RH
There is no staff quarters available at RH Amgaon of Gondia district .To cater the
services round the clock staff should reside in the campus of Hospital. Thus quarters for
these staff at Hospital vicinity is proposed.
Construction of Staff Quarters in WH, DH & RH
Residential Quarter for Hospital employees. With a view to provide 24 hour health
services to the patients attending RH . The health staff need to available in hospital
premises because of non-availability of residential quarter most of the employees in 3
RH stay outside the premises and they are not in position to render quick services to the
needy patients.
Construction of Staff Quarters in PHC
With a view to provide 24 hour health services to the patients attending PHC . The
health staff need to available in hospital premises. But because of non-availability of
residential quarter most of the employees in 4 PHCS stay outside the premises and they
are not in position to render quick services to the needy patients.
Page | 45

Table: Budget required for Gondia under Special Action Plan
Section Activities No. Of Unit
Cost per
Unit
Total
Budget
1
Construction of MPW quarter in sub center
building in highly naxal affected blocks (Deori,
Salekasa, Arjuni/ Mor.)
39 9 351
2 Construction of Staff Quarter in RH 1 100 100
3 Construction of Staff Quarters in WH,DH& RH 3 60 180
4 Construction of Staff Quarter in PHC 4 22.35 89.4
GADCHIROLI DISTRICT:
Total 720.4
New construction of Ware House
A large quantity of medicine is supplied to PHCs and Hospitals as this is special focus
district. At present there is no sufficient and convenient storage facility available for
storage of this huge quantity of medicines and consumable. It is proposed to construct
one Warehouse in the premises of District Hospital for both the DHO and Civil Surgeon.
Thus construction of new warehouse at District level is proposed for safe storage and
distribution of Medicine and consumables.
Construction of Dharmashala at DH
As DH is the only place to receive specialty care in district, large number of tribal
patients attends the DH and SDH Aheri daily. These poor patients do not have any
facility to stay. As monsoon of this area is very strong, patients are at very much
hardship. Therefore it is proposed to construct shelter (Dharmashala) for poor patients
one each at Gadchiroli and Aheri. This will consist of two halls one kitchen room with
platform and two sanitary blocks (separate for men and women).
New construction of MPW Quarter at Sub Centre
One ANM and a MPW are appointed at sub center to cater basic health care at village
level. One of these is supposed to be available on 24 hrs. basis for serving the
population. Thus construction of MPW quarters at well-performing subcentres are
proposed in the special action plan.
New construction of Medicine store Room at Primary Health Centre
Page | 46

PHCs are catering health services in the form of OPD as well as IPD(6 beds or
more).Availability and storage of medicine is very important at the PHC itself. At present
32 PHCs in the district haven’t their medicine store. Therefore, construction of 32
medicine store rooms are required in these PHCs.
New construction of 20 Bedded EYE Ward at District Hospital
Gadchiroli District hospital caters various specialty services to rural population. There is
no separate ward for ophthalmology patients in this hospital. Ophthalmology patients
need to stay in the hospital for cataract surgeries and in case of ophthalmic
emergencies. Separate 20 bedded eye ward is proposed for this purpose.
New construction of Trauma Ward at District Hospital
Gadchiroli is tribal and naxalite affected area. Naxalite activities used to occur in this
district which leads to large no. of trauma emergencies . To handle these emergencies at
present no separate trauma ward in DH. All these emergencies come to DH ,hence
trauma ward construction is proposed.
New construction of Type- IV Quarter at District Hospital
DH Gadchiroli is a big health facility and a large no. of Class IV employees works for the
hospital. Residence quarters for these employees are less as compare to no. of
employees .So to accommodate all class IV employees additional 18 quarters are
needed.
Table: Budget required for Gadchiroli under Special Action Plan
Sir Name of Activities/initiative Unit cost
No. of
units
Rs. In Lakhs
Budget
required
2
New construction of Ware House at District Health
Officer
90 1 90
3 New construction of MPW Quarter at Sub Center 8 10 80
4
New construction of Medicine store Room at
Primary Health Center
4 15 60
5
New construction of 20 Bedded EYE Ward at District
Hospital
100 1 100
6
New construction of Trauma Ward at District
Hospital and Dharmashala
115 1 115
7
New construction of Specialist Room at District
Hospital
15 5 75
Page | 47

8
New construction of Type- IV Quarter at District
Hospital
22 18 396
Total 916
SUBSECTION B.5.15 : STRENGTHENING OF HIGH UTILIZATION PHCs and HOSPITALS
In Maharashtra, utilization of Hospitals is fairly good. Utilization of some of the health facilities
is very high. It is proposed that PHCs with very high delivery rate and Hospitals with more than
90% bed occupancy rate will be strengthened. Requirement of additional wards, Operational
theater, labour room, OPD complex, laboratory complex, Blood bank, water supply,
electrification, diet and laundry facility and also quarters for important staff required for 24
hours services (excluding managerial staff) will be fulfilled for such highly utilized hospitals.
Budget requested below is block estimates of the requirement as prescribed by IDW Engineers.
Once the activity is approved, exact estimates will be prepared by the PWD for these works.
Maharashtra PWD has appointed one Chief Engineer level officers from PWD as Co-ordination
Officer for all the works to be undertaken under NRHM grants. One Construction Tracker is also
developed for tracking all the constructions. Beside this, now regular meetings of Executive
Engineers and Civil Surgeons are being carried out by Health Department to get the works
faster and in time.
Following groups are considered for additional help to health facilities
i. Primary Health Centers with more than 50 deliveries per month (6)
ii. SDH with more than 80% bed occupancy (1)
iii. Women hosptials with more than 80% bed occupancy (4)
iv. District Hosptials with more than 80% bed occupancy (6)
Group wise budget requirement of health facilities is as follows:
Sr Name of the activity
No. of deliveries in
2011-12
Table – Budget required for Primary Health Centers
Sonpeth
dist
Parbhani
Dongaon
Dist
Buldhana
Name of the PHC
PHC
Walur
Dist
Parbhani
Sakharshet
Dist Thane Barahali
Lasur
Stn
Dist
Abad
1501 703 654 493 447 588
Rs. In Lakhs
Total
budget
requiremetn
Page | 48

Sr Name of the activity
1
2
Extension of Labour
Room
Female Ward for
delivery cases
Sonpeth
dist
Parbhani
Dongaon
Dist
Buldhana
Name of the PHC
PHC
Walur
Dist
Parbhani
Sakharshet
Dist Thane Barahali
Lasur
Stn
Dist
Abad
Total
budget
requiremetn
4.5 1.5 2 2.5 2.5 2 15
16 4.5 4 5 0 4.5 34
3
Construction/repairs
of Laboratory
3 0 2.5 3 0 2.5 11
4
Medicine Store
Room
2.5 2.5 0 2.5 0 2 9.5
5 MO quarters 18 18 18 18 36 17 125
6 Driver quarter 12 12 12 12 12 12 72
7
Twin Quarter for
nurses
Construction of one
48 36 24 44 44 24 220
additional toilet 1.5 0 2 2.5 3 2 11
8 block
9
Repairs of Sanitaory
block and drainage
system
1.5 2.5 1 5 0 0 10
Water Supply
system and water
storage system for
24 hours water
8 3 2.5 9 0 2 24.5
10 supply
11 Kitchen Shed 2.5 0 2 2 2 2 10.5
12 Electrification 3 3 3 0 0 2.5 11.5
13 Internal Roads 12 0 10 12 8 0 42
Total 132.5 83 83 117.5 107.5 72.5 596
Table – Budget required for Sub-District Hosptials
Rs. In Lakhs
Sr Name of the activity Name of the Hospital
Facility Jawahar
Bed Occupancy 92.93
1 Dedicated labour room for inf cases 45
2 Additional Female Ward for delivery cases 78
Page | 49

Sr Name of the activity Name of the Hospital
3 Establishment of NBSU 0
4 Repairs of OT 20
5 Repairs of Laboratory 9.06
6 Repairs of Blood Storage Unit 30.18
7 reapirs of x-ray 7
8 Reapis of ICU 40
9 Repairs of blood bank & dental room 7
10 Reapirs of labour ward 3
11 Kitechen room 7
12 Medicine Store Room 85
13 Doctors quarters 22
14 Driver quarter 56
15 Nurses quarters 356
16 Repairs of Sanitaory block and drainage system 40
17
Water Supply system and water storage system for 24 hours water
supply 20
18 Electrification 70
19 Waiting room 20
20 Gardening and planting 10
21 Internal Road 25
22 Septic Tank 20
23 Dhobi Ghat 5
24 Denatl Room 15
25 Fire Extinguisher 14
Total 1004.24
Table – Budget required for Women Hosptials
Sr Name of the activity Name of the Hospital
Rs. In Lakhs
Total budget
requirement
Facility Jalna Amravati Akola Thane
Bed Occupancy 148.69 125.4 124.43 85.61
Repairs of existing labour room
1 and addtioal labour room for inf
cases
18 14 27 24 83
2
Additional Female Ward for
delivery cases
140 76 105 112 433
Page | 50

Sr Name of the activity Name of the Hospital
Total budget
requirement
Establishment of NBSU 0 0 0 0 0
Repairs of OT 24 16 19 23 82
Repairs of Laboratory 14 19 21 14 68
Repairs of Blood Bank 9 44 35 0 88
3 Medicine Store Room 12 12 13 15 52
4 Doctors quarters 784 615 541 225 2165
5 Driver quarter 36 49 35 22 142
6 Nurses quarters 54 550 468 596 1668
7
8
Repairs of Sanitaory block and
drainage system
Water Supply system and water
storage system for 24 hours
water supply - pump and
harvesting
207 38 35 32 312
47 12 26 11 96
9
Electrification - repairs and new
90 13 16 64 183
11 Security guard Cabin 10 5 0 5 20
12 Internal Road 115 134 121 98 468
13 Gardening 25 15 15 5 60
14 Installing transformer MSEB 20 0 0 0 20
Total 1605 1612 1477 1246 5940
Table – Budget required for District Hosptials
Sr Name of the activity District wise budget
Rs. In Lakhs
Total
budget
requiremetn
Facility Chandrapur Amravati Bhandara Osmanabad Ratnagiri Hingoli
Bed Occupancy 119.78 100.6 91.36 89.74 89.71 84.9
1
Repairs of existing labour
room and addtioal labour
room for inf cases
41 0 32 33 150 52 308
2 Additional Female Ward
for delivery cases
72 0 145 133 142 156 648
3 Establishment of NBSU 0 0 0 0 0 0 0
4
Construction of Obstretic
ICU
0 0 156 106 55 114 431
5 Repairs of OT 58 55 86 74 87 79 439
6 Laboratory - repairs and
new constructin
23 71 85 64 16 78 337
7 Repairs of Blood Storage 0 0 0 0 0 0 0
Page | 51

Sr Name of the activity District wise budget
Unit
Total
budget
requiremetn
8 Wards 105 117 173 149 0 165 709
9 Burns ward 72 54 46 51 16 51 290
10 Speciality wards 204 194 213 258 205 198 1272
11 Medicine Store Room 54 52 48 42 50 22.4 268.4
12 Kitchen repairs 23 26 19 21 18 18 125
13 Kitchen shed for patient
relatives
14 11 0 11 15 14 65
14 Doctors quarters 150
155 145
1611
15 Driver quarter 42 205 44 52 415 541 138
16 Nurses quarters 206 314 312 832
17 Lift construction/repair 35 1 41 36 35 24 172
18 X - ray room 18 19 21 18 18 20.6 114.6
19
Repairs of Sanitaory block
and drainage system
198 84 104 41 114 89 630
20
Water Supply system and
water storage system for
24 hours water supply
75 84 68 27 69 81 404
21 Electrification 88 59 74 85 38 47 391
22
Shed and canteen for
relatives 15 15 19 17 18 52 136
23 Express feeder 0 0 0 0 85.91 0 85.91
24 OPD Complex 0 0 0 212 151.21 0 363.21
25 Land
Development/scaping
18 41 12 14 19 20 124
26 Cattle trap & main
0 0 0 0 0 3 3
entrance gate
27 Internal roads 105 89 97 85 74 34 484
Total 1616 1177 1952 1986 1791.12 1859 10381.12
Summary of budget requested is as follows:
Table – Summary of budget required for High Utilisation Health Facilities
Rs. In Lakhs
Budget
Sr Type of health faciliyy
requrested
1
Primary Health Centers with more than 50 deliveries per month (6)
596
2 SDH with more than 80% bed occupancy (1) 1004.24
Page | 52

3
4
Women hosptials with more than 80% bed occupancy (4)
District Hosptials with more than 80% bed occupancy (6)
5940
10388.12
Total 17928.36
SECTION - B.6 : CORPUS GRANT TO HMS/RKS
Approval in ROP accepted.
SECTION : B.7 : PREPARATION OF DISTRICT HEALTH ACTION PLANS
For preparation of District Action Plan, Rs. 1.0 Lakh is provided per district and State is provided
Rs. 5.0 Lakh. In Maharashtra, DHAP preparation is carried out as per GoI guidelines for DHAP by
steps given below:
1. One day Dissemination Workshop of RCH Officers, DPM and DAM at state level to
communicate GoI guidelines for the year for DHAP. Formats are circulated and detailed
planning is discussed.
2. Same meeting is organized at district level of MO PHC and MS Hospitals and other
officers of Disease Control Programs. Printed formats are distributed to all the PHCs and
Hospitals.
3. PHC workshop is organized after district meeting. Village plans are discussed and
formats distributed.
4. Village plans prepared in one week and submitted to Village Health Committee.
5. MO PHC and supervisor meet at block level and PHC level plans are prepared at Block
level. This meeting is conducted at 353 block HQ. Approval of RKS is taken. Hospital
plans are prepared at hospital level and submitted to RKS.
6. MS of Hospitals, THO, 1-2 MO and supervisors meet at district level to prepare block
level plan. This plan is submitted to Block Health Mission.
7. All block plans are collected and one week workshop is conducted at HFWTC level of all
districts. RCH Officer, RMO (O), DPM, DAM, Dist Supervisors (6 persons from one
district) attend this workshop. DHO and Civil Surgeon attend the workshop on 4 th and
5 th day to finalize the plan.
8. The prepared plan is submitted to District Mission and after approval of mission,
submitted to state.
9. Principal HFWTC, his staff, Deputy Director Circle and his staff are travelling from day of
MO preparation meeting to submission of plan.
Page | 53

10. All the plans are prepared by our own staff without any help of consultants.
GoI has approved only Rs. 38 Lakhs for the total exercise. With this exercise, it will not be
possible to conduct PHC level, block level and district level workshops and as HFWTCs and
Circles are not given budget, no supervisory visits can be conducted.
Experience of Maharashtra of last four years indicate that calling all blocks at district level and
calling all districts inc] circle at HFWTC helps in developing quality plans.
As per GoI guidelines, NRHM has allowed up to Rs. 20.0 Lakh per district for DHAP. This budget
is 25% of the guidelines.
If bottom up approach as per DHAP guidelines is to be followed, it is very difficult to prepare
plans in approved amount. Therefore it is requested to approve the budget as proposed.
Budget requirement
This issue was discussed during 6-8 June Meeting at New Delhi. It was decided that budget for
DHAP will be provided as per expenditure of year 2011-12. Accordingly budget requirement is
submitted as follows:
Table –: Budget required for preparation of PIP for year 2012-13
Sir Particulars
PIP
Exp.
prep.
10% add
Rs. In Lakhs
Budget
required for
yr 2012-13
1
District Health Action Plan at block
level
143.24 157.564 160
2
HFWTC for Preparation
Compilation workshops
and
7.99 8.789 9
3 Circle offices for supervision 0.03 0.033 1
4
State PIP (All components - meeting,
review, printing, etc)
35 38.5 40
Total 210
Page | 54

SECTION - B.8 : PANCHAYATI RAJ INITIATIVE
SUBSECTION - B.8.1 : & B.8.2 : CONSTITUTION AND ORIENTATION OF COMMUNITY LEADERS
AND VHSC, SHC, PHC, CHC, ETC
Approval received. Accepted.
SUBSECTION - B.8.2 : GUIDED TOURS FOR MLAs, MLCs AND OFFICE BEARERS OF ZILLA
PARISHADS
Approvals received. Accepted.
SECTION - B.9 : MAINSTREAMING OF AYUSH
GoI has approved almost all the sub-components of the program. However, re-consideration is
requested for only one activity as mentioned below:
TA/DA to AYUSH Coordinators : TA/DA of Rs. 12.25 Lakh for AYUSH Coordinator was
requested. There is no other source of budget for this activity. Therefore TA/DA for tours may
be approved. Otherwise, review meetings and monitoring will be difficult in AYUSH program.
As per discussion during 6-8 June meeting, provision of AYUSH facility to Women Hospitals is
shifted to Chapter B.15 : Innovations.
Rest of the activities in AYUSH acceptable as per ROP.
SECTION - B.10 : IEC/BCC UNDER MISSION FLEXI-POOL
Introduction :
Maharashtra is considered to be one of the better developed state of India.
However there are considerable variations in language, culture and social setup. While
implementing IEC BCC activities. We have to focused on local needs and linked with expected
out come of health goals.
State focus for IEC/BCC will be on following issues.
1) Reduction of MMR
2) Reduction of Anaemia in mothers, children and adolescent girls.
3) Reduction of IMR
4) Reduction of TFR
Page | 55

5) Improving age at Marriage
6) Adolescent Reproductive and Sexual health
Currently in Maharashtra the MMR is 104, the state has setup goal for reduction
it < 90 by 2013. To achive this goal IEC BCC will focused on Inter Personal Communications
activities, cultural programmers and various compitations for women groups. Awareness will
be generated through community & electronic media regarding Intuitional delivery, J.S.Y, JSSK,
ARSH, immunization, PCPNDT, family planning etc.
Child health
While considering the status of child health indicators IEC BCC activities will be
implemented to achieve the following goals.
1) Reduction in neonatal mortality from 29 to 20 and reduction of IMR from 33 to 27
2) Immunization coverage up to 85%
3) Early breast feeding up to 65%
4) Reduction in grade 3 and grade 4 malnutrition.
For achieving the goals the activities like mother counseling, groups meetings
healthy baby computations, will be implemented. Awareness will be generated through
community and, Folk media, special women’s camps will be organized in rural area.
Family Planning
The Maharashtra has always been in the forefront in the implementation of
family planning programme. State has declared Population policy. According to policy state has
accepted 2 children family as a small family norm.
Awareness generation activities will be implemented for increase the acceptance
of NSV, Use of contraceptives, sterilization, acceptance of IUD etc. through IPC, Folk media,
Health melas, Exhibitions and Electronic media.
10.1 IEC Strategy :
IEC strategy development requires decisions with respect to three key questions :
Whom to address, that is identification of target groups.
What do we want to say to them that is selection of messages contents .
What communication method should we use to deliver a specific message to a particular target
group, that is media selection.
In Maharashtra state for planning, implementation and monitoring of IEC/BCC
activities an independent state Health IEC Bureau is established in the year 1996 which is
headed by the Deputy Director of Health Services, a mass Media Specialist. Every district has a
small IEC unit of 2-3 officials functioning under the supervision of District Health Officer.
Page | 56

Planning, implementation and monitoring of various IEC/BCC activities under
Reproductive and child Health Programme as well as other various national health programmes
are being carried out throughout the year through the state Health IEC Bureau. Maharashtra
Arogya Patrika a monthly magazine in Marathi is being published and circulated regularly by
the State Health IEC Bureau for continuous health education to health providers and
community in the State. Parivartan Express, a very unique a audio visual Van is run by State
Health IEC Bureau. Various activities such as health exhibitions, film shows are organized
throughout the State with the help of Parivartan Express.
Areas to be focused
- Mother health - Child care
- Immunization - Spacing
- Family Planning - Adoselant health
- Diet - Safe Abortion
- PCPNDT - Institutional Delivery
- Breast Feeding - Ayush
- Janani Surksha Yojana - TB Control
- Janani Shishu Surksha Karyakram - Malaria, Dengue, Chikungunya
- Rugn Kalyan Committee - Water barn diseases
- Child Develapment Center - Non Communicable diseases
- Village & Sanitation Committees - Blindness Control
- Nutrition - Sickle cell Control
- Mental Health
Target groups
Three segments we need to be included in the target audience for all institutions
Govt. functionaries working at the grass root level- Ashas, ANMs Anganwadi
workers, Gramsevikas, school teachers, extension workers & multi purpose health workers –
should be targeted for information pertaining to what health services are available and where.
These workers are likely to be seen as opinion leaders by the population. They serve & they can
be key information sources in spreading knowledge about the working of the referral system .
Women are be considered as priority target : they are ,managers of the
households health status & have also demonstrated their capacity as a group to mobilize
community response.
Page | 57

Patients who enter the hospitals & health centre’s are considered a priority
target There word-of-mouth as satisfied user will carry far more weight than any other channel
of communication strategy to succeed improvement in quality clinical care & proper counseling
of user may serve this purpose
The community at large also constitutes an important target group since the
initiative taken by community leaders and other stakeholders
IEC for whom
- ANM’s
- Ashas
- Anganwadi Workers
- Health Workers
- School teachers
- NGO Workers
- Other Service Providers
- Mothers
- Women's
- Girls & Boys
- General Community
- Community Leaders
- Panchayat members
- Elected representatives
- Social Workers
- Doctors
- Media Persons
Methods & Media
Often media such as print or electronics, dominates any mention of IEC whereas
methods of communication are neglected. The IEC bureau will correct this imbalance of
emphasis by underscoring the methods & media according to their role and contribution in
behavior change. In the state of Maharashtra where for example awareness of family planning
appears to be universal the role of mass media becomes secondary (basically to support re –
enforce re- assure message) to two way channels of communication such as group approach
inter-personal communication & counseling these approaches help a potential user of
contraceptives to make the crucial decision of adopting the practice, by clarifying & doubts &
misconceptions he or she might have.
Community participation is another important approach in IEC. Community will be involved
at all levels from strategy, planning to programme evolution.
Electronic Media
Electronic media such as radio and T V are the most powerful channels of
communication, for creating awareness of health issues. Electronic media when used in a
Page | 58

planned and creative way can be the most cost-effective way to inform and reassure people.
Production of high quality T V and radio programmes is, however, a complex and technical task.
Selection of Media
1) Print Media
- Handbills
- Folders
- Flip Booklets
- Posters
- Banners
- News Papers, Advertisement
- Message through electricity bills
2) Electronics Media
- T. V.
- Radio
- Local Cable
- SMS
- F M Stations
- Scrolling boards
3) Community Media
- Rallies
- Falk art
- Film shows
- Exhibitions
- Health Melas
- Floats
Page | 59

- Hoardings
- Wall Painting
4) Group Media (I.P.C.)
- Home visits
- Small group meetings
- Personal visits
- Religious Functions
- Haldi-Kum-Kum Programme
- Immunizations
10.2 Implementation of Strategy
While implementing IEC / BCC Plan following issues will be focused.
(1) Message will be well designed to solve the indentified health problems and
issues.
(2) IEC / BCC Messages, Material and media will be linked with programme
objectives.
(3) Intergrated approach will be adopted for implementing IEC / BCC activities.
(4) Programmes will be strictly monitored for timely dispatch of IEC material to
proper destination and its utilization.
(5) Instead of mass media approach, IPC approach will be adopted for disseminate
the message among the rural masses.
(6) The district will be focal point for developing local specific IEC.
(7) Special training programme will be organized for developing the communication
skills of service providers and IEC personals.
(8) State will encourage the Best IEC practices.
(9) Role of different functionaries for implementation and supervision will be
ensured.
(10) Decentralized and participatory approach will be adopted.
(11) Service providers at grass root level will be equiped with proper IEC material and
methods.
(12) Media people as well as journalists will be encouraged with best awards.
(13) Health Meals will be organized for mass awareness.
(14) Mass publicity campaigns will be organized for declining the sex ratio.
Page | 60

Activities (B. 10.2.1 to B.10.2.4)
Inter personal communication
For behavior change, Inter personal communication is very effective tool. For this
purpose. Counseling and interactive sessions with ASHAs, ANMs, and Anganwadi Workers,
group meetings at village and block level, workshop for women groups, community leaders,
adolescent groups at block and district level has been proposed. 358 workshops at block level
@ Rs.5000) and 33 workshops at district level @ Rs. 10000 total Rs.21.20 lakh are proposed for
the IPC activities.
Community media – Folk Art:
For creating awareness regarding various health porgrammes and projects, the activities
like folk art, Rallies, Street plays have been proposed. 300 folk programmes @ Rs.4000 will be
organized in each district. Provision of Rs. 396 lakhs is made in the PIP.
Community media – Rallies:
On occasion of health days, fairs and campaigns, 5 rallies in each district @ Rs. 10000
will be organized. Rs. 16.50 lakhs have been proposed for 165 rallies.
Electronic Media :
To reach the masses, television and radio is the best option. The T.V. & Radio programs
are watched by all classes of community. Various programs like serials, dances and music,
News, discussions, interviews are telecasted and broadcasted for different target groups.
considering the importance of T.V. & Radio following activities are proposed.
• Telecasting of TV spots : Rs. 60,000/- per telecast x 475 telecasts = Rs. 285.00 lakhs.
• Broadcasting of Radio jingles : Rs.13,000/- per broadcast x 500 = Rs.65.00 lakhs.
Thus, a budget of Rs. 350.00 lakhs is proposed during the year
2012-13 for publicity through electronic media.
Newspaper advertisements:-
Newspaper is very popular and effective medium, through which health messages can
be reached up to different target groups. Pictorial advertisements will be published in
newspapers @Rs.15000/- per advertisement x 100 advertisements. Thus, a budget of Rs. 15
lakh Proposed .
Subsection – B.10.4: Health Mela
For mass awareness regarding various health programs, health mela is the best
opportunity. We can provide health check-up services as well as awareness campaign in the
same mela. Health mela in each district will be organized. Each Mela will be for the period 1
day. The mela will be organized in selected Sub district hospital premises or public ground. The
facilities for health check-ups and diagnostic purpose will be provided to community by
specialists. Health exhibitions, film shows, folk programs will be arranged in the mela. IEC
material will be distributed to the beneficiaries.
Page | 61

Pre-publicity of the camp through banners, posters, Davandi, Radio publicity will be
done. Transport of public to the venue of Health mela, Remuneration of Private Specialist
doctors (if requjired and mela expenditure will be required.
Rs.5.00 lakhs x 33 Melas =Rs. 165.00 lakhs
Subsection - B.10.5: Creating Awareness on Declining sex ratio issue
Declining sex ratio is one of the big challenge before health services in the state. State is
tackling this issue with creating awareness as well as implementations of law.
For creating awareness, the media like T.V. Radio, Newspaper, hoardings, messages on
electricity bills, Rallies, pictorial floats, banners, posters, exhibitions, folk programe will be
utilized.
(1) Telecasting of TV spots : Rs. 60000/- per telecast x 100
telecasts = Rs.60.00 lakhs.
(2) Broadcasting of Radio Jingles : Rs. 13,000/- per broadcast x 46
broadcasts = 06.00 lakhs.
(3) Newspaper advertising Rs.5,000 x 100 advertisements = 15.00 lakhs.
Subsection – B.10.6: Other Activities
Awards for Journalists
Award will be honored to journalists for best press articles and stories on 'Mother and
Child Health' topic. For the award scheme, evaluation of articles will be done by expert
committee, and awards will be distributed in a special function at state level. Details of the
award scheme are as follows:
1) Selection procedure : Rs. 2.00 lakhs
2) Award distribution ceremony : Rs. 2.00 lakhs
3) Pre-publicity of award scheme : Rs. 25.00 lakhs
4) Prizes : Rs.00.63 lakhs
(1 prize : Rs.25,000/- + 11 prize : Rs. 15,000/- + iii prize :
Rs.10,000/- + IV prize : Rs.1,5000/- + V prize " Rs. 5,000/-)
Award to district for best performance in IEC:
Awards will be given to best three districts on performance basis in IEC. Evaluation will
be done on the performance of the year 2011-12 and the sinner districts will be awarded with a
momento in the same function of journalists. Therefore budget is requested only for awards. A
budget of Rs. Rs.2.00 lakhs is proposed for this purpose.
Exhibitions in major fairs in districts:
Page | 62

In each district, exhibitions, film shows will be arranged in the major fairs where more
than 1 lakh pepole gathered. 5 exhibitions will be arranged per year in each district. Thus 165
exhibitions will be arranged in 33 districts.
Rs.20,000 x 165 exhibitions = Rs.33.00 lakhs.
Health Issues IPC
Activitie
s
Mother child
health
21.20 112.0
0
Health issue wise Media plan budget provision
(Rs. In lakhs)
Print Media Folk Electronic Media Community Media
Books Newspa Media T.V. Radio Rallis Health Exhibitio
per
Melas ns Film,
Advt.
shows
- 264.0
0
285.00 65.00 16.50 165.0
0
Page | 63
Hoardin
gs
47.40 14.58
PCPNDT - - 15.00 60.00 60.00 6.00 33.00 - - -
Mass deverming
and
Vitamin a
supplementati
ons to children
-
5.00
10.00
-
Epilepsy - - - - - - 3.30 3.30 - -
Ayush - 25.00 - - - - - - - -
5.00
5.00
-
-
-
-

Activ-ity
Code
MAHARASHTRA
IEC / BCC UNDER MESSION FLEXIPOOL PIP 2012-13
B. 10 BUDGET SUMMERY
B.10.2.1
To
B 10 2.4
Focused
areas for IEC
1)Mother health
2)Child care,
3) Institutional
delivery,
4)Breast
Feeding
5)Immunization
6)PCPNDT
7)NSV
8)Spacing
9)Adolescent
Health
10)Age at
Marriage
Other RCH
issues
Importance of
Girl Child
Small family
norm
B 10.4 1)Mother health
2)Child care,
3)
Immunization
4)NSV
5)Spacing
6)Adolescent
Health
7)Blindness
8)Heart
problems
9) Mental
Health
10)Leprosy
11)T.B.
12)HIV Aids
13)Any health
problem.
IEC for
whom
Target
groups
Service
Providers
General
community
General
community
General
community
Mode of
Awareness
Media
Inter personal
communicatio
n
Methods Expected
Budget
(Rs In
lakhs)
A – DISTRICT LEVEL ACTIVITIES
Community
media - Folk
Art:
Community
media -
Rallies:
Community
media
For effective IPC
counseling and
interactive sessions
with ASHAs, ANMs,
and Anganwadi
Workers, (block and
district level)
workshops has
been proposed.
358 workshops at
block level (@Rs.
5000) and 33
workshops at district
level (@Rs. 10000)
For creating
awareness
regarding various
issues of RCH, the
activities like folk
art, Rallies, Street
plays have been
proposed. 200 folk
programmes @Rs.
4000 will be
organized in each
district.
On occasion of
health days, fairs
and campaigns, 5
rallies in each
district @ Rs. 10000
will be organized.
For mass
awareness
regarding various
health
programmes,
health mela is the
best opportunity.
We can provide
health check-up
services &
awareness
campaign in the
same mela. One
health mela in
each district will be
organized. Each
Mela will be for the
period of 1 day at
Sub district
hospital. The
21.20
264 .00
Implemen
tation
Period
June
2012 to
Sept 2013
Sep 2012
to Dec
2012
16.50 June 2012
to March
2013
165.00
Sept.2012
to Feb.,
2013
Outcome
Workshops will
help to increase
IPC skills of
ASHAs, ANMs
& Anganwadi
workers to
communicate
messages
effectively
amongs
womens group
& community.
Acceptance of
health services
by community
will be
increased.
To create
awareness in
community
People can get
all the health
check-ups &
IEC under one
umbrella as
well as they will
get proper
treatment.
Page | 64

Activ-ity
Code
Focused
areas for IEC
IEC for
whom
Target
groups
B 10.6 Malnutrition General
community for
Tribal areas
Mode of
Awareness
Media
Mass Media
Awareness
through
government
approved
Audio Visual
Van agency
Methods Expected
Budget
(Rs In
facilities for health
check-ups and
diagnostic purpose
will be provided to
community by
specialists. Health
exhibitions, film
shows,folk
programmes will be
arranged in the
mela. IEC material
will be distributed
to the
beneficiaries. Prepublicity
of the
camp through
banners,
posters,Davandi,
Radio publicity will
be done. Transport
of public to the
venue of Health
mela,
Remuneration of
Private Specialist
doctors. Grant of
Rs 5.00 lakh will be
allotted per Mela.
(Rs. 4.00 lakh will
be placed at the
disposal of Civil
Surgeon & Rs.
1.00 lakh will be
kept with IEC
Bureau.
Rs. 5.00 lakh X 33
districts
For the sensitization
in 3 tribal districts
(Amarawati, Dhule
& Thane) about
malnutrition, IEC
through Audio
Visual Van is a very
effective medium.
Government
approved Audio
Visual Van agency
will be selected for
this purpose. 200
villages in each
district X 12
programmes X Rs.
2000/- per
programme =
Rs 4.80 lakhs for
one district X 3 dist.
lakhs)
14.40
Implemen
tation
Period
July 2012
to Aug
2012
Outcome
Awareness will
be created in
tribal people
and the health
services will be
accepted by
them.
RCH and General In each district, 5 exhibitions will be 33.00 Aug 2012 ____”____
Page | 65

Activ-ity
Code
Focused
areas for IEC
other
communicabl
e & non
communicabl
e diseases.
Malnutrition,
sickle cell
and RCH
issues.
IEC for
whom
Target
groups
Mode of
Awareness
Media
community exhibitions, film
shows will be
arranged in the
major fairs
where more
than 1 lakh
people
gathered.
Service
Providers &
community
Service
Providers &
community
PCPNDT General
Community
Exhibition set &
computers for
district media
units
Funds will be
given to 15
tribal districts
for printing of
IEC material in
local tribal
language
For
organization of
awareness
campaign and
preparation of
floats on the
occasion of
26 th January
2013
POL to IEC
Van at
districts/Hiring
of IEC Van
Methods Expected
Budget
(Rs In
arranged per year.
in each district.
Thus 165
exhibitions will be
arranged in 33
districts.
Rs. 20,000 X 165
exhibitions
33 districts X Rs.
2.00 lakhs per
district
15 districts X Rs.
1.00 lakhs
Rs. 1.00 lakh X 33
districts
Rs. 1.00 lakhs X 33
Districtd
lakhs)
Implemen
tation
Period
to March
2013
66.00 June 2012
to Oct
2012
15.00 Aug 2012
to Dec
2012
33.00 July 2012
to March
2013
33.00
A District level Total 661.10
Note:-State level activities continued on next page
STATE LEVEL ACTIVITIES
Outcome
District IEC cell
will be strength
The IEC
material in local
language will
help to
understand the
messages
Help to create
awareness in
community and
the birth rate of
girl child will be
increased.
Page | 66

Activ-ity
Code
B.10.5
Focused
areas for IEC
PCPNDT
Mother and
Child care,
Immunization,
Breast
IEC for
whom
Target
groups
General
Community
General
Community
Mode of
Awareness
Media
1) Telecastin
g of TV
Spot
2) Broadcast
ing of
Radio
Jingle
3) Newspap
er
Publicity
4) Messages
through
folk art
and
drama
Electronic
Media
Methods Expected
Budget
(Rs In
For creating
awareness, the
media like T.V.,
Radio, Newspaper,
hoardings, Rallies,
pictorial floats,
banners, posters,
exhibitions, folk
programme will be
utilized.
(1) Telecasting of
TV spots :
Rs. 60,000/-
per telecast x
100 telecasts =
Rs 60.00 lakhs
(2) Broadcasting
of Radio
Jingles : Rs.
13,000/- per
broadcast x 46
broadcasts =
Rs. 06.00 lakhs
(3) Newspaper
advertising : Rs
15,000 X 100
advertisements
= Rs. 15.00
lakhs
(4) Messages
through folk art
and drama :
Programmes
will be taken in
the selected 20
districts where
the girl sex
ratio is less :
20 districts X 5
programmes X
Rs. 50,000 per
programme =
Rs. 50.00 lakhs
For Selection
procedure of
Folk Media
groups = Rs.
10.00 lakhs
: Total 60.00
lakhs
Telecasting of TV
spots : Rs. 60,000/-
per telecast x 475
telecasts = Rs.
lakhs)
141.00
350.00
Implemen
tation
Period
14 th Nov
2012 to
14 th Dec
2012
June 2012
to Dec
2012
Outcome
Awareness will
help to increase
the sex ratio of
girl child
After creating
awareness,
more
beneficiaries
Page | 67

Activ-ity
Code
Focused
areas for IEC
Feeding,
PCPNDT,
NSV, JSSK.
JSY,
Institutional
delivery,
referral
services,
Nutrition,
Spacing
methods,
Care at
pregnancy
Mother &
Child Health.
Award to
district for
best
performance
in IEC :
IEC for
whom
Target
groups
Media
Persons
Service
Providers
Mode of
Awareness
Media
Award will be
honored to
journalists for
best press
articles and
stories on
'Mother and
Child Health'
topic. For the
award scheme,
evaluation of
articles will be
done by expert
committee. and
awards will be
distributed in a
special function
at state level.
Awards will be
given to best
three districts
on
performance
basis in IEC.
Evaluation will
be done on the
performance of
the year 2011-
12 and the
winner districts
will be awarded
with a
momento in a
Methods Expected
Budget
(Rs In
lakhs)
285.00 lakhs
Broadcasting of
Radio Jingles : Rs.
13,000/- per
broadcast x 500
broadcasts =
Rs.65.00 lakhs
1) Selection
procedure : Rs.
2.00 lakhs
2) Award
distribution
ceremony : Rs.
2.00 lakhs
3) Pre-publicity of
award scheme
: Rs. 25.00
lakhs
4) Prizes : Rs.
00.63 lakhs
( I prize : Rs.
25,000/- + II
prize : Rs.
15,000/- + III
prize: Rs.
10,000/- + IV
prize : Rs.
7,500/- + V
prize : Rs.
5,000/-)
1) Selection
Procedure
2) Special
Function
3) Memento
29.63
Implemen
tation
Period
2.00 Nov 2012
to Mar
2013
Outcome
will accept the
health services.
Jan 2013 The award
scheme will
help to get
positive
feedback from
press people.
Due to
appreciation,
district IEC
team will give
better results.
Page | 68

Activ-ity
Code
Focused
areas for IEC
RCH & other
health issues.
RCH & other
health issues.
IEC for
whom
Target
groups
Service
Providers,
Community
Leaders
(Sarpanch)
General
Community
Ayush Service
Providers &
Community
Mode of
Awareness
Media
special function
Hiring of
Advertisement
agency.
Hiring of IEC
consultant
Development
of Information
centre at IEC
Bureau
Printing of
Maharashtra
Arogya Patrika
Magazine and
to provide it to
Sarpanch,
ASHAs, all
health
institutes in the
state
Charges for
transportation
and
redesigning of
Audio Visual
Van 'Parivartan
Express'
Designing of
Float
Printing of
book
Methods Expected
Budget
(Rs In
lakhs)
Rs. 2.00 lakhs per
month X 6 months
Implemen
tation
Period
12.00 July 2012
to Mar
2013
--- 3.50 June 2012
Purchase of
exhibition panels,
maintenance of
exhibition sets,
Artwork, workshops,
and other creative
work, Flex on
existing hoardings
97,000 copies per
month X 10 months
1) 9,70,000
copies @
X Rs. 10
= Rs.97
lakh.
IEC Bureau
organizing
exhibitions in
awareness
campaign Health
Melas and other
occasions. The
Parivartan Express
Van is used for this
purpose only.
Innovative float will
be designed in
State level Republic
day function.
Information
regarding Ayurved,
Homeopathy, Unani
and Yoga will be
given with
appropriate pictures
in the book. It will
be made available
in 23 district
hospitals and 236
SDH & RH where
Ayush Service is
available.
Size – A4
Pages – 48 + 4
Paper Maplitho 60
GSM
Cover – Art paper
120 GSM
Printing – Four
14.50 May 2012
to March
2012
97.00 July 2012
to Mar
2013
5.00 June 2012
to March
2013
6.00 26 th Jan
2013
25.00 Oct. 2012
to Feb.,
2013
Outcome
To create
awareness in
community
To create
awareness
regarding
Ayush Services
Page | 69

Activ-ity
Code
Focused
areas for IEC
IEC for
whom
Target
groups
Mode of
Awareness
Media
Ayush Community Information
boards
regarding
Ayush services
1) PCPNDT
2)Mother and
Child Health
3)Immunization
4)Breast
Feeding
5)NSV
6) Spacing
Other RCH
issues
All Health
Issues
Mass de-
Worming and
vitamin A
supplementati
on to Children
General
community
Service
Providers &
officers
Community
media –
Messages
through
hordings
National &
Regional
Workshops
Methods Expected
Budget
(Rs In
colour
Copies - 2 lakhs
Expected cost - Rs.
25 per copy Rs. 25
lakh.
Information boards
will be displayed in
the premises of 23
District Hospitals
and 236 SDH & RH.
Boards will be put
up by hospital
authorities and the
funds will be provide
to 23 Civil
Surgeons.
Rs. 50,000 x 23
C.S.
= Rs. 11.50
Flex Messages will
be displayed on 162
hordings owned by
health department
in the premises of
health institutes in
the States
Hoardings size : 20
feet X 10 feet
No of hordings : 162
Each hording cost
Rs. 9000/- for three
quarters
Rs. 9000 X 162 =
14.58 lakh
Organization,
Travelling and other
related cost for
national and
regional workshops
lakhs)
B State Total 793.31
Parents Com Biannual mass de 25.00
munit worming and
y vitamin A
Medi supplementation
a campaign will be
organized in June &
December. For
second phase
awareness
campaign will be
organized in the
month of Nov. 2012
following IEC
activities will be
implemented.
1) Newspaper
Advertisement
Rs. 10.00 lakh
2) T.V.Scrolling
Implemen
tation
Period
11.50 Oct, 2012
to Feb.,
2013
14.58 June 2012
To March
2013
50.00 June 2012
To March
2013
Outcome
For creating
awareness
-
Page | 70

Activ-ity
Code
Focused
areas for IEC
IEC for
whom
Target
groups
Mode of
Awareness
Media
Epilepsy Parents Community
Media
A District level: 661.10 + B State level
: 793.31
Methods Expected
Budget
(Rs In
Messages 5.00
lakh
3) Broadcasting
of Radio
Jingles 5.00
lakh
4) Printing of
Posters 5.00
lakh
Organization of
Epilepsy day on 17th Nov. Event will be
organized at every
district level place.
33 Events @ Rs.
10,000
Organization of
Epilepsy and Other
neurological
disease camps.
33 Camps @
Rs.10,000/-
lakhs)
Total of A & B 1454.41
SUBSECTION – B.10.7 : REGIONAL / NATIONAL WORKSHOPS
Approved.
SUBSECTION – B.10.8 : AWARENESS CAMPAIGN
Not approved. Accepted.
SUBSECTION – B.10.9 : PRINTING OF FORMATS
Implemen
tation
Period
3.30 Nov.2012
3.30 Sept 2012
To
March
2013
As per GoI instructions, all the printing in the PIP is submitted at one place. There are six
major printing activities in the PIP as mentioned below:
Sr FMR
Table – Printing required for various activities – 2012-13
Name of
Activities
1 B.16.1.3 Printing of R-
3 & R-4
Registers
Budget
Proposed
Budget
Approved
by NPCC
Resubmitted
for
Approval
Outcome
Rs. In Lakhs
Remark
18 0 18 Printing of registers for
FW cases records
Page | 71

Sr FMR
Name of
Activities
2 B.8 Panchayat
Raj initiative
3 B.10 IEC/BCC
4 B.15.3 Monitoring
&Evaluation
5 B.15.3.3 Mother
&Child
Tracking
System
6 B.16 Procurement
for ARSH
Budget
Proposed
Budget
Approved
by NPCC
Resubmitted
for
Approval
35.3 35.3 0
113 28.25 84.75
53.2 53.2 0
115.06 115.06 0
7.15 7.15 0
7 B.16.2 Procurement
of Drugs &
supplies 4.72 4.72 0
Total 346.43 243.68 102.75
Remark
B.8.1 ( Consitution &
Orientation of
Community Leader &
VHSC,SHC,PHC,CHC)
Preparation of Traninig
Material
B.10.6 Printing of
Maharashtra Arogya
Patrika Magzine , 8
Tribal district for
printing of IEC material
in local language
Other Expenses
(Printing revised
Formats MIS,
shc,PHC,RH,DH,Traning)
Printing & Supply Of
RCH Registers to each
village & health
facilities in the State
Printing of Training
modules for
MO,ANMs/LHVs&ASHA,
new record keeping
regist er& formats
Printing of consent
forms & laboratory
forms each for testing
of pregnant mothers.
Out of the above mentioned six activities, budget is provided for all the activities except
B.10 Printing of Arogya Patrika etc. Therefore it is requestd to approve B.10 as proposed.
Budget requestd is Rs. 84.75 Lakh.
Approval accepted as per ROP
SECTION - B.11 : MOBILE MEDICAL UNITS
Page | 72

SECTION - B.12 : REFERRAL TRANSPORT & MOBILITY SUPPORT
Transport facility is required to transfer emergency patients, attending epidemics and
transferring serious patients, attending accidents and natural calamity, etc. and also to
transfer routine patients, support to implement the activities related to National Health
Programs and visit to ASHA, ANM and health institutions for supportive supervision.
Plan of action 2012-13
Approach for referral transport will be as follows:
• On highways and at block HQ, EMS ambulance will be available for all the
emergencies. One ambulance will be deployed for 1.0 Lakh population in rural areas
and 2.0 Lakh populations in urban areas.
• EMS ambulance will pick up obstratic emergencies but will not transport pregnant
women not in emergency.
• Regular Hospital ambulance will transport pregnant women willing to come for
delivery and also other patients who are not in emergency but need transportation.
• PHC vehicle is called as ambulance cum supervisory vehicle as this vehicle is used for
transportation of patients, to check anganwadies, to attend epidemics and also to
supervise the RCH / DCP work of health workers and nurses.
• Support to existing ambulances in the form of repairs, POL and hiring driver if
required if the state government grants are not sufficient due to higher load in
health institution. This budget will be provided to RKS of the institution. This will
ensure 24 hours availability of ambulance
• Provision of ambulances wherever not available.
• Review of all supervisory vehicles available in state and provision of supervisory
vehicles where ever not available.
As per discussion during NPCC meeting and 6-8 June 2012 meeting, total budget of referral
transport and mobility is put in one chapter and submitted to GoI as follows:
SUBSECTION – B.12.1 : REFERRAL TRANSPORT OF PATIENTS
Referral transport of patients is at two levels. First level is Basic Ambulance Services. This
level if of ambulance infrastructure of PHCs and Hospitals. This is required for quick
transport of patients from home to hospital and back or from hospital to hospital for
referral service. This is available for non-emergency patients / beneficiaries of National
Health Programs such as Mothers for delivery, FW patients, cataract patients, health camp
patients etc. These ambulances will be fitted with tracking system and will be controlled by
District RT Cell by universal telephone no. 102.
Second level of referral transport system is advanced and is called as Pre Hospital
Emergency Response (Ambulance) scheme. In this scheme, one ambulance per 1 lakh
Page | 73

population in rural areas and per 2 lakh population in urban areas is provided. This
ambulance is used only for emergency purpose including road accidents and also emergency
referral of pregnant or delivery patents or neonates. This system will be controlled by State
level control room under telephone no. 108.
B.12.1.1 : REFERRAL TRANSPORT BY BASIC AMBULANCES SERVICES
About 85% PHCs/Rural Hospitals and all District Hospitals have ambulances. However many
of the presently available ambulances are off road as they require repairs. It is proposed to
provide funds for repairs, POL and driver salary whichever is deficit, to these institutions
through RKS with condition that repairs to be carried out only by authorized dealers.
This is for patients transport system. Transport will be from home to hospital to home or
hospital to hospital. Transport will be of emergency patients, mothers for delivery in
emergency or without emergency and transport of beneficiaries of National Disease Control
Programs.
Budget is required for procurement of new ambulances to PHCs and Hospitals where they
are not available and also for additional repairs and POL grants to PHC and Hospital
ambulances.
Plan of action 2012-13
Approach for mobility support will be as follows:
• Support to existing ambulances in the form of repairs, POL and hiring driver if
required if the state government grants are not sufficient due to higher load in
health institution. This budget will be provided to RKS of the institution. This will
ensure 24 hours availability of ambulance
• Provision of ambulances wherever not available.
Budget requirement 2012-13
Budget proposed for providing vehicles to all the health institutions is as follows:
Table – : Budget required for mobility support– 2012-13
Sr Institution
No. of
vehicles
Unit cost
Rs. In Lakhs
Budget
required
A POL for ambulances
1 PHC Ambulances 1743 0.2 348.6
2 RH/SDH Ambulances 347 0.3 104.1
3 DH Ambulances 96 0.5 48
Total 2186 500.7
B
Repairs and procurement of tyres, batteries,
etc
1 PHC Ambulances 1235 0.08 98.8
2 RH/SDH Ambulances 286 0.14 40.04
3 DH Ambulances 42 0.14 5.88
Total 1563 144.72
Page | 74

Sr Institution
C
Procurement of new ambulances for Basic
Ambulance Services
No. of
vehicles
Unit cost
Budget
required
1 PHC Ambulances (TATA SUMO) 196 5.2 1019.2
2 Hospital Ambulance (Force) 84 7.3 613.2
Total 280 1632.4
Grand Total 2277.82
B.12.1.2 : PRE HOSPITAL EMERGENCY MEDICAL RESPONSE (AMBULANCE) SERVICES (EMS)
Major part of approvals mentioned in ROP is acceptable. Only two important submissions
are to be considered.
1. Posts of Medical Officers and consultants are continued since 2011-12 and all are in
position. However ‘new post not approved’ is written in remarks column against
these posts. As this activity will be starting in next three months, all these posts are
required. Therefore, it is requested to continue all existing posts. Salary of these
posts will be paid from existing budget only.
2. GoI has approved budget of Rs. 60.76 Crores as against 113.03 Crores. Approved
budget is for 50 ALS and 150 BLS ambulances. This need not be changed now.
Presently Hon. High Court has issued order in favor of SHS Maharashtra. However
has given time for complainants to file appeal. Considering all this, if the agency fixed
for provision of ambulance is able to provide more number of ambulances, then
Maharashtra may require more budgets. That may be approved from cushion
available to state.
SUBSECTION – B.12.2 : MOBILITY SUPPORT FOR PROGRAM MANAGEMENT
As per discussions during 6-8 June 2012 meeting, mobility support includes support
provided to block, district, regional and state level offices for supervision of work,
verification of data, checking of work done and for visits during emergencies. Mobility
support required for implementation of programs is requested from the program only so it
is not added in this chapter.
Some of the officers have been provided with hired vehicles. However, State Govt has
approved drivers and POL for these posts which remain unutilized. Therefore it is proposed
to procure cheapest vehicles (Standard Indogo) available on RC to these officers. One
vehicle is purchased in one and half year cost of hiring. This will save budget on mobility
support.
Page | 75

As mentioned above, officers from block to state level require mobility support for
monitoring work. Names and number of officers required for this work is mentioned in table
below:
Sr Level
Table – Expected visits of officers in NRHM
Names of Officers
included for monitoring
visit
No in
state
No. of
visits
expected
in one
month/
officer
No. of
visits
expected
in one
year
Total
Expected
visits in one
year
A Block Block Health Officer 353 12 144 50832
Block Accountant 353 4 48 16944
Medical Suprentendent 433 4 48 20784
Total 1139 88560
B District Dist Health Officer 33 8 96 3168
Civil Surgeon 33 8 96 3168
Dist RCH Officer 33 12 144 4752
RMO (O) 33 12 144 4752
MO DTT 33 12 144 4752
Stastical Officer 33 12 144 4752
DPM 33 8 96 3168
DAM 33 8 96 3168
M & E Officer 33 12 144 4752
IPHS Coordinator 33 12 144 4752
Dist Senior Supervisor 72 12 144 10368
SH Coordinator 33 12 144 4752
Deputy Engineer 35 16 192 6720
ASHA Coordinator 33 12 144 4752
Total 503 67776
C Circle Deputy Director 8 6 72 576
Assistant Director 8 12 144 1152
Circle Project Manager 8 8 96 768
Principal HFWTC 7 8 96 672
Vice Principal HFWTC 7 12 144 1008
HEMR Unit 8 16 192 1536
Public Health Specialist 8 16 192 1536
Ex. Engg (IDW) 8 16 192 1536
Total 62 8784
D State Add. / Joint Directors
(Bureau Chiefs)
9 8 96 864
Deputy Directors of DCPs 6 8 96 576
Assistant Directors of
RCH and MFP
9 8 96 864
Principal and faculty
SIHFW
4 6 72 288
Page | 76

Sr Level
Names of Officers
included for monitoring
visit
No in
state
No. of
visits
expected
in one
month/
officer
No. of
visits
expected
in one
year
Total
Expected
visits in one
year
Supt Engineer 1 12 144 144
Senior Consultants (EMS,
PPP, IPHS, RCH, Trg, etc)
Public Health Specialist
8 8 96 768
Program Officers 18 8 96 1728
Total 55 5232
Grand Total 1759 170352
Budget required for these officers is calculated considering the area they are covering for
supervision, TA/DA of the post, mode of travel (public transport, hired vehicle, train with
class and air) allowed to them as per Governing Body decision.
Conditions are being put on officers for using the Mobility Support budget. These conditions
will be as follows :
• After each tour, the person touring should give brief actionable points to controlling
authority
• Action taken points to be submitted within one month after the communication of
actionable points. This will be responsibility of the concerned touring officer, staff.
• There should be pre-decided outcome of the tour which will be examined after one
month of tour by the touring officer.
Accordingly budget required for mobility support is as follows:
Sr Category of Officers
Table – One year Budget requirement for Mobility support
Unit rate
(Per day)
No. of
torus in
year
Budget
required
Rs. In Lakhs
Remarks
A Block Level
1 THO + MS 0.008 71616 572.928
Hired veh/POL in block
only
2 Others 0.002 16944 33.888 Public Transport
Total 88560 606.816
B District Level
1 Dist Senior Officers 0.015 15840 237.6 Dist tour / hired veh/POL
2 Dist Middle level officers 0.012 9504 114.048 Dist tour / hired veh/POL
Page | 77

Sr Category of Officers
Unit rate
(Per day)
No. of
torus in
year
Budget
required
Remarks
3 Senior contractual staff 0.01 15840 158.4 Dist tour / hired veh/POL
4 Other staff 0.03 26592 797.76 Public transport
Total 67776 1307.808 0
C Circle
1 Deputy Director 0.04 576 23.04 Regional / state tours
2 Senior Offices 0.024 3600 86.4 POL/hired veh
3 Others 0.003 4608 13.824 Public Transport
Total 8784 123.264 0
D State
1 Bureau Chiefs 0.08 864 69.12 State tour, Air travel
2 Other senior officers 0.04 2640 105.6
3 Other staff 0.08 1728 138.24 Public / hired
Total 5232 312.96 0
Grand Total 170352 2350.848 0
GoI has approved 25% budget for some activities in approval. Total budget already
approved is Rs. 122.53 Lakh. In addition to this, new guideliens will take another one month
for implementation. Considering this, budget reqested is as follows:
Table – Budget required for Mobility support – 2012-13
Sr Category of Officers
One year budget
requirement
Rs. In Lakhs
Budget for
2012-13
A Block Level
1 THO + MS 572.93 401.05
2 Others 33.89 23.72
Total 606.82 424.77
B District Level 0.00
1 Dist Senior Officers 237.60 166.32
2 Dist Middle level officers 114.05 79.83
3 Senior contractual staff 158.40 110.88
4 Other staff 797.76 558.43
Total 1307.81 915.47
C Circle 0.00
1 Deputy Director 23.04 16.13
2 Senior Offices 86.40 60.48
3 Others 13.82 9.68
Total 123.26 86.28
Page | 78

Sr Category of Officers
One year budget
requirement
Budget for
2012-13
D State 0.00
1 Bureau Chiefs 69.12 48.38
2 Other senior officers 105.60 73.92
3 Other staff 138.24 96.77
Total 312.96 219.07
Grand Total 2350.85 1645.59
SECTION - B.13 : PPP/NGOs
SUBSECTION - B.13.3 : NGO PROGRAM : GRANT IN AID TO NGOs
Budget of Rs. 247.80 Lakh was requsted under this scheme which is approved by GoI.
However, this amount is required for ongoing NGOs. Although MNGO scheme will be
discontinued in next year, SNGO scheme will continue to be implemented after that.
Considering this, revised budget requestd for the scheme is as follows:
Budget requirement for 2012-13
Sir Activity Proposed
Table : Budget requirement for NGO Scheme
No.of
Units
Unit cost
Budget
required
1 MNGO SCHEME 6 15 90
2
3
SNGO SCHEME PHASE- (Existing
NGOs)
SNGO SCHEME PHASE- (New
NGOs) Only for Nandurbar,
Gadchiroli, Nashik, Amravati,
Beed, Yavatmal, Chandrapur,
Bhandara, Dhule, Gondia)
7 15 105
16 8.5 136
4 EXTERNAL EVALUATION
TRAINING TO NGOs (before &
9 1 9
5
During the project like Baseline,
data software, Writing project
proposal, record keeping etc.)
19 0.2 3.8
6 Quarterly meeting 4 0.4 1.6
7 Annual workshop 1 2 2
Rs. In Lakhs
Remarks
Remaining
payments
of last year
scheme
Page | 79

Sir Activity Proposed
No.of
Units
Unit cost
Budget
required
8 Monitoring & Evaluation 19 0.6 11.4
Total 358.8
SECTION - B.14 : INNOVATIONS
Remarks
SUBSECTION : B.14.1 : ORGANIZATION OF EPILEPSY CAMPS WITH THE HELP OF EPILEPSY
FOUNDATION MUMBAI
Childhood diseases are very important to diagnose and treat at earliest to avoid the
permanent damage to health of the child and to help him/her to have optimal scholastic
performance. Many diseases which are important in childhood. School Health Program is
mainly screening these children and identifying the children who require specialized care.
Presently following activities under NRHM are being implemented for health of the children.
1. School health program to screen the children, health education for healthy living,
provide treatment for minor ailments and refer to higher institutions as per
requirement.
2. Tribal Health Camps of specialists – Specialist care to school children of schools in
tribal areas. Non-tribal children are also treated in these camps that are staying in
notified tribal areas.
3. Sickle cell program – children are identified at early age, counseling, treatment of
crisis, immunization, etc.
4. Hemophilia and thalassemia treatment – as pilot basis in few districts of state.
5. Epilepsy – specialist camps for rural children
As discussed in 6-8 June Meeting, other programs are dealt in corresponding activities and
are sanctioned by GoI. Epilepsy program is remaining and is submitted in this chapter.
Epilepsy is one of the important diseases of Public Health Importance. The prevalence of
epilepsy is an average one in thousand children & also quite common in adult populations
there are many new methods come for diagnosis & treatment. More than five thousand
school boys are dictated suffering of from Epilepsy in school health examinations. To treat
them properly & give regular follow-up, training of Pediatrician & Physician from district
hospital along with the nurses is proposed.
There could be many children & women suffering from Epilepsy. Stigma about this
disease prevents them to great a good care & service. There are many misconceptions
regarding Epilepsy in society. Considering above situation the following action is proposed
during the year 2012-13.
• Training of Medical Officer to improve the diagnostic skill
• Proper treatment to the epileptic patients by Health care provider
• Regular follow-up & proper management of the patients
Page | 80

• Improve the skill & Knowledge of nurses for patients care
• Create awareness in society regarding Epilepsy
• Organization of Epilepsy day in the state to create the awareness
Budget requirement
The details of the budget proposed is as follows
Table – Budget requrement for Epilepsy Camps
Rs. In Lakhs
SR Activity Unit cost
No. of.
units
Budget
required
1 Travel charges to specialists and team 1 11 11
2 Staying arrangements for specialists 0.3 11 3.3
3 Arrangements of camps 0.25 11 2.75
4
Honorarium to EEG technicians OT, PT
and speech therapy technician
Medicines and consumables for camps
0.1 11 1.1
5
and for regular treatment ( Regular camp
2.00 lakh and follow-up Medicine 1.00
lakh)
2.5 11 27.5
6
Diet facility to the patients (Tribal areas
only)
0.25 11 2.75
Total 4.4 48.4
B.14.2: CAPACITY BUILDING AND ORGANIZATION OF EPILEPSY DAY
Budgeted under IEC/BCC
B.14.3: HEALTH ADVISE CALL CENTER
Approved
B.14.4: AYUSH FACILITY IN WOMEN HOSPITALS
Indian Systems of Medicine & Homoeopathy (ISM&H) have proven strengths of treating
common and chronic diseases. With a view to make available the benefits of Ayurveda,
Unani, Siddha, Yoga & Naturopathy and Homoeopathy to the public at large, so that the
people can exercise their choice in accessing and specialized treatment centers of ISM&H in
the Allopathic hospitals. The objectives is to build bridges across medical systems by
providing general and specialized therapies of Ayurveda, Unani medicine, Siddha, Yoga &
Page | 81

Naturopathy and Homeopathy for utilization as an adjunct or better alternative to
conventional medical treatment.
In Daga Hospital Nagpur, AYUSH facility is provided to pregnant women attending the
hospitals. Women are given good response to all pathies but particularly to Yoga and
Naturopathy. Considering this, it is proposed to provide AYUSH treatment to all the 11 (New
and old) Women Hospitals in the State. Budget required will be as follows:
Table – Budget required for AYUSH services in Women Hospitals
Rs. In Lakh
Sr Particulars Unit price No. of units
Total
budget
required
3 Salary of Medical Officer Yoga 0.864 11 9.504
4 Salary of Medical Officer Naturopathy 0.864 11 9.504
Total 19.008
B.14.5: Blood Bags transportation to BSCs
Public Health Hospitals in Maharshtra has 29 Blood Banks and 104 Blood Storage Units
currently functional. In addition to this, establishment of Blood Storage Unit is under
process in 87 hosptials. As per FDA Rules, blood is collected and tested at Blood Bank. Each
of the Blood Storage Unit is attached to nearby Blood Bank and the test blood bags of each
group (2/group) are kept at Blood Storage Units for use. Plain Blood bags has 35 days expiry
and Blood Bags with presetvative has 42 days expiry. Blood bags with prevervatives are
available only at Mahanagar Blood Banks. Therefore in majority of the Blood Banks, blood
bags expires in 35 days. Units which are not used are send back to Blood Bank at least 5
days before expiry. It requires transport facility to collect blood from Blood Bank and to
again send back to BB if not used. Curently ambulances of hosptials are used for this
purpose. Cost of ambulance transportation is very high as its running cost is around Rs. 5
per KM and also ambulance is not available for patients when it has gone for blood bags
collection. Considerin g this problem, it is propoed to introduce innovative scheme for ue of
Motor Cycle for transportation of the Blood Bags. One person per district will be employed.
He will be provided motor cycle with one Cold Box fitted on rear seat. This person will be
going to each hospital as per need and also be usefull for Blood Banks to get blood from
other Blood banks in case of emergency. It is proposed to start this scheme as pilot at 4
places in the state.
Budget required for this scheme is as follows:
Table – Budget required for transportation of blood bags to BSC
Sir Activity Proposed
No.of
Units
Unit cost
Rs. In Lakhs
Budget
required
Page | 82

Sir Activity Proposed
1
2
Procurement of Motor Cycle and
fitting up of cold box on rear seat
Salary of the Blood Bag Transporter
(Rs. 8000/month for 6 months)
No.of
Units
Unit cost
Budget
required
4 0.6 2.4
4 0.48 1.92
3 POL for motor cycle 4 0.6 2.4
Total 6.72
SECTION - B.15 : PLANNING, IMPLEMENTATION AND MONITORING
SUBSECTION - B.15.1 : COMMUNITY BASED PLANNING & MONITORING (CBPM)
Approved
SUBSECTION - B.15.2 : QUALITY ASSURANCE
There are some changes in approval. However approval given is acceptable.
SUBSECTION - B.15.3 : MONITORING AND EVALUATION
Review meetings : Subject wise meetings not approved. Acceptable. This expenditure will
be booked in respective program.
15.3.1n : Staff for monitoring and evaluation : Computer specialist (2)
ROP Remarks : New Post, Not approved.
All the posts are approved except for Computer Specialist with comments that ‘New Post
not approved’. This is not true. These posts are existing since last two years and persons are
working on these posts. They are required for E-Office, maintaining HMIS website and
website of NRHM. They are also helpful in troubleshooting in various software being used in
State Health Society, Maharashtra. Therefore budget of Rs. 6.48 may be approved
considering this explanation.
15.3.1p : TA/DA to M & E Officer & 15.3.1q : TA to Statistical Officer.
ROP Remarks : 25% amount approved to total proposed budget. Further, State needs to
submit comprehensive plan subject to 100% facility based data reporting on HMIS portal.
Maharashtra was using its own software till 2009 and after that DHIS-2 software. Meeting
under Chairmanship of Hon. ACS (PH & FW) has taken decision to move to GoI software
which has facility based data reporting system. Maharashtra needs to add few indicators to
Page | 83

currently available GoI system. That process is going on. Facility masters are being prepared
by the state. Major part of work is over and Maharashtra will switch on to the GoI software.
Considering the progress State has made in accepting facility based data reporting, it is
requested to release remaining budget for the state. Thus total Rs. 49.20 Lakh may be
approved for TA/DA to M & E Officer and Rs. 39.60 Lakh for TA to Statistical Officer.
15.3.1z : Contingency at District Level & 15.3.1aa : Contingency at State level :
Remarks of ROP : Not approved.
This contingency is basically required to maintain the internet connection, maintenance of
computers and printers and stationary. All these three things are very important for HMIS to
function. Therefore it is proposed to reconsider this decision and approve the activity.
Considering this, contingency to district level Rs. 49.5 Lakh and Contingency at State level to
all bureaus Rs. 24.0 lakh may be approved.
15.3.1ab : Creation and maintenance of website
Remarks of ROP : Not approved
Currently three websites are being maintained by the State health Society. One website is
for general information and tenders, advertisements, important circulars to be published.
Second is for HMIS and third is for all the schemes of NRHM. Out of these, two websites are
to be maintained daily and one on monthly basis. Approximately Rs. 10.0 Lakh required per
website for routine updating and maintenance. Therefore, Rs. 30 Lakh as proposed may be
approved.
15.3.1ac : Establishment of State Data Health Center
Approved activity.
SUBSECTION - B.15.3.3 : MOTHER AND CHILD TRACKING SYSTEM
Mother and child tracking system
Approval received is acceptable.
Strengthening of State MCTS Cell
Approval received is acceptable.
Training of district staff in MCTS
Approval received is acceptable.
Review of MUCH tracking activities
Page | 84

Not approved. Acceptable.
Monitoring of data collection and data activity
Not approved. Acceptable.
Establishing of State Level MCTS Call Center
Approval received is acceptable.
SECTION - B.16 : PROCUREMENT
Procurement of some goods not approved by GoI. Few of the not approved activities need
to be reconsidered. Activities that submitted for re-consideration with reasoning are
submitted as below:
B.16.1.5 : Procurement of Laptops
Not Approved. Accepted
B.16.2.2 : Drugs required for mass deworming and Vitamin A supplementation
Remarks of ROP : Not approved. State to resubmit proposal with re-calculation and unit
cost. Approval pended.
B.16.2.4 : Procurement of Iron Folic Acid Tablets for adolescent boys and girls
Remarks of ROP : Approved @ Rs. 0.15. Cost projected is higher. Rates to be obtained by a
transparent bidding process.
SECTION - B.17 : REGIONAL DRUG WAREHOUSE
SUBSECTION - B.17.1 : STATE LEVEL ACTIVITIES
Remarks of ROP : Not approved
Government of India is informing the States to set up Tamil Nadu like structure for Health
Department. Two specific letters are submitted hear. First is letter from Shri B. K. Prasad,
Joint Secretary, GoI dated 25.3.10. In this letter staff to be appointed by State Governments
is indicated. Second letter is from Shri K. Chandramouli, Secretary GoI dated 24.5.2010. In
this letter also Hon. Secretary (H & FW) has instructed States to form Procurement
structure. During NPCC meetings of 2010-11 and 2011-12 also States were informed to go
for Separate structure like Tamil Nadu.
Page | 85

Salient features of procurement system
• Currently medicine and equipment are partly procured at state and partly at district
level. As Procurement Division of the state is now fully functional all the purchases in
2012-13 will be by Procurement Division of the state.
• E-tendering software and Inventory control software is introduced in the state. This
has enabled to get precise information about stock situation of every drug and
equipment and also in procurement.
• Demand generation, distribution of drugs and stock position is completely
computerized. Data entry is made at PHC level onwards.
• Medicines purchased will be stored in Regional and District warehouses. Therefore 8
warehouses at regional level and 33 warehouses at district level will be
strengthened.
• Currently there are two warehouses in each district. One for DHO (for PHCs) and one
for CS (for DH and CHCs). Now onwards, only one warehouse will be constructed in
District Hospital premises. This will save in manpower and security requirements and
will be easy for monitoring.
• All the Pharmacies in Public Health Department offices are now connected by web
for inventory control. This system will be strengthened further.
• Medicines will be purchased by E-tender system only.
• Medicines required in very small quantity and of minimal cost (requirement less than
Rs. 1000/institute in year) and medicines of short expiry (e.g. adrenaline) will only be
purchased locally. All other medicines will be purchased from central level.
• State level Procurement Cell, Regional and district stores, etc. will be supported
under NRHM.
• Daily stock of important medicines is being monitored in the state.
• One Procurement Verification Officer is appointed since 2009-10. This person visits
all the stores at Districts and major blocks and verifies the stock register, assures
whether the stock book is maintained, all NRHM purchases are entered in registers,
etc.
Based on Guidelines of GoI, Maharashtra has done following progress:
Previous system of procurement:
Maharashtra has two separate departments for Medical Education and Public Health.
Medical Education department was fixing rates of the medicines required to all the hospitals
in the state under Medical Education, Public Health and ESIS. Rate contracts were published
for three years and procurement was made by Districts and State offices as per need based
on these rate contracts.
System adopted by State Government since October 2011.
Page | 86

1. Separate Procurement Section is established by Public Health Department for
procurement of the medicines.
2. List of Medicines required for each type of Hospitals finalized by experts.
3. Quantity contract is published for one time with staggered supply as per need.
Medicines required for all the health facilities and all the programs are included in
this contract.
4. Total contract is by E-Tendering system. Officers from Procurement Cell, important
bureaus and Vendors were informed about the E-Tendering system. One workshop
was organized specially for vendors to understand the E-Tendering System.
5. Two bid systems similar to Tamil Nadu are applicable for medicine purchase except
for World Bank funded projects.
6. Staff is trained for procurement procedure at ASCI Hydrabad and YASHADA Pune.
7. Committee under chairmanship of Secretary Public Health established. This
committee includes officers from FDA, Industries Department, Medical Education,
Medical Directors of Private Hospitals, etc.
Distribution system for medicines
1. All the Districts are to submit facility wise requirement to the State.
2. Medicines are now purchased centrally by analyzing the requirement.
3. Vender is supposed to supply medicines up to Divisional level. Warehouses are being
established at all the 8 divisional places in the state.
4. Medicines will be distributed to Health Facility and District Warehouses as per need
of the program.
5. One software is installed to all the Pharmacy Officers in the State. Received medicine
is entered in this software. Utilization of medicines is also entered in this software.
Staff in Procurement Cell
Joint Director who is incharge of Procurement Cell is senior Public Health Department
Officer. Other staff at State and Circle/District level is also appointed.
Staff appointed at State level is mix of regular and contractual staff. Required staff which is
not available from Government and mentioned in GoI letter is appointed on contract basis.
Date of appointment of each of the staff is mentioned in remarks.
Table – Appointment of staff in Procurement Cell
Sr.No. Name & Designation Responsibility
Regular/
Contractual
1 Joint Director of Health Services Overall in charge Regular
2
Deputy Director of Health
Services
Overall in charge Regular
Page | 87

Sr.No. Name & Designation Responsibility
3
4
5
6
Assistant Director of Health
Services (Medicine)
Shri.R.R.Rane, Supdt. All over Supervision (All files of
Cell moves through), Court cases,
Monitoring of all purchases done by
procurement cell and related issues.
Smt. Trupti Patil, Procurement
Officer
Smt. Vaishali Daulatkar,
Procurement Officer
7 Smt. Shrutika Patil, Pharmacist
8 Smt. Varsha Gavane, Pharmacist
9 Shri Jaywant Jadhav, Pharmacist
10 Shri Sandeep Powar, Pharmacist
11
Smt. Gayatri Shetye, Data Entry
Operator
12
Smt. Seema Waghmare, Data
Entry Operator
Shri A.G.Khandekar, Statistical
13 Assistant
14
Shri Rajesh Bhankal, Senior
Clerk
Establishment of regional
Warehouses, Procurement of
Medicines ( T. No.21-28)
Procurement of Medicines ( T.
No.13-20)
Procurement of Medicine ( T. No.
6-12)
Procurement of Medicine ( T. No.
28-34)
Assistant to Smt. Trupti Patil
Assistant to Smt. Vaishali
Daulatkar
Procurement as per requirement as
per Jt.DHS
( M,F & WBD)
RTI, Meeting of State Purchase
Committee, State Scrutiny
Committee & Director level
Purchase Committee and
Miscellaneous
Regular/
Contractual
Regular
Regular
Contractual
(From Sept.11)
Contractual (From
March 12)
Contractual (From
Dec.11)
Contractual (From
March.12)
Contractual (From
March 12)
Contractual (From
February 09)
Contractual (From
Sept.08)
Regular
Regular
15 Smt. A.V.Joshi, Junior Clerk Inward Outward Regular
16
Smt. Chanda Dhurandhar,
Lower Grade Steno
P.A. to Jt. DHS
Regular
17
18
19
20
Assistant Director of Health
Services (Instruments &
Regular
Equipment )
Smt. Hire, Senior Clerk Procurement of Instrument
Equipment for NPCB Regular
Shri. Arvindekar, Senior Clerk Procurement of Lab. Equipment ,
Rate contract of Lab. Material & as
per requirement of Jt. DHS
Shri K.S.Patil,
Senior Clerk
(Hospital)
Procurement of Instrument
Equipment for Deafness control
program & as per requirement of Jt.
DHS (Hospital)
Regular
Regular
Page | 88

Sr.No. Name & Designation Responsibility
21
22
23
24
25
26
Shri Amit Karchalwar,
Procurement Officer
Smt. Saraswati Patil,
Procurement Officer
Shri Yogesh Yevale,
Procurement Officer
Smt. Monali Sankhe, Quality
Assurance Officer
EMS, HACC, Solar Photovoltaic
Inverter System, Hospital Furniture,
Radiodignostic Center on PPP basis
Printing of Banner, Poster, Booklet,
Flipbook for IEC Program,
Purchase by inviting quotations.
Procurement of vehicle, Software &
Computer and All paper bill
Pre-Dispatch Inspection &
Demonstration of Instruments &
Equipment.
Shri F.B.Sayyed, Pharmacist Sell of Tender Document,
Collection of Samples, EMD
Shri Swapnil Bawiskar, Data
Entry Operator
Assistant to Smt.Hire
Regular/
Contractual
Contractual (From
May 09)
Contractual (From
May 09)
Contractual (From
Dec.11)
Contractual (From
Sept.11)
Contractual (From
February 11)
Contractual (From
Feb.11)
Similarly, One Pharmacist is appointed each at Circle Medicine Store, DHO Medicine Store
and Civil Surgeon Medicine Store. These appointments are from year 2010-11.
Major part of staff is appointed during 2010-11 and also during 2011-12 as per guidelines of
GoI. Except for the post of Senior Consultant (Doctor) and Procurement Consultant
(Pharmacy Postgraduate) all other staff already exists in the Department. Therefore these
staffs need to be continued.
Circle level and district level staff is appointed as per guidelines in 2009-10. This staff is
existing since last three years. Therefore this staff is also required to be continued.
Repairs and contingency
Regarding repairs of Warehouses, this activity is completely revised and submitted in table
below> Contingency is required to continue the internet facility, photocopying, travel for
pre-dispatch inspection for NRHM procurements, etc. Considering this, it is proposed to
approve these activities.
Budget requirement – 2012-13
Budget requested in this PIP is for currently functioning system, i.e. for divisional and district
warehouses. Considering the above plan, budget required for procurement plan of
Maharashtra state is as given below:
Table - : Procurement Plan of Maharashtra state : 2012-13
Sr Particulars Unit cost
A State Level Activities
No. of
units
Rs. In Lakhs
Budget
required
Page | 89

1
Sr. Procurement Consultant (Medical
Postgraduate with at least 3 years’ experience in
Procurement and trained at reputed agency in
World Bank Procurement Procedure)
Procurement Consultant (Pharmacy postgraduate
5 1 5
2
with at least 3 years’ experience in procurement
and Trained at reputed agency in World Bank
Procurement procedure)
Salary of Procurement Officer (medicines (2),
3.6 1 3.6
1 Equipment (2) and Other goods (1) at state
procurement cell
3.4 5 17
2
Salary of procurement assistant /Pharmacist at
state procurement cell (6)
1.26 8 10.08
3 Quality Assurance Officer 2.6 1 2.6
5 Contingency to Procurement Cell 15 1 15
6
Travel and Daily allowances to State Procurement
Officers for pre-dispatch inspection and meetings
20 1 20
B Circle and District Level activities
1
Repairs and new construction of Circle
warehouses
12 8 96
2
Repairs and new construction of District
Warehouses
13 33 429
3 Pharmacist to DHO/CS and Circle warehouses 1.26 74 93.24
4 Contingency to circle and district warehouses 1.2 74 88.8
5 Stores Verification Officer (Rs. 25000/PM) 3.4 1 3.4
Total 783.72
SECTION - B.18 : NEW INITIATIVES / STRATEGIC INTERVENTIONS / PROJECTS
SUBSECTION - B.18.1 : BIOMETRIC ATTENDANCE FOR HEALTH STAFF
Presence of health staff is important to provide health services. Many times serious patients
get delayed treatment because concerned staff is not available. Therefore, it is essential to
monitor the arrival and leaving of health staff in hospitals/PHCs and concerned
establishments. Three districts in Maharashtra, Thane, Akola and Wardha have
implemented biometric attendance system on pilot basis. Attendance and timeliness of
health staff in these districts have improved significantly. Based on experience of these
districts, it is proposed to extent this scheme to all the PHCs, RHs and District Hospitals of
the state.
Salient features of the scheme will be as follows:
• Biometric attendance is being installed in all the offices and health facilities except
THO office and PHCs this year. These places will be covered in 2011-12.
Page | 90

• The staff including senior officers will be required to put thumb impression on the
device at the time of arrival and at the time of leaving the hospital. The device will
keep record of arrival and departure.
• The biometric device will be connected online with central server at district level and
state level.
• District information will be available on line to CEO ZP, DHO and Civil Surgeon at
district level and Director of Health services and ACS (PH & FW) at state level.
• Special efforts with the help of experts will be made in PHCs where there is no
internet connection available for submitting information. These PHCs are not more
than 10% in state.
• Central server for HMIS will be sued for this purpose.
Compliance of remarks
• Biometric Attendance system is being used for basically two types of staff. One is
office staff having fixed duty hours from 9.45 AM to 5.30 PM and health facility staff
having changing duty system.
• Regarding office staff, the system has started showing results within one month. As
this system records impression of fingers, the person has to come to office in time.
This is now being linked to salary software from 1.4.2012. After that every absentee
will be treated as LWP unless certified by controlling officer.
• Regarding clinical staff like doctors, nurses and support staff who have changing
duties, there is some problem at operational level particularly in bigger hospitals.
These problems are being sorted out with the help of IT experts.
• Total data of the district is received at district, regional and state HQ. This data is
reviewed. Even senior officers are called by Hon. ACS (PH) for their explanation if
they are consistently late to office.
• Except at 2 places in the state, the machine was well accepted by staff. No mischief
was done but staff to make the machine out of order.
• We expect that because of timekeeping by doctors and nurses, accessibility will be
improved which will finally improve quality of health care delivery. However, till
today no systematic study is done for this.
• For year 2012-13, the expansion will be in PHC where problem of regular attendance
is much more serious.
Considering above fact, it is proposed to approve this scheme.
Budget requirement
Budget requires for following purposes
• Biometric device
• Staff for monitoring
Computers and internet facility is already available in PHC and all hospitals, therefore there
is no request for budget for these items. Staff mentioned below is sanctioned in 2011-12
and was appointed last year. This staff will be continued this year.
Detailed budget requirement is as follows:
Page | 91

Table -: Budget required for biometric attendance in health institutions
Sr Activity Unit cost
No.of
units
Rs. In Lakhs
Budget
required
1 Biometric equipment in PHCs and THO offices 0.3 1246 373.8
2 One Computer Manager at DHS 3 1 3
3 Computer Assistants one in each circle and 4 at DHS 1.26 12 15.12
4 Contingency, internet stationary at circle HQ 0.5 8 4
6 Contingency at state HQ 1.2 1 1.2
Total 397.12
SUBSECTION - B.18.2 : PREVENTION OF SICKLE CELL DISEASE
For Sickle Cell Disease Control Program, budget of Rs. 1816.95 Lakh was requested out of
which Rs. 1781.92 Lakh is approved. Few activities especially new staff is not approved.
Explanation for approval of these activities is submitted for re-consideration.
It is requested to consider the above and sanction the counselors for Sickle Cell Disease
Control Program at Day Care Centre level.
2. Salary of Lab Tech. in DH & WH (Day Care Centre)
Remarks:- New staff not approved
Justification:- The Hon. Lokayukta, Maharashtra State has ordered the establishment of Day
Care facilities for treatment of Sickle Cell patients at district level. Electrophoresis and HPLC
(Confirmatory test for SCD) are made available in district and women's Hospitals. Presently,
there is no dedicated lab technician for electrophoresis test. Since this is a long and skilled
procedure, a separate, specially trained lab technician is needed for testing at DH/WH level.
This technician would also be responsible for all tests to be performed for Sickle Cell
Sufferers who come to Day Care Centre. As these are skilled posts and considering the load
of patients and Lokayukta ruling, it is requested to sanction these technicians.
3. Salary & TA DA of SCD Coordinator (NGO Districts)
Remarks:- Approved for 10 SCD Coordinator for Rs.1.62 lakhs per annum as per last year
rates
Justification:- The total no. of required units is 11 as there are 20 districts included in Sickle
Cell Program out of which 11 are NGO districts. As only 10 posts are sanctioned it is
requested to sanction one additional post. This post is there from 2009-10.
The previous year's rate was 1.74 lakhs per annum. Therefore the calculated cost of 11
Coordinators as per previous year's rates is 11 X 1.74 = 19.14 lakhs
4. Salary & TA DA of SCD Coordinator (Non-NGO Districts)
Remarks:- Approved for 9 SCD Coordinator for Rs.1.62 lakhs per annum as per last year
rates
Justification:- The previous year's rate was 1.74 lakhs per annum. Therefore the calculated
cost of 9 Coordinators as per previous year's rates is 9 X 1.74 = 15.66 lakhs
Page | 92

B.18.2.3 : DISTRICT LEVEL BUDGET REQUIREMENT FOR NGO DISTRICTS.
Salary of Laboratory Technician in DH/WH (Day care center) & Salary of Counselor in
District Hospital (Day Care Center)
Remarks of ROP : New Staff. Not approved.
B.18.2.4 : HEALTH WORKER DISTRICT BUDGET (NON NGO) FOR NGO DISTRICTS.
Salary of Laboratory Technician in DH/WH (Day care center) & Salary of Counselor in
District Hospital (Day Care Center)
Remarks of ROP : New Staff. Not approved.
Justification :-The Hon. Lokayukta, Maharashtra State has ordered the establishment of Day
Care facilities for treatment of Sickle Cell patients at district level.
More and more Sickle Cell patients and Carriers are being detected during screening. As this
is a genetic disease it is mandatory to counsel Sickle Cell Carriers and Sufferers for marriage,
family planning and regular treatment. No other trained and dedicated staff is available at
district hospital level for Counseling of Sickle Cell patients and Carriers. The role of the
Counselor is envisaged as follows:-
Create individualized diagram of inheritance for each Sufferer (Punnet square) and family
tree when required based on laboratory results. Provide genetic counseling: Counseling
prior to screening, Counseling of Carriers, Counseling of Sufferers, Counseling for antenatal
testing of eligible couples, Group counseling (Sufferer support group). Provide psychosocial
support. Provide information and support needed to make decisions about marriage and
family planning Provide educational materials to patient and family. Provide information
about health problems which can occur in SCD and recommendations for regular treatment.
Provide information and counseling regarding pre-natal diagnosis and facilitate the testing.
SUBSECTION - B.18.3 : TELEMEDICINE PROJECT
Salary & TA/DA of Telemedicine Consultant
Remarks: - Approved as per last year's rates
Justification: - Last FY 2011-12 Rs. 2.70 Lakhs Salary & TA/DA for the Telemedicine
Consultant was proposed for only 9 months.
In this FY 2012-13 the post of telemedicine consultant was already filled up & therefore the
Salary & TA/DA will required for 12 months. Therefore it is sincere request to sanction the
proposed amount on account of Salary and TA/DA of Telemedicine Consultant.
SUBSECTION - B.18.4 : HAEMATOLOGY PROGRAM
Approval accepted
SUBSECTION : B.18.5 : SHORT TERM CERTIFICATE COURSES FOR MEDICAL OFFICERS IN
PUBLIC HEALTH DEPARTMENT
Page | 93

Maharashtra state has started short term certificate courses for Medical officers in Public
Health Department of Maharashtra because Presently proportion of vacancies in the
specialties’ like Pediatrics and Medicine is more than 60%. Specialists are not willing to join
rural areas although appointed by the department due to various reasons like payment,
basic amenities, lack of education facilities etc. Those who join the department are not
continuing and proportion of leaving the job is significant etc. Necessary infrastructure has
been developed at hospital level however it is not optimally utilized due to shortage of
specialists.
Requirement and availability of all type of specialists is as below.
o Total posts of specialists sanctioned 521
o Out of that post filled : 176
o Total number of vacancies 346
Therefore to fulfill the requirement of department of providing appropriate speciality
services, Government has started short term training courses in all required specialities.
Initially this will cover Pediatrics and Medicine and in due course other subjects like
Gynecology, Obst. and Anesthesia will be included as per need. In addition to this training
will also be imparted to Medical officers and some paramedical staff in disciplines like Bio
chemistry, Microbiology and Radiology and Psychiatry .
The training will be in the form of a certificate course and the certificate will be given
by the Directorate of Health Services this will be only for working in the health facilities of
health department and not for general practice outside the department.
With the approval from Government of Maharashtra. We already have formulated core
committee under Chairperson Dr. Mrudula A. Phadke ( Ex
Vice- Chancellor of Maharashtra University of Health Sciences) For planning,
implementation and monitoring of these training courses.
Trainees have been identified from Medical officers with MBBS qualification who
are already working in the dept. and willing to work at least for five years in the department,
initially the selected medical officers were deputed to Nine govt. Medical colleges for the
training and now next batch has 9 medical college and Duration of Course will be 6
months. Curriculum has been prepared as per the requirement of the department based on
the clinical services expected to be delivered at the respective hospital level. And these has
been developed by the experts in the corresponding field. These experts group has been
appointed by the core committee.
Training will be given at following sites depending on the availability of trainers and also
clinical cases.
Medical College both govt. and Private as per willingness consent has already
been taken from Medical Education Dept.
All District Hospitals.
Private Hospitals.
Trainers have been appointed by the core committee.
Page | 94

Examination of first batch will be held on 29 th and 30 th of June and successful
candidates on 29 th and 30 th of June and successful candidates will be given MOCP
certificates through D.H.S.
Now Government Department of Public Health has issued 2 GR including 6 more
colleges. So the training will be imparted through 9 colleges and around 90 Medical
Officers will be trained. These Colleges are as under.
1) Government Medical College, Nagpur
2) Government Medical College, Aurangabad
3) B. J. Medical College, Pune
4) Seth G. S. Medical College and KEM Hospital, Parel, Mumbai
5) Topivala National General Medical College and B. Y. Nair hospital, Mumbai Central,
Mumbai
6) Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal College,
Sion (West), Mumbai
7) ESI-PGIMSR Mahamta Gandhi Memorial Hospital, Parel, Mumbai
8) Mahamta Gandhi Institute of Medical Science, Sewagram, Wardha
9) Sir J J Hospital – Grant Medical College, Byculla, Mumbai.
After having taken the training and completing MOCP course these Medical Officers will
be deputed in strategic PHCs like in Dhule (Nardhana), Nandurbar, (R.H. Molgi), Igatpuri and
others where they will be able to take ECG’s, manage patients of cardiac ailments, infants
with septicemia and malnutrition. This will be the ideal utilization of doctors after training.
Budget requirement
Budget is revised as per discussion during 6-8 June 2012. Budget for each course will be
required for various activities as below:
Table – Budget required for MOCP Course
No Activity Rate
Rs. In Lakhs
Budget required
1. Preparation of training curriculum, Rs. 1 lac. For all 9
1
listing of essential skills, time table colleges
etc.
2. Remuneration for trainers 0
a. For theory sessions (there will be Rs. 1000 for each
2.4
about 5-10 trainers. They will take Session *24
one session per week. Total 24 Session *10
sessions of each trainer)
Trainers
b. For practical and hands on training Rs. 10000/- per
7.2
(There will be about 5 – 12 trainers month*12 trainers
from local district)
* 6 months
Page | 95

3. Contingency funds for printing
training material conduct of
examination books etc.
4 Office expenses Rs. 50,000 per
month
Videoconferencing expenditure for
virtual classroom
5 Facility of video conferencing and
CD preparation
Total 22.6
Every Batch of 90 students at 9 colleges, the expenditure is Rs. 22.6 lakhs.
SUBSECTION – B.18.6 : NEW INITIATIVES IN HIGH FOCUS DISCTRICTS
High Focus districts have special probmels. Considering this, new initiatives are planned in
these districts. Theses activtiies were submitted in separate chapter of high focus districts.
However, as per discussion during 6-8 June 2012, these activities are shifted to chapter of
new initiatives.
B.18.6.1 : Health Shelter In Nandurbar District
In blocks of Dhadgaon and Akkalkuwa, many of the health facilities and also villages are at
such a remote place that health worker need to travel up to 45 Kilometers on foot to reach
remote villages from his/her HQ. This makes extremely difficult for them to travel to these
remote villages. There are no homes, schools or other places to stay overnight for the staff.
Considering this peculiar situation, it is proposed to build pre-fabricated shelter homes at
places where the villages are more than 25 KM from HQ of the health worker. Ten places in
these blocks have been identified for such shelter homes.
Shelter will be two rooms of 150 sq. feed one for male staff and one for female staff, one
kitchen of 50 sq. feet and one toilet block of 50 sq. feet. Total shelter will be of 400 sq. feet.
Local SHG or ASHA will be given responsibility to maintain the shelter. She will be paid Rs.
3000/PM towards maintenance and provision of food. Food charges will be borne by
concerned health worker.
List of facilities where health shelter is required is submitted in annexure
Budget requirement
Budget required for shelter is for construction of shelter, maintenance and contingency for
keeping drinking water, etc. Detailed budget requirement is as follows:
Table – Budget requirement for Health Shelter
5
3
0
4
Rs. In Lakhs
Sir Activity Unit cost No.of Budget
Page | 96

1
Construction of Health Shelter including one bore
well for water supply (one time)
units required
12 10 120
2 Maintenance by SHG/ASHA 0.36 10 3.6
3
Other maintenance charges (Drinking water,
electricity, drainage, etc.)
0.36 10 3.6
4 Furniture grant (one time) 0.5 10 5
Total 132.2
B.18.6.2 : Wireless Contact In Nandurbar District
Major part of interior areas in the district is not approachable by any means of
communication including mobile phones and BSNL wireless network. Therefore it is
proposed to provide one wireless set to each of the SC in interior areas. The base of the
wireless network will be at district level. Message for ambulance to shift mother in labour,
critically ill child and epidemics are expected from this system. System will be procured by
following procurement procedure. Budget required for this activity will be as follows
Table – Budget requirement for Wireless contact system
Sir Activity Unit cost
No.of
units
Rs. In Lakhs
Budget
required
1 Wireless set 0.5 56 28
2 Base station at Nandurbar 5 1 5
3 Salary of operator at Nandurbar 1.2 1 1.2
4 Contingency including civil works, stationary, etc. 0.5 1 0.5
Total 34.7
B.18.6.3 : Floating Dispensaries And Floating Ambulances In Nandurbar District
About 50 villages of Nandurbar district are completely isolated due to Backwaters of Sardar
Sarovar. These villages have mountain on one side and back water on other side.
Government of Maharashtra is providing health services to theses villages by floating
dispensaries. These dispensaries visit all the villages on fixed days and provide services. Only
the post of Medical Officer and Driver are approved by Government. These dispensaries are
providing good services, however, in case of emergency, particularly the delivery case or
critically sick child, they have to discontinue the service and take the patient back to Health
Facility for treatment. This leads to major disruption of services to remaining villages and
irregularity in service provision.
Page | 97

Distance between floating dispensary and bank of river changes every time and patients
need to travel in water to reach dispensary. This becomes very difficult for the patients
particularly the pregnant women. In addition there is no place for patients to wait till the
Floating dispensary approaches the villages. Therefore, one clinic room is proposed at each
stop of the dispensary.
Considering the above condition, it is proposed to provide additional essential staff and
space to Floating Dispensary and three Floating Ambulances to this areas so that these
ambulances can be called to shift pregnant women, critically ill neonates and other sick
persons. The ambulance will be called through wireless contact system.
Budget required for this activity is as mentioned in table below:
Table – Budget requirement for Floating dispensaries and Ambulances
Sir Activity Unit cost
No.of
units
Rs. In Lakhs
Budget
required
A Floating dispensary
1 Pharmacist (one per dispensary) 1.2 2 2.4
2 ANM 1.44 2 2.88
3 Laboratory Technician 1.2 2 2.4
4 Construction of clinic (Fibre - 400 sq. feet) 12 16 192
5 Maintenance of clinic by local ASHA 0.36 16 5.76
6 Solar light system and water supply 3 16 48
4 Assistant 0.96 2 1.92
5 Medicine 0.5 2 1
6 Additional POL 0.5 2 1
Total Floating dispensary 257.36
B Floating Ambulance
1 Procurement of Floating Ambulance 20 3 60
2 One Driver 0.48 3 1.44
3 One ANM in ambulance 0.72 3 2.16
4 One Assistant 0.36 3 1.08
5 Total Floating Ambulance 64.68
Grand Total 322.04
Considering the time required for procurement, salary of staff for Floating ambulance is
requested for six months only.
Subsection - B.18.6.4 : Specialised Services By Speciality Vans In Gadchiroli District
Gadchiroli district is completely LEA area and length of the district is about 350 KM. Except
for DH Gadchiroli and SDH Aheri, there is no availability of dentist, pathology unit or the
Ophthalmological unit. Considering this, six mobile units have been supplied under IAP to
Gadchiroli districts. These include 2 Dental Units, 2 Pathology Units and 2 Ophthalmologist
Page | 98

units. However, these units are not functional due to non-availability of funds for manpower
and operational expenses. As no such services are available in periphery, these units are
extremely essential for the district. Considering this, it is proposed to support these units
from Mission Flexi Pool. Budget required for these units is as follows:
Table – Budget required for operationalization of Mobile Units
Sir Particulars
Unit
rate
No. of
units
Rs. In Lakhs
Budget
required
A Mobile Dental Unit (2)
1 Salary of Dentist (Rs. 20000/PM) 2.4 2 4.8
2 Salary of Dental Technician (Rs. 12000/PM) 1.44 2 2.88
3 Salary of Attendant (Rs. 6000/PM) 0.72 2 1.44
4 Salary of driver (Rs. 8000/PM) 0.96 2 1.92
5 Medicines and consumables (Rs. 1.2 L/year) 1.2 2 2.4
6 POL 1.2 2 2.4
7 Overheads 1 2 2
Total 17.84
B Mobile Ophthalmic Unit (2)
1 Salary of Ophthalmic Officer (Rs. 14000/PM) 1.68 2 3.36
3 Salary of Attendant (Rs. 6000/PM) 0.72 2 1.44
4 Salary of driver (Rs. 8000/PM) 0.96 2 1.92
5 Medicines and consumables 0.6 2 1.2
6 POL 1.2 2 2.4
7 Overheads 1 2 2
Total 12.32
A Mobile Pathology Unit (2)
1 Salary of Doctor (Rs. 25000/PM) 3 2 6
2 Salary of Laboratory Technician (Rs. 12000/PM) 1.44 2 2.88
3 Salary of Attendant (Rs. 6000/PM) 0.72 2 1.44
4 Salary of driver (Rs. 8000/PM) 0.96 2 1.92
5 Lab consumables 6 2 12
6 POL 1.2 2 2.4
7 Overheads 1 2 2
Total 28.64
Grand Total 58.8
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SUBSECTION - B.18.7 : STRATEGIC INTERVENTIONS TO IMPROVE HEALTH CARE
MANAGEMENT
Considering the volume of activities being carried out by Public Health Department, number
of persons involved and amount data generated in system, it has been decided to
computerize all the activities in the state step by step. Ultimate aim of the computerization
is to get real time data for all important indicators and enable the higher level managers to
act upon without any time lag. It is also important to monitor the grievences of public in
getting the services. Considering this, following programs are submitted for approval.
The programs mentioned below were submitted under M & E Seciton. However as per
discussion during 6-8 June 2012, these activities are re-located to Section B.18 as follows:
B.18.7.1 : Establishment And Functioning Of Grievance Cells
Under Community Based Monitoring System, Grievance Cell is to be established at all
District Headquarters, Circle and State Headquarters. After that GoI published guidelines to
establish Grievance cell for JSY and recently for JSSK. Considering the importance of
Grievance cell, following action was taken:
1. One Grievance Cell at SHS. This cell established in 2009-10. There is one Grievance
Redressal Officer and one DEO approved and functioning on this post. One Joint
Director level officer is in charge of the cell.
2. One Grievance cell at each of the Circle. One Grievance Redressal Officer is
appointed in each circle. There is Grievance redressal committee at circle level.
Members of committee are:
a. Deputy Director i/c circle or his representative
b. One NGO representative, preferably the CBM NGO of the city
c. One retired judge or senior journalist of the city
3. One Grievance Redressal Cell is established at each District HQ. No contractual staff
is appointed here. Administrative Officer of FW Program is incharge of cell and DPM
assists the AO for this activity.
Work done by GR Cell
Work done by GR Cell is mentioned below:
• During the year 2011-12, Grievance cell received total 291 complaints. All these
complaints were processed. Out of these, action completed in 131 complaints and
action in process in 160 complaints.
• Lot of complaints are received regarding grievances against regular staff. Such
complaints are tracked till enquiry is made and enquiry report is sent to DHS for
further action. Enquiry has been started against 13 officers due to constant follow up
of the Grievance Cell.
• Currently, grievance Cell is also entrusted responsibility of tracking the news appear
in local newspapers.
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• Telephone charges are doubled due to increase in follow up of the complaints to
district and state HQ. This is good indication.
Following are the details of grievances registered in the year April 2011 to march 12
Sr. no Grievance Cell Office
Name
No Of
Complaints
Received
Year 2011-12
No Of
Complaints
Resolved
No of
Complaints
In process
1 State Office, Mumbai. 80 55 25
2 Dy. Director, Health,
Pune Office
11 6 5
3 Dy. Director, Health,
Thane Office
16 4 12
4 Dy. Director, Health,
Kolhapur Office
13 9 4
5 Dy. Director, Health,
Aurangabad Office
17 8 9
6 Dy. Director,
Health, Latur Office
50 8 42
7 Dy. Director, Health,
Akola Office
26 6 20
8 Dy. Director, Health,
Nagpur Office
56 31 25
9 Dy. Director, Health,
Nashik Office
22 4 18
Total 291 131 160
Budget requirement
Budget required for grievance cell is for telephone and Grievance Redressal Officer. Budget
will be required to one state cell and one cell each for 8 circle offices in state. Total budget
required is as follows:
Table - : Budget requirement for grievance cell
Sir Activity Unit cost
No. of
units
Rs. In Lakhs
Budget
required
1 Telephone charges 0.48 9 4.32
2 Salary of GR Officer 2.4 9 21.6
3 Salary of DEO to GR Officer at state 1.26 2 2.52
3 TA/DA to nonofficial members 1.2 8 9.6
4 Contingency 0.6 8 4.8
Total 42.84
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Considering the fact that all the GR offices are in position since 2011-12 and work done by
the GR Cell and also considering guidelines of GoI under JSY and JSSK to establish GR Cell, it
is requested to approve this activity for year 2012-13.
B.8.7.2 : Computerization Of HMIS, E-Governance And E-Health
Presently, following E-Governance activities are being carried out or in execution stage in
the state
• E-office introduced for the first time in Maharashtra at NRHM Mumbai. It has
started functioning well.
• Biometric attendance system in all health offices, PHCs and hospitals. Biometric
system is installed in all the Hospitals. Once it is functional, PHCs will be
introduced in the system.
• Development of ASHA software – ASHA software already developed. Information
of about 60000 ASHA in place. Software has helped to pay compensation to
ASHA in time.
• Hospital MIS software being established in State initially for 23 District Hospitals,
4 General Hospitals and 8 Women Hospitals. This software will completely
computerize the hospital functioning and will improve the efficiency of the
system.
• Inventory management - Computerization of Medicine distribution system –
already started and providing good results. Now daily monitoring of all the
important medicines in all health facilities of state is possible. This has resulted
into saving of medicines from expiry, calculating correct demand, indications
before the medicine is out of stock.
• Computerization of Medical Equipment inventory – This software is also in
progress and is being prepared with the help of agency appointed by Department
of Information Technology, Govt. of Maharashtra.
• Fund transfer through E-banking to district level – already started in all the
districts, circle offices and training centers.
• Payment of cheques through e-banking – Cheques to venders and other
personnel are now being paid through e-banking.
• Tally ERP-9 Introduced at state, district and block level.
• GIS mapping with the support from UNICEF – GIS maps are being used for
decision making and presentation in the state.
• Use of MCTS software and HMIS software as per GoI guidelines.
• E-transfer – All the request transfers are now online. Officers interested in
request transfer will have to submit their request online to the Government.
These requests will be considered based on need and transfers will be made.
B.18.7.3: E- Office and Software For Hospitals
Considering the implementation of all the above mentioned activities in the state following
actions are proposed for year 2012-13 :
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1. Creation of awareness among health officials for E-Governance: All the officers of
Health Department need to know the strengths of E-Governance and advances of
technology available for health related monitoring. If they understand the concepts
and benefits of E-Governance, then they will start monitoring from their own.
Considering this, now there is one session of senior IT expert regarding technologies
available for health. As these sessions are included in regular meetings, no additional
cost is required for this activity.
2. Expansion of E-Office to other State level Offices: E-Office is started in SHS office
and senior officers related to NRHM such as Director of Health Services, Additional
Chief Secretary (PH&FW), etc. The software is from NIC and installation, training,
handholding for one year, maintenance, etc. is being carried out by NIC. One
department of Directorate (Joint Director (Hospitals)) is also included in the scheme.
Now it is proposed to expand this scheme to all the state level offices in Mumbai,
Pune and Nagpur. These offices will require Computers, Scanners, cabling, etc. for
these offices. This is very important for Maharashtra as State level offices in the state
are situated in three different cities and at 8 different places.
3. Establishment and Expansion of Hospital Software : Maharashtra has 455 hospitals
and bed strength of these hospitals ranges from 30 beds to 550 beds. It is proposed
to completely computerize these hospitals in phased manner. Initially all District
Hospitals, all women hospitals and hospitals above 200 beds (General Hospitals) are
being computerized and later on 100 bedded hospitals will be included for
computerization. The software for computerization is prepared by Tata Consultancy
Services and will be procured from Maha-online a Government of Maharashtra
company. Budget required for this will be for software, computers, servers and LAN
and also for additional manpower for initial period till the system settles down.
4. Biometric Attendance System : Biometric Attendance System is introduced in the
state. Initially, all the offices from State to District level are covered and then the
Hospitals are covered. Now, it is proposed to cover all the Primary Health Centers in
the state. This activity is separately mentioned in next chapter.
Budget requirement
As mentioned above, budget is required for procurement of software, hardware and
manpower. Budget required for each of the software system is as follows:
Table – Budget requirement for E-Governance
Sir Particulars Unit rate
No. of
units
Rs. In Lakhs
Budget
required
A Expansion of E-Office in State Offices
1 Payment to NIC for software 20 1 20
2 Procurement of Computers 0.4 214 85.6
3 Procurement of Scanners 0.8 36 28.8
4 Lan system 2 8 16
5 Internet connectivity 1.2 6 7.2
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Sir Particulars Unit rate
No. of
units
Budget
required
6 Computer specialist (one for one building) 2.64 6 15.84
7 Overheads 2 6 12
Total 185.44
B
Establishment
Software
and Expansion of Hospital
1 Payment to 'Maha Online for Software 300 1 300
2 Procurement of Computers 0.4 1240 496
4 Lan system 5 23 115
5 Internet connectivity 1.2 23 27.6
6 Manpower 2.64 6 15.84
7 DEO (4/hospital) (92) 1.2 92 110.4
8 Pharmacy Officer (2/Hospital) (46) 1.2 92 110.4
9 Overheads 1 23 23
C
Total 1198.24
Other E-projects that will come up during 2012-
13
10 5 50
Grand Total 1433.68
B.18.7.4 : Strengthening Of Supervision And Monitoring System
The state has established the Health Management Information system for easy monitoring
and data retrieval. This helps in Monitoring and supportive supervision of health
institutions. Such an attempt to automate the records of health institutions would help, in
the long run, to reduce the workload of maintaining physical records and in compilation and
collation of data generated. This would also facilitate timely reporting of data as well as
analysis and interpretation of various data generated. In the future, such an initiative can
pave way for attempting emerging trends in medicine like telemedicine.
Support is required to establish and maintain the E-Governance system which is submitted
in this chapter.
Plan of action
It is also proposed to support the program offices directly involved in the NRHM activities.
Six old and three new important Disease Control Programs get funds as per PIP. However
some program offices such as Nursing, Hospitals, Primary health institutions actually
implement important activities of program but are not directly provided funds. Therefore it
is proposed to provide funds to these institutions along with the peripheral health
institutions.
As discussed during 6-8 meeting, requirement of DEO and districts is deductd and revised
budget is proposd as follows:
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Budget requirement
Budget is required for establishment of Computer Laboratory, internet facility, salary of
support staff required for supervision provided to the program officers and related facilities
to all the concerned Program Officers at state level.
Budget required for this purpose is as follows:
Table – : Budget requirement for strengthening MIS and supervision
Rs. In Lakhs
Sir Particulars Unit cost
No. of
units
Budget
required
Replacement of old computers and
1 maintenance of existing computers in all
the State level offices
12 8 96
2
Procurement of Heavy Duty Printers (2 per
office
0.3 8 2.4
3 LAN System 2 8 16
4 Civil Works 5 8 40
5 Support to program offices 6 8 48
6 Support to MIS section of Directorate 18 1 18
Total 220.4
B.20 : RESEARCH, STUDIES AND ANALYSIS
Two operational research topics of operational research importance are submitted for
approval. National Rural Health Mission, Directorate of Health Services and Senior Faculty of
Medical Colleges are involved in these research projects. Detailed description of the projects
is as follows :
The research studies submitted in this chapter are proposed by the teams in which retired
Vice Chancellor of Maharashtra University of Health Sciences, retired Professors and Deans
and also Directors of Research Institutes are included. Remarks on these researches were
shown to the team. The team has opined that, these studies are Maharashtra specific and
they will definitely benefit for identifying high risk infants and their management.
Considering this, it is proposed to sanction these studies.
SUBSECTION - B.21.1 : PACKAGE OF NEONATAL CARE BY ASHA (PNC BY ASHA)
Activity not approved by GoI. Decision accepted.
SUBSECTION - B.21.2 : MULTICENTRIC BIRTH COHORT TO STUDY THE ANTHROPOMETRIC
MEASUREMENTS OF CHILDREN IN MAHARASHTRA AND THEIR SOCIOEDMOGRAPHIC
CORRELATES
Remarks of ROP : Not approved. A similar study is being undertaken by AIIMS with support
from IAP and WHO. Also any recommendations regarding MUAC cut-offs for diagnosis of
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SAM will uniform at National Level. Till then the values provided by WHO are to be used in
the National Program. Therefore, the results from the National Level Study may be awaited.
Explanation of authors to the remarks is as follows:
Multicenter birth cohort from Maharashtra will be undertaken with a view to get
assessment of infants & children from Maharashtra, a state with high rates of stunning &
wasting specially in Advasi (Tribal ) region which may not be reflected in other studies.
The study also envisages to cover infants below 6 months wherein current data for
MUAC is not available & not covered by other studies (Like AIIMS & Others). Proposal from
Maharashtra will also study biochemical hormonal & immunological aspects of SAM which
will cover cytokines interleukins.
Besides all this it is important to have many studies all over India, specially of this
nature as one multicentre study from AIIMS may not be able to address each and every
research question. Malnutrition is a priority for the county and 'National Shame'. Any
amount of work is an absolute necessity & need of the hour.
In addition the Hon. High court of Mumbai has asked opinion from experts on the
role of wt. for age vis a vis wt. for height in detection of SAM, MAM, SUW & MUW for
children of Maharashtra as the PIL is filed by NGO activists from Melghat.
In order to answer all these questions academically, operationally, administratively as
also legally, it is crucial to undertake study in Maharashtra as outlined in our proposal.
Aims and Objectives :
Primary -
1)To obtain anthropometric data from infants and children from Maharashtra.
2) To evaluate the utility and diagnostic efficacy of wt for age, wt for ht and MUAC in infants
and children to detect SAM
Secondary -
3) To assess renal, immunological, biochemical and hepatic functions in babies detected to
have malnutrition and correlate anthropometrically.
Methods :
This is a multicentric study that will be conducted in Government Medical College hospitals
and private nursing homes, primary health centers, rural, sub-district hospitals in various
cities and towns of Maharashtra so as to cover families from varied socio-economic
backgrounds. We shall recruit 10000 women from different wealth quintiles. We will form a
birth cohort recruiting babies after due informed consent of the mothers taken in last
trimester of pregnancy. Along with this longitudinal study a cross sectional study will be
undertaken to study anthropometry of infants of various months as they attend the
Page | 106

immunization clinics of the hospitals. Longitudinal study would be on 1000 infants and 9000
infants from birth to 3 years of age will be studied cross sectionally.
Duration of study :
Data collection - 6 months for cross sectional study. 2 years for longitudinal study. Data
analysis- 3 months, paper writing- 6 months, dissemination- 6 months
Post funding Timeline
Activity 3mths 6 9 12 18 24 36
Meeting of all investigators and CRF development
workshop
+ + +
Recruitment of ROs and ANMs +
Training of Ros and ANMs +
Procurement of equipment +
Piloting of CRF +
Data collection- enrollment, follow-up + +
Data analysis + +
Paper writing +
Dissemination of data +
Sample size- per center and total. For each center, 1000 women from different wealth
quintiles.
Financial Implications –
Non- recurring -
Weighing balance, tapes (MUAC) caliper identical at all centers. Rs.15,000/- per center.
Rs.1,50,000/- at 10 centers.
Recurring –
Travel Rs. 20,000/- per center every year.
Rs. 2,00,000/- for 10 centers for 1 year.
Stationery Rs.1,00,000/- for all the centers
Staff- Research Assistant- (MBBS or MD) nurse or ancillary helper Rs. 20,000/- per
month
Rs.24,00,000/- per year.
Cost for investigations (Chemicals, Lab kits) Rs.10,00,000/-
Contingency Rs.50,000/-
Total Expenditure -
Rs.39,00,000/-
Considering above explanation, it is submitted to approve this study.
Page | 107

Activity approved
B.21 : ESTABLISHMENT AND FUNCTIONING OF SHSRC
SECTION – B.22 : SUPPORT SERVICES
SUBSECTION : B.22.1 : SUPPORT STRENGTHENING NPCB
ACTIVITY : B.22.1.1 : OPERATIONALIZATION OF SUPERSPECIALITY HOSPITAL FOR CHILD
EYE CARE
Activity Approved
ACTIVITY : B.22.1.2 : PROVISION OF HIRED VEHICLES TO OPHTHALMIC SURGEONS FOR
CATARACT OPERATIONS
Activity Approved
ACTIVITY : B.22.1.3 : PROCUREMENT OF OPHTHALMIC EQUIPMENT FOR CATARACT
OPERATIONS
Activity Approved
SUBSECTION : B.22.3 : SUPPORT STRENGTHENING NVBDCP
Approval with changes accepted.
SUBSECTION : B.22.4 : SUPPORT STRENGTHENING RNTCP
Approval with changes accepted.
SUBSECTION : B.23.6 : OTHER NDCP SUPPORT PROGRAMS
ACTIVITY : B.22.6.1 : RENOVATION OF OCCUPATIONAL THERAPY AND KITCHEN
DEPARTMENT IN 4 REGIONAL MENTAL HOSPITALS – 2 nd PHASE
Approved
ACTIVITY : B.22.6.2 : LEPTOSPIROSIS PREVENTION AND CONTROL PROGRAM
Approved
ACTIVITY : B.22.6.3 : PIP FOR STATE BUREAU OF HEALTH INTELLIGENCE AND VITAL
STATISTICS
As per discussion with Hon. AS & MD, proposal is resubmitted.
To strengthen all activities under this bureau, strong monitoring and evaluation is essential.
Considering this aspect PIP for the year 2012-13 has been prepared. In this plan emphasis
Page | 108

has been given on training, monitoring and evaluation, publication of various annual reports
and printing of Birth and Death forms, conduction of statistical evaluation studies and
building construction/renovation. Detailed plan of action is furnished below.
1 Printing
1.1 State Level
1.1.1 For printing of annual reports: Civil Registration System , Survey
of Causes of Death and Medical Certification of Causes of Death,
expected expenditure Rs 1 ,00,000 has been proposed.
1.1.2 Survey of causes of Death (Rural) Scheme is being implemented
in one selected village of every primary health center. For the
training of MO,ANM,MPW working under this scheme, printing
of training modules and guidelines of the scheme Rs 2,00,000/- is
proposed.
1.1.3 Printing of Registration of Birth and Death Act 1969 booklet is
proposed. Expenditure of Rs 25,000 is expected.
1.2 District Level
1.2.1 Printing of Birth and Death formats, form No 1 Birth reporting
form, form no 2 Death reporting form, form no 3 Still birth
reporting form, monthly summary report of Birth, Death and Still
birth form no 11, 12 and 13 Rs. 32,41,200/- expenditure is
needed.
1.2.2 According to the directives from Government of India,
Standardized birth and death certificates are to be issued to all
rural units. For this printing of form no 5 (birth certificate) and
form no 6 (death certificate) RS. 7, 18,880/- is proposed.
1.2.3 Printing of Form no 4 and 4a under Medical Certification of
Causes of Death to be provided to districts is essential for which
Rs. 3,16,680/- is proposed.
1.2.4 SCD scheme is implemented in all the Primary Health Centers.
One village from each Primary Health Centre is selected under
this scheme. Out of 1818 PHCs in the State 1813 are working
under this scheme. The information on Births, Deaths, Still Births
and Causes of Deaths is collected every month by this office. It is
the responsibility of this office to provide prescribed formats of
reporting to the PHCs. For printing of these forms funds required
budget is Rs. 11, 02,500/-.
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2 Monitoring and Evaluation
3 IEC
2.1.1 The data entry of Block level is expected to be done in newly
developed software by NIC Pune. For this purpose new Server for
HIVS Bureau is required. Rs. 5, 00,000/- is the expected
expenditure.
2.1.2 a) Under Survey of causes of Death scheme®, for ascertaining
cause of death, two physician per district will be authorized and
they will be expected to ascertain every cause of death under
this scheme in their district. An honorarium of Rs. 25/- per
physician per death is planned. For this RS. 11, 50,000/-
expenditure is expected.
b) Under SCD scheme Health worker (M/F) are required to visit
fortnightly to the selected village for collecting sign and
symptoms of deceased before death from their relative. Hon. Of
Rs 25/- per death to health worker is proposed. For 2300 deaths
under SCD scheme Rs. 5, 75,000 are proposed.
2.1.3 a) Appointment of one programmer is need for NIC developed
software for taking output of various combinations of variables
under civil registration system. Estimated expenditure of Rs 1,
80,000 /- is needed for contractual appointment of one
Computer (software) programmer in the financial year 2012-13
for a period of nine months.
2.1.4 Deleted
b) Data entry of Birth and death registration of urban units is
done at State level at HIVS bureau. On an average data entry of
10 lakh urban births and 3.5 lakh urban deaths are expected per
year. As existing staff is not able to complete the data entry in
stipulated additional manpower is required. Hence, appointment
of 10 data entry operators is proposed. For this financial
assistance of Rs. 8, 64,000/- is required for a period of
nine months.
2.1.5 For statistical analysis of Medical Certification of Causes of
Death, software needs to be developed. Rs. 1, 00,000/- is
expected for this purpose.
2.1.6 Deleted
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4 Training
3.1.1 IEC plays an important role in giving information to various
provisions under this act to public at large. Coverage of Death
registration appears to be low due to non-registration of deaths
under 6 years of age. Focus of IEC on registration of deaths under
6 years of age is the need of hour. Rs. 6, 60,000/- expenditure is
required for this publicity.
4.1.1 Under civil registration events like Births, Deaths and Still Births
that occur are filled in prescribed forms. On the basis of this
forms various statistical tables are generated which are used for
future planning purpose. NIC, Pune has developed software for
data entry of these forms. Training at block level is proposed for
which an amount of Rs. 3, 76,000/- is required.
4.1.2 To ascertain the causes of death under SCD scheme, training of
three selected / authorized physicians per district is proposed.
For these 4 batches, State level TOT will be conducted. 100
participants will be trained. This will require budget of Rs. 1,
40,000/-.
Total budget required for HIVS is Rs. 102.5 Lakhs
ACTIVITY : B.22.6.4 : IDSP ADDITIONAL BUDGET FROM NRHM MISSION FLEXIPOOL
Approval in ROP accepted
SECTION – B.24 : SPECIAL SCHEMES FOR TRIBAL AND LEFTIST EXTREMISM AFFECTED
AREAS
Maharashtra has 15 tribal districts out of which 5 are sensitive and six are leftist
extremism affected districts. Considering the health problems of these areas and nonavailability
of trained staff to provide the health services, specific schemes are proposed for
these areas. Schemes in Part –A are related to all the tribal areas of the State. However
more focus is given to districts with remote tribal areas. Part – B of this Section is related to
special schemes and activities proposed for high focus districts namely: Nandurbar, Gondia
and Gadchiroli.
Following schemes are proposed for tribal and leftist extremism areas.
SUB-SECTION – B.24.2 :MAHER SCHEME
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Approved
SUB-SECTION – B.24.4 : VOLUNTEER TO TRIBAL AND LEFTIST EXTREMISM AFFECTED PHCS
Approved.
SUB-SECTION – B.24.5. : MOBILITY SUPPORT
Comprehensive plan for mobility support submitted elsewhere
SUB-SECTION – B.24.6 : SOLAR BACK-UP SYSTEM FOR TRIBAL AREAS
Shifted to B.4
SUBSECTION - B.24.8 : ORGANIZATION OF SPECIALIST MEDICAL & DENTAL CAMPS
THROUGH MEDICAL COLLEGES IN TRIBAL HOSPITALS
Approved
SUBSECTION - B.24.9 : PILOT PROJECT TO REDUCE IMR IN MELGHAT REGION (DIST.
AMARAWATI) OF MAHARASHTRA
Activity not approved. Accepted.
SUBSECTION - B.24.10 : COORDINATION CELL FOR TRIBES IN SELECTED LEA & TRIBAL
DISTRICTS HOSPITALS
Approved
SUBSECTION - B.24.11 : INTEGRATION OF PALLIATIVE CARE IN JAWHAR TRIBAL BLOCK DIST
THANE
Remarks of ROP : Approved.
NPCC has approved this activity. However two components of this activity, incentive to
ASHA and post of Medical Officers are not approved. Submission for reconsideration of
these activities is as follows:
1. Incentives for ASHA workers & other Health Care Provider
Budget proposed was Rs. 2.0 Lakh and not approved. This is important activity and
needs to be continued for effective implementation of program. Important points in this
regard are as follows:
• 232 ASHAs form Jawhar block are trained for providing palliative care to the patient
by experts from Tata Memorial Center, Mumbai in 2011-12.
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• ASHA detected and provided palliative care to 164 patients during 2011-12 (ASHA
identified patients were confirmed expert doctor).
• ASHA were provided medicine kits and they were given weekly follow up visits to the
patients.
• ASHA were provided Rs. 50/- on identification and referring each patient to PHC and
Rs. 50/ - more on confirmation by expert doctor.
• ASHA are paid Rs. 25/- for weekly follow up visit to patient.
• Majority of patients registered for palliative care project are bed-ridden and are need
in domiciliary care which on day to day basis ASHA can provide.
• ASHA gets performance based incentives; hence the incentive to ASHA needs to be
approved.
For effective implementation of the project and continuation of the project as in
2011-12, there is a need of additional budget Rs. 2.00 Lakhs for incentives to ASHA .
2. Salary of Contractual Medical Social Worker (Counsellor) & Medical Officer (Budget
required – Rs. 3.5 Lakhs)
Medical Social worker was appointed in June 11 and Medical Officer in November 11.
Salary of MO is Rs. 16000/PM and salary of Medical Social Worker is Rs. 15000/PM.
As these were new appointments, salary was not requested for whole year. However, as
both of them are continued from 1 st April 2012, requirement of salary for one year even
if it is not increased will be as follows:
Table – Salary of Medical Officer and Medical Social Worker for year 2012-13 (at old
rates)
Rs. In Lakhs
Sr Post Monthly salary Budget required for
salary of 2012-13
1 Medical Officer 0.16 1.92
2 Medical Social Worker 0.15 1.8
Total 3.72
Table above indicate that budget required for this approved activity is Rs. 3.72 Lakh.
Considering the explanation, GoI is requested to approve Rs. 2.0 lakh for ASHA and Rs.
3.72 lakh for salary of MO and MSW. Accordingly total budget required for this activity
will be now Rs. 13.72 Lakh.
SUBSECTION – B.24.12 : ESTABLISHMENT OF NUTRITIONAL REHABILITATION CENTERS IN
TRIBAL AND LEA BLOCKS.
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Activity not approved. Accepted.
SUBSECTION – B.24.13 : ESTABLISHMENT OF MEDICINE WAREHOUSE AT SELECTED PLACES
IN TRIBAL AREAS.
Activity not approved. Accepted.
SUB-SECTION –B.24.14: TELEMEDICINE IN TRIBAL AREAS
Not approved. Accepted.
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