Nayagarh

DDistrict
Fa amily Weelfare
Buureau
Zilla Swasthy S ya Samiti
Nayyagarh,
Odisha
DDistrict
FFam
mily
PPlannning
PPlann
NAAYAGA
ARH
2012-113
Drafft
1

Background
Chapter 1
The Nayagarh district, originally was a part of undivided Puri district, is located
towards the west and surrounded by Cuttack district in the North, Phulbani district in the
West, Ganjam district in the South and Khurda district in the East. The west side of
Nayagarh is the hilly region, part of eastern Ghats with fertile valleys and the north and
eastern part is constituted of agricultural plateaus intersected by small streams and rivers.
River Mahanadi flows in the north and brings water for irrigation and calamity during
floods. The climate of the District is extreme in nature with high temperature during
summer and cooler in winter. Nayagarh is also acknowledged for its leather works, brass
and bell utensils and sugar factory.
Spread over an area of 3,890 Sq.Km square kilometers, with forest cover is as high
has 2080.97Sq.Km. The population of the district is 9, 62,245 (2011 Census) with
6% Scheduled tribes and 14% Scheduled castes. The literacy rate of the district is
79% and the female literacy is 71% (2011 Census).
Administratively the district has 8 blocks, 180 Grampanchyats and 1694 revenue
villages. It has 4 towns and 2 urban local bodies i.e. NAC of Nayagarh and
Khandapada. Out of the 8 blocks, 2 are categorized as RCH difficult or high focus
blocks. Both the blocks are the most difficult in terms of accessibility with very
low service utilization. The neonatal mortality rate of the district is high &
contributes 56 % of total infant death. In addition to this, there is high morbidity
and mortality due to communicable diseases (Malaria, ARI and water borne
diseases).The institutional delivery is 86% as per HMIS of the total reported
deliveries in the district. The major public health issue is malaria and each year
the district reports high morbidity and mortality. Malnutrition and Anemia are two
other major issues in the district. However, the immunization coverage stands at
86% as per HMIS data (49.2% as per DLHS III).
Though the district has made progress with respect to improving the health
of its people over the last two decades and there is significant improvement in the
key health indicators in the district, but still there are challenges in health service
delivery system. Non availability of doctors at periphery levels is seriously
hampering public health delivery services, thus affecting management of
complicated cases at facility levels. To tide over the situation, contractual doctors
(including O & G & Paed Spl) have been given appointment for operationalisation
of MCH Centers.
2

District Map of Nayagarh
3

SL.
NO.
GENERAL
DEMOGRAPHIC PROFILE
ITEMS INFORMATION
1 Area (sq. km) 3890
2 % in total state’s area 2.50
3 CD Blocks 8
4 Towns 2
5 No. of Village 1694 Inhabited 1151 (OHD Report, 2004)
Uninhabited 543
5 No. of Tehsils 8
6 Towns & Urban Areas 2
7 No. of Gram Panchayats 179 (Dist.Panchayat Office, Nayagarh)
8 No. of NACs/Municipality/Corporation 02 (Nayagarh, Khandapara)
DEMOGRAPHIC PARTICULARS (CENSUS 2011)
9 Population (Total) 962245 (2.29 % to total population of the State)
9a. Male 502194 (52.19% of Dist. Pop.)
9b. Female 460021 (47.80% of Dist. Pop.)
Population in the age group of 0-6 years (2011)
1 Total 101337 (12.75% of dist. Pop.)
2 Male 54759 (10.90% of dist. Pop.)
3 Female 46578 (10.12 % of dist. Pop.)
4 % of 0-6 population to total population 10.53 %
Population Density
1. 1991 201 per sq. km
2. 2001 222 per sq. km
3. 2011 247 per sq. km
Sex Ratio (Census 2011)
Sex Ratio 916 female/1000 male (2011 Census)
Child sex ratio in the age group of 0-6
1. 1991 950
2. 2001 904
3. 2011 851
Literacy Rate (Census 2011)
Literacy Rate (Total Population) 79.17
Literacy rate (Male) 86.63
Literacy Rate (Female) 71.08
4

Sl
No.
Type of Institutions
HEALTH INFRASTRUCTURE
Number
1 District Hospital 01 (DHH, Nayagarh)
2 District Post Partum Centre 01 (PPC, Nayagarh)
3 Block Post Partum Centre 01 (Ranpur PPC)
Community Health Centers (CHC) 12 (Nuagadiasahi, Saranakul,
Bhapur, Mahipur, Rajsunakhala,
4
Gania, Badapandusar,
Madhyakhanda, Dasapalla,
Ranpur, Odagaon &
Khandapada)
5 Single Doctor PHC 36
6 Sub Centres 166
7 Mobile Health Unit 3 Nos
8 Anganwadi Centers
Ayurvedic
1544 (1142 Main AWC)
9
Homeopathy
Hospitals 0
Dispensaries 13
10
Hospitals 0
Dispensaries 19
11 Other Hospital BMSN, Chandapur
12 AIDS Counseling & Testing Centers 5 ICTCs
13
“Shradha” – AFHC Clinic 3 (DHH Nayagarh, Sarankul CHC
& Dasapalla CHC)
14
Blood Bank(BB) / BSUs 1 BB at DHH/ 1 BSU at Dasapalla
CHC
15 ANM Training Center, Dasapalla 1
STD Clinic at DHH 1
16 No of ASHA sanctioned 885
17 No of ASHA in-position 884
18 RKS at DHH is formed 1
19 RKS at CHC level 12
20 RKS at PHC (N) level/others 37
21 Physiotherapy Centre (PPP) at DHH 1
22 Tele-Medicine Centre 1
23 Central Drug Warehouse 1
24 Janani Express 12
25 Ambulance 9
26 Accredited Family Planning Center 1 (Krishna Clinic, Nayagarh)
27 Total Bed Strength 650
5

MCH CENTER/ DELIVERY POINTS LINKAGES:
Human Resource:
(A) Sanctioned Staff (Regular)
Sl. Name of the
Post
Sanctioned In position
1 O & G 15 06
2 Pediatrics Spl 13 04
3 Anesthetist 2 01
Blood Bank
Officer
1 01
1 Asst. Surgeon 44 17
Total Doctors 127 62
2 Staff Nurse 91 79
3 Pharmacist 89 88
3 MPHW(M) 139 86
4 MPHW(F) 187 184
5 MPHS(M) 48 37
6 MPHS(F)/LHV 30 24
7 L.T. 20 18
8 Radiographer 8 8
6

The above table clearly indicates that there are high vacancies in technical human
resources. More over the vacancies in FRU & 24 x 7 institutions are largely high.
Most of the Specialist, especially O & G and Paed Spl. are lying vacant in FRU and
24x7 Institutions. However to operationalise the MCH Center the district has
initiated steps by giving Contractual O&G & Paed Spl. At Gania (L2) & in
Rajsunakhala CHC (L3) and Retd MBBS doctors at MCH centres/ delivery points for
utilization of Maternal and child health services. it has been experienced in the
year2011-12 that contractual doctors have also been engaged in providing family
planning services at designated facilities at Mahipur and Daspalla( L2 and L3
facilities)
(B) Contractual staff engaged by NRHM:
Sl. Name of the Post Sanctioned In position
1. Staff Nurse 47 26
2. Additional ANM 32 32
3. LT 4 3
4. AYUSH doctor 40 36
5. Work Consultant 3 3
6. Assistant Engineer 1 1
7. Immunization (computer Asst) 1 1
8 System Incharge-cum-DEO 1 1
9 BPO 8 7
10 Block Accountant 8 7
11 DPM 1 1
12 DAM 1 1
13 DHIO 1 1
14 District ASHA Coordinator 1 1
15 DMCH 1 1
16 DPMU Accountant 1 1
17 Hospital manager 1 1
18 DHH Accountant 1 1
19 Vaccine & Logistics Manager 1 1
20 MIS Cum Field Coordinator 8 8
21 Office Asst. DPMU 1 1
22 Accountant, Area Hospital 4 3
7

Chappter-
02
Family y Planning performannce
in the Nayagarh N in
percentaage
Family pplanning
Achhievement
Vs V Target
F.W.
Activiti ies
2009-20010
Sterilizzation
37667
1970 52.30
IUD
91775
4769 51.98
CC
198776
9685 48.73
Oral Pilll
107002
5893 55.06
3782
6104
14087
7043
201 10-2011
3274 866.57
3787
5130 844.04
4572
5763 400.91
9161
5260 744.68
5398
2011-122
3829
3991
7727
5122
It has be een experieenced
fromm
the 3 yeaars
family pplanning
data
that theere
has beeen
a remarkable
progress
with re egards to aachievemennt
of ELA, pparticularlyy
in the yeaar
2011-12.
Besides achieving a ddistrict
tarrget
some blocks likee
Ranapur, Gania, annd
Mahipurr
have demonstrated
100% achieevement
with
regards to sterilizaation.
Therre
has been
a remarkkable
increaase
in steriilization
acchievementts
from 57% % to 87% annd
from 87% % to 100% ( (2011-12). The interventions
by district heealth
admin nistration foor
this succ cess are
1.
Adherenc ce to Fixedd
day Family
plannin ng services at all L3 centers annd
seelected
L2 centers.
2.
Regular aand
focusedd
Block wisse
review aat
district health reviiew
meetinng
by
CDMO and
ADMO (FWW).
3.
Capacity building off
technical and parammedics
persoonnel’s
(on Minilap annd
IUUCD)
from MCH M centers
on prioriity.
4.
Support to poor pperforming
blocks wwith
regardds
to instruments
annd
equipments
availabilit ty, regularr
monitorinng
by Wingg
officers and districct
8
101.11
87.29
84.34
94.88

nodal officers, diverting of trained surgeons to poor performing blocks on
Parivar Kalyan Diwas.
5. Maximum emphases at ASHA sector meeting for mobilization of cases to
FDS.
6 .Strategic utilization of 4 Camp cost budget
Situation Analysis:
Population stabilization and reduction of TFR (total fertility rate) are the goals of
NRHM which contributes significantly to improve the maternal and child health
outcomes. Though family planning has been one of the major components of the
RCH program, yet it has been out of focus in the last couple of years for one
reason or the other. The performance in family planning processes is seasonal with
most of the achievements occurring during October to March. However from 2011
July Population week , district has accelerated Family Planing interventions like(
Fixed day static services, up gradation of OT for operation at L2 institutions ,
accelerating training program of personnels from 43 MCH Centres and
procurements of Family planning instruments, which has shown result in the year
2011-12.
DLHS II
DLHS III
Unmet Need
0 5 10 15 20 25
Unmet Need
A comparison of DLHS-II and DLHS- III data on family planning indicators shows a
mixed scenario of the district.
DLHS-II & DLHS-III comparison
Indicators DLHS - 3 DLHS - 2
Marriage and Fertility, (Jan 2004 to 2007-
08)
Total Rural Total Rural
Percentage of girl's marrying before
completing 18 years 33.1 34.4 35.0 41.8
Percentage of Births of Order 3 and above 19.6 20.3 37.4 42.6
Sex Ratio at birth 101 100 - -
Percentage of women age 20-24 reporting
birth of order 2 & above. 46.3 48.0 - -
Percentage of births to women during age 15-
19 out of total births 15.0 15.0 - -
Family planning (currently married women,
age 15-49)
9

Current Use :
Any Method (%) 49.9 49.5 63.2 58.9
Any Modern method (%) 33.1 33.4 44.0 44.0
Female Sterilization (%) 24.3 24.4 33.0 36.0
Male Sterilization (%) 1.3 1.4 0.0 0.0
IUD (%) 0.1 0.1 0.3 0.5
Pill (%) 6.3 6.4 8.2 6.2
Condom (%) 1.1 1.0 2.2 1.0
Unmet Need for Family Planning:
Total unmet need (%) 23.8 24.4 17.9 18.1
For spacing (%) 7.8 8.1 4.8 4.9
For limiting (%) 16.0 16.3 13.1 13.3
DLHS data Analysis
• Percentage of girls marrying before 18 years of age has shown a marginal reduction
from 35.0% in DLHS-II to 33.1% in DLHS-III which indicates that there is a gradual
increase in the level of awareness on mean age of marriage and people have gradually
started internalizing the benefits of delaying the marriage of the girls so as to ensure a
better reproductive life.
• A birth of order 3 and above has witnessed a decrease from 37.4% in DLHS-II to 19.6%
in DLHS-III which indicates an increased awareness among the target audience about
the benefits of small family.
• Unmet need for the district has gone up from 18.1% in DLHS II to 23.8% in DLHS III
which indicates the wider acceptance and willingness among beneficiaries for FP
program in the district and warrants for more comprehensive approach to promote
various contraceptive methods with follow up activities by skilled personnels, both at
sub centre level and facility level. Potential beneficiaries’ needs to be shared with
basket of family planning choices with popularization of designated MCH centres for
utilizing FP services by faroff beneficiaries. District health administration will be
focusing on ensuring family planning services at inaccessible pockets of the districts
with functionalisation of 6 more FDS centers in the district.
• CPR has also shown a fall down from 63.2% in DLHS-II to 49.9% in DLHS-III which is in
fact a matter of concern for the district. Female sterilization, being the most accepted
method in Family Planning has gone down from 33% to 24.3%.
SERVICE DELIVERY FP SERVICES –FDS AND ACHIEVEMENT IN FDS CENTERS
District has achieved 100% sterilization during 2011-12 due to
operationalisation and mandatory availability of FP services on PARIVAR KALYAN
DIWAS i.e. on Monday at designated L3 and L2 institutions of the district. Due to
continuous & regular monitoring by wing officers and Nodal officers, designated for
8 blocks, the FP services at designated 9 FDS centers could be accelerated with
achievement of block target. 9 facilities (8 CHC and PPC Nayagarh) are currently
providing FP services on PKD against the target of 12. From this year i.e. (2012-13)
District has planned to extend it to another 7 MCH centers/ delivery points of the
10

district which includes (3 L2 institutions and 4 L1 institutions) . In addition to this,
district has started ground work for providing IUCD services at TB hospital
Chandpur from this year. District has trained all ANM and selected SN from 43 MCH
centers of the district on IUCD and the post training skill utilization has started
showing result at 2 L1 facilities( i.e. at PHC Lathipada and Golapokhari Sub centre)
.In the year 2011-12 district has trained 3 new surgeons on Minilap ( Dr Banamali
Pradhan MOI/C Mahipur(L2) Dr Pramila Dash, CHC Daspalla(L3), and Dr Sanjit
Mishra, DHH Nayagarh(L3)in view of their strategic posting at MCH centres and
district will start utilizing their services from June onwards. At present all the
ASHA i.e. 884 are engaged in Social Marketing of Contraceptives, which is further
bridging the gap between service providers and service acceptor with increased
emphasis on availability, accessibility and affordability of contraceptives. The
scheme is having good impact at 3 blocks like Bhapur, Khandapada and Mahipur.
ELCO survey, which is going to be started in Ist week of June will further help in
accurate targeting of potential eligible couple with basket of choices and sector
and block level need based planning for quality family planning services.
Post Partum & Post abortion Contraception
With the strengthening of Assured referral linkage support system (plying of Janani
Express, Ambulances, and MHUs) and free services availability in (JSSK),
institutional delivery has increased tremendously in the district. District is
committed to utilize the golden moment of 48 hours hospital staying and will
further extend PP IUCD and PP Sterilization to 3 L3 institutions and one L2
institutions (CHC Daspalla, CHC Sarankul, CHC Rajsunakhala and CHC Khandapada).
Two persons ( Dr. PK Swain, O&G Spl. of CHC, Khandapada and Sr. Staff Nurse
Rasmitabala Jena from DHH Nayagarh ,have already received state level TOT on PP
IUCD and the services will be further extended to periphery facilities from the year
2012-13. PP IUCD training at district level will start from June, 2013 onwards.
Service Environment
Institution wise/ Delivery point wise availability of critical equipments status.
District has initiated efforts for procurement of FP instruments (such as 16 Minilap,
26 IUCD and 7 NSV Kits) as per the budget earmarked in 2011-12 NRHM PIP. Due to
quick efforts of district level officials, the instruments could be distributed to
selected MCH centres during peak season of family planning program i.e. Oct-
December, 2011. The table provides the availability of functional instruments at
MCH centres, which has been distributed based on the case load.
Sl Name of the Cat Name of the Units Status Remark/Steps
11

.
N
o.
institutions/Delivery
points
ego
ry
(L1,
L2,
L3)
Besides the above distribution, Kits have been provided to other delivery points
like Nuagaon PHC (N) and Bahadjhola PHC (N) of Mahipur block and LHV of these 2
facilities have been trained on IUCD .
QUALITY ASSURANCE PROCESS :
equipment
(IUCD/NSV/Mi
nilap Kit
/Lap.
Machine)
(Functional/
nonfunctional
taken (if any)
1 DHH, Nayagarh L3 IUCD, NSV, Functional
Minilap kit.
2 CHC Dasapalla L3 IUCD kit, Functional
Minilap kit
3 CHC Rajsunakhala L3 IUCD kit, Functional
Minilap kit
4 CHC Saranakul L3 IUCD kit, Functional
Minilap kit
5 CHC Bhapur L2 IUCD kit, Functional
Minilap kit
6 CHC Khandapada L2 IUCD kit, Functional
Minilap kit
7 CHC Mahipur L2 IUCD kit, Functional
Minilap kit
8 CHC Gania L2 IUCD kit, Functional
Minilap kit
9 CHC Ranapur L2 IUCD kit, Functional
Minilap kit
10 CHC Madhyakhanda L2 IUCD kit, Functional
Minilap kit
11 PHC(N) Kantilo L2 IUCD kit, Functional
12 PHC(N)
L2
Minilap kit
IUCD and
Majhiakhand
Minilap kits
will be
provided
2012-13
in
13 PHC(N) Lathipada L1 IUCD kit Functional
14 PHC(N) Godipada L2 IUCD Functional
15 CHC Badapandusar L2 IUCD & Functional
16 CHC Odagaon L2
Minilap Kit
Miniulap kit Functional
17 SC Golapokhari L1 IUCD kit Functional
18 SC Darpnarayanpur L1 It will be
provided IUCD
kits in 2012-13
12

Government of India places utmost importance to the Quality assurance
Committee in family Planning aspects. The Honorable Supreme Court directives
clearly outline the structure, institutional arrangement, role and responsibility and
significance of the Quality Assurance Committee. The QAC has been activated in
the district with settlement of failure cases and monitoring by ADMO(FW) and
other wing officers for maintaining quality and standard procedure at selected
facilities. However more efforts are required for further strengthening the roles
and responsibilities of QAC. From this year district is planning to review the
empanelled surgeon’s performance particularly of O&G Spl. and encourage them
for achieving their institution specific targets with timely district support.
Private Sector Partnership & Accredited Institutions
Only one private institution, Krishna Clinics,Nayagarh, has been accredited
to provide family planning services exclusively for Minilap services. The targets are
spread over the year and the concerned clinic is providing services satisfactory. As
per the data available the clinic has provided Sterilization services to 414
beneficiaries and district is planning to accredit another institution for family
planning services.
Human Resource Development
District has 31 empanelled surgeons in the year 2011-12 and some of the surgeon’s
performance has been spectacular.Surgeons like Dr S Jibrail O&G Spl of
Rajsunakhala CHC has performed well with regards to sterilization operation.
Similarly Dr AP Tripathy of Gania CHC has performed well with regards to
sterilization operation, particularly after receiving Minilap training by district. The
below mentioned table clearly provides institution wise surgeons posting at L3 and
L2 institutions.
Sl.
No
Name of the Surgeon Presently posted
Category
Of Institute
(L1/L2/L)
1 Dr. Balaji Shankar Ray, “O & G” Spl. CHC Sarankul L3
2 Dr. Panchanan Moharana, Sur. Spl CHC Sarankul L3
3 Dr. Bhagaban Sahoo, Contractual PHC(N) Godipada L2
4 Dr. Ashwani Ku. Mishra, Asst. Surgeon PHC(N) Magarbandha Non MCH
13

5 Dr. Lochan Ku. Kata, Asst. Surgeon CHC ODAGAON L2
6
Dr. Arun Ku. Mohapatra, Asst.
Surgeon
PHC(N) Kural Non MCH
7 Dr.Bachaspati Dash “O & G” Spl. CHC Bhapur L2
8 Dr. Sekh Jibrail, “O & G” Spl. CHC Rajsunakhala L3
9 Dr. Sadananda Mishra, Sur. Spl CHC Ranapur L2
10 Dr. Radhakanta Nath, “O & G” Spl. CHC Ranapur L2
11
Dr. Panu Charan Mandal, Asst.
Surgeon
CHC Madhyakhanda
12 Dr. N.K.Mohanty, Sur. Spl CHC Daspalla L3
13
Dr. R.K.Moharana, “O & G”
Contractual
CHC Daspalla
14 Dr. Baidya Nath Nanda, Asst. Surgeon PHC(N) Takera Non MCH
15 Dr. Akashya Kumar Das, Asst. Surgeon CHC Khandapada L2
16 Dr. Paresh Ku. Swain, “O & G” Spl. CHC Khandapada L2
17
Dr. Tarun Ku. Satapathy, “O & G”
Spl
CHC-II, Mahipur
18 Dr. Somanath Mishra, Contractual CHC-II, Mahipur L2
19
Dr. Basanta Kumar Barik, Asst.
Surgeon
PHC(N) Itamati
L2
L3
L2
Non MCH
20 Dr. Akashya Ku. Sahoo, Asst. Surgeon PHC(N) Lathipada L1
21 Dr. Ananda Prasad Tripathi, M.O.I/c CHC Gania L2
22
Dr. Sukanta Ku. Jena,“O & G” Spl
SMO
PPC Nayagarh
23 Dr. Sanghamitra Dash, ,“O & G” Spl PPC Nayagarh L3
24 Dr. L.N.Bisoi, Asst. Surgeon DHH Nayagarh L3
25 Dr. Raghunath Nayak, Sur. Spl DHH Nayagarh L3
26 Dr. Nilamadhaba Mishra, ADMO(FW) DHH Nayagarh L3
27 Dr. Sachidananda Mishra, ADMO(PH) DHH Nayagarh L3
28 Dr. Ajit Kumar Nath, Asst. Surgeon PTS Nayagarh Non MCH
Dr. Ramesh Ch. Naik, Retd. Sur. Spl
29 Accrediated Nurshing Home Non MCH
30
Krishna Clinic Nayagarh
Dr. Raj Kishore Sarangi, Retd. Non MCH
L3
14

“O&G”Spl
31 Dr. Umesh Ch. Mishra, Retd. Paed Spl Non MCH
Monitoring and Evaluation
District has delegated supervisory power to all Nodal officers assigned for each
block and family planning review occupies an important agenda at each block
health review meeting. It has been decided to strengthen Family planning
monitoring by QAC members. Block wise and surgeon wise review will be taken up
in monthly district health review meeting. ADMO (FW) and ADPHCO will monitor
the delivery points regularly.
15

Chapter-03
Plan for 2012 – 2013
District has provided ELA to all blocks, based on the figure provided by state and
planning to achieve 100% with induction of more trained surgeons in empanelled list
for the year 2011-12.
Sl.
No
Name of the
Block CHC/PPC
ELA
Sterilization IUCD CC OP
1. PPC, Nayagarh 75 71 135 79
2. CHC
Badapandusar 593 686 1296 762
3. CHC Bhapur 422 491 928 546
4. CHC Gania 157 182 344 202
5. CHC
Khandapada 488 515 971 571
6. CHC
Madhyakhanda 414 498 940 553
7. CHC Mahipur 376 430 811 477
8. CHC Sranakul 691 770 1456 857
9. CHC
Rajsunakhala 685 746 1409 829
10. Total 3901 4389 8290 4876
16

A. Service Delivery Plan
As on
01.04.12
Facility & Community Level (Spacing & Limiting)
Functional FDS
Delivery Points MCH centers
SC PHC (N) CHC DHH Remark
8 1
Plan 12-13 2 4 2 0
DPS non-MCH(strategic Locations)
SC PHC (N) CHC DHH Remark
As on 01.04.12 0 0 0 0
Plan 12-13 1 1 0 0
As per the decisions taken at monthly health review meeting of April,2012, all the
FDS centre should start providing services including( OP, CC and IUCD) from April
onwards . ASHA sector meeting forum will be utilized for further mobilizing
potential beneficiaries to Parivar Kalyan Diwas with display of PKD charter at all
L3, L2 and L1 institutions. Sector MO has also started reviewing ASHA on their
incentivised performance for Family Planing activities.
Monitoring Supervisory plan for FDS functionalisation
Sl.
No.
Name of the Institution Nodal officer for block & micro level FDS
monitoring
1 DHH, Nayagarh Hospital Manager & ADMO (Medical)
2 CHC Dasapalla ADMO(FW)
3 CHC Rajsunakhala DF,UNFPA & DPM, NRHM
4 CHC Saranakul ADMO (PH)
5 CHC Bhapur DMCH & DAC, NRHM
6 CHC Khandapada DTO,Nayagarh
7 CHC Mahipur ADMO(FW)
8 CHC Gania DHIO, NRHM
9 CHC Ranapur DF,UNFPA & DPM, NRHM
17

10 CHC Madhyakhanda ADMO(FW)
11 PHC(N) Kantilo DTO
12 PHC(N) Majhiakhand DF,UNFPA & DPM, NRHM
13 PHC(N) Lathipada ADPHCO
14 PHC(N) Godipada ADMO(PH)
15 CHC Badapandusar ADPHCO
16 CHC Odagaon ADMO(PH)
17 SC Golapokhari DMCH & DAC, NRHM
18 SC Darpnarayanpur DF,UNFPA & DPM, NRHM
ACTIVITIES TO BE TAKEN UP FOR QUALITY FDS SERVICE DELIVERY.
District has planned to review PHC (N) ANM and sub centre ANM in health sector
meeting for of FDS centre at micro-level. Emphasis will be given on quality
reporting, attendance to complication cases and quick referral of patients to FRUs
for higher level of treatment. Nodal officers will also emphasize upon quality of
Family planning services through addressing gaps with regards to utilization of
trained manpowers, availability of instruments and required drugs at each FDS
centres.
B. Human Resource Development Plan(Training Plan)
Training Calendar for Family Planning Services -2012-13:
Q1 Q2 Q3 Q4 Total
target
IUCD 0 1 1 1 3
(batches)
PPIUCD 0 0 1 0 1
(batches)
NSV/CV 0 0 0 0 0
(batches)
Minilap 1 0 0 1 2
(batches)
Person
responsible
DMCHC/ADPHCO
DMCHC/ADPHCO
DMCHC/ADPHCO
DMCHC/ADPHCO
Contraceptive update(doctors) 0 0 0 0 0(batch) DMCHC/ADPHCO
Contraceptive update(paramedics) 0 1 0 0 1
(batches)
DMCHC/ADPHCO
18

C. QUALITY ASSURANCE PLAN
This year it is planned to have regular QAC meeting to update the
empanelled surgeons list for sterilization operation and perform the assigned duty
of facility audit, exit interview, access quality relating to prudent clinical
practices.
Action: DMCH Coordinator & ADMO (FW)
D.Plan for promoting Public Private Partnership for Family Planning :
Only one private nursing home i.e Krishna clinic, Nayagarh is accredited to
provide the Family Planning services. It is proposed to expand the facility to
another 1 institutions during this year by critical assessment by end of second
quarter.
Action: DMCHC, DPM & ADMO (FW)
C. ELCO Survey :
Eligible Couple serves the basis of the family planning programme and
interventions. The last headcount and detail assessment of the eligible couples was
done in 2005. Since then there was only annual updation. This year it is proposed
to conduct the Eligible Couple survey during the first quarter by involving the
ASHA, AWWS and Health Worker (Male and Females). The activity is approved as
per the Programme Implementation plan-NRHM for the year-2012-13. In addition to
that for a qualitative approach of the survey, it is planned to take the support of
UNFPA to roll out the block level trainings for the principal stakeholders of the
survey i.e. ANM, Sector level supervisors and Block supervisors etc.
Action: DPM, DMCHC, ADMO (FW), MOI/C
D. Monitoring & Supervision plan
Besides the regular IEC and other folk media activities, other formal programmatic
intervention will be initiated in the year 2012-13
1. Orientation of RKS and GKS members on advantages of family planning
and change their mindset towards facility up gradation for fixed day
static center services.
2. Display boards in front of the PPCs and other selected L3 and L2 facilities
on family planning services and methods as an information kiosk.
3. Wide publicity through banner, poster, wall paintings about the FDS
centers, provisions and incentives in family planning programmes.
4. Periodic monitoring and field visit by the district officials and QAC
members to assess facility with other activities like exit interview and
verification of records and registers.
5. Tracking the progress through facility based reporting and action towards
non- reporting from functional FDS Centres.
6. Quarterly review of Family planning programmes and regularizing the
QAC meeting in every quarter.
19

MONITORABLE INDICATORS FOR FAMILY PLANNING 2012-13
(Against each indicator, Districts are to provide consolidated quarterly targets and trace month wise achievements)
Baseline
(1 st Q1 Target Q2 Target Q3 Target Q4 Target Annual
April 2012)
C Family Planning
C.1 Service Delivery
C.1.1 % of total sterilization against ELA 101.11% 481 2000 820 600 3901
C.1.2 % post partum sterilization 2%
C.1.3 % male sterilizations 3.53% 5 58 29 25 117
C.1.4 % of IUD insertions against planned 87.29% 500 2194 1097 598 4389
C.1.5 % IUD retained for 6 months
C.1.6 % Sterilization acceptors with 2
children
C.1.7 % Sterilization acceptors with 3 or
more children
C.2 Quality
C.2.1 % of complications following
sterilization
C.3 Outputs
51.73 % 240
30.84% 144
8% 0
1000 410 300
600 246 180
0 0 0
C.3.1 % doctors trained as minilap 1.61 % 3 0 0 0 3
C.3.2 % doctors trained as NSV 0 0 0 0 0 0
C.3.3 % doctors trained as laparoscopic
sterilization
0 0
0 0 0
1950
1170
0
0
20

C.3.4
% ANM/LHV/SN/MO trained in IUD
insertion
C.4 HR productivity
C.4.1 Average no. of NSVs conducted by
trained doctors
C.4.2 Average no. of minilap sterilizations
conducted by minilap trained doctors
C.4.3 Average no. of laparoscopic
sterilizations conducted by lap
sterilization trained doctors
C.5 Facility utilization
C.5.1 Average no. of sterilizations performed
in FRUs
C.5.2 Average no. of sterilizations performed
in 24x7 PHCs
12 % 0
2 0
95
0
45.40% 218
54.60% 263
1 1 1
0 0 0
908 372 272
1092 448 328
MONITORING AND SUPPORTIVE SUPERVISION TEMPLATE FOR DISTRICTS ON FIXED DAY STASTIC CENTRES
Activities Time Line Responsible Reviewing Achiev If No
Person/Officer
Officer ed
Reasons and
Yes/N
O
Corrective action
Sterilization operations conducted in
Each assigned L2 & L3 institutions
( Delivery points, non –MCH Center )
1 st Qtr
May 30 th
3 batch
0
1771
2130
21

IUCD insertion & Services in another
specific day ( in all L2 & L1 centers and
delivery points)
The performance in Fixed day sites (
for all methods)analysis and
presentation to the District Team(
ADMO(FW),CDMO, DPM – at District
Level
In block level the concern SA/the
person in charge of reporting (regular
incumbent) to share with BPO & BEE
and present before the MOI/c
Camp scheduled after the quarter to
address the backlog – organizing camp s
and other details as per guideline
IEC/BCC activities regarding the
a. Fixed Day Static Centers
b. Camps
Monitoring visit to the Fixed Day Static
Centers
2012
1 st quarter Designated block nodal
officer
Every Month
Each
fortnight
Fixed Days
After each
quarter/Deci
sions
SA and ICA to prepare
and share with DHIO in
each month and DHIO
& SA collectively
responsible for
presenting it to CDMO,
ADMO(FW) & DPM
PHEO of the block
ADMO (FW), ADPHCO &
PHEO
ADPHCO & PHEO
Continuous ADMO(FW)/ Wing
officers and nodal
officers assigned for
each block.
CDMO,ADMO(F
W)
ADMO(FW)
MOI/c to take
corrective measure,
BPO /BEE for
proceedings &
meetings.
ADMO(FW)
MOI/c
CDMO & ADMO(FW)
to review and
rectify
22

Activities Time Line Responsible
Person/Officer
Reviewing
Officer
Achieved
MONITORING AND SUPPORTIVE SUPERVISION TEMPLATE FOR DISTRICTS ON LOGISTICS & SUPPLY CHAIN
Assessment of stock /Contraceptive Commodity
Security for free supply & ASHA
U
pdation in CLMIS/ProMIS
Transportation of Family Planning Supplies
Dist.to Block
Block to Sector/SC
Store Pharmacist
Store Pharmacist
Store Pharmacist
ADMO
(FW)/CDMO
ADMO
(FW)/CDMO
ADMO
(FW)/CDMO
Yes/NO
MONITORING AND SUPPORTIVE SUPERVISION TEMPLATE FOR DISTRICTS QUALITY ASSURACE PLAN
Periodic QAC meeting Every quarter
Facility audit/Exit Interview /verification
of records
Failures/Complications
Insurance Claims etc.
Every month
At QAC meeting
At QAC meeting
ADMO(FW),ADPHCO
All designated nodal
officer
ADMO(FW),ADPHCO
ADMO(FW),ADPHCO
CDMO
ADMO(FW),
CDMO
CDMO
CDMO
If No
Reasons and
Corrective action
23

PIP
Code
Budget head
RESOURCE ALLOCATION
Family Planning Budget- 2012-13
Unit
Of
measure
Base
line
Curren
t
status
Rate/R
s/Unit
Target
A3.1 Terminal/Limiting Methods Q1 Q2 Q3 Q4
A3.1.1
A3.1.2
A3.1.3
Dissemination of manuals on sterilization
standards & quality assurance of sterilization
services
Quarterly Female Sterilization Camps to address
backlogs - 2 camp per qtr per district in the low
performing zone
NSV camp - one camp per qtr per district in 10
districts ( Koraput, Rayagada, Malkanagiri,
Nabarangpur, Kalahandi, Nuapada, Bolangir,
Sonepur, Mayurbhnaj and Kandhamal)
A3.1.4 Compensation for Female sterilization
A3.1.5 Compensation for Male sterilization
A3.1.6
A3.1.6.1
Total of Sterilization
Budget for Sterilization (85% of Total
Sterilizations Budget)
Accreditation of private providers for
sterilization services
Regional level orientation of accredited private
providers on service protocols & reporting
Sub-total A3.1 (excluding Sterilization & NSV)
A3.2 Spacing Methods
Per camp
per
quarter
Per camp
per
quarter
Per
Beneficiar
y
Per
Beneficiar
y
Per inst.
Total
Target
Budget
15000 1 0 0 0 1 0.15
15,000
35,000
1,000
1,500
2,500
2 2 2 2 8 1.20
0 0 0 0 0 0
925 925 925 925 3700 37.00
20 20 20 20 80 1.20
Officer/Person
Responsible
24

A3.2.1 IUD Camps
A3.2.2 IUD services at health facilities/ compensation
A3.2.2.1
A3.2.2.2
A3.2.3
For Beneficiary (to be utilized to meet essential
requirements on IUD services at institution level)
Incentive to ASHA for ensuring retention of IUD
by beneficiary for 1yr
Incentive to private accridated institutions for
IUD insertion services
A3.2.4 Social Marketing of contraceptives
A3.2.4.
1
A3.2.4.1
.1
A3.2.4.1
.2
A3.2.4.1
.3
A3.2.4.
1.4
A3.2.4.1
.4.1
A3.2.4.1
.4.2
A3.2.4.1
.5
A3.3
Delivery of contraceptics by ASHA at door step
in 18 high focus district
Sensitisation workshop at district level
ToT for ASHA training
Training of ASHA on operational modalities
(except Angul dist)
Eligible copule survey
At District level (MO I/c, BPO, PHEO, SA, HQ LHV
from block level, 2 staff from PPC, district level
participants - CDMO, SI, MCH, DHIO, ICA, DPHEO)
At Sub district level - Orientation to programme
officer, supervisor & ASHA at existing meeting
platforms
Distribution of contraceptives
Sub-total A3.2
POL for FP/Others - Trasportation of FW
materials
A3.3.1 State to district
A3.3.2 District to Block
A3.3.3
Block to Sector (ASHA to be provided
contraceptives at sector meeting)
A3.4 Repair of laparoscopes
Per
beniciary
Per case
Per case
Per
district
Per ASHA
per
participan
t
20
150
75
275
500
1143 1143 1180 1180 4646 0.93
30 30 30 30 120 0.12
UNFPA support
UNFPA support
25

Sub-total A3.3 & A3.4
A3.5 Other strategies/activities
A3.5.1
A3.5.1.
1
A3.5.1.
2
A3.5.1.2
.1
A3.5.1.2
.2
A3.5.1.2
.3
A3.5.2
A3.5.2.
1
A3.5.2.1
.1
A3.5.2.1
.2
A3.5.2.1
.3
A3.5.3
A3.5.3.1
A3.5.3.2
Strengthening of Family Welfare Bureau for
quality implementation of family planning
programe
At State level
At District level
Manpower
Mobility cost for supportive supervision including
QAC members
Operational cost for Dist. FW Bureau for meeting
exp., reporting, internet, telephone, postage
etc.
Operationalization of fixed day static services -
Family welfare day
Contingency for Fixed day static FP services
At L3 FRU
At L2 24x7
At Other DPs
Promote postpartum and post abortion family
planning services including sterilization in
facilities having high institutional deliveries
Remuneration of Family Planning Counsellor (32
DHH + SCB MCH) @Rs.10,000/- + PI Rs.1500/-
(max 20%)
Sensitization of service providers on PP
sterilization
Per
district
per month
Per inst.
Per
quarter
Per inst.
Per
quarter
Per month
-
-
2500 1 1 1 1 4 0.10
1,200
600
-
4 4 4 4 16 0.192
11 11 11 11 88 0.52
-
-
-
26

A3.5.3.3
Sensitizing ASHA & AWW to motivate the
beneficiary
A3.5.3.4
Orientation to PPC SN & ANM on FP counseling &
on PP
A3.5.5 Trainings
A3.5.5.
1
Laparoscopic sterilization training
A3.5.5.
2
Minilap training
A3.5.5.2 Minilap training for MO (Asst Surgeon of L3 & L2):
.1 twelve working days at District level
A3.5.5.
3
A3.5.5.3
.1
A3.5.5.3
.2
A3.5.5.3
.3
A3.5.5.
4
A3.5.5.4
.1
A3.5.5.4
.2
A3.5.5.4
.4
A3.5.5.4
.7
A3.5.5.4
.8
A3.5.5.
5
A3.5.5.5
.1
NSV training
NSV training for MOs five working days. State
level TOT
NSV training for MOs five working days. District
level
NSV TOT training for surgery specialist or PG
holder in surgery at National Level .
IUD insertion training
Six days Dist level IUCD training for MO and SN
3/batch 41625 1 0 0 1 2 0.83
5/batch 0 0 0 0 0 0
5/batch
5/batch
12/batch,
person
76210 0 0 1 1 2
Six days Block level IUCD training for ANM, LHV 10/batch 48530 0 1 0 0 1
Three days Postpartum IUCD Training for O&G
Spl and Staff Nurses of Respective Districts
(5MOs+5SNs)
1 day district level Orientation to Block MO I/C
& PHEO on IUCD 375-A
1 day Orientation to ANM, SN on IUCD 375-A at
Block Level of L2 & L1 Institution
Contraceptive update training
One Day Contraceptive update & family planning
guideline trg. for MOs (District)
0
-
-
-
1.52
-
0.485
10/batch 50000 0 0 1 0 1 0.50
10/batch
30/batch 30000 1 0 0 0 1 0.30
30/batch
-
-
27

A3.5.5.5
.2
A3.5.5.
6
A3.5.5.6
.1
A3.5.5.6
.2
A3.5.6 Printing
Contraceptive update Trg. To Paramedics
(SN,LHV,HWF,HWM,HSM) per Dist. One batch at
District level
Other FP Training
Orientation training of newly trained surgeons on
standards & protocols of FP methods (State)
Orientation training of FP Counsellor on
standards & protocols of FP methods (State)
30/batch 26000 0 1 0 0 1 0.26
30/batch
30/batch
A3.5.6.1 Printing of sterilization case cards Per card
A3.5.7
Procurement of equipment & instrument for
operationalistion of FP services
A3.5.7.1 NSV kit Per kit 0 0 0 0 0 0
A3.5.7.2 Minilap kit Per kit 6000 2 0 0 0 2 0.12
A3.5.7.3 IUCD kit Per kit 2000 13 0 0 0 0 0.26
A3.5.7.4 Laprosocpe machine
Per
mechine
A3.5.8 Performance Based Awards
A3.5.8.1 Best performing districts (3 districts)/block Lump sum
A3.5.8.2
Best performing Surgeon (Female & Male
sterilization)
A3.5.9 Monitoring
A3.5.9.5
A3.5.9.6
A3.5.10 IEC/BCC
A3.5.10.
1
A3.5.10.
2
A3.5.10
.3
District level QAC meeting (Integrated with
general QAC meeting)
Quarterly family planning review by District
Authorities
Production of AV resource materials,
broadcasting & telecasting in mass media
channels
Advertisement of local dailies on FP
Observation of World Population Fortnight
Lump sum
Per
district
per
quarter
1000 1 1 1 1 4
0.40
-
28

A3.5.10
.3.1
A3.5.10
.3.2
A3.5.10.
3.2.1
A3.5.10.
3.2.2
A3.5.10
.3.3
A3.5.10.
3.3.1
A3.5.10.
3.3.2
A3.5.10.
3.3.3
A3.5.10.
3.3.4
A3.5.10.
3.3.5
A3.5.10.
4
A3.5.10.
5
A3.5.11
At State level
At District level
District level function
Documentation
At Block & sub-block level
Per
district
Per
district
Block level function Per block
IEC Van
Per van
for 2
block
Poster, leaflet, hoarding etc Per block
Village contact drive Per block
Documentation Per block
Sensitizing Kalyani Club members/ NYKs Youth
volunteers on FP issues
Board for Designated FP Day at designated
institution (Promotion of Fixed day approach)
Wall painting - promotion of ASHA contraceptive
in 18 high focus districts
Sub-total A3.5
Per block
4nos per
block
5,000
5,000
1,500
15,000
10,000
10,000
1,000
1,000
-
-
-
42.707
29