Chapter-I Background - Regional Resource Centre for North Eastern ...

Chapter-I 

Demographic features: 

The state is situated in the northeastern part of India, bounded by international 

boundaries with China in the north, Myanmar in the southeast and Bhutan in the west. The state 

is situated at latitude of 90.36 0 E to 97.3 0 E and longitude of 26.42 0 N to 29.30 0 N covering a total 

land area of 83,743 sq. km. The population of Arunachal Pradesh is 10, 91,117 (Census 

2001).Density of population is 13 persons per square kilometer. Sex ratio of the state is 901 

females per 1000 males as per census 2001. The total literacy rate of the state is 54.74% with a 

male literacy rate of 64.07% and female literacy rate of 44.24%. The per capita income (97-98) 

of the state is Rs. 13424. [Source: Provisional Census of India 2001]. 

The state has a total population of 10,91,117 (Census 2001) with male constituting 

573951 and 517166 females. The percentage of population below poverty line in 1999-2000 is 

33.47 (SRS Bulletin, April 2001) with a percentage decadal growth of 26.21 and Average Annual 

Exponential Growth Rate of 2.33. The rural population constitutes 79.59% and the urban only 

20.41 %. The decadal growth rate of urban population is a staggering 101.29 %. 

Administrative divisions 

The administrative set up of Arunachal Pradesh and its changing district boundaries 

correspond broadly to natural boundaries of river basin. Even the boundaries of Sub-Divisions, 

Community Development Blocks and Administrative Circles within the districts have also been 

directly affected by the terrain features, though there is no cadastral survey conducted till date 

for clear cut demarcation of administrative boundaries. 

There are 16 Districts, 37 sub-divisions, 155 circles, 17 towns, 84 blocks and 3862 

villages constituting an elaborate administrative structure for diffusing developmental activities 

in the state. 

SPIPSSP 1 

Background

Chapter-2 

Maternal Health 

The mothers who had atleast 3 ANCs visits for their last birth in the state is 36.2% 

(DLHS-3).Those mothers who consumed IFA for 90 days or more when they were pregnant with 

their last child is 42.9%(DLHS-3). There is a wide gap between the mothers who had attended 

the ANC vistis and may be provided 100 IFA but very minimal numbers of mother actually 

consumed the IFA. Similarly, birth assisted by SBA is 33.4% (NFHS-3). However, 47.7 % 

(DLHS-3) have actually delivered in the institution. The reason could be due to lack BCC / IPC 

to be provided by health personnel and also may be due several health facilities not manned by 

ANMs. 

The mothers who received post natal care within 2 weeks of delivery is 38.3% (DLHS-3). 

There is ample evidence that health personnel are not proactive in providing the PNC. This is 

compounded by lack of requisite manpower in the facilities especially in SCs and PHCs. Another 

reason could be that the health personnel pooled in PHCs are not going to the mothers for PNC 

due to lack of motivation in the health personnel itself. There is an area for BCC to pick up in the 

state broadly for the whole community and particularly to the health personnel. 

Child health 

Children 12-23 months who are fully immunized is 40.3% (DLHS-3) and who had BCG 

is 58.2% (DLHS-3). This shows that there is a wide gap between introduction to immunization 

and sustenance of the service. The possible reasons could be lack of awareness on the part of the 

community and also availability of services. Accessibility is an area of concern for the state of 

Arunachal Pradesh. Likewise, children who had received 3 doses of OPV is 52.6% (DLHS-3) but 

as compared to vaccines given later are less. This clearly indicates vast area of improvement in 

terms of continuous BCC / orientation about the importance of full immunization. 

Children who have received 3 doses of DPT Vaccine is 55.6% (DLHS-3). There is a 

variation between OPV and DPT whereas these 2 vaccines are given together. The reasons that 

are prevalent in area are mothers are worried of fever after the vaccination, maternal psyche not 

tolerating injection / cry of the beloved child etc but it has improved over the years. Measles 

coverage is at 65.5% (DLHS-3). Children 12-35 months old who received vitamin A doses in last 

9 months stands at 45.1% (DLHS-3) only. Very often, it is due to non availability of Vit A supply 

and also due non promotion regarding the need of administering vitamin A by the health 

personnel. 

Children who received ORS is 64.1% (DLHS-3). Children with diarrhea taken to a 

health facility during the last 2 weeks are 57.9% (DLHS-3). The evident reason for very low level 

of hospital treatment is due to lack of facility nearby / accessibility is poor and similarly 

consumption of ORS is low due to ignorance / the taste of the preparation. Another reason 

prevalent in some districts could be that if ORS is taken, it aggravates diarrhea. Regarding ARI 

taken to a health facility is 43.6% (NFHS-3). Varied methods of BCC etc are urgently required 

for improving the utilization of the services. 

SPIPSSP 2 

Situational Analysis

Children under 3 years breastfed within 1 hour of birth are 38% (DLHS-3) and 

exclusively breastfed upto 5 months is 51.5% (DLHS-3) . Introduction of weaning food for 6-9 

months children is 18.6%(DLHS-3). Traditionally, breast feeding is practiced in the state but 

little more effort has to be put in BCC in general and particularly to the mothers by the attending 

health workers. 

Children under 3 years who are stunted is 34.2%(NFHS-3) , who are wasted is 16.5% 

(NFHS-3) and who are underweight is 36.9%(NFHS-3). Acitivities related to improved intake of 

quality food and timely feeding of required food has to be informed to the community through 

BCC etc. There is an area of improving the knowledge and skill of the health personnel to 

promote the same. 

Children age 6-35 months who are anaemic is 66.3% (NFHS-3). The reason could be 

initiation of weaning food in time and also quality food. 

Family Planning 

Current use of any method is 52% (DLHS-3) and any modern method is 49%(DLHS-3) 

which include male sterilization (0.5%), IUD (3.7%), Pill (10.9%) and Condom (3.1%). The 

promotion of all these methods has been slow and tardy leading to very low level of acceptance. 

Serious BCC has to to designed to address these issues. A vigorous BCC needs to be formulated 

to involve male in limiting the family size. Convergence with other agencies dealing with similar 

agenda would have to be involved like APSACS. 

Total unmet need for family planning is 14.3% (DLHS-3) contributed by spacing (3.9%) 

and limiting (10.4%). Due lack of health personnel in many facilities across the state and may be 

unmotivated health workers etc are few reasons seen at ground level. However, even acceptance 

level is low due to ignorance and lack of motivation. 

Adolescent Reproductive and Sexual Health (ARSH) 

Data shows that women age 15-19 years who were already mothers or pregnant is 8.2% 

(DLHS-3). Early marriage is a social problem some pockets of the state. Necessary BCC 

activities to sensitize the community are on through health department and other agencies. The 

trend is that the marriage age during adolescent period is coming down. 

District / sub district variations. 

INDICATORS ON MATERNAL HEALTH (Source: DLHS-2007-08) 


1. Upper Siang, East Kameng, Upper Subansiri, Lohit, Lower Dibang Valley districts 

shows poor performance and needs to be emphasized more to improve Mothers 

registered in the first trimester when they were pregnant with last live birth/still 

birth(%). The State average is 36.2%. 

2. Mothers who had at least 3 Ante-Natal care visits during the last pregnancy (%) 

explicates that the performance of most of the districts are comparatively average except 

Upper Siang and East Kameng districts with 12.6% and 27% respectively. The State 

average is 48.2%. 

3. According to the data, Mother who got at least one TT injection when they were 

pregnant with their last live birth/still birth (%) reflects that the performance of all the 

SPIPSSP 3

districts are almost uniform and reach to an average of 61.4%. Amongst the districts, 

Papumpare performed well with 76.4%. 

4. The average Institutional births percentage is 47.7% in the State. Amongst the 16 

districts, Papumpare district achieved high with 71.3% and Lower Subansiri district with 

62% achievement seems reasonable good, whereas, in Upper Siang it is 13.1% only. 

5. Delivery at home assisted by a Doctor/Nurse/LHV/ANM (%) in Arunachal Pradesh is 

2.3% with very good indication in Papumpare district showing of nil report which fulfills 

and serve the cause i.e. delivery at institutions. 

6. Mother who received post natal care within 48 hours of delivery of their last child (%) 

required to be emphasized more in Arunachal Pradesh as the data spelt out that only 

38.3% of mother received post natal care within 48 hours. The prime reason being that 

most of the mother discharged from the health facilities before 48 hours if there is no 

complications as due to insufficient infrastructure facilities especially like lack of beds in 

indoors as well as space for occupancy of patients and also due to insufficient numbers 

of medical practitioners & paramedical staffs in the District Hospitals/ CHCs/ PHCs 

and hence most mother never turned again for post natal care within 48 hours. 

SPIPSSP 4

Particulars 

Mothers registered in te first 

trimester when they were 

pregnant with last live 

birth/still birth(%) 

Mothers who had at least 3 

Ante Natal care visits during 

the last pregenancy (%) 

Mother who got at least one 

TT injection when they were 

pregnant with their last live 

birth/still birth (%) 

Tawang 

West Kameng 

East kameng 

Papum Pare 

Lower Subansiri 

Kurung Kumey 

SPIPSSP 5 

Upper Subansiri 

West Siang 

44.0 48.5 15.4 49.3 40.6 33.8 27.8 33.2 32.4 10.0 28.6 46.7 23.1 42.5 53.6 30.1 

45.8 54.0 27.0 57.8 60.4 48.7 52.4 47.6 49.3 12.6 37.2 43.0 66.8 52.1 59.5 45.6 

59.5 64.6 52.9 76.6 65.9 49.6 58.1 53.7 65.3 34.1 67.2 72.7 68.5 52.7 71.7 53.4 

Istitutional births (%) 40.5 42.9 30.6 71.3 62.2 52.1 59.1 54.4 53.8 13.1 48.5 56.6 57.9 33.5 45.3 49.5 

Dilivery at home assisted by a 

Doctor/Nurse/LHV/ ANM(%) 

Mother who received post 

natal care within 48 hours of 

delivery of their last child (%) 

3.7 2.7 0.5 0.0 1.3 3.6 1.6 3.3 1.8 2.0 2.8 2.9 1.2 3.6 1.6 1.9 

35.3 36.9 22.9 47.2 40.8 38.9 42.9 30.7 36.4 9.5 34.6 43.0 42.0 32.3 45.1 24.3 

East Siang 

Upper Siang 

L/ Dibang Valley 

Dibang Valley 

Lohit 

Anjaw 

Changlang 

Tirap

Child Health 

As per the State Child Health Indicators, 40.3% Children (12-23 months) fully immunized; 24.8% 

Children (12-23 months) not received any vaccination; 58.2% Children (12-23 months) who have 

received BCG vaccine; 55.6% Children (12-23 months) who have received 3 doses of DPT vaccine; 

52.6% Children (12-23 months) who have received 3 doses of polio vaccine; 65.5% Children (12-23 

months) who have received measles vaccine; 45.1% Children (12-23 months) received one dose of 

vitamin A supplement. 

The below indicators is quite predominant thread and special attention needed to reach the target 

with special deliberation to cover Children (12-23 months) fully immunized. Specially, districts like 

Upper Siang and East Kameng to be marked as high focused area so to equate and thereafter to 

increase the percentage. 

SPIPSSP 6

DISTRICT INDICATORS ON CHILD HEALTH (Source: DLHS-3 007-08) 

Particulars 

Children (12-23 months) 

fully immunized 


who have received 

BCG(%) 


who have received 3 

doses of Polio 

Vaccine(%) 



doses of DPT Vaccine(%) 



doses of Measles 

Vaccine(%) 

Tawang 

West Kameng 

East kameng 

Papum Pare 

Lower 

Subansiri 

Kurung Kumey 

SPIPSSP 7 

Upper 

Subansiri 

West Siang 

50.6 43.4 17.7 63.3 48.8 23.8 31.2 28.0 39.8 12.4 40.5 61.7 68.2 41.5 64.4 50.0 

88.4 85.9 43.1 91.4 60.0 66.7 63.8 53.3 68.6 59.2 95.7 90.0 91.9 56.1 84.4 75.0 

62.8 51.5 33.9 74.8 53.2 38.1 46.0 44.4 43.6 24.3 52.5 70.0 68.7 39.0 66.8 75.0 

65.8 55.8 38.3 74.5 54.8 47.6 36.3 39.7 45.7 30.0 38.5 65.0 77.1 48.8 80.1 83.3 

77.2 84.4 38.7 73.1 59.0 40.5 52.3 43.4 54.1 44.7 77.4 88.3 77.1 53.7 81.7 66.7 

East Siang 

Upper Siang 

Lower Dibang 

Valley 

Dibang Valley 

Lohit 

Anjaw 

Changlang 

Tirap


In Arunachal Pradesh it seems that Any method is having more acceptability with 52% and even in 

rural areas it is more than 50%. The data indicates that West Siang district record highest by 

achieving 68% and East Kameng with a low of 36% among all districts relating to Any Method. The 

said method is followed by Any modern method with 49% which is followed by female sterilization 

with 30.6%; use of Pill is 10.9%; use of IUD is 3.7%; use of condom is 3.1%; use of any traditional 

method is 2.9%; Male sterilization is 0.5% as the State average respectively. 

Focus to be given to adopt Male sterilization techniques as it records very poor percentage. But, at 

the same time more acceptable family planning methods also needs to be given attention which 

continuously required to be provided as a option so to enhance the percentage and to reach to its 

optimum. Further, more mass awareness generation campaigns on Total unmet need (%) to be 

organized at various levels being ignorance emerge as one of the root cause in far flung 

topographically challenged villages of Arunachal Pradesh. 

SPIPSSP 8

DISTRICT INDICATORS ON FAMILY PLANNING (Source: DLHS-3 007-08) 

Particulars 

Any 

Method(%) 

Any 

Modern 

method(%) 

Female 

Sterilization 

Tawang 

West Kameng 

East kameng 

Papum Pare 


Kurung Kumey 


SPIPSSP 9 

West Siang 

53.2 51.3 36 60.8 54.4 47.2 60.2 68.2 57.2 44.2 48 37.8 53.2 42.4 54.7 47.7 

50.5 50 33.7 57.2 51.6 46.4 54.5 61.2 55.8 42.5 46.6 36.1 49.4 41.5 51 44.2 

15.8 26 24.3 40.4 36.6 36.7 40.4 48.6 43.4 34.9 28.7 16.1 38.3 24.2 32.3 26.9 

Male 

Sterilization 

1.2 0.4 0.1 0.4 0.3 0.5 0.7 1.4 0.5 0.2 0.3 0.3 0.7 0.6 0.1 0.3 

IUD(%) 7.9 4.8 1.1 1.8 5.1 3.8 3.9 2.2 1.5 0.7 3.2 4.5 2.7 1.6 2.4 5.8 

Pill(%) 23.7 15 6.5 11 4.9 3 4.2 4.3 7.6 5.3 11.7 13.7 6.2 12.5 12.8 9.2 

Condom(%) 1.3 2.8 1 3.1 4.6 2.5 4.6 4.7 2.6 1.5 2.3 1.4 1.5 2.6 3.3 2 

Unmet need for Family Planning (%) 

Total 

unmet need 

(%) 

16.6 14.9 19 19.1 9.4 7.9 10.2 12 23 24.4 23.4 25.1 8.8 11.3 7.7 6.1 

For spacing 3.2 3 7 7.6 4.4 1 2.9 2.2 6.3 7.4 4.9 7.4 2.1 4.4 3.2 1.9 

For 

limiting(%) 

13.4 11.9 12 11.5 5 6.9 7.3 9.8 16.7 17 18.5 17.7 6.7 6.9 4.5 4.2 

East Siang 

Upper Siang 

Lower Dibang Valley 

Dibang Valley 

Lohit 

Anjaw 

Changlang 

Tirap

Health Infrastructure/ Facilities 

At present, Public Health facilities are the back bone of health delivery and family welfare 

services in the State as private hospitals are not available. Catering to the health and family welfare 

needs of the people are 2 General Hospitals at Naharlagun and Pasighat, 13 District Hospitals at 

Tawang, Bomdila, Seppa, Ziro, Daporijo, Along, Yingkiong, Roing, Anini, Tezu, Changlang Khonsa and 

Hawai, 44 Community Health Centers (CHCs), 116 Primary Health Centers (PHCs), 592 Sub-Centers 

(SCs), 44 Homeopathy Dispensaries and 10 Ayurveda Speciality Clinic. 

There are 273 SCs functional with ANM and other paramedic. 

There are 20 PHCs is providing 24x7 service. Even though PHCs are functional, all the PHCs 

are not as per IPHS in terms of physical infrastructure requirement for which further improvement is 

required. Only 28 PHCs are having proper labour room and the rest providing delivery service in 

relocated / make shift labour room. Further, accommodation for staffs are limited which often translate 

into staffs not staying at the PHC. IMEP is not addressed at this level so far except for routine 

immunization. 

Upgradation of CHCs was taken up and 15 are functional 24x7. 27 CHCs are provided with 

labour room and further improvement on the critical componets would be taken up from RKS fund. Due 

to lack of specialist and disuse, OTs already provided is deteriorating and now, it needs repair and 

renovation. IMEP is not addressed at this level so far except for routine immunization. Blood storage 

facility is available in 3 CHC (1 is functional at CHC Ruksin which is an FRU) and the rest are to be 

made functional. 

DH / GH are being upgraded and minimum requirement to be an FRU are available except that 

there is requirement of residential quarters. 

Human Resource Development including Training 

The state has no training centre. Training programs however are being conducted at the two 

General Hospitals which are identified as the training centre in the state and also has vertical programs 

organizing various training activities. Since, all the training programs face complex tasks. Establishment 

of a well equipped training centre is a mandatory. 

Problem Identification: 

With ever increasing number of manpower employed, development of a separate HRM to 

organize, conduct and monitor the personnel and training activities in the state has become very 

important. The identified training centre renders training programs to health personnel who are 

registered for the training. This covers around 50% of the trainees. The remaining trainees fail to 

receive the training at the training centre and so has to be imparted training in the district hospitals. 

Allocation of per diem of Rs.125/day for paramedics and Rs.200/day for MOs is very less as per Actual. 

Discrepancy: 

Training centre should be able to impart training and provide minimal accommodation to the 

trainees. It should also provide training to all the identified trainees in the state. But currently only 

10

about 50% of the trainees receive the training in the training centre and the rest receive in District 

Hospital. Training program needs to be enhanced through OR program from the existing level 

Inequity/ Gender 

In Arunachal Pradesh, there is not much of gender discrimination / biasness at present. 

Vulnerable communities in Arunachal Pradesh include those groups who are underserved due to 

problems of geographical access, and those who suffer social and economic disadvantages such as 

Scheduled Castes/Scheduled Tribes (SCs / STs) and the urban poor. Scheduled Castes and Scheduled 

Tribes do not live only in homogeneous communities, but are found within heterogeneous communities 

both in rural and urban areas. Arunachal Pradesh is one out of those six predominantly tribal populated 

States/ UTs where more than 60% of the population is tribal. However, in the State of Arunachal 

Pradesh, the SC population is less than 3%. The RCH indicators for slum population are worse than the 

urban average. Marginalization results in poorer social indicators for these groups, including maternal 

and child health indicators. This can be as much a result of service provider behavior as of health 

seeking behavior and capabilities. It is proposed in the later part to address the vulnerable group. 

Logistic 

The present system of logistic in the state of Arunachal Pradesh needs further review and 

streamlining for Procurement, storage and distribution. The current logistics in the state has lead to 

material loss and inefficient management at all levels. 

There is a need for establishment of warehouse or proper storehouse at state and zonal levels 

along with a proper storage manual / guidelines. There are several needs but storehouse for the districts 

are required urgently. There is a need to involve RRC-NE for further strengthening the logistic system in 

the state. 

HMIS/ M&E (existing capacity including availability of staff at state and district levels, access to 

computers, internet, etc.) 

A State HMIS Cell is already created, where every Data related to Program is being maintained. 

Reports and returns received from the districts are compiled and analyzed. Existing capacity including 

availability of staff at state and district levels, access to computers, internet, etc. are as follows: 

Manpower Status 

State HMIS/M&E Cell 

1. State Program Officer/Deputy Director (M&E) 1 

2. Consultant (HMIS) 1 

3. Data manager 1 

4. Data Assistant 5 

District HMIS/M&E Cell 

11

1. District Program Manager 8 

2. District Data Assistant 16 

3. Computer Assistant 16 

Equipment at state and district levels 

BCC 


1. Computers 02 Nos 

2. Internet Connection 01 

3. Fax Nil 

4. Telephone Nil 


1. Computers 16 Nos 

2. Internet Connection 06 

3. Fax 10 

4. Telephone 16 

Status of IEC Bureau in Arunachal Pradesh 

a. State IEC Bureau - 1 

b. District IEC wing - 16 

c. District Family Welfare Bureau - 2 

IEC MANPOWER IN THE STATE 

i. Deputy Director, IEC (State level) - 1 

ii. Mass Education and Information Officer (District Level) - 1 

III Dy. Mass Education and Information Officer (District Level) - 4 

IVDistrict Extension Educator (District Level) - 6 

STATUS OF MAHILA SWASTHA SANGH (MSS) IN ARUNACHAL PRADESH DURING THE 

YEAR 2008-09 

Sl.No. Name of the districts No. of MSS functioning 

1 Tawang 18 

2 West kameng 50 

12

Convergence/ Coordination 

3 East kameng 22 

4 Papum pare 27 

5 Lower Subansiri 20 

6 Kurung Kumey 17 

7 Upper Subansiri 10 

8 West Siang 50 

9 East Siang 30 

10 Upper Siang 15 

11 Lower Dibang Valley 45 

12 Dibang Valley 25 

13 Lohit 34 

14 Changlang 18 

15 Tirap 40 

16 Anjaw 27 

TOTAL 448 Nos. 

A convergence committee has been constituted at the state level under the chairman ship of the 

Chief Secretary which includes secretaries/ Directors from related department and representatives from 

NGO, PRI etc are the members. This committees will overseas the activities which are to be convered at 

all level. However, activity of the committee needs to be up-scaled. 

The executive committee of the state health society constitutes different program officer within 

the department to look into this activity. The DCs and the other administrative officers are the chairman 

of DHS & RKSs and are regularly involved in NRHM Programs. 

However, the committee is weak and needs improvement in the proposed year. Better plan for 

convergence at intra-departmental and inter-departmental level has been proposed. 

The National Population Policy 2000 and the National Health Policy, 2001, include 

decentralization and convergence of service delivery at village levels and recognize the PRI as the 

agency responsible to ensure this. In the context of health and family welfare, perhaps the most 

significant impact is the ability of women to get elected to local bodies. In some areas, women PRI 

members take an active role in polio eradication, health camps, mobilize women for services and 

monitor attendance of staff. 

Several factors influence the progress of decentralized planning and implementation, not the 

least being political will, and peoples’ readiness to engage with decentralization. 

The National Rural Health Mission (NRHM) is seen as a vehicle to ensure that preventive and 

promotive interventions reach the vulnerable and marginalized through expanding outreach and linking 

with local governance institutions. PRIs are seen as critical to the planning, implementation, and 

monitoring of the NRHM. At the District level a District Health Mission will coordinate NRHM 

functions. 

13

ASHA, (Accredited Social Health Activist), the mechanism to strengthen village level service 

deliveryare in place. The Village Health Committee (VHC) will form the link between the Gram 

Panchayat and the community, and will ensure that the health plan is in harmony with the overall local 

plan. 

Capacity building of PRI is required in thematic areas and leadership skills, negotiating, 

monitoring, ability to withstand patronage and political interference. Capacity building processes need 

to be tailored to literacy levels, sex and circumstances of PRI members. Joint orientation and 

sensitization meetings between PRI and health and medical professionals could help to bridge the gap in 

education and social strata. Developing Citizen Charter of Rights and Codes of conduct also lay down 

guidelines for boundaries of operation and accountability which is already addressed under RKS. NGOs 

could be involved in PRI strengthening in a variety of ways, including: consciousness raising, provision 

of technical advice, support in participatory planning, capacity building and facilitating monitoring 

processes, such as community and social audits to improve accountability. 

SWWCD 

The slow pace of progress in infant mortality and child malnutrition is an area of serious 

concern and maximum infant deaths occur in the neonatal period. Proximate determinants of infant and 

child survival include a mix of preventive and curative interventions which can be successfully 

implemented through a mix of actions at the village level 

Community level action for increasing mobilization, action and behavior change processes, 

supported by well organized primary and secondary health systems, are required to enable women cross 

a range of barriers, including gender inequity and poor access to quality health services. 

The SWWCD covers the Integrated Child Development Services (ICDS), to provide supplementary 

nutrition for pregnant and lactating mothers and children under six, and non-formal preschool 

education; programmes to ensure social and economic empowerment of women through collectivization, 

welfare and support services etc. At the village level, it is represented by a village level honorary 

worker, the Anganwadi Worker (AWW) and her assistant, an Angnawadi helper. At the block Level, the 

Child Development project Officer is the functionary in charge of DWCD schemes. 

The AWW under the purview of the SWWCD performs the duties of frontline grass roots workers 

along with the ASHA. The AWW is also involved in several programs like RI, Blindness Control, 

Leprosy, Pulse Polio Immunization, and the RCH programme. Coordination is immensely needed in 

areas such as health services, nutrition, immunization, and referral. Both are having overlapping goals, 

and thus complementary programming is essential. 

The National Rural Health Mission (NRHM) is seen as a vehicle to ensure that preventive and 

promotive interventions reach the vulnerable and marginalized through expanding outreach and linking 

with local governance institutions. 

The child health strategy concentrates on the: essential newborn care, breastfeeding, 

immunization, and care of the sick newborn and child through outpatient/home based care and inpatient 

14

care. This approach is called the Integrated Management of the Neonatal and Child hood Illness 

(IMNCI). 

SWWCD Interventions DHFW Interventions 

Child Health 

-Monthly Weighing of children under six 

-Maintaining Growth chart 

-Child cards for children below six (for 

medical history) 

-Nutrition supplementation 

-Referral of children with 2SD and 3SD 

malnutrition to the PHC 

-Non-formal pre school education 

-Health and nutrition education 

-Elicit community support and participation 

in running the programme 

-Assist PHC staff in immunization of 

children- House visits to ensure appropriate 

feeding practices and attendance at AWC. 

Maternal health 

-Nutrition supplement to a sub-sect of all 

pregnant and lactating women (BPL) 

-Enables all pregnant and lactating mothers 

to collect at the AWC for ANM visit 

Other women’s health issues: 

Child Health 

- Identify malnutrition among children (0-5) and 

manage or refer to PHC 

-Provide ORS to children with diarhoea 

-IFA to infants and young children 

-Vitamin A solution 

-Immunization 

-Weigh and examine newborn as son as possible 

after birth. 

-Health Education 


-Register and provide care to all pregnant women 

throughout pregnancy 

-Urine and Hb test, BP and three abdominal 

examinations 

-Refer complications and facilitate referral 

-Conduct three postnatal visits 

-Health education 


-Family planning motivation 

-Distribution of contraceptives 

-Referral for IUD or terminal methods 

-Follow up of users for side effects 

-RTI/STI education, recognition, and referral 

-Minor ailments treatment/referral 

They will be responsible for ensuring that all children 0-6 and children for immunization and 

other health services are brought to the AWC on a fixed day, when ANM and MO visit to provide 

immunization, and other health care services. Services to be provided on the Health & Nutrition Day 

include: ANC, Newborn check up, Postnatal care, Immunization of mothers and children, IFA and 

Vitamin A administration, treatment for minor ailments, and health education. 

They will mobilize women and children, with support from community to access services through 

a fixed Village Health & Nutrition Day held every month at the AWC. They will counsel women for 

institutional deliveries and facilitate referral. It will be emphasized that AWW and/or ASHA to be 

present at all home deliveries (as second attendant) to provide care and advice for the newborn. 

15

They could motivate newly married women and recently delivered women to use family 

planning. The AWC would serve as the depot for pills and condoms and also facilitate referral for other 

methods. 

They would participate in routine immunization and special campaigns like pulse polio and also 

provide Vitamin A 

In order to ensure effective functioning of the two areas of convergence discussed above, joint 

planning of between the two at various levels is necessary. 

Other cross cutting areas: 

Success of convergence in health, nutrition, and empowerment requires convergence of approaches in: 

planning modalities, monitoring and information systems, capacity building and training inputs. 

Additionally the Health Department must ensure that convergence efforts are backed by a strong service 

delivery system, responsive to community needs. 

School 

There may not be direct scheme / activities linked to the health indicators but as a major 

Department having capacities and establishment across the state, it will be ensured that there resources 

are being utilized for improving health indicators. This includes using of students in health programs, 

school health programs in the schools in sensitizing the students etc to health needs. Teachers may also 

be utilized for propagation of health information to the students in turn who will disseminate the 

messages to the parents and community. 

PHED 

Under NRHM it is to help and to promote sustainable and equitable access to water, 

particularly safe drinking water and sanitation facilities in urban and rural areas. It also promotes 

effective management in order to reverse unsustainable exploitation of water resources. 

The Community seeks to promote knowledge sharing and inter-agency collaboration as the means to 

achieve this end. By tapping into the collective knowledge of diverse practitioners across the sector, the 

Community helps members increase the effectiveness of water and environmental sanitation operations 

and development initiatives. There are issues which is covered 

• Access, quality and effectiveness of water and sanitation service delivery 

• Responsible management of water as a natural resource 

• Unsustainable use of water 

• Water pollution and contamination 

• Inadequate delivery mechanisms and infrastructure 

• Inefficient institutional and governance structures 

• Financial resource constraints 

• Socio-economic and cultural barriers to water access 

16

The facility survey also indicates that majority of the households are not provided with potable 

and safe drinking water. Similarly, sanitation facilities are also very scarce. Under the convergent 

efforts of the line departments, it is hoped that these issues also would be sddressed during the program 

period. 

VH&ND is another area where convergence has started. The committee will oversee under the 

aegis of SHM & DHM. This committee will not only address the health need but also covering all the 

aspects of sanitation. 

Administration 

Involvement of General Administration in RCH and NRHM activities is indispensable to the 

success of the programme, beginning from the State level down to the village level. Active participation 

of the district administration in required in mobilizing manpower and arranging transport facilities 

during IPPI campaigns and other health camps. At the decision making level, Chief Secretary is the 

chairman of SHS governing body and the Secretary(H) is the chairman of executive body of SHS. They 

are regularly in touch with the DCs in the districts, while at the district level Deputy Commissioners are 

the chairman of governing body of District Health Society and holding regular meetings and monitoring 

the progress of the programs with major emphasis on RCH activities. Administrative officers at all levels 

are the chairman of Rogi Kalyan Samity. By virtue of their position in various institutions of NRHM, 

their involvement in decision and policy making has become vital. At the implementation stage, their 

participation is invariably required for ensuring inter-departmental coordination and convergence of 

activities related to health programs. 

Finance 

a) RCH Flexible Pool Fund for the Financial Year 2009-10 (2 nd qtr)) 

SL. NO RCH-II Activity Approved Budget Expenditure % age of 

(Rs. In Lakhs) (Rs. In Lahks) Utilisation 

1 Maternal Health 12.80 7.75 60.54 

2 Child Health 10.08 0.00 NA 

3 Family Planning Services 4.20 0.00 NA 

4 Adolescent health 1.00 0.00 NA 

5 Urban Health 22.28 0.00 NA 

6 Tribal Health 0.00 0.00 NA 

7 Vulnerable Groups 0.00 0.00 NA 

8 Innovations/ PPP/ NGO 541.57 205.73 37.99 

9 Infrastructure and HR 160.08 95.05 59.38 

10 Institutional strengthening 50.12 5.75 11.49 

11 Training 72.69 7.16 9.85 

12 BCC/IEC 90.46 14.10 15.59 

13 Procurement 0.00 0.00 NA 

14 176.46 72.32 40.98 

Total Base Flexi pool 1141.74 407.86 35.72 

17

JSY 160.00 28.99 18.12 

Sterilization compensation 

NSV camps 

25.54 0.00 

- 

Total RCH Flexipool 1327.19 436.85 53.84 

4.15 Template-1 

Sl.No. Background Characteristics Number 

1 Geographic Area (in Sq. Kms) 83743 

2 Number of blocks 84 

3 Size of Villages (2001 Census) 3862 

1-500 3442 (Census-2001) 

501-2000 392 (Census-2001) 

2001-5000 26 (Census-2001) 

5000+ 3 (Census-2001) 

4 Number of towns 17 

5 Total Population (2001) 1097968 (Census-2001) 

Urban 227881 (Census-2001) 

Rural 870087 (Census-2001) 

6 Sex Ratio (F/M*1000) • Population Sex Ratio 901 

Population Sex Ratio 893 

Child Sex Ratio 964 

7 Decadal growth rate 26.21 

8 Density- per sq. km 13 

9 Literacy Rate (6+ Pop) 54.74 

Male 64.07 

Female 44.24 

10 %SC population 0.507 

%ST population 67.77 (2001 Census) 

11 No. of schools 538 

12 No. of Anganwadi Centres 3862 

13 Length of road per 100 sq. km. 15356 

14 % of villages having access to safe drinking water facility 70.4 

15 % of households having sanitation facility (Specify Type –sewer, 

septic tank) 

66.4 

16 

33.47 (SRS Bulletin April 

% of population below poverty line 

2001) 

17 Health Status Morbidity Male Female Child 

18 MMR 306 

IMR 61 

19 Health Resources-Facilities (Specify level of Facility like 

Subcentre) Personnel(Sanctioned Vacancy) 

Finances(Requirement and Releases) 

Will be given separately 

20 1.Birth rate and death rate 

2. Fertility rate. 

3. Disease maximum Disability. 

4.High Risk Groups 

3.03 (NFHS III) 

18

21 B.To link with the nutritional determinants-1. % of Infants with 

low birth weight. 2.Weight for Age no. above 90%, 3. No between 

60%-80%, 4. 

19 

DNA 

22 No. below 60% weight for age 

23 No of Primary school teachers 1280 

24 No of children enrolled 

(Age wise) (All relevant data needed to Start School Health 

Programme) 

Programme Objectives for Arunachal Pradesh 

Public Health Facilities Templates 2 

Health Facility 

Number 

Government Buildings Rented 

District Hospital 13 DH+2GH 0 

Medical College Hospital 0 0 

AYUSH Colleges and 

Hospitals 

0 0 

Sub District 0 0 

Rural Hospitals 0 0 

UFWC 4 0 

CHC including Identified 

FRUs 

50 0 

BPHC 0 0 

119 (28 with Labour 0 

Sector PHC 

Room) 

Subcentre 565 (80 with Quarter) 0 

Ayurvedic Dispensary 9 0 

Homeopathic Dispensary 45 0 

Human resources Templates 3 

Staff Sanctioned In-Position Vacant 

District Medical Officer 

16 16 

DRCHO 16 16 

Medical Superintendent-CHC 0 0 

Medical Officers including specialists ( sub 

district facilities) / from AYUSH also 

NA 459 

560 405 (82 including 

Medical Officers/from AYUSH also 

AYUSH)

Lady Medical Officers only if there is any 

separate cadre in the state) 

0 

Lab technicians 

X-ray technicians 

64 100(30 contractual) 

Staff Nurse 170 214 (194 contractual) 

LHV 2 2 

ANMs 390 405( 152 contractual) 

Male MPWs 

District TB Officer 13 13 

Senior Treatment Supervisor (STS) 13 13 

Senior TB Laboratory Supervisor 13 13 

Staff provided under the Vector Borne Disease 

Control Programme like District Malaria 

Officer, Assistant Malaria Officer and, Malaria 

Inspector 

Mention any other category 

2 2 

District Programme Manager 

8 

Accountant 

Data Assistant 

17 

21 

Functionalities & critical staff in position Templates 4 

Critical Staff Names Sanctioned 

District Hospital Availability of 

staff needed for service 

Guarantees 

CHC Ob&Gy specialists (either 

qualified or trained), 

Pediatrician Anesthesist (either 

qualified or trained) at identified 

FRUs 

PHC Availability of a medical 

officer at PHC 

Sub Centre Availability of an 

ANM at sub centre (resident at 

sub-centre) 

Indicate blocks where 

more than 20 percent 

posts are vacant 

Indicate PHCs, with 

more than 10 percent 

posts are vacant 

20 

In 

Position Vacancy 

Obs – 9 12 More 

Anaes- 9 7 sanctioned post 

Paed- 6 9 reqd. 

1 More 

1 requirement 

0 for other 

1 facilities as 

Relocated state Govt is 

from not sanctioning 

among 

MOs with 

PG 

degree. 

the posts. 

50 With 1 

MO- 30 

With 2 

MO-25 

565 173

Logistics Templates 5 

Logistics Elements Description 

Availability of a dedicated District warehouse for 

health department 

Nil 

.Recurrent stock out occurs but no exact is 

Stock outs of any vital supplies in last year available 

Indenting Systems (from peripheral facilities to 

districts) 

District demand as an when stock out. 

Existence of a functional system for assessing The cold chain system is in force right from 

Quality of Vaccine 

airport at ghty to the SC level. 

Training Templates 6 

Details about the training institution/s 

Name of the Institution: Key issues 

Physical Infrastructures Availability of lecture halls, place for training faculty, Nil 

residential accommodation for trainees ( men and women) , dining hall, 

furnitures, safe drinking water and electricity etc 

Provide details of Faculty (Sanctioned and In-position) with designation and Nil 

specialization 

Availability of Teaching Aids, computers etc. Assessment of availability of Nil 

common audio visual aids at the facility 

Availability of annual training plans for the last year and achievements of the yes 

plan? 

Availability of training calendar for the current year with clear cut time line for Yes 

the training activities. Training activities under NRHM: i) Orientation / 

sterilization workshops on NRHM -District level officers of related 

departments, sub district level officers, elected PRIs, field NGOs, faculty of 

ANMTCs/DTCs, block panchayat and Gram panchayat ii) Training for 

strengthening of health system -ASHA training -Skill based trainings The 

districts are required to indicate the trainings conducted for all categories of 

health personnels with reference to the training load. The cumulative number 

of trained manpower and the number of trained during the current year along 

with percentage of achievement may be specified. 

BCC Infrastructure Template-7 

Human Resources for BCC i.e. District Media 

officers, Dy Media officers and block level staff 

Any trainings the staff has undergone in media 

planning or material development in past five 

years Any functional Mass media audio- visual 

aids such as 16 mm projectors, Video cameras, 

VCD/DVD players 

There are 12(twelve) IEC/BCC officers positioned in 

the whole state. Most of the districts are without IEC 

manpower. None of these 12 officers had undergone 

any training in media planning or material 

development. Proposals for new recruitment are 5 Nos. 

of District Extension Education (DEE) 

21

-Did the district prepare a BCC plan in the past 

year? -If yes, what BCC activities were planned 

and undertaken? -In the absence of plan, find 

out what BCC activities were undertaken? 

Are there other institutions available in the 

private sector for conducting communication 

activities using modern media or folk media??? 

No BCC Plan proposed by the District. However, 

districts have undertaken few activities as per their 

local situation. Activities are Outdoor & Rural 

publicity Campaign such as – through IPC, Health 

Awareness Camp, wall writings, Pictorial Hoardings, 

Folk Dramas & Plays, Postures/Leaflet/pamphlet and 

involvement of MSS members 

1) HOPIN FILMS BANK TINALI, ITANAGAR, 

ARUNACHAL PRADESH 

2) FRONTIER FILMS, ABOTANI COLONY 

ITANAGAR-(A.P) 

3) Aaj Ki Awaj 

Private Health facilities Templates 8 

Private Services Facilities 

Multi-Specialty Nursing Homes 

Solo Qualified Practitioners 

22 

Number and location in case of sub district 

facilities. 

Practitioners from AYUSH 

5 

Approved MTP centres in Private sector 

RMPs (Less than formal qualified practitioner) 

1NGO 

Number of nursing homes with facilities for comprehensive 4 (Ramakrishna Mission Hospital, Niba 

emergency obstetric care 

Accredited centres for sterilization service 

Clinic, BTM Hospital, Heema Hospital) 

Accredited centres for IUD services 1 

ICDS Program Templates 9 

Name of the block 

with ICDS 

Programme 

Number of 

AWCs 

CDPOs 

and 

ACDPOs 

Supervisors AWWs AW helpers 

S F S IP S IP S IP S IP 

State 2359 2359 16 16 2359 2359 2359 2359 

Total 

Elected representatives Templates 10 

Name of the 

block 

panchayat 

villages Total 

members Total ZP Total BDC/Mandal 

members 

Total Panchayat 

Pradhans 

Male Female Male Female Male Female 

84 1640 91 45

NGOs, CBOs etc Templates 11 

Names of NGOs 

Key Activities in 

Health/Nutrition/community 

organisation 

23 

Block/Villages of NGOs operations 

VHAI 

Lumla (Tawang) 

Health 

Thrizino (W.Kameng) 

Deed Neelam (L.Subansiri) 

Nacho (Upper Subansiri) 

Gensi (West Siang) 

KARUNA TRUST Health Khimyang (Changlang) 

Wakka (Tirap) 

Mengio (Papumpare) 

Walong (Anjaw) 

Bameng (East Kameng) 

Sangram (Kurung Kumey) 

Jeying (Upper Siang) 

Etalin (Dibang Valley) 

Anpum (Lower Dibang Valley) 

Future Generation 

Arunachal (FGA) 

Health Selle (East Siang) 

Alok Prayas JAC Health Wakro (Lohit) 

Nani Sala Foundation Health MNGO for P/Pare 

VHAAP Health MNGO for East Kameng, W/ Kameng. 

Daying Ering Foundation Health UH Pasighat 

Boria Tari Memorial Society Health UH Naharlagun / Itanagar 

VHAI Health CHC Deamali(Tirap) 

Maternal Health Templates 12 Source DLHS -3 

Sl. No Particulars 

Maternity Care (for births in the last 3 years) 

Overall Rural Urban 

1 Mothers who had atleast 3 ANC visits for their last birth(%) 48.2 43.9 64.7 

2 Mother who consumed 100 IFA Tablets(%) 

42.9 45.2 34.3 

3 Birth assisted by a doctor/nurse/LHV/ANM/other health 

personnel (%) 

1.2 1.3 0.8 

4 Institutional births (%) 47.7 42.5 67.7 

5 Mothers who received postnatal care 

from a doctor/nurse/LHV/ANM/other 

health personnel within 2 days of 

delivery for their last birth (%) 

38.3 35.3 49.7

Family Planning Templates 13 Source DLHS -3 

Sl. No. Particulars Overall Rural Urban 

Current use 

1 Any method (%) 52.0 50.9 57.4 

a. Any modern method (%) 49.0 48.2 52.8 

b. Female sterilization (%) 30.6 30.5 30.9 

2 

c. Male sterilization (%) 

d. IUD (%) 

0.5 

3.7 

0.5 

3.4 

0.2 

4.9 

e. Pill (%) 10.9 10.6 12.3 

F. Condom (%) 3.1 2.9 3.6 

Unmet need for family planning 

3 

Total unmet need (%) 14.3 13.6 18.0 

a. For spacing (%) 3.9 3.7 4.9 

b. For limiting (%) 10.4 9.9 13.1 

Child Health Templates 14 Source DLHS -3 

Sl. No. Particulars Overall Rural Urban 

Child immunization and vitamin A supplementation1 

1 Children 12-23 months fully immunized (BCG, 

measles, and 3 doses each of polio/DPT) (%) 

40.3 34.5 55.8 

2 Children 12-23 months who have received 

BCG (%) 

58.2 54.7 67.5 

3 Children 12-23 months who have received 3 

doses of polio vaccine (%) 

52.6 47.1 67.7 

4 Children 12-23 months who have received 3 

doses of DPT vaccine (%) 

55.6 50.1 70.2 

5 Children 12-23 months who have received 

measles vaccine (%) 

65.5 63.1 71.7 

6 Children age 12-35 months who received a 

vitamin A dose in last 6 months (%) 

45.1 41.9 54.9 

Treatment of childhood diseases (children under 3 years) 

7 Children with diarrhoea in the last 2 weeks 

who received ORS (%) 

64.1 58.7 87.3 

8 Children with diarrhoea in the last 2 weeks 

57.9 59.0 52.8 

taken to a health facility (%) 

9 Children with acute respiratory infection or 

fever in the last 2 weeks taken to a health 

facility (%) 

Child Feeding Practices and Nutritional Status of Children 

10 Children under 3 years breastfed within one 

hour of birth (%) 

11 Children age 0-5 months exclusively breastfed 

(%) 

12 Children age 6-9 months receiving solid or 

semi-solid food and breast milk (%) 

24 

76.9 78.4 

73.4 

38.1 37.0 41.4 

51.5 52.6 47.9 

18.6 21.4 10.5

National Disease program Templates 15 

National Vector Borne Disease Control Programme (Malaria) 

Description Number Source 

API for Malaria (per 1000 population) 37 State VHDC Society 

Slide positive rate 13.98 State VHDC Society 

Plasmodium Falciparum Rate (PFR) 3.64 State VHDC Society 

Annual Blood examination Rate (per 100 population) 25.57 State VHDC Society 

Fever Treatment depots and 

DDCs 

Revised National Tuberculosis Control Programme 

25 

574 

534 

State VHDC Society 

SL. 

Description Number/ 

Source 

No. 

Percentage 

1 Percentage of TB suspects examined out of the 

2% State Health 

total outpatients. 

Society- RNTCP 

2 Annualized New Smear Positive (NSP) case 

71% State Health 

detection rate per 100000 population. 

Society 

3 Annualized Total Case detection rate per 1,00,000 201% State Health 

population 

Society 

4 Treatment success rate 86% State Health 

Society 

National Blindness Control Programme 

SL. 

No. 


1 Cataract surgery rate (CSR) 579 (Upto Nov’09) State record 

2 % of Reflective error age group 10-14 years 1054(Upto Nov’09) State record 

3 Surgical camp organized last year State record 

4 Personnel trained State record 

5 Service delivery points having quality assurance 

guidelines 

GH,DH,CHC,PHC State record 

6 % of teachers trained State record 

7 Number of NGOs receiving assistance and 

beneficiary assessment. 

Nil State record

National Leprosy Eradication Programme 

Description 

Number 

Source 

PR – Leprosy cases per 10,000 population 56 0.44/10,000 

population 

ANCDR – New Leprosy cases per 1,00,000 population 36 2.80/100,000 

population 

Proportion among the new cases detected 

MB 

32 88.8 

Female 03 8.33 

Child 02 5.55 

ST 11 30.5 

SC 06 16.6 

Proportion of Patients completed treatment (RFT) 

National Integrated Diseases Surveillance Programme 

32 47.05 


Percentage of facilities sending their reports in time 16 districts Arunachal 

Surveillance Society 

Up gradation of Labs Nil 

Training of staff in disease surveillance Pending 

National Iodine Deficiency Disorders Control Programme (NIDDCP) 


No. of persons suffering from IDD 

6 % NIDDCP Cell 

Number of persons consuming Iodized salt 

Locally endemic diseases in the district 

Names of locally endemic diseases such as JE, chikengunya, 

filariasis, endemic goitre, kala azar, endemic flourosis or other 

occupational diseases Chemical contamination of water sources 

or other zoonotic diseases such as Anthrax etc 

All the vertical programs are addressed separately in the relevant columns. 

26 

For implementation of RCH-programme , the assistance from various related departments shall 

be mandatory to achieve desired result in plan period and specifically coordination and convergence of 

ICDS services at village level must be ensured. 

At the block level the PHC management committee which includes PRI, ICDS, education, PWD, 

PHE, and Rural Development is being constituted to have coordinated effort to implement the RCH-II 

activities. 

At the district level the district health and family welfare society (DHS) has already been 

functioning under the Chairmanship of Deputy Commissioner and 

Head of the Departments of Districts as members. For better coordination, representatives from various 

related departments of the districts are included in the district level management body. The public 

representatives are made partners in planning and implementation of RCH activities. 

RTI/ STI activities, blood safety measures shall be integrated under RCH-II and converse with 

the on going activities under APSACS / NACO. 

A state level committee already exists and similar committee will be constituted in the districts. 

New interventions under NRHM Templates 17 

Activity Goal Achievement % 

Number of ASHAs selected 3862 3580 

Number of ASHAs undergone First Orientation training for seven 

days 

No of Fully trained Accredited Social Health Activist (ASHA)for 

every 1000 population/large isolated habitations 

Number of clients benefited under JSY 

No of Village Health and Sanitation Committee constituted and 

untied grants provided to them. 

No of 2 ANM Sub Health Centres strengthened/established to 

provide service guarantees as per IPHS, 

No of PHCs strengthened/established with 3 Staff Nurses to 

provide service guarantees as per IPHS. 

No of CHCs strengthened/established with 7 Specialists and 9 Staff 

Nurses to provide service guarantees as per IPHS. 

No of Sub Divisional Hospitals strengthened to provide quality 

health services. 

No of District Hospitals strengthened to provide quality health 

services 

No of Rogi Kalyan Samitis/Hospital Development Committees 

established in all CHCs/Sub Divisional Hospitals/ District 

Hospitals. 

No of Untied grants provided to each Village Health and 

Sanitation Committee, Sub Centre, PHC, CHC to promote local 

health action. 

Annual maintenance grant provided to every Sub Centre, PHC, 

CHC and one time support to RKSs at Sub Divisional/ District 

Hospitals. 

27 

3226 

762 

4455 (upto 2 nd 

qtr) 

3862 3012 

50 (approx) 

10 

0 

0 

12 

12 DH 

2 GH 

31 CHC 

85 PHC

Systems of community monitoring put in place. 

Procurement and logistics streamlined to ensure availability of 

drugs and medicines at Sub Centres/PHCs/ CHCs 

No PHCs/CHCs/Sub Divisional Hospitals/ fully equipped to 

develop intra health sector convergence, coordination and service 

guarantees for family welfare, vector borne disease programmes, 

TB, HIV/AIDS, leprosy etc. 

District Health Plan reflects the convergence with wider 

determinants of health like drinking water, sanitation, women’s 

empowerment, child development, adolescents, school education, 

female literacy, etc. 

28 

0 

31 CHC 

85 PHC 

273 SC 

14 DH 

Yes 

Facility and household surveys carried out or not 16-Facility Survey 

Completed 

11-House hold 

Survey Completed 

(West Kameng, 

East Kameng, 

Papumpare, West 

Annual State and District specific Public Report on Health 

published Institution-wise assessment of performance against 

assured service guarantees carried out. 

Institution-wise assessment of performance against assured service 

guarantees carried out. 

Mobile Medical Units provided Yes 

Siang, East Siang) 

Not done 

Not done yet 

No. of Ayush dispensaries re-located to PHCs 10 

No. of PHCs where AYUSH physicians appointed 27 

Outcome of Objective Setting - Template 18 


Child Health 

Other health 

Indicator Present Status 2010-11 Yr 5 

1.Complete ANC coverage 48.2% (DLHS-III) 60 

2.% of institutional deliveries 47.7% (DLHS-III) 75 

3. % of safe deliveries 48.9% (DLHS-III) 80 

4. Unmet need 

14.3 

10 

-Limiting 

10.4 

-Spacing 

3.9 

(DLHS-III) 

5. Full Immunization rate 40.3 %(DLHS-III) 70 

6.% exclusively breastfeeding 51.5 % (DLHS-III) 80 

9. Incidence of grade III/IV 

anemia 

66.3% (NFHS-III) 30 

10. PF Rate-Malaria 4.17% (NFHS-III) 

11. Case detection rate-TB 91 % (NFHS-III) 

12. Complete cure rate-TB 93 % (NFHS-III)

Outcome of B/ L Consultations - Template 19 

Problems Solutions 

Access to service Lack of infrastructure, lack of 

manpower, manpower not 

willing to stay in SC / difficult 

areas. 

Quality of service Lack of interest seen in many of 

the workforce, sincerity, lack 

recurrent knowledge / skill 

upgradation. 

Demand/ 

Community Involvement 

29 

More infrastructure be provided 

and manpower, strong HRD 

required. 

More training needed and 

motivation to the providers 

especially in for difficult areas. 

Demand is seen More BCC / IPC required.

Chapter-III 

Process of Plan Development 

A decentralized participatory planning process has been followed in development of this State 

PIP 2010-11. This bottom-up planning process began with consultations with block stakeholder groups, 

Block /core Group members and village communities in all villages of each Block of the District. Block 

Action Plans were developed based on the inputs gathered through village action plans prepared by 

Village Health & Sanitation Committees. 

The health facilities in the block viz. SCs, PHC and, CHC were surveyed using the templates 

developed by Government of India earlier. Those are updated now (Facility Survey update). The inputs 

from these facility surveys were taken into account while developing the Block Action Plan. 

The District Health Action Planning Team (DHAPT) provided technical oversight and strategic 

vision for the process of development of District specific Health Action Plans for 2010-11. 

The members of the DHAPT had also taken the responsibility of contributing to the selected 

thematic areas such as RCH, newer initiatives under NRHM, immunization etc. Assessment of overall 

situation of the District and development of broad framework for planning was done through a series of 

meetings of DHAPT and PRI leaders with consent from DC of the districts. 

This State PIP 2010-11 has been prepared through a process of integration of Block Health 

Action Plans including Health Facility Surveys. An initial meeting was held in which the current status 

of the District Health Action Plan was presented and suggestions and feedback taken. Based on the 

inputs received from the Blocks, a draft of each chapter was developed after discussions. These were 

further improved upon through individual consultations with Teams and MO i/c of the Blocks and health 

centre.Specific dates and times were fixed for this purpose. A date was also proposed for a meeting 

during which the individual chapters would be discussed and approved before the final DHAP was 

prepared for presentation to the District Health Society for approval. 

Following were the main activities conducted for the preparation DHAP 2010-11: 

1. Village level: 

• Consultative meeting with VHSC members at village level. 

• Data collection through ASHA ( Population, eligible couple, pregnant women, Immunization 

Status, Sanitation , drinking water, electricity, AWC, common disease prevalence etc. to update 

the House Hold Surveys. 

• Preparation of VHAP by ANM, PRI leaders and ASHA with guidance of Block MO I/C. 

2. Block level: 

• Formation BHAP team at the Block level in Sept 2009. 

• Update of facility survey of the Health centre. 

• Incorporation of VHAP for BHAP, mapping, tabulation. 

• BHAP approval meeting at the Block. 

30 

Process of Plan Development

3. District level: 

a. Constitution of Dist Health Action Plan Team in Sep-Nov. 2009. 

b. Collection of BHAP and facility survey from Block MO i/c. 

c. PRI (ZPM) level meeting at Dist. Hq. on 8/12/09 for the finalization BHAP for DHAP. 

d. Final discussion of BHAP for developing DHAP at Dist Hq. from 1 st to 15 th Dec. ’09 

e. Re view of DHAP of all NE & Sikkim at Guwahati on 18 th & 19 th Dec. 2009. 

f. Capacity building workshop on DHAP at Itanagar on 22 nd & 23 rd Dec. 2009. 

g. Final approval was obtained from Dist Health Society. 

All the DHAPs are then reviewed and summaries for development of the state PIP. Apart from the 

requirements of the districts, the state level requirements are incorporated in this State PIP. 

31

Chapter-IV 

Summary of Progress 

State Health Mission (SHM) 

The State Health Mission was constituted under the chairmanship of HCM along with State 

Health Society wherein governing body under SHS is headed by CS and the Executive body is headed by 

Secretary (Health). The State NRHM Secretariat is headed by Mission Director under State Programme 

Management Unit. 

Similarly, all the Districts have District Health Mission under the Chairmanship of chairman, 

Zila Parisad. The District Health Society headed by Deputy Commissioner. 

Act. 

All the District Health Society are constituted, notified and registered under Society Registration 

The last State health Mission meeting was held in the month of February 2008. 

The state Executive Body meeting was held in the month of 17th July’09 

Rogi Kalyan Samiti (RKS) 

Rogi Kalyan Samiti/Hospital Management Committee has been constituted, notified and 

registered in 14 out of 14 District Hospitals, 31 out of 44 CHCs and 85 out of 116PHCs as on date. 

Account books have been opened in 14 District Hospital, 31 CHCs and 85 PHCs. 

Out of 565 Sub centres, so far 273 untied fund Joint Account Books have been opened. 

Village Health Sanitation Committee (VHSC) 

Out of the expected 3862 VHSC, so far 3012 VHSC has been constituted and 2442 bank account 

opened and the process of constituting more VHSC is going on. 

The details are as below: 

Name of the District TOTAL Bank Account 

TAWANG 189 145 

BOMDILA 198 198 

EAST KAMENG 200 7 

PAPUMPARE 274 274 

32 

Progress made 2005-10

UPPER SIANG 92 92 

KURUNG KUMEY 154 151 

LOWER SUBANSIRI 98 60 

WEST SIANG 399 399 

EAST SIANG 132 132 

DIBANG VALLEY 25 25 

LOWER DIBANG VALLEY 100 100 

LOHIT 200 200 

ANJAW 154 19 

CHANGLANG 205 106 

KHONSA 156 105 

UPPER SUBANSIRI 436 436 

Facility Survey/ House Hold Survey 

Total:- 3012 2449 

Facility Survey for 12 DH, 29 CHC, 41 PHC, and 299 SC has been completed along with 11 /16 

House hold Survey completed. The summary of survey reports are as below: 

House hold Survey in the Districts was conducted during the year 2006 – 07. The State has 

received survey reports of only 6 Districts. There are 3862 numbers of Villages in the state, of which 436 

villages have been covered in this analysis. This analysis is based on 58903 households included in the 

survey. As per the survey, 12.2% houses are Pucca, 16.41% House are semi pacca and 71.31% houses 

are Kachha. It can be seen that out of the households surveyed, 12.13 % villages have toilet facilities 

inside the village. A very negligible percentage of 0.72% villages have Community toilets. Therefore, it 

can be analyzed that proper Sanitation facilities is an area of concern. Proper drinking water facility is 

another area of concern. It can be seen and observed that only 39.11% out of the surveyed households 

have proper drinking water facility. As far as disease and illness of the population is concerned, the 

prevalence of malaria is observed to be the highest with a percentage of 71.13%. Jaundice 15.89% and 

TB 6.43%. Deaths of children aged less than five years reported during last one year Male 52.44%, 

Female 47.55% is also observed to be high. Maternal deaths reported due to cause related pregnancy/ 

child birth during last one year before the survey is also much higher giving a total of 90 mothers with a 

percentage of 0.016%.. However, updation of the HHS and FS cis being undertaken now.. 

33

CHC upgradation to Indian Public Health Standard (IPHS). 

Under Block pooling, Basar CHC was upgraded. 

Janani Suraksha Yojana(JSY): 

JSY has been implemented in the state since 2005-06.The rural poor women are availing the 

facilities provided under this scheme. 

JSY Beneficiaries 

2006-07 2007-08 2008-09 2009-10(Upto 2 nd Qtr) 

1433 7689 9018 4455 

Drug-Kits: Drug Kits under NRHM has been supplied to all the districts through GoI 

during 2009-10. 

MMU Camp: 

Health Melas have been organized at at Namsai (Lohit), Longding (Tirap), Thrizino PHC(West 

Kameng), Bameng PHC(East Kameng), Tawang and Jairampur (Changlang), Mengio (Papum Pare) 

and Anjaw.During 2009-10 till Dec’09 27 health camp have been organised. 

Ambulance: 

Under NRHM there are 81 Basic Ambulances and 4 Critical Care Ambulance in the state 

Training completed: 

Name of Trainning 

Programme 


Categories of Trainees Trained till January’10 

SBA 

Master Trainer 

ANM/GNM 

1 

53 

EmOC 


MO 

1 

5 

LSAS MO 5 

MTP MO 64 

RTI/STI 

Child Health 

MO 20 

IMNCI 

Navjat SishuSwasthya 

MO 

ANM/GNM 

79 

60 

Karyakaram MO 5 (Child Specialist) 

Gyneocologist 1 

Laparoscopic sterilization 

MO 20 

ANM 83 

34

Contraceptive Update 

DMO, DRCHO, Gyneocoligist & 

DPM 60 

Programme Management Trainning 

District Nodal M&E Officer 16 

State HMIS 

District Accounts Manager 

Computer Assistant of other 

16 

Programme 16 

District HMIS 

Finanicial Mgt. 

Block Level Participant 3district 

Orientation training on 

financial mgt & accounting 

Orientation training of 

programme officer of vertical 

programme 8 

Skill upgradation training Accounts personnel of State & dist. 

30 

on finance, accounts & Health Society ( including Vertical 

audit 

Programme) 

Induction RKS 

Accounts personnel of State & dist. 

Health Society ( including Vertical 

96 

Programme) 

Orientation Training to 

30 

Skill upgradation training 

Paramedics 798(during 08) 

on finance, accounts & 

210,90 & 84 ( during07,08 & 

audit 

Orientation Training to MO 

Orientation Training to Computer 

09) 

Assistant 

Orientation Training to Cold 

0 

Chain Handlaer 52 (during 08) 

Accredited Social Health Activist (ASHA) 

Already 3226/3862 ASHAs completed in 1 st module, 2894 ASHAs in Module-II, 2597 ASHAs in 

Module-III, 2229 ASHAs in Module-IV and 890 ASHAs in Module-V. Drug kits already provided to 

2622ASHAs along ASHA diary. The training is continuing at present. The quality of the training is 

monitored by the senior level state / district NRHM officials. 

District Health Action Plan (DHAP) / State PIP 

All 16 districts have submitted the DHAP for the year 2010-2011 

35

Public Private Partnership (PPP) for PHCs/CHC 

The PPP project has been the most successful initiative undertaken by the state under NRHM 

Program to functionalise remote 16 PHCs and 1 CHC of Arunachal Pradesh.The MoU was signed 

between the state and 4 NGOs namely; Voluntary Health Association of India, Karuna Trust, JAC 

Prayas and Future Generations Arunachal. 

Management of 9 PHCs have been given to Karuna Trust, namely; Bameng PHC, Mengio PHC, 

Sangram PHC, Jeying PHC, Anpum PHC, Etalin PHC, Walong PHC, Khimyong PHC and Wakka PHC. 

Voluntary Health Association of India has been handed over 5 PHCs namely, Lumla PHC, Thrizino 

PHC, Nacho PHC, Deed Neelam PHC and Gensi PHC and 1 CHC Deomali. 

JAC Prayas have been handed over 1 PHC Wakro and Future Generations Arunachal have been 

handed over 1 PHC Sille. 

Achievements 

• Immunization, Institutional Delivery, ANC Coverage, Family planning methods etc. 

ANC coverage has increased. 

• Institutional Delivery has increased. 

• All the PHCs managed under PPP are now run on 24 x 7 basis. 

• Minor operations have also been carried out in the OT, Laboratory services are also 

being performed with facilities for pathological & biochemical investigations, like tests 

for malaria,TB etc. 

• The project has also contributed in family planning services to people for use of any 

kind of contraception. 

• Many outreach activities and Health Melas have been conducted. 

• RKS/PHC management committees have been constituted and functioning well. 

• All the SCs under PPP PHCs are functional are now functional. 

• Awarded best state for PPP by GoI in 2007. 

• VHSC and VHND are functional in all the villages falling under PPP PHC area. 

Further, one CHC at Deomali in Tirap District has been taken up under PPP to be 

functionalised as FRU. VHAI, NGO partner for running PHC under PPP mode has been 

entrusdted to run the CHC. The performance has been very encouraging in terms of increase in 

OPD, IPD cases etc and positioning of specialist manpower at the CHC. 

State Convergence Committee: Constituted and notified on 31-10-2006. 

NPCC Approval under NRHM 2009-10 

Sl. 

No. 

Components Amount Approved by 

NPCC 

1 RCH Flexipool 1327.19 

2 Mission Flexipool 2710.05 

3 Immunization 196.74 

36

4 NVBDCP 1015.00 

5 RNTCP 247.84 

6 NPCB 233.00 

7 NIDDCP 38.00 

8 IDSP 46.02 

9 NLEP 76.00 

10 Infrastructure Maintenance (Treasury 

Transfer) 

743.40 

Total 6633.24 

RCH outcome and service utilization 

The Maternal Health, Child Health, Family Planning and ARSH are addressed in the situational 

analysis. However, the performance as per MIS data is given below: 

Performance Indicators Achievement 

(HMIS DATA) 

Maternal Health 05-06 06-07 07-08 08-09 09-10 (upto 

2 nd qtr) 

ANC Registered 18753 20835 17978 20689 10280 

ANC 3 check-ups 7607 8757 4816 5298 3732 

TT2+Booster 11626 13389 8826 10293 4749 

Institutional Deliveries 8594 8342 8003 10154 3868 

Home Deliveries 224 267 245 674 122 

JSY beneficiaries 1433 7689 9018 4455 

RTI/STI 2583 392 2999 4881 2706 

MTP 1481 1475 888 875 415 

RCH Camp 

Child Health 

Immunization(Infant 0-1 year) 

42 15 

BCG 20574 21428 16446 20344 6793 

DPT(3 rd dose) 15230 20778 13193 16892 5463 

OPV (3 rd dose) 15501 20987 13389 17119 5561 

Measles. 

School Health Programme 

Childhood diseases 

24406 19373 14006 18751 5164 

Diarrhea and dehydration 11017 8620 12776 18605 8887 

Measles 215 311 1793 3013 325 

Pertussis 


0 176 76 105 13 

Male Sterilization 5 12 34 26 1 

Female sterilization 1988 1934 2277 3443 349 

IUDs 2927 3110 2523 1877 944 

Oral Pills 18688 21273 16347 17283 6320 

Condom 62384 74039 48164 28369 12991 

Number of ASHA Selected 

Number of ASHAs who have received 

1615 1228 310 244 183 

37

training 

Module -1 

Module-II 

Module-III 

Module-IV 

Module-V 

3226 

2894 

2579 

2229 

890 

ASHA Drug Kit. 2622 

Village Health Sanitation Committee VHSC constituted=3012 

(VHSC) 

Bank account opened=2442 

Village Health & Nutrition Day 

(VHND) held 

28 318 1370 931 

Rogi Kalyan Samiti (RKS) 14 DH,30CHC,79PHC 

RKS Meeting 89 

State Health Society Meeting 1 1 1 1 

District Health Society Meeting 16 17 1 7 

MMU Camp 36 27 

Out Reach Session 46 48 

Public Private Partnership (PPP) for 

PHCs 

16 16 16 16 16 

Public Private Partnership (PPP) for 

CHC 

Implementation of civil works during RCH-II period 

Nil Nil Nil Nil 1 

Substantial development of infrastructure has been achieved in the rural areas during the RCH- 

II period since 2005-06 by implementing various approved civil works under NRHM. Though this has 

brought about remarkable improvement in the health service delivery system in the rural areas, there is 

lot more to do in this arena considering the poor communication facilities of the State, its large and 

inhospitable areas, and widely dispersed settlement of population. The details of the civil works 

implemented under NRHM are as follows: 

38

LIST OF CIVIL WORKS IMPLEMENTED 

UNDER RCH-II PROGRAMME DURING THE YEAR 2005-06 

District Sl. 

No. 

Name of work Classification Location Budgeted Amount (Rs) 

Tawang 1 C/o Cold Chain room Major Jang PHC 1,00,000 

2 C/o New born care corner Minor District Hospital Tawang 40,000 

3 Improvement of electricity Minor Zemithang SC 1,00,000 

4 Improvement of water supply Minor Jang PHC 1,60,000 

5 Repair & maintenance of Health centre Minor Jang PHC 1,50,000 

DISTRICT TOTAL 5,50,000 

Lower Subansiri 6 C/o Cold Chain room Major Yajali PHC 1,00,000 

7 C/o Sub-centre building attached with 

ANM’s quarter 

Major Manipolyang SC 6,00,000 

8 Improvement of electricity Minor Raga PHC 1,60,000 

9 Improvement of water supply Minor Reru SC 1,20,000 


Kurung Kumey 10 C/o Cold Chain room Major Koloriang CHC 2,00,000 

11 C/o RCH store room Major Nyapin CHC 2,00,000 

12 Repair & maintenance of Health centre Minor Palin CHC 1,80,000 

13 Repair & maintenance of labour room Minor Nyapin CHC 1,40,000 

14 Improvement of water supply Minor Chambang PHC 1,60,000 

15 Repair & renovation of PHC (PPP) Minor Sangram PHC 2,00,000 


Upper Subansiri 16 Repair & renovation of PHC (PPP) Minor Nacho PHC 2,00,000 

17 C/o RCH Store room Major Taliha CHC 2,00,000 

18 C/o New born care corner Minor Baririjo PHC 40,000 

19 Improvement of water supply Minor Gusar SC 1,20,000 

20 Improvement of electricity Minor Siyum SC 1,00,000 

21 Repair & maintenance of Labour room Minor District Hospital Daporijo 1,50,000 

22 Improvement of water supply Minor Maro PHC 1,60,000 

39


District Sl. 

No. 


West Siang 23 C/o Sub-centre building attached with ANMs 

Quarter 

Major Zirdo SC 6,00,000 

24 C/o blood storage facility Major Mechuka CHC 3,20,000 

25 Repair & maintenance of Health Centre Minor Kombo 1,50,000 

26 C/o Newborn Care Corner Minor District Hospital Along 40,000 


East Siang 27 C/o Cold Chain room Major Riga PHC 1,00,000 

28 C/o RCH Store Room Major Bilat PHC 1,00,000 

29 Improvement of water supply Minor Ledum SC 1,20,000 

30 Repair & maintenance of Health centre Minor Mebo CHC 1,80,000 

31 C/o Blood Storage Facility Major Ruksin CHC 3,20,000 


Upper Siang 32 C/o Sub-Centre building attached with 

ANMs Quarter 

Major Ramsing SC 6,00,000 

33 Repair & maintenance of Labour room Minor District Hospital Yingkiong 1,50,000 


Dibang Valley 34 C/o RCH Store room Major District Hospital Anini 2,00,000 

35 C/o Sub Centre building attached with ANMs 

Quarter 

Major Alinye SC 6,00,000 

36 C/o Newborn Care Corner Minor District Hospital Anini 40,000 


Lower Dibang 37 C/o Blood storage facility Major Parbuk CHC 3,20,000 

valley 

38 C/o Immunisation room Major Hunli PHC 1,00,000 

39 C/o Newborn Care Centre Minor District Hospital Roing 40,000 

40 Repair & maintenance of Health Centre Minor Anpum PHC 1,50,000 

41 Repair & maintenance of Labour room Minor Dambuk PHC 1,40,000 

42 Repair & maintenance of Labour room Minor Parbuk CHC 1,40,000 


40

District Sl. 

No. 


Lohit 43 C/o Sub Centre building attached with ANMs 

Quarter 

Major Wingko SC 6,00,000 

44 Repair & maintenance of Labour room Minor Namsai CHC 1,40,000 

45 C/o Blood Storage Facility Major Namsai CHC 3,20,000 

46 Repair & renovation of PHC (PPP) Minor Wakro PHC 2,00,000 


Anjaw 47 C/o Labour room Major Hayuliang CHC 4,00,000 

48 C/o Newborn Care centre Minor Hayuliang CHC 40,000 

49 Improvement of water supply Minor Goiliang SC 1,20,000 

50 Repair & renovation of PHC (PPP) Minor Walong PHC 2,00,000 


Changlang 51 C/o RCH Store room Major Nampong PHC 1,00,000 

52 C/o Immunisation room Major Nampong PHC 1,00,000 

53 Improvement of water supply Minor Borkhet SC 1,20,000 

54 Improvement of water supply Minor Joirampur PHC 1,60,000 

55 Repair & maintenance of Health centre Minor Joirampur PHC 1,50,000 

56 Repair & maintenance of Health centre Minor Miao CHC 1,80,000 


Tirap 57 C/o Cold Chain room Major District Hospital Khonsa 2,00,000 

58 C/o Cold Chain room Major Kanubari PHC 1,00,000 

59 Repair & maintenance of Health Centre Minor Deomali CHC 1,80,000 

60 Improvement of electricity Minor District Hospital Khonsa 2,00,000 

61 C/o Newborn Care Corner Minor District Hospital Khonsa 40,000 


Papum Pare 62 C/o Cold Chain room Major Sagalee CHC 2,00,000 

63 C/o RCH Store room Major Balijan PHC 1,00,000 

64 Repair & renovation of PHC (PPP) Minor Mengio PHC 2,00,000 

65 Repair & maintenance of Labour room Minor Balijan PHC 1,00,000 

41

66 Repair & maintenance of Health centre Minor Kimin PHC 1,50,000 

67 Improvement of water supply Minor Leporiang PHC 1,60,000 


East Kameng 68 C/o RCH Store room Major Bana PHC 1,00,000 

69 C/o Newborn Care centre Minor Bana PHC 40,000 

70 Improvement of water supply Minor Pampoli SC 1,20,000 

71 Improvement of water supply Minor Chayangtago CHC 1,60,000 

72 Improvement of electricity Minor Bana PHC 1,60,000 

73 C/o Labour room Major Chayangtago CHC 4,00,000 


STATE HQs 74 Renovation of Office Block into RCH Major O/o State Project Director 4,50,000 

Seminar Hall 

(RCH) 

GRAND TOTAL 1,38,80,000 

(One crore thirty eight lakh eighty thousand) only 

42

MINOR CIVIL WORKS SANCTIONED DURING 2006-07 AND 

IMPLEMENTED DURING 2007-08 UNDER RCH-II PROGRAMME 

MINOR CIVIL WORKS 

District Sl.No. Name of work Location Budgeted Amount (Rs.) 

Tawang 1 Improvement of water supply DH Tawang 200000 

2 Repair & maintenance of Labour Room DH Tawang 300000 

Disrict Total 500000 

West Kameng 1 Improvement of water supply Nafra PHC 180000 

2 Repair & maintenance of Labour Room Rupa PHC 250000 


Papum Pare 1 Improvement of electricity Leporiang PHC 190000 

2 Repair & maintenance of Hospital building Basarnalla PHC 200000 

3 Repair & maintenance of Hospital building Leporiang PHC 200000 

4 Improvement of water supply Mengio PHC 180000 


Lower Subansiri 1 Improvement of electricity Bulla SC 160000 


Kurung Kumey 1 Improvement of water supply Hiya SC 150000 

2 Improvement of electricity Hiya SC 160000 

3 Improvement of water supply Phasing SC 150000 


West Siang 1 Repair & maintenance of Hospital building Kombo SC 100000 

2 Improvement of water supply Darak SC 150000 


43

East Siang 1 Improvement of electricity Bilat PHC 180000 


Upper Siang 1 Improvement of electricity DH Yingkiong 200000 

2 Repair & maintenance of Hospital building Geku PHC 200000 


Dibang Valley 1 Improvement of electricity DH Anini 200000 

2 Repair & maintenance of Hospital building Alinye SC 150000 

3 Improvement of water supply Alinye SC 150000 


Anjaw 1 Repair & maintenance of Labour Room DH Hayuliang 300000 


Lohit 1 Improvement of water supply Piyong PHC 180000 

2 Improvement of water supply Lathao PHC 180000 

3 Improvement of electricity Lathao PHC 190000 


Changlang 1 Improvement of water supply Nampong PHC 180000 

2 Repair & maintenance of Hospital building Jairampur PHC 200000 

3 Repair & maintenance of Hospital building Miao PHC 200000 


Tirap 1 Improvement of electricity Lazu PHC 190000 

2 Repair & maintenance of Labour Room Lazu PHC 250000 


GRAND TOTAL 5520000 

44

MAJOR CIVIL WORKS SANCTIONED DURING 2006-07 AND 

IMPLEMENTED DURING 2007-08 UNDER RCH-II PROGRAMME 

MAJOR CIVIL WORKS 

District Sl.No. Name of work Location Budgeted Amount (Rs.) 

Tawang 1 C/o Cold Chain room DH Tawang 300000 

District Total 300000 

West Kameng 1 C/o Cold Chain room DH Bomdila 300000 

2 C/o Immunisation room Thrizino PHC 200000 


Papum Pare 1 C/o Labour Room Basarnalla PHC 320000 


Lower Subansiri 1 C/o Immunisation room Yazali PHC 200000 

2 C/o Cold Chain room Yachuli PHC 200000 


Kurung Kumey 1 C/o Labour Room Sangram PHC 320000 


Upper Subansiri 1 C/o Labour Room Baririjo PHC 320000 

2 C/o Cold Chain room Maro PHC 200000 


West Siang 1 C/o RCH Store room DH Along 300000 

2 C/o Immunisation room Daring PHC 200000 


East Siang 1 C/o Labour Room Yembung PHC 320000 

2 C/o RCH Store room Yembung PHC 200000 

45


Dibang Valley 1 C/o Cold Chain room DH Anini 300000 

2 C/o RCH Store room Etalin PHC 200000 


Lower Dibang Valley 1 C/o RCH Store room DH Roing 300000 


Anjaw 1 C/o RCH Store room DH Hayuliang 300000 


Lohit 1 C/o RCH Store room DH Tezu 300000 


Changlang 1 C/o RCH Store room Nampong PHC 200000 


Tirap 1 C/o Immunisation room Lazu PHC 200000 


GRAND TOTAL 5180000 

46

LIST OF CIVIL WORKS SANCTIONED UNDER NRHM DURING 2006-07 & 

IMPLEMENTED DURING 2007-08 

Name of work Sl. 

No. 

C/o of Sub-Centre 

building attached 

with ANM’s 

Quarter 

Identified 

Health Centre 

District No. of 

units 

47 

approved 

Sanctioned amount 

(Rs) 

1 Passa SC East Kameng 1 Rs. 6,00,000/- 

2 Toru SC Papum Pare 1 Rs. 6,00,000/- 

3. Leel SC Kurung Kumey 1 Rs. 6,00,000/- 

4. Sito SC Lower Subansiri 1 Rs. 6,00,000/- 

5. Sago SC West Siang 1 Rs. 6,00,000/- 

6. Padi SC 1 Rs. 6,00,000/- 

7. Sibe SC 1 Rs. 6,00,000/- 

8. Ngorlung SC East Siang 1 Rs. 6,00,000/- 

9. Komkar SC Upper Siang 1 Rs. 6,00,000/- 

10. Karko SC 1 Rs. 6,00,000/- 

Total 10 Rs. 60,00,000/- 

C/o PHC Quarter 1. Seijosa PHC East Kameng 1 Rs. 4,00,000/- 

2 Leporiang PHC Papum Pare 2 Rs. 8,00,000/- 

3. Basernallo PHC 2 Rs. 8,00,000/- 

4. Yangte PHC Kurung Kumey 1 Rs. 4,00,000/- 

Pake 

PHC 

Kessang East Kameng 1 Rs. 4,00,000/- 

5. Deed 

PHC 

Neelam Lower Subansiri 1 Rs. 4,00,000/- 

6. Tirbin PHC West Siang 2 Rs. 8,00,000/- 

7. Supple PHC East Siang 2 Rs. 8,00,000/- 

8. Yembung PHC 1 Rs. 4,00,000/- 

9. Anpum PHC Lower 

Valley 

Dibang 2 Rs. 8,00,000/- 

10. Jengging PHC Upper Siang 2 Rs. 8,00,000/- 

11. Laju PHC Tirap 1 Rs. 4,00,000/- 

12 Innao PHC Changlang 2 Rs. 8,00,000/- 

Total 20 Rs. 80,00,000/- 

GRAND TOTAL Rs. 1,40,00,000/- 

Name of 

work/ Scheme 

C/o of Sub- 

Centre 

Building 

(attached with 

ANM’s 

quarter) 

LIST OF CIVIL WORKS SANCTIONED UNDER NRHM DURING 2007-08 & 

IMPLEMENTED DURING 2008-09 

Name of District Sl. Location/ Identified Health Sanctioned Amount 

No. 


(Rs) 

Tawang 1 Lhou Sub-Centre 9,00,000/- 

2 Rho Sub-Centre 9,00,000/- 

West Kameng 3 Jamiri Sub-Centre 9,00,000/- 

East Kameng 4 J. Bagang Sub-Centre 9,00,000/- 

Papum Pare 5 Ompuli Sub-Centre 9,00,000/- 

6 Rillo Sub-Centre 9,00,000/- 

7 Mabiaso Sub-Centre 9,00,000/-

Upgradation 

of PHC 

Block Pooling 

of CHC (C/O 

Staff Quarters) 

Name of 

approved civil 

work 

Construction 

of Sub-Centre 

attached with 

Lower Subansiri 8 New Pania Sub-Centre 9,00,000/- 

9 Ambam Sub-Centre 9,00,000/- 

10 Kampurijo Sub-Centre 9,00,000/- 

Kurung Kumey 11 0-Point Sub-Centre 9,00,000/- 

12 Sango Sub-Centre 9,00,000/- 

Upper Subansiri 13 Bui Sub-Centre 9,00,000/- 

West Siang 14 Bam Sub-Centre 9,00,000/- 

15 Yigi Kaum-II Sub-Centre 9,00,000/- 

16 Jirdin Sub-Centre 9,00,000/- 

East Siang 17 Namsing Sub-Centre 9,00,000/- 

18 Riga Sub-Centre 9,00,000/- 

19 Parong Sub-Centre 9,00,000/- 

Upper Siang 20 Katan Sub-Centre 9,00,000/- 

Dibang Valley 21 Arjoo Sub-Centre 9,00,000/- 

Lower Dibang Valley 22 New Abali Sub-Centre 9,00,000/- 

23 Rukmo Sub-Centre 9,00,000/- 

Lohit 24 Sitpani Miri Sub-Centre 9,00,000/- 

25 Nongkhon Sub-Centre 9,00,000/- 

Anjaw 26 Halaikrong Sub-Centre 9,00,000/- 

Changlang 27 Kengkhu Sub-Centre 9,00,000/- 

28 Balupather Lungri Sub- 9,00,000/- 


29 Mudoi Sub-Centre 9,00,000/- 

Tirap 30 Pumao Sub-Centre 9,00,000/- 

31 Makat Sub-Centre 9,00,000/- 

Sub-Total 2,79,00,000/- 

East Kameng 1 Bana PHC 14,00,000/- 

Kurung Kumey 2 Pasi- Parlo PHC 14,00,000/- 

Upper Siang 3 Jeying PHC 14,00,000/- 

Changlang 4 Khimiyong PHC 14,00,000/- 

Papum Pare 5 Mengio PHC 14,00,000/- 

Sub-Total 70,00,000/- 

West Siang 1 Basar CHC 14,93,500/- 

Sub-Total 14,93,500/- 

GRAND TOTAL 3,63,93,500/- 

LIST OF CIVIL WORKS UNDER NRHM SANCTIONED DURING 2007-08 

FROM STATE SHARE FUND OF 2007-08 & IMPLEMENTED DURING 2008-09 

Sl. 

No. 

Location/ identified 

health 

centre/hospital 

Name of district No. 

of 

units 

48 

Rate (Rs) Total 

budgeted 

amount 

(Rs.) 

1 Seru SC Tawang 1 9,00,000/- 9,00,000/- 

2 Kamrung SC Papum Pare 1 9,00,000/- 9,00,000/- 

3 Yadang SC Papum Pare 1 9,00,000/- 9,00,000/-

ANM’s 

quarter 

Construction 

of PHC 

quarter 

Construction 

of District 

Hospital 

quarter 

4 Meer Camp SC Kurung Kumey 1 9,00,000/- 9,00,000/- 

5 Panyo Mori SC Upper Subansiri 1 9,00,000/- 9,00,000/- 

6 Pareng SC East Siang 1 9,00,000/- 9,00,000/- 

7 Pagi SC West Siang 1 9,00,000/- 9,00,000/- 

8 Tillai SC Lohit 1 9,00,000/- 9,00,000/- 

9 Danglat SC Lohit 1 9,00,000/- 9,00,000/- 

10 Ahi Valley SC Dibang Valley 1 9,00,000/- 9,00,000/- 

TOTAL (Rs) 10 90,00,000/- 

1 Bameng PHC East Kameng 2 6,00,000/ 12,00,000/- 

2 Bana PHC East Kameng 1 6,00,000/ 6,00,000/ 

3 Taraso PHC Papum Pare 2 6,00,000/ 12,00,000/- 

4 Chambang PHC Kurung Kumey 1 6,00,000/ 6,00,000/ 

5 Dollungmukh PHC Lower Subansiri 1 6,00,000/ 6,00,000/ 

6 Riga PHC East Siang 1 6,00,000/ 6,00,000/ 

7 Dari PHC West Siang 1 6,00,000/ 6,00,000/ 

8 Pobdi PHC West Siang 1 6,00,000/ 6,00,000/ 

9 Diyun PHC Changlang 2 6,00,000/ 12,00,000/- 

TOTAL 12 72,00,000/- 

1 District Hospital 

Tawang 

Tawang 2 6,00,000/- 12,00,000/- 


Seppa 

East Kameng 2 6,00,000/ 12,00,000/- 

3 General Hospital 

Naharlagun 

Papum Pare 4 6,00,000/ 24,00,000/- 

4 District Hospital Lower 2 6,00,000/ 12,00,000/- 

Ziro 

Subansiri 

5 District Hospital Upper 2 6,00,000/ 12,00,000/- 

Daporijo 

Subansiri 

6 General Hospital 

Pasighat 

East Siang 2 6,00,000/ 12,00,000/- 


Aalo 

West Siang 2 6,00,000/ 12,00,000/- 


Yingkiong 

Upper Siang 2 6,00,000/ 12,00,000/- 


Changlang 

Changlang 2 6,00,000/ 12,00,000/- 

TOTAL 20 1,20,00,000/- 

GRAND TOTAL(Rs) 2,82,00,000/- 

49

Lessons learnt:- 

1. The HRD policy has been changed and decentralized down to District Health Society level 

for technical staff. The decentralization would facilitate recruitment and posting of manpower as per 

the local need. ToR of all categories of staff and recruitment norms along with appraisal norms have 

been forwarded to the District Health Societies. 

However, due to non-availability of doctors at the district and sub-district levels, the 

recruitment of MOs and Specialists will be undertaken centrally at the Mission Directorate. 

2. The PPP for running PHCs by NGOs has been a success intervention. The monthly reports 

shows that the performance has been very good and quality health care services are delivered. 

Therefore, the PPP model may be continued and may be replicated to some more PHCs or even to 

CHCs.GoI may consider continuation and if acceptable similar model may be replicated to CHCs even 

though it takes away major chunk of RCH funding. External evaluation by RRC- NE has been 

completed and the report is evaluated. 

3. It has been experienced during the last year that intimation regarding conduct of multi 

skilling training for MOs is often received by the State belatedly. It is therefore suggested that such 

trainings may be intimated at least 20 days earlier so that necessary arrangements can be done well in 

advance. 

4. It has further been experienced that training programmes are conducted by the Ministry of 

Health & Family Welfare, Govt. of India at different places at the Central level which are often not in 

congruence with the training plan enshrined in the State PIP. It amounts to execution of training plan 

framed by the Ministry and not the one proposed by the State in its PIP. This may be clarified. 

5. Based on the experience of the last three years of NRHM period, it is strongly felt that 

adequate training needs to be imparted to the current SPMSU & DPMSU staff to enhance their 

technical skills. 

6. The implementation of JSY scheme during the last year was severely hampered due to lack of 

fund for the purpose. While other states were provided specific fund for JSY, Arunachal Pradesh was 

asked to meet the expenses from RCH-II flexible pool fund which was not sufficient even for recurring 

programme management expenses and other approved technical activities. 

7. The State’s population being highly dispersed far and wide in inaccessible areas with 

linguistic and ethnic diversity of the people having different socio-economic backgrounds, it was 

focused on developing district wise and community and tribe specific activities which can be adaptable 

by the tribal people. 

8. Due to shortage of IEC personnel in the districts, IEC activities could not be implemented as 

desired in the peripheral level. Therefore, additional manpower in the districts will be required to 

implement the IEC activities and to translate the objectives into reality. 

9. Lack of awareness regarding different health care services were the continuing problems 

among the people in the state. Therefore, IEC activities have been implemented through various print 

50

and electronic media to bring awareness generation among the people in the state. Print advertisement 

containing essential RCH/FW messages have been published in the local newspaper and magazine for 

wider publicity in the state. Outdoor publicity campaign has been implemented in all the districts as per 

the requirement of the people based on local needs. Fund were released to district health society for 

group meeting, IPC campaign, FGD, health camp, health mela, folk song, plays and dramas, 

exhibition, film shows, advocacy programme and school programme to disseminate RCH and its 

services to the people especially emphasized on maternal health, child health, family planning and 

adolescent health. Radio jingles were broadcast in eleven local dialects through five AIR stations 

including FM Radio Oo..la..la at Itanagar. Two health camps were successfully conducted in the 

district. Descriptive Health Chart Board on JSY were procured and distributed to all the districts as a 

part of innovative IEC/BCC campaign in the state. 

10. Fund was utilized as per the State Programme Implementation Plan (SPIP) and more 

strategies will be focused as per need during this financial year for effective implementation of 

IEC/BCC in the state. 

11. A State HMIS Cell is already created, where every Data related to Program is being 

maintained. Reports and returns received from the districts are compiled and analyzed. Now almost all 

the districts are well acquainted with the system. With the existing capacity, including availability of 

staff, the system is in the trend of improvement. Now, almost all the health facilities of the state are well 

provided with the new MIES reporting formats. As online reporting cannot be ensured from the sub 

district level, manual reporting is in place. However, regular and quality reporting from the sub centre 

level has always been an acception due to lack of proper communication facilities. 

12. The web based HMIS portal launched by the GoI has been initiated by the state at the state 

headquarter level and shall continue. During the year, Two days orientation has also been given to the 

DPMSU with technical support from NHSRC. The system of Feedback is introduced. 

Programme Management 

Programme Management Cost: 

During the financial year 2007-08, the programme cost inevitably overran to nearly 11-12% of the total 

allocation which overshot the prescribed ceiling of 6%. Due to meager amount of allocation to the 

State of Arunachal Pradesh vis-à-vis other bigger states, the 6% prescription for management cost is 

not sufficient to meet the recurring expenses under programme management. The Ministry may 

consider exemption for the state from this prescription and increases the cap to 12% of the total 

allocation. 

Reasons for the underutilization of fund during the financial year 2008-09: 

• The State Health Society received bulk of its allocated fund pertaining to the year 2007-08 

amounting to Rs. 18 Crores during the financial year 2008-09, on 9 th & 11 th April. 

• Due to unprecedented rainfall during monsoon last year, most of the districts remained cut off by 

road communication for as many as 7 months at a stretch, thereby hampering the execution of 

approved civil works in which bulk of the NRHM funds were tied up. 

51

Chapter-V 

• Utilisation of RKS funds at the sub-district level was low due to ignorance about the guidelines 

regarding utilization of fund. 

• There was some delay in the execution of the MMU scheme due to belated supply of the vehicles by 

the suppliers. 


PROCESS/ INTERMEDIATE INDICATOR CURRENT 

STATUS 

1. % of all births in government and private 

institutions (Overall) 

52 

47.7 

(DLHS– III) 

2. % Delivery at Home 52.1 

(DLHS – III) 

3. % of pregnant women getting registered in first 36.2 

trimester 

(DLHS – II) 

4. % of pregnant women receiving 3 or more 48.2 

antenatal checks 


5. % of pregnant women consumed 100 IFA Tablets 42.9 


7. Number of facilities operationalized to provide 24 

hours delivery (and Basic Emergency Obstetric 

Care) according to GOI norms 

CHCs 31 

PHCs 10 

(DHS, AP-2009) 

8. % of mother who received post-natal care within 

two weeks of delivery 

38.3 

9. Number of facilities operationalized in a 

sustained manner as per GOI norms for providing 

Comprehensive Emergency obstetric care (including 

provision of Caesarean section and blood 

storage/banking facilities): 

GH/DHs (blood bank in 7 are being functionalized) 3(1 at RKM) 

(DHS, AP-2009) 

CHCs (Blood storage being operationalized) 1 

(DHS, AP-2008) 

Current Status and Goal 

GOAL 

10-11 11-12 

60 70 

40 30 

45 55 

60 70 

55 65 

10 10 

45 

6 5 

1 0 

55

Child / Neonatal health 


STATUS 

1. Percentage of exclusively breastfed at 6 months of 

age 

2. Percentage of 13 – 23 months of age fully 

immunized children 

3. Percentage of children given ORS in diarrhea 

4. Percentage of children received treatment for ARI 

5. Prevalence of anemia in children 

53 

40.3 

(DLHS– III) 

40.3 

(DLHS– III) 

64.1 

(DLHS– III) 

43.6 

(NFHS-III) 

66.3 

(NFHS-III) 

Family planning 


STATUS 

1. % Total unmet need : 14.3 


2. Couple using spacing method for more than 6 15.3 

months %: 


3. Any modern method % 52.0 


4. Female Sterilization % 30.6 


5. Male sterilization % 0.5 


Adolescent Reproductive and Sexual Health 

GOAL 

10-11 11-12 

60 80 

50 70 

70 80 

65 80 

45 30 

GOAL 

10-11 11-12 

12 9 

10 6 

55 60 

35 40 

1 1.5 

PROCESS/ INTERMEDIATE INDICATOR CURRENT STATUS GOAL 

10- 11- 

11 12 

1. Unmarried Women who have heard of RTI/STI % 25.5 (DLHS – III) 30 40 

2. Mean age at marriage for boys 25.4 (DLHS – III) 27 28 

3. Mean age of marriage for girls 21.7 (DLHS – III) 22 23 

4. Boy marriaged below 21 14.5 (DLHS – III) 10 8 

5.Girls marriaged below 18 8.2 (DLHS-III) 5 5

Public health infrastructure 

At present, Public Health facilities are the back bone of health delivery and family welfare 

services in the State. Catering to the health and family welfare needs of the people are 2 General 

Hospitals at Naharlagun and Pasighat, 13 District Hospitals at Tawang, Bomdila, Seppa, Ziro, 

Daporijo, Along, Yingkiong, Roing, Anini, Tezu, Changlang, Khonsa and Hawai , 50 Community 

Health Centers (CHCs), 119 Primary Health Centers (PHCs), 565 Sub-Centers (SCs), 45 Homeopathy 

Dispensaries and 9 Ayurvedic uni ts. 

No. Facility 

Required / 

Sanctioned 

54 

In Position 

(on 31/12/09) 

1 Sub-centres 565 

1.1 Sub-centres functional b 273 (230 with ANM) 

2 Primary Health Centres - 116 

2.1 PHCs offering 24 hour services (except manpower) 20 

3 Community Health Centres 44 

3.1 CHCs functioning as FRUs 1 

4 District Hospitals 15 

4.2 DHs/GH functioning as FRUs( 2 without Anesthetist) 10 

Private and NGO health services/infrastructure 

Names of NGOs Block/Villages of NGOs operations 

VHAI Lumla (Tawang) 

Thrizino (W.Kameng) 

Deed Neelam (L.Subansiri) 

Nacho (Upper Subansiri) 

Gensi (West Siang) 

KARUNA TRUST Khimyong (Changlang) 

Wakka (Tirap) 

Mengio (Papumpare) 

Walong (Anjaw) 

Bameng (East Kameng) 

Sangram (Kurung Kumey) 

Jeying (Upper Siang) 

Etalin (Dibang Valley) 

Anpum (Lower Dibang Valley) 

Future Generation Arunachal (FGA) Sille (East Siang) 

Alok Prayas JAC Wakro (Lohit) 

Nani Sala Foundation MNGO for P/Pare 

VHAAP MNGO for East Kameng, W/ Kameng. 

Daying Ering Foundation UH Pasighat 

Boria Tari Memorial Society UH Naharlagun / Itanagar

Institution arrangement and organizational development: 

Issues and gaps 

• Institutional involved in RCH 

The Mission Director (NRHM) coordinated all arrangements under the technical inputs / 

support from the Nodal Officer (NRHM) cum SPM and the DRCHO in the districts were instrumental in 

ensuring coordination, planning and implementation of RCH activities. 

Inter departmental cooperation was received from the Department of Social Welfare, Women 

and Child Development through AWW in implementing RCH activities primarily at the grass root level. 

The PRIs were involved in many activities under NRHM as detailed in NRHM PIP. Two mother NGOs 

for 3 districts along with few field NGOs were assigned roles during the year. NGOs running PPP 

under NRHM were a part of the team. 

Different works department of the state Government were involved in the preparation of 

estimates and execution of civil works in the state as there is no separate construction cell in the 

directorate. 

Above all, the different branches in the health department had full cooperation & coordination 

during the year for implementation of RCH / NRHM activities. 

55

State Finance Manager 

Accountant/ 

Accounts Clerk 

SFMG 

Director (F&A) 

Accounts Officer/ 

Accounts Manager/ 

State Accounts 

Manager 

State Accountant 

ORGANOGRAM OF MISSION DIRECTORATE 

Mission Director PA to MD 

Consultant(Trg.) 

Computer Assistant 

56 

State Programme Manager 

Consultant (HMIS) 


SPMSU 

State Nodal Officer 

State Data 

Manager 


State IEC Officer 

Dy. MEIO 

DEE

Organogram of District Programme Management Support Unit (DPMSU) 

Accountant 


DMO-cum-CEO (Governing Body) 

DRCHO/DFWO-cum-CEO (Executive Body) 

District Programme Manager 

57 

Statistical Investigator 

Data Assistant

JT. DHS 

(FW) 

Program Officer 

(NBCP) 

State Health &FW Department in relation to NRHM Vs Vertical Programs. 

JT. DHS 

(NLEP) 

Program Officer 

(DENTAL) 

Asst. 

Food 

Ministry of Health & Family Welfare 

Secretary (Health & Family Welfare) 

DIRECTOR OF HEALTH SERVICES 

JT.DHS 

(NAMP) 

Admin. 

Officer 

DDHS 

(TB) 

58 

DDHS 

(PH) 

JT DHS 

(EST) 

Accounts 

Officer 

DDHS 

(S&T) 

MD (NRHM) 

JT. DHS 

(P&D) 

DDHS 

(GA) 

Asst. Drug 

Controller 

SPMU 

DPMU 

State 

Epidemiologis 

t

• Accountability of staff 

Mission Director: The Mission Director is accountable to the Government of Arunachal Pradesh 

for overall implementation of NRHM activities. 

Nodal Officer (NRHM): NO(NRHM) is the main technical person accountable to the Mission 

Director for advise and guide in all matters of planning and implementation of NRHM activities. The 

state has no SPM as on date and the responsibility of SPM rest with state Nodal officer (NRHM). 

Director (Finance & Accounts): He is accountable to the Mission director for timely and proper 

audit of annual accounts under the NRHM, timely release of fund to implementing agencies, effective 

internal control system, timely submission of financial reports and returns. He is responsible for overall 

monitoring and supervision of finance and accounts. 

State Finance Manager and State Accounts Manager: They are accountable to the State 

Finance Manager for proper maintenance of books of accounts as per Finance & accounts Manual at the 

Mission Directorate, timely and proper collection and preparation of financial reports & returns, timely 

release of funds to the implementing agencies. 

Consultant (HMIS) and State Data Manager: They are directly responsible to the State Nodal 

officer for proper maintenance of demographic/health data bank, timely reporting of demographic and 

health data. 

Consultant (Training): He/She is directly accountable to the State Nodal Officer for timely and 

proper preparation of training plan and calendar, proper coordination of training activities, timely 

release of training fund to districts and implementing agencies and reporting to various agencies 

involved in monitoring and supervision. 

• HRD including placement of staff, tenure, job descriptions, delegation of power, performance 

appraisal system 

- Some of the contractual staff, especially ANMs, could not be optimally placed as per plan. It 

was found that several ANMs were posted at District Hospitals and CHCs. This was on account of nonavailability 

of SC building / residential quarters in the sub-centres, low pay rates and high cost of living 

in the rural areas and non-sanctioning of enough SNs by the state for DH / GH in the state. However, 

Steps will be initiated to rationalize the manpower and work load facility wise. 

- In order to streamline the staff recruitment, posting, ToR, Terms & condition etc for staffs under 

NRHM, it has been decentralized upto DHS level. The decentralization involves the following: 

- The existing contractual technical staff posted and serving as on date under NRHM at the 

district shall be the exclusive staff of DHS of the respective districts. The existing staffs shall not be 

transferable to other districts and are transferable within the districts as per requirement. 

- The relevant documents of already serving concerned staffs shall be made available to the 

respective District Health Societies of the districts for maintenance of staffs. 

59

- The recruitment of the contractual technical staffs except specialists and Medical Officers under 

NRHM for the districts will be done by the respective District Health Societies after getting approval and 

sanction from MD (NRHM). 

- The recruitment process in the districts shall be as per recruitments rules and terms of 

conditions and TORs issued by the State Health Society. 

- On completion of recruitment process, the names of contractual staffs recruited with place of 

posting shall be intimated to the MD (NRHM). 

- The recruitment rule for NRHM staffs is already exists. 

Performance appraisal system:- 

Training 

- The appraisal for all categories of contractual staffs under NRHM has been appraised on 

yearly basis as on date at state and district society level. 

- The appraisal is done for each staff by a standing performance appraisal board at state and 

district health society level on the basis of standard performance appraisal indicators. 

- However, the appraisal of all categories of NRHM staffs is being modified to address all the 

possible areas of activities along with a modified performance appraisal board members. 

Presently only one training centre exits in the state i, e Health and Training Research Centre, 

Pasighat, which provides basic training courses for ANMs only. There is no training centre to cater 

for in-service training and other nursing and medical course. This is one of the major bottlenecks in 

the successful implementation of Training Program. During the year, no regular training as proposed 

under RCH II could be implemented. However, continuation of RCH training could be conducted in 

all the Districts. The GoI would be required to provide assistance for the same in the form of 

establishment of SHFTC. 

Performance of training for the year 2009-10 (upto Dec’09) 


Programme 



SBA 


ANM/GNM 

1 

53 

EmOC 


MO 

1 

5 

LSAS MO 5 

MTP MO 64 

RTI/STI MO 20 

Child Health 

IMNCI MO 79 

60

ANM/GNM 60 


Karyakaram MO 5 (Child Specialist) 



MO 20 

ANM 83 



DPM 60 



State HMIS 



16 

Programme 16 

District HMIS 







programme 8 


30 


audit 

Programme) 

Induction RKS 



96 

Programme) 


30 




210,90 & 84 ( during07,08 & 

audit 



09) 

Assistant 


0 


• Logistics- Procurement, warehousing , distribution and timely use 

The state follows the NRHM procurement guidelines and or state procurement norms. 

However, there is no standard protocol on the subject. 

State and district store is required exclusively for storing NRHM articles. As on date, the 

articles are stored in makeshift / temporary store rooms and at times, items become un-useable 

due to want of ideal store room. 

The distribution of NRHM items is carried out either by hiring transportation from State 

headquarter or district headquarter. The state need transport system for timely and safe 

61

distribution of NRHM items. Proper stock maintenance, issue, receipt etc is being maintained but 

it needs improvement. 

• HMIS 

The HMIS / M&E have been one of the poor areas where the state has failed. However, 

with the existing manpower and new good plan, it is expected that the area of concern will 

improve considerably. 

Programme Finances 

• Lack of proper communication facilities. 

• Irregular reporting 

• Poor monitoring due to lack of fund 

• Frequent Power failure 

• Lack of awareness regarding importance of reporting 

• No monitoring plan at the sub district levels 

In order to overcome the identified gaps, following measures shall be ensured. 

• Telephone with Internet facility 

• Capacity building training, Review meetings 

• Proper monitoring plans 

• Provision of power backup 

• Hiring of Vehicle for monitoring. 

• Analysis of budget availability : 

Budget availability for RCH-II from different sources during 2009-10 is depicted in the following 

table: 

Budget availability for RCH-II during 2009-10: (Rs. In Lakhs) 

Projects State Plan 

(State 

Share 

State Non-Plan Central Plan (Govt. of 

India) 

RCH –II 

Nil 1292.00 1292.00 

NRHM Additionalities 

Routine 

200.00* 

Nil 1494.00 1694.00 

Immunisation Nil 49.00 49.00 

Grand Total 200.00 Nil 2835.00 3035.00 

*Rs. 200.00 lakh released by State Govt. pertains to the State share of the previous year 2008-09. The 

proposal for sanction and release of 500.00 lakh out of the total prescribed share of 836.00 lakh is under 

active consideration of the State Govt. 

62 

Total

• Analysis of expenditure during 2005-06 to 2008-09 and 2009-10 and key issues for shortfalls 

Financial Performances during the financial year 2005-06, 2006-07 and 2007-08 

63 

(Performance in % age) 

Activities 2005-06 2006-07 2007-08 

2008-09 

RCH Flexible Pool 66.36 60.64 69.96 93.85 

Mission Flexible Pool 58.43 38.70 42.51 57.91 

Routine Immunisation 78.99 86.35 74.96 119.32 

IPPI 69.98 94.66 90..96 97.95 

The fund utilization rate in respect of all the three components of NRHM – RCH-II flexible pool, NRHM 

additionalities and Immunisation – registered a phenomenal improvement during the year 2008-09 over 

the previous year 2007-08, as per audited accounts. The increase in the fund utilization rate may be 

attributed to the following factors: 

1 Smooth flow of funds and improvement in financial management after the constitution of 

the State Financial Mnagement Group (FMG) under the leadership of Director (Finance 

& Accounts) and State Finance Manager and integration of all vertical programmes 

under the single umbrella of NRHM at the State and district levels. 

2. Extensive delegation of administrative and financial powers under NRHM at all levels. 

3. Strengthening/ restructuring of State Programme Management Support Unit (SPMSU) 

under the leadership of State Nodal Officer at the State level and DRCHOs at the district 

level. 

4. Appointment of an administrative officer from the State Civil Service as the Mission 

Director. 

5. Placement of DRCHOs-cum-Chief Executive Officers of District Health Societies under 

the direct administrative supervision and control of the Mission Director. 

6. Faster flow of fund from the Ministry of Health & Family Welfare, Govt. of India, during 

the year as against the previous year.

Financial Performances during the financial year 2009-10 (Upto 3 rd Qtr.) 

Projects Opening Balance Fund 

Received 

64 

(Rs. in Lakhs) 

Total Fund Expenditure 

incurred 

RCH Flexible Pool -285.14 1666.00 1380.86 797.91 57.78% 

NRHM Additionalities 1551.17 1694.00* 3245.17 476.13 14.67% 

Routine 

Immunisation -20.51 49.00 28.49 26.52 93.08% 

Grand Total 1245.52 3409.00 4654.52 1300.56 27.94% 

*Includes State Govt’s share of Rs 2.00 crore pertaining to the previous financial year 

% of Expenditure 

to Total Fund 

The low fund utilization rate in respect of NRHM additionalities is attributed to the belated release of 

fund by Govt.of India and non-release of State Share by the State Govt. . As per the records of the Mission 

Directorate, till 31 st December, 2009 the Ministry had released Rs. 2.62 crorre only on this account, 

while the bulk of the grant amounting to Rs. 14.32 (including State Share) was received only in the first 

week of January 2010. 

No Issues of fund overlap have been detected. 

• Fund routing mechanisms in RCH-II: timelines 

The State Health Society trasnfers funds to the District Health Societies and other implementing 

agencies including NGOs by electronic mode. However, due to non-availability of banking facilities in 

most of the sub-district level areas, funds are remitted from the district level to CHCs/PHCs/SCs by 

means of demand draft/ cheques.

Chapter-VI 

Goal, Objectives, Strategies and activities 

Part A: Reproductive and Child Health (RCH) 

1. MATERNAL HEALTH 

Goal: Reduction of Maternal Morbidity and Mortality. 

Objective-1 A.-: Increase complete ANC from 48.2 to 60 & consumption of 100 IFA tablets from 42.9 to 

55 by 2011. 

Strategy -1 A.1-Provide early & quality antenatal care to pregnant woman by increasing the access 

through existing Govt. facilities 

Activities: 

Goal, Objectives, Strategies, and Activities 

a. Early ANC registration to PW in all the functional health institutions in the state. Currently, there 

are 12 GH / DH, 31 CHCs, 85 PHCs and 273 SCs providing ANC. Every effort is being made to 

provide regular check up availability and quality ANC at the facilities. More facilities will be 

improved to provide ANC especially at the SC level. It is proposed to functionalise 30 more SC 

during the year. 

b. Regular supply of logistic will be ensured. 303 SC Drug Kit A & B will be provided to all the 

functional SCs. Further, ANM Kit / ANC Kit is available in 110 SCs and the remaining 193 SCs 

will be provided. 

c. 138 additional contractual ANM will continue to man the SCs. 

d. The ASHA Drug Kits will be provided to all the 3862 ASHAs during the year. It will be further 

ensured that IFA tablets are provided to all the pregnant women and are actually consumed in 

the villages. Timely refilling of ASHA kit as per the local situation from PHC / CHC / DH will be 

ensured. The ASHA facilitators, ANMs, District Community Mobilizer, Block Accountant cum 

Data Assistants and DPMSUs will ensure that the re-fillings are done in time during ASHA day 

at PHCs. 

e. The Village Health and Nutrition Day will be organized in all the villages where ASHAs are in 

position. Strict order and regular monitoring of the ASHAs through ASHA facilitators, ICDS 

supervisor, VHSC and RKS members and PRI will be ensured. During VHND, it will be ensured 

that all pregnant women are identified and registered (on positivity using NISCHAY PTC) and 

ANC done wherever ANM attends the VHND. The ASHA with AWW will also keep record and 

track all pregnant women using new tracking card ( a cord for mother and child which is being 

developed at state level) for ANC at the health facilities. 

f. Every ANM will provide services for early detection & referral of high risk Pregnant Women to 

higher centre. The referral services will be provided free of cost to BPL families using ambulance 

services borne from RKS. 

g. The quality of ANC provided will be reviewed at PHC meeting by concern MO i/c. Enough ANC 

card will be made available in all the health facilities. 

h. ANC services will be provided during RCH camps in every quarter under PHC areas. The service 

will also be provided during health melas in the PHC / CHC areas. In the urban areas, regular 

65

outreach sessions will be ensured for providing early registration, TT injection and IFA tablets 

and completion of ANCs. 

i. The MMU outreach activities will also cater ANC services to pregnant women in the state at the 

rate of at least 2 MMU activities per month per district. IEC component during MMU activities 

will be ensured to motivate the pregnant women for compulsory 3 ANCs. 

Strategy -1 A.2: Provide quality ANC to all PW in most difficult & inaccessible areas. 

Activities: 

1. 320 ANC outreach sessions in the villages and inter-village areas will be organized @Rs. 1000/- 

per session in most difficult and inaccessible areas along with VHND on every alternate month. 

The activity during VHND will be carried out by ANM from the nearby SC/PHC/CHC. A 

microplan will be developed for this purpose in consultation with ASHA and AWW. The ASHA 

facilitator, MO i/c of the nearest health facility, RKS and DPMSU will monitor the 

implementation at village level. 

2. During MMU activities wherever possible, the nearby areas will be informed through 

ASHA/AWW and PRI for attending MMU camp for ANC. The ANC will be carried out by MO on 

MMU duty. The MMU plan will be circulated well in advance about the site, date etc through 

MOi/c of the PHC area so as to have maximum attendance. Further, the Obstetrician on MMU 

service will provide high quality ANC. 

3. The RCH camps will be organized in all the blocks / circles in the districts. Quality ANC will be 

provided to pregnant women along with IFA (100 tablets) and TT injections. The camps will be 

organized as per microplan prepared at district level. The activity will also involve ASHAs, 

AWW, PRI members for wide publicity and mobilization of pregnant women from nearby most 

difficult and inaccessible areas. 

Strategy -1 A.3.Increase awareness among the mothers and community about the need of ANC and 

consumption of 100 IFA (L) tablets 

Activities: 

Communication strategies to increase awareness among the mothers and communities with 

emphasis on marriage after 18 years, first child after 20 years, need of 3 ANCs, ingestion of 100 IFA (L) 

tablets, 2 TT injections, birth preparedness and importance of hospital delivery and exclusive breast 

feeding are addressed under IEC component. 

Strategy -1 A.4. Operationalise Sub-Centres 

Activities: 

There are 592 nos. of Sub-Centres notified by the State Government, but only 273 SCs are 

functional and manned by Health Workers. 

201 SCs are with 1 ANM and 29 with 2 or more ANMs (A total of 230 ANMs in the SCs). The rest 

are manned by other paramedics like HW (Male), Pharmacist etc. 

66

Out of these 273 SCs, 211 are functioning in their own building and the rest (62) are located in 

other buildings such as local community constructed OBT building, panchayat building, schools etc. 

Only 99 SCs have ANM quarters at present and extension of SC Building is going on at 122 SCs 

to provide residential facilities for ANMs. Meaning thereby, that 52 SCs are without any form of 

residential quarters 

The following table is a summary of the status of the 273 SCs. A district-wise break-up of these 

SCs along with name is given as Annexure. 

Sl. 

No District 

No.of 

Functional 

SC 

with 1 

ANM 

67 

ANM 

with 2 ANM 

or more 

Without 

ANM 

Own 

Building 

1 Tawang 12 8 3 1 10 7 

2 West Kameng 20 6 0 14 12 5 

3 East Kameng 13 8 3 2 5 2 

4 Papum Pare 22 20 2 0 19 10 

5 Lower Subansiri 19 13 5 1 10 6 

6 Kurung Kumey 12 10 2 0 8 0 

7 Upper Subansiri 20 15 0 5 12 4 

8 West Siang 30 23 4 3 23 5 

9 East Siang 30 26 1 3 30 20 

10 Upper Siang 10 8 2 0 9 2 

11 L/ Dibang Valley 14 12 2 0 10 4 

12 Dibang Valley 3 1 2 0 3 2 

13 Lohit 19 12 0 7 17 5 

14 Anjaw 14 8 2 4 14 9 

15 Changlang 20 19 1 0 15 8 

16 Tirap 15 12 0 3 14 10 

Total 273 201 29 43 211 99 

ANM 

Qtr

During the year, 30 more SCs will be made functional by relocation of ANM from the existing 

pool and provision of new buildings. 

The 118 additional ANMs for manning SCs will continue. The new state Health Policy addresses 

the burden of positioning of ANMs in the SCs and also the recruitment norms for contractual ANMs. 

Performance based incentives payments will be made by respective RKS. All the ANMs will provide daily 

ANC, PNC, institutional deliveries, immunization, attending VHND, attend RCH camps, MMU activities 

locally apart from her activities specified for each SCs. The ANMs will ensure active participation of 

ASHAs in the VHND, RI program, promotion of FP program, RCH camps and other health activities 

mainly for mobilization and motivation of the community. 

The progress of the plan will be closely monitored by RKS including quality of service delivery 

and utilisation through field visits. The monthly meeting at PHCs will review the ANM performance 

regularly. The MO i/c at PHC / CHC will continually review the activities performed by the ANM. The 

guidelines related to all the activities to be performed by ANM are already in place in all the blocks. The 

overall responsibility for quality issue will related to ANM performance at village and SC level will be on 

DPMSU and quality assurance committee at district level. 

The training requirements for ANMs for all categories of activities are addressed under training 

section. 

Objective-1B: Increase the institutional delivery from current level of 47.7 to 60 percent & skilled birth 

attendant at home from current level of 10.8 to 50 percent by 2011. 

Strategies: 1.B.1: Increasing the access through facility strengthening 

Activities: 

a) Operationlization of facilities at all level. 

a.1: Operationalise DHs as FRUs 

There are 13 District Hospitals, 2 General Hospitals and 44 CHCs (31 functional) in the state out 

of which, 2 GHs and 1 CHC are fully functional as FRUs. 7 DHs are partially functional as FRU and 

lack blood bank facilities. Certification of Blood Bank in these 7 DHs is awaited. 

FRUs. 

SNCU will be established at GH Naharlagun and Stabilization Unit in the 3 fully functional 

Establishment of newborn care corner (NBCC) as per guidelines is also being proposed for all 

the 10 facilities in the Child Health section. 

68

Status of existing 3 FRUs 

District Manpower availability Facilities available 

Obstetrician 

Anaesthetist 

Paediatrician 

69 

OT 

Labour room 

Blood Bank 

New born 

facilities 

Power Back 

up 

GH-Naharlagun Yes Yes Yes Yes Yes Yes Yes Yes 

GH- Pasighat Yes Yes Yes Yes Yes Yes Yes Yes 

CHC Ruksin Yes Yes Yes Yes Yes Yes Yes Yes 

Status of 7 DHs functioning partially as FRUs 

District Manpower availability Facilities available 

Obstetrician 

Anaesthetist 

Bomdila Yes Yes (LSAS) By MO Yes Yes 

Paediatrician 

OT 

Labour room 

Blood Bank 

Inspection done 

Certification awaited 

New born 

facilities 

Power Back 

up 

Yes Yes 

Ziro Yes Yes Yes Yes Yes Yes Yes 

Daporijo Yes Yes Yes Yes Yes Yes Yes 

Aalo Yes Yes Yes Yes Yes Yes Yes 

Yingkiong Yes Yes Yes Yes Yes Yes No 

Roing Yes Yes (LSAS) Yes Yes Yes Yes Yes 

Tezu Yes Yes (LSAS) By MO Yes Yes Yes No 

Apart from the earlier mentioned 10 Health Facilities, it is proposed to make 4 more DHs 

functional as FRUs during 2010-11

Sl. 

No. Variables 

Status and Gaps identified for these 4 DHs 

Name of proposed FRUs 

Seppa Khonsa Changlang 

70 

Tawang 

1 Bed Strength 80 48 85 30 

2 Name of CHCs / PHCs / SCs will be benefited by 2 CHC, 9 3 CHC, 8 PHC, 38 3 CHC, 10 PHC, 38 4 PHC, 20 SC 

that FRU 

PHC, 43 SC SC 

SC 

3 Population covered (projected population of 

2010) 

64100 116647 164519 48128 

4 Bed occupancy rate/CS required patient load in 

recent past 

70% 60% 65% 90% 

5 Human resources: 

5.1 Critical Staff availability 

Obg & Gyn 0 0 0 1 

Anaesthesia 0 0 0 0 

Paed 0 0 0 0 

Lab Tech 1 2 2 1 

Blood bank / Storage MO Identified Identified identified Identified 

5.2 Multi Skilling 

EmOC 1 1 1 0 

LSAS 0 1 1 0 

5.3 Re-deployment 

6 Equipment (Review past receipt of E-P Kits) Nil Nil Nil Nil 

7 Infrastructure needs 

7.1 Status of Labour Room. Good Good Good Good 

7.2 Status of operation theatre equipped for 

undertaking anaesthetic and emergency surgical 

procedures including Caesarean Sections and 

Laporotomies. 

Available Not Available Available Available 

7.3 An area earmarked and equipped for New-born 

Care in the Labour Room and also in the ward. 

Yes Yes yes Yes 

7.4 A functional laboratory with facilities for all 

essential investigations. 

Available Yes yes Yes 

7.5 Blood bank / storage facility as per the guidelines Building & Building & Building & Building &

issued by Govt. of India (GoI). equipments 

available 

(certification 

visit done) 

71 

equipments 

available(certification 

visit done) 

equipments 


visit done) 

equipments 


visit done) 

7.6 24-hour water supply. Yes Yes yes Yes 

7.7 Arrangements for waste disposal No No No No 

7.8 Regular electricity supply with back-up 

Yes with Yes with back up Yes without back up Yes with back up 

arrangements to ensure uninterrupted supply to back up Generator 

Generator 

Generator 

the operation theatre and labour room, cold chain 

and blood storage facility. 

Generator. 

7.9 Telephone connection. Yes Yes Yes Yes 

8. Referral transport: Ambulance (owned or 

arranged through local hiring). 

Nil Yes (Govt.) Yes (Govt.) Yes(Govt.) 

9. Status of RKS : In position In position In position In position 

9.1 Bank Account(Y/N) Yes Yes Yes Yes 

9.2 Monthly Monitoring Meeting (Y/N) Irregular Irregular Irregular Irregular 

9.3 Frequency of Executive Body Meeting Irregular Irregular Irregular Irregular 

10. Availability of Citizens’ Charter No Yes Yes Yes

Plan for upgrading these 4 DHs to FRU are as below: 

Infrastructure: 

1. Construction of OT for DH Khonsa. 

2. 10 KVA Generator for DH Changlang. 

3. The equipments (E-P Kits) for all the 4 DHs may be provided by GoI, 

4. Anaesthesia equipment for DH Khonsa will be provided @ Rs 5 Lakhs. 

5. New born care corner equipment requirement will be put in place 

6. The minimal recurring expenditure for maintenance will be met from RKS fund available with 

the districts. 

Manpower: 

1. Two nos. of Paediatricians will be recruited for 2 DHs (Bomdila and Khonsa) and 2 MOs 

from DH Seppa & Tawang will be given training on F-IMNCI 

2. One Medical Officer each will be trained in LSAS from among the MOs of DH, Seppa and 

DH, Tawang during the year. 

3. Additional Lab. Techs. will be recruited for Seppa & Changlang. Additional Staff Nurses, if 

available, will be recruited on contract for these facilities as depicted below. The HRD 

component, however is addressed separately 

4. 

Training / IEC/BCC: 

Facility Status Required 

Staff Nurse Lab Tech Staff Nurse Lab Tech 

Seppa 3 1 6 1 

Khonsa 6 2 3 0 

Changlang 3 1 6 1 

Tawang 5 2 4 0 

Total 14 6 19 2 

The training component is addressed in specific section. 

Drugs & supplies: 

All the 14 DH/GHs will be provided drug kits as below: 

1. FRU Kit – one each for all the FRUs. 

2. RTI / STI Kits – one each for all the FRUs. 

Monitor progress against plan; follow up with training, procurement, etc 

72

The progress of the implementation will be monitored by SPMSU, DPMSU and the monitoring 

team existing in the state and districts. 

Monitor quality of service delivery and utilisation including through field visits. 

The quality issue will be monitored by quality assurance committee at state and districts level on 

quarterly basis. 

a.2 Operationalise CHC / PHCs to provide 24-hour services: Prepare plan for operationalisation 

across districts 

There are 44 CHCs notified by State Government out of which 31 are functional. 15 are 

functioning as 24 X 7 and 15 CHCs are providing basic services. CHC Ruksin is functional as FRU. 

During 2010-11, 10 more CHCs are proposed to be made functional as 24x7. 

The existing status of these 30 CHCs are given below. The gaps identified in these facilities will 

be addressed this year. 

73

District Sl.No. Name of CHCs 

Medical Officer 

GNM 

Status of 24x7 CHCs 

ANM 

Manpower Infrastructure 

Total Nurses 

Tawang 1 Jang 3 1 1 2 0 1 1 1 5 1 Yes Yes 

West Kameng 2 Dirang 2 3 8 11 1 0 1 1 18 1 Yes Yes 

Papumpare 

74 

Lab.Tech. 

3 Sagalee 5 1 3 4 2 1 - 1 13 1 Yes Yes 

4 Doimukh 15 5 5 10 2 6 - 1 24 1 Yes Yes 

5 Kimin 5 3 1 4 1 4 - 1 16 1 Yes Yes 

U/Subansiri 6 Dumporijo 3 1 5 6 0 1 - 1 8 0 0 Yes 

West Siang 7 Basar 7 3 4 7 1 3 - 1 34 1 Yes Yes 

West Siang 8 Lakabali 5 3 4 7 1 3 - 1 25 0 Yes Yes 

East Siang 

9 Boleng 4 3 2 5 0 0 - 1 25 1 Yes Yes 

10 Mebo 3 7 1 8 0 1 1 1 15 1 Yes Yes 

11 Nari 3 2 1 3 0 1 1 1 7 1 Yes Yes 

Upper Siang 12 Jengging 5 2 1 3 0 0 - 1 6 0 No Yes 

Lohit 

13 Namsai 7 5 4 9 1 0 4 1 25 1 No Yes 

14 Mahadevpur 3 0 3 3 1 2 9 - No Yes 

HA 

Pharmacist 

Building 

Residential Qtr 

Ambulance 

OT 

Labour Room

Changlang 15 Miao 5 4 5 9 1 2 2 1 41 1 Yes Yes 

District Sl.No. Name of CHCs 


CHCs to be operationalized as 24x7 

GNM 

ANM 


West Kameng 1 Kalaktang 2 1 3 4 1 1 0 1 11 1 No Yes 

Total Nurses 

Papum Pare 2 Balijan 3 2 2 4 1 5 1 13 1 No Yes 

Kurung Kumey 3 Palin 3 4 0 4 0 0 1 2 No 

West Siang 4 Mechuka 2 1 3 4 0 0 1 7 1 No Yes 

East Siang 5 Pangin 2 1 4 5 0 1 1 1 13 1 Yes Yes 

Upper Siang 6 Mariyang 2 1 2 3 0 3 1 8 1 Yes Yes 

Lohit 7 Chowkham 3 5 3 8 0 0 3 1 12 1 Yes 

Changlang 8 Jairampur 2 4 1 5 0 3 1 10 1 No Yes 

Tirap 

75 

Lab.Tech. 

9 Longding 2 1 5 6 0 1 1 21 1 No Yes 

10 Kanubari 2 1 3 4 0 5 1 16 1 Yes Yes 

HA 

Pharmacist 

Building 

Residential Qtr 

Ambulance 

OT 

Labour Room

There are 116 PHCs notified by state Government providing required services. However, only 20 PHCs are functional as 24x7. During 

2010-11, 10 more PHCs are proposed to be made functional as 24x7. 

District Sl.No. 

The existing status of these 30 PHCs are given below. The gaps identified in these facilities will be addressed this year. 

Name 

of PHCs 


GNM 

ANM 

Status of 24x7 PHCs 


Total Nurses 

Lab.Tech. 

Tawang 1 Lumla 3 1 9 10 2 2 1 SPT 14 1 Yes Yes Yes No Yes * 

West Kameng 2 Thrizino 3 2 7 9 1 2 SPT 13 1 Yes Yes Yes Yes Yes * 

East Kameng 3 Bameng 2 0 2 2 1 2 1 SPT 4 1 Yes Yes Yes Yes Yes * 

Papum Pare 4 Mengio 2 2 3 5 1 2 1 SPT 2 1 No Yes Yes Yes Yes * 

Lower Subansiri 5 Deed Neelam 3 1 14 15 1 3 1 SPT 15 1 Yes Yes Yes Yes Yes * 

Kurung Kumey 6 Sangram 2 2 2 4 1 2 1 SPT 2 1 No Yes Yes Yes Yes * 

Upper Subansiri 7 Nacho 2 0 10 10 2 3 1 SPT 4 1 Yes Yes Yes Yes Yes * 

West Siang 8 Gensi 2 1 11 12 2 1 1 RCC 13 1 Yes Yes Yes No Yes * 

76 

HA 

Pharmacist 

Building Type 

Staff Quarter 

Ambulance 

Labour room 

Functional Laboratory 

Water Supply 

Power Backup available 

New Born Care Corner 

Available

East Siang 

9 Tirbin 2 1 1 2 1 1 SPT 8 1 Yes Yes Yes No Yes * 

10 Bilat 3 2 4 6 0 1 1 SPT 17 1 Yes Yes Yes No Yes * 

11 Sille 2 0 7 7 0 1 1 SPT 6 1 Yes Yes Yes Yes Yes * 

Upper Siang 12 Jeying 2 1 4 5 1 2 1 SPT 1 1 No Yes Yes Yes Yes * 

Lower Dibang Valley 13 Anpum 2 3 3 6 2 1 1 SPT 4 1 Yes Yes Yes Yes Yes * 

Dibang Valley 14 Etalin 2 0 6 6 1 0 1 SPT 4 1 Yes Yes Yes Yes Yes * 

Lohit 15 Wakro 2 1 6 7 2 2 1 RCC 6 1 Yes Yes Yes Yes Yes * 

Anjaw 16 Wallong 2 1 3 4 1 1 1 RCC 3 1 Yes Yes Yes Yes Yes * 

Changlang 

17 Khimiyong 2 2 4 6 1 3 1 RCC 1 1 Yes Yes Yes Yes Yes * 

18 Nampong 2 1 4 5 0 1 RCC 5 Yes Yes Yes No Yes * 

19 Kharsang 2 1 4 5 0 1 RCC 7 1 Yes Yes Yes No Yes * 

Tirap 20 Wakka 2 2 3 5 1 1 1 Yes 2 1 Yes Yes Yes Yes Yes * 

N.B :- Yes* - Not as per guideline. Equipments proposed under Child Health 

77

East Kameng 

District Sl.No. Name of PHCs 


GNM 

PHCs to be functionalized as 24x7 during 2010-11 

ANM 


Total Nurses 

Lab.Tech. 

78 

HA 

1 Bana 2 0 1 1 0 1 0 RRC 3 0 Yes No Yes No No 

2 Pakke Kessang 0 0 0 0 0 1 RCC 5 1 No No Yes No No 

Papum Pare 3 Jote 2 1 1 2 0 2 SPT 2 1 No No Yes No No 

East Siang 4 Tellam 1 0 2 2 0 2 SPT 6 1 Yes Yes Yes No No 


5 Raga 2 1 3 4 0 0 SPT 5 1 No Yes Yes No No 

6 Yachuli 2 1 1 2 0 0 0 RCC 2 1 No Yes Yes No No 

Kurung Kumey 7 Yangte 0 0 0 0 0 1 0 SPT 0 0 No No Yes No No 

Upper Subansiri 8 Maro 1 1 1 2 0 0 0 SPT 4 1 No No Yes No No 

Lohit 9 Lathao 2 0 2 2 0 1 RCC 6 1 Yes Yes Yes No No 

Changlang 10 Namtok 0 0 1 1 0 0 RCC 0 No No Yes No No 

Pharmacist 

Building Type 

Staff Quarter 

Ambulance 

Labour room 

Functional 

Laboratory 

Water Supply 

Power Backup 

available 

New Born Care 

Corner Available

(A) Manpower 

The MOs working as on date is enough and is projected under NRHM additionalities and they will 

continue to work at the PHC level only. There are 60 SNs working under RCH II component and will 

continue. There are 30 laboratory Technicians in position and will continue at the PHCs/CHCs. Fifteen 

Dental Surgeons under NRHM additionalities will continue. 

Due to shortage of SNs in the state and not willing to join difficult districts / outpost, the 

requirement of SNs may be replaced with ANM. The existing SNs will be provided incentives as proposed 

under NRHM additionalities. Training of all categories of manpower is addressed in separate section. 

Referral of pregnant women will be provided through ambulances provided to the CHCs/PHCs free of 

cost to all the BPL women through RKS. 

Interventions: 

� MOs and Nurses from the existing pool to be posted in these CHCs/PHCs to offset the gaps 

identified 

� Additional recruitment of Lab Tech numbering 28 may be made for CHCs / PHCs during the 

year. (addressed in HR Section) 

(B) Infrastructure: 

Interventions: 

� 8 Labour Rooms will be constructed 

� Patient waiting room will be provided to 35 CHCs / PHCs functioning as 24x7 @ Rs 5 lakhs per 

unit (Addressed under NRHM additionalities). Other minor civil activities will be taken up by 

RKS. 

� Provision of 16 generators (5 KVA) are proposed for the PHCs @ Rs 2.5 lakhs per set and the 

shed plus the required maintenance and PoL will be borne from RKS fund. 

� All the 31 CHCs and 85 PHCs will be provided delivery kits one each @ Rs.9, 900/ 

� Newborn care corner equipments for 30 CHCs and 30 PHCs (addressed under Child Health) 

� The quarters are very scarce and majority of them requires major repair. Requirement of 

residential quarters is addressed in NRHM additionalities. 

(C)Drugs & Supplies: 

Government of India may provide drug kits in kinds as per the requirement lists detailed below: 

CHC / PHC RCH Kit - 116 Kits 

RTI/STI - 116 Kits 

SBA Kit - 116 Kits 

79

Monitor progress against plan; follow up with training, procurement, etc 

The progress of the implementation will be monitored by SPMSU, DPMSU and the monitoring 

team existing in the state and districts. 

Monitor quality of service delivery and utilisation including through field visits. 

The quality issue will be monitored by quality assurance committee at state and districts level on 

quarterly basis. 

Strategy - 1B.2. To ensure 48 hrs stay of mothers at the health facilities after delivery 

Activity: 

Provision of Incentives to mothers. 

Stay of mother and newborn at the health facilities for 48 hrs after delivery ensures quality Post 

Natal and Newborn Care, thereby reducing both Maternal and Neonatal Mortality. 

Efforts will be made to ensure 48 hrs stay of mothers in the health facilities all across the State 

after Institutional Delivery. To promote this initiative, a “Mother and Baby Kit” will be provided to the 

mothers who fulfil this criterion. These kits will consist of the following: 

Fresh Towels for mother and baby: 1 each 

Baby Shampoo, Soap and Oil: 1 each 

Diaper: 1 packet of 10 

Mackintosh Sheet: 1 

Baby Mosquito Net: 1 

Rs. 500 has been budgeted for 12797 deliveries (70 % of all Institutional Deliveries) 

Strategy - 1B.3. Social mobilization through JSY 

Activities: 

Implementation of JSY 

Implementation of JSY in the state is to be made more effective. There was some delay in getting 

the funds and releasing them to the districts in time. So, beneficiaries could not be paid as per the 

guidelines. Each district has projected their JSY requirements in the DHAP. As per the DHAPs sufficient 

funds will be disbursed to the districts in time. Care is taken in providing referral transport under the 

scheme. The beneficiaries will be provided transport facility from their residence to the service delivery 

facility and back for which provision for transportation will be in all the institutions. ASHA help desk 

will be functionalized in all the DH, CHCs and PHCs to address the grievances relating to JSY 

mobilization and ASHA activities. It will also be ensured in all the health facilities that ASHAs and the 

80

eneficiaries mobilized by ASHA are taken care off with courtesy by the health workers at the health 

facilities. 

Adequate need - based IEC/BCC activities will be instituted right from the District Hospital to the 

SC level through various means of communication/ tools as appropriate to the people as per needs. 

Outdoor & rural publicity campaign will be undertaken for the target groups to popularize JSY scheme. 

The details are provided under IEC / BCC component. 

Particulars 

Physical 

target 

Approval for 2009-10 JSY Projection for 2010- 

11 

Budget 

in lakhs 

Achievement 

(As per 

HMIS as on 

6.10.09) 

81 

Budget 

utilized in 

lakhs (as on 

30 th 

Sept.2009) 

Physical 

target 

Budget in 

lakhs 

Home delivery 4000 20 21 0.105 1000 5.00 

Ins. Del. Rural 

6.048 11521 80.65 

10769 75 864 

Ins. Del. Urban 5761 40.33 

Caesarean Sec (LSCS). 

ASHA package for Rural 

areas Rs. 600x No. of Ben. 

ASHA package for Urban 

areas Rs. 200x No. of Ben. 

Administrative cost 1% for 

State Hq. ( M&E, 

Stationeries etc.) 

Administrative cost 4% for 

District Hq.( M&E, 

Stationeries etc.) 

65 864 5.184 69.13 

Total deliveries 14769 885 18282 

11.52 

Total budget under JSY 160 11.337 216.95 

Targets have been set based on the performance during 2007-08-09 ,09-10(upto 2 nd qtr) & 

expected capacity to absorb the case load. The beneficiary under JSY has been calculated at about 55% 

of the target set. Additional funds will be requested once the state is able to achieve record & report 

2.07 

8.26

performance above 55%. Considering the case load, the calculations have been made to increase the 

institutional delivery to 55% during the year. 

The payment to the beneficiaries will be ensured at the time of delivery to the mother in the 

institution. Referral package will be made as per guidelines. MOICs of Health centres will be the Nodal 

person for Grievance redressal. Also the beneficiaries outside the PHC/CHC etc. will be instituted for 

ensuring better health care facilities and transparency and for facilitating grievance redressal. Two days 

stay after delivery in the hospital will be implemented in all the health centres to ensure safety of the 

mother and new born child. 

Proper documentation and updated records on JSY will be maintained and timely submission of 

JSY reports will be adhered while implementing the scheme during the year. 

The ASHA incentive for tribal states may be implemented in Arunachal Pradesh where Rs.1400/- 

to mother and Rs.600/- to ASHA as was allowed during 2008-09. The decrease in incentive following 

NPCC approval this year, there has been lots of de-motivation among the pregnant women and ASHAs 

The Involvement of MNGO & FNGO will be ensured in 3 districts where MNGO scheme is going 

on. The ASHA Resource Centres at state and district level will ensure involvement of ARC personnel for 

motivation and involvement of ASHAs and Supervisors. It will also be ensured that the JSY payments are 

made to the ASHAs in time through RKS. 

Strategy -1.C.4.To ensure referral provision of obstetric emergencies. 

Activities: 

a. The referral transport facility shall be provided to all the pregnant mothers seeking institutional 

delivery from village to PHCs / CHCs / DHs. Cases to be referred from villages will be provided 

free transport in consultation with VHSC (Likely cases for such referral in the state is very less). 

b. The referral component under JSY will be provided to those actually requiring referral and will 

be provided in time. 

c. Few complicated pregnancies belonging to BPL from PHCs/CHCs area shall be provided 

referral transport free of cost through RKS using ambulances already in position. 

d. The referral transport from one health institution to another higher centre shall be provided 

through ambulance services provided in the 6 PHC and 1 DH during emergency obstetric cases 

free of charge. 

e. The estimated beneficiary is calculated at 10 percent of total institutional 

delivery which comes to 168 deliveries. 

Strategy 1D: To make adequate provision of health care services in the outreach areas. 

Activitiy: 

Integrated outreach RCH services 

Implementation by districts of RCH camps in outreach areas. 

During 2009-10, 67 RCH camps were conducted in the PHC / CHC areas where several patients 

from the community were benefitted. Outreach RCH camps are an essential component considering the 

82

difficult geographical lay-out, difficult terrains, scattered institutions and low health seeking Behavior. 

Actions are taken to increase the accessibility of the health services by increasing the number functional 

facilities as proposed above. The details of the services provided and outcome is to be assessed which will 

be done during 2010. 

96 RCH camps @ 6 camps per districts, which will be organized in PHC /CHC areas in all the 

16 districts. The services like ANC, PNC, Immunization services, FW activities, IEC activities etc will be 

provided during these camps which will hold for 2 days. The mobile medical unit (MMU) will also be a 

part of the RCH Camps with all provisions under MMU wherever functional. Further, sterilization camps 

will be integrated as per the availability of laproscopic trained Gynaecologist. Consumables as detailed 

below would be provided for this activity. 

Contents and Budget for one RCH camp is as below: 

Service components Unit cost(Rs) 

1. Medicines 15,000 

2. Transportation (hiring) 5000 

3. Public announcement / notice etc 1000 

Honourarium for staff 

1 MO: 

1 Staff Nurse: 

1 ANM: 

1 Attendant: 

83 

200 

125 

75 

50 

4. Documentation 300 

5. Refreshment 1000 

6. contingencies 250 

Total 23,000 

The RCH camps will organize as per the microplan prepared. The RKS of the camp area will also 

be involved for such activity and are a part of monitoring team. The District monitoring and state 

monitoring team will ensure that all the camps are closely monitored. 

During the camp, the ASHAs, ASHA supervisors, ANMs, MO of the location along with RKS / 

VHSC members and ICDS functionaries will take active part for organization and motivation. 

Activity: 

To ensure holding of VHND for providing basic health services at the village level. 

Monthly Village Health and Nutrition Days at Anganwadi Centers/schools 

931 Village and Health Day was conducted during 2009-10till 2 nd quarter. The state performance 

was far below the expected numbers of VHND during 2009-10.

Monthly Village Health and Nutrition Days at Anganwadi Centers/schools / community building 

would be organized in 3595 villages once a month (n=3959x12) where trained ASHAs are present.The 

effort will be to mitigate the burden of recurrent camps in the PHC / CHC areas. 

Village Health & Nutrition Day (VHND) will be organized once a month every village. It will be 

ensured that there will be involvement of village Health & Sanitation Committee comprising of 

ASHA/AWW/ANM/PRI in the VHND. The VHND will be attended by ANM from the nearest SC / PHC in 

atleast 5 VHND / month in the SC area. 

There are certain villages in the state which are not having AWCs. In such places, VHND will be 

organized in the SC/ community hall / a suitable facility identified in the village for this purpose by the 

VHSC. ANC registration will be a priority in VHND and ANC performed wherever ANM is present. On 

tracking of pregnant women by the ASHA, it will be ensured that ANM visit that village on VHND for 

ANC. Provision of IFA (L) tablet, Iron syrup etc will be provided and additional activity like de-worming 

will be a part of the VHND. 

The contingency expenditure for organizing VHND will be met from VHSC untied fund and as 

decided by the VHSC. However, incentives may be made to ASHAs at the rate of Rs 150 per VHND from 

the VHSC fund proposed under NRHM additionalities. 

Apart from technical services, the VHND activity will comprise of awareness activity on total 

health, immunization session, providing OCP, condom, anti malaria activity etc and on attendance by 

ANM, the VHND will provide ANC, PNC IUD insertion etc. 

The quality of the VHND will be monitored by ASHA supervisor, ANM, MO i/c, VHSC members. 

There will be monthly ASHA day at the PHCs where the performance of the ASHAs will be reviewed. 

Quarterly, the VHNDs will be monitored by District Monitoring Committee under District Health Society. 

Objective 1E: To operationalise MTP services at health facilities 

Strategy : Enhanced accessibility of MTP services by the target group. 

Activity: 

The MTP services are provided effectively in 14 DHs and 1 CHC. In addition to this, 20 PHCs and 

20 CHCs have MTP trained MOs where the services are provided using MVA. 

Further for the year, it is proposed to further strengthen this 55 health facilities providing MVA 

@10 nos. @Rs.1500/- per set. MTP set numbering 30 will be procured @1 set per facility @Rs.3000/- 

per set and placed to the identified facilities (PHCs/CHCs). Rest of the minimal requirement will be met 

locally through RKS. 

- The training plan is detailed under training head. 

84

Monitor of the progress of implementation will be done by District Monitoring Team and Quality 

Assurance Committee at the district level. The RKS will also review the progress. 

Objective 1F: To promote RTI/STI facility in PHC, CHC & DH by 2011. 

Strategy -1 F.1: Continue operationalization of services for diagnosis & treatment of RTI/STI at 

PHC,CHC & DH. 

Activities: 

Currently, the RTI/STI facilities are provided in 14 DHs, 31 CHCs and 85 PHCs. It is proposed 

to further improve the performance and quality of the service in all these facilities. The services are 

provided in collaboration with APSACS at 14 district hospital in the form of STI clinic. 

The manpower requirement in the form of Laboratory Technician may be provided during the 

year for CHCs / PHCs. Rest of the LT requirement will be relocated from the existing manpower. 

Equipment required is 50 Binocular Microscope only for 50 OHCs / CHCs where old and 

outdated microscopes are presently being used @Rs. 40,000/-.The recurrent items for testing will be 

provided from RKS fund locally. 

above. 

The RTI / STI kit will be provided to all the identified facilities in kinds by GoI which is addressed 

Training is addressed under training component. Standard treatment protocol already available 

at state and districts will be disseminated to all the health facilities. 

The progress against the plan to improve the performance will be closely monitored by District 

Monitoring team and RKS. 

Objective 1G: Review of Maternal Deaths 

Strategy 1.G.1: Documentation of verbal autopsy of maternal deaths in all districts 

Activities: 

Maternal Health Division has just provided the soft copies of the guidance note, formats and 

Annexures etc. After the regional level orientation on these strategies, orientation workshops will be 

carried out at the State and District level. 

Further, training of field workers will be done on the simplified verbal autopsy format followed 

by printing of the formats to ensure implementation of the strategy. 

Meanwhile, creating awareness on maternal deaths will be a focused activity during the VHNDs 

in all the villages in the state. 

85

2. CHILD HEALTH 

Goal: To reduce infant mortality rate from 32 (SRS-2009) to 30 by 2012. 

Objective 2 A: Provide new-born care, treatment facilities and training to health workers and 

community base workers for improvement of child care by 2011. 

Strategy -2A.1. Ensure provision of facility based care for children. 

A. Establishment of SNCU at Referral Hospital: 

Services at the unit 

The configuration of the SCNU at the district level should be such that it supports delivery of 

necessary quality services and meets the potential need to expand in order to accommodate increased 

demand. The SCNU at the district hospital is expected to provide the following services: 

1. Care at birth, including resuscitation of asphyxiated newborns 

2. Managing sick newborns (except those requiring mechanical ventilation and major surgical 

interventions) 

3. Post-natal care 

4. Follow-up of high risk newborns 

5. Referral services 

6. Immunisation services 

In addition, the unit should also provide training to medical officers and nurses in newborn care 

Location within the district hospital 

The unit is proposed to be established at General Hospital, Naharlagun. 

Size (projected bed demand) of the unit 

As a general guide for all deliveries occurring within the health facility, three beds for every 1,000 

annual deliveries may be dedicated to the newborn care unit. This demand is for intramural deliveries 

(those occurring within the district hospital). Additionally, for newborns delivered outside the hospital 

(extramural) and being brought to the hospital for special care, an extra allowance of 30 per cent of the 

estimated beds should be considered. For example, if a hospital conducts 3,000 deliveries per year, the 

number of beds required would be: 

86

• For intramural: 3/1000 X 3000 = 9 beds 

• For extramural: 30%*9= 3 beds 

• Total beds required = 12 

Minimum space requirements 

Each newborn space shall contain a minimum of 100 square feet (9.9 square metres) of clear floor space, 

excluding hand washing stations and columns. 

This 100 sq ft per bed of space should be utilised as follows: 

• Baby care area: 50 sq ft per bed 

• General support and ancillary areas: 50 sq ft per bed 

Baby care area 

The baby care area (50 sq ft per bed) may be divided into two interconnected rooms separated by 

transparent observation windows with the nurses’ work place in between. This facilitates temporary 

closure of one section for disinfection. 

Space for ancillary (supplementary) services 

Distinct support space be provided for all clinical services that are routinely performed in the SCNU. The 

ancillary area includes space for the following: 

• Gowning area at the entrance 

• Hand washing stations 

• Examination area 

• Clean area for mixing intravenous fluids andmedications 

• Mother’s area for expression of breast milk,breastfeeding and learning mother crafts 

• Side laboratory 

• Boiling and autoclaving 

Requirement of equipments: 

a. Item and Description 

1. Open care system: radiant warmer, fixed height, with trolley, drawers, O2-bottles 

2. Phototherapy unit, single head, high intensity 

3. Resuscitator, hand-operated, neonate, 250 ml 

87

4. Resuscitator, hand-operated, neonate, 500ml 

5. Laryngoscope set, neonate 

6. Pump, suction, portable, 220V, w/access 

7. Pump, suction, foot-operated 

8. Surgical instrument. suture/SET 

9. Syringe pump, 10,20,50 ml, single phase 

10. Oxygen hood, S and M, set of 3 each, including connecting tubes 

11. Oxygen concentrator 

12. Thermometer,clinical,digital,32-43ºC 

13. Scale, baby, electronic, 10 kg 

14. Pulse oxymeter, bedside, neonatal 

15. Stethoscope, binaural, neonate 

16. Sphygmomanometer, neonate, electronic 

17. Light,examination, mobile,220-12V 

18. Hub cutter, syringe 

19. Tape, measure, vinyl-coated, 1.5m. 

20. Basin, kidney, stainless steel, 825ml 

21. Tray,dressing,ss,300x200x30mm 

22. Stand, infusion, double hook, on castors 

23. Indicator, TST control spot/PAC-300 

24. Irradiance meter for phototherapy units 

25. Monitor, vital sign, NIBP, HR,SpO2, ECG, RR,Temp 

26. ECG unit, 3 channel, portable/SET 

27. Infantometer, plexi, 3½ft/105cm 

28. X-Ray, mobile 

29. Transport incubator, basic, with battery and O2, w/o ventilator 

88

30. Autoclave, steam, bench top, 20L, electrical 

31. Laundry washer dryer, combo, 5kg 

32. Drum,sterilising,165mm diameter 

33. Electric Steriliser 

34. Washing machine with dryer 

35. Gowns for staff and mothers 

36. Washable slippers 

B. General equipment 

1. AC (1.5 Tonne) 

2. Generator set 25-50 KVA 

3. Refrigerator, hot zone, 110L 

4. Voltage Servo-Stabiliser (three phase): 25-50 KVA 

5. Room Heater(Oil) 

6. Computer with printer 

7. Spot Lamps 

8. Wall Clock with second hand 

C. Renewable and consumables 

1 Adaptor, Meconium aspirator, disposable (for suction pump) 

2 Line, infusion pump, sterile, disposable 

3 Multistix, urine, 5 parameter, Glu, Prot, Eryt, Spc Grav, pH 

4 Cuvettes, Glu, box of 200 

5 Cuvettes, Hb, box of 200 

6 Vacuum tube, EDTA, 3ml, set of 100 

7 Vacuum tube, EDTA, 6ml, set of 100 

8 Vacuum tube, serum, 3ml, set of 100 

9 Vacuum tube, holder, set of 100 

89

10 Vacuum tube, needle, 22G set of 100 

11 Lancet,safety,sterile,single-use/PAC-200 (1.8mm) 

12 Capillary tubes, box 1000 

13 Sealing compound, capillary tubes, pck 500g 

14 Mask, surgical, disposable, box 100 

15 Cap, surgical, disposable, box 100 

16 Cord clamp, disposable, set of 10 

17 Extractor, mucus, 20ml, ster, disp Dee Lee 

18 Tube,suction,CH10,L50cm,ster,disp 

19 Tube,suction,CH12,L50cm,ster,disp 

20 Tube,feeding,CH05,L40cm,ster,disp 



23 Syringe,dispos,1ml,ster/BOX-100 




27 Syringe,dispos,20ml,sterile/BOX-80 

28 Needle,disp,22G,ster/BOX-100 



31 Needle, scalp vein,21G,ster,disp 

32 Needle, scalp vein,25G,ster,disp 

33 Gloves,exam,latex,medium,disp/BOX-100 

34 Gloves,surg,7,ster,disp,pair 

35 Infusion set, pediatric, with chamber 150ml, ster, disp, with 22G needle 

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36 Cotton wool,500g,roll,non-ster 

37 Compress,gauze,10x10cm,n/ster/PAC-100 

38 Compress,gauze,10x10cm,ster/PAC- 

39 Tube, connection, 2.2mm, length, box of 100 

40 Connector, 3-way, stop cock valve, ster, disp 

41 Disinfectant, chlorhexidine, 20% 

42 Disinfectant, bleach percentage 

43 Disinfectant, handsoap 

44 Antiseptic, betadine 

45 Tape,adhesive, Z.O., 2.5cmx5m 

46 Scalpel blade, ster, disp, no.22 box of 100 

47 Umbilical Venous catheter No 5, 6 

48 Disinfectant Bacilloid 

49 Blood transfusion, set 

50 Nasal prongs, disposable, set of 3 

51 Endotracheal tubes 

52 Electrodes, neonatal, box of 200 sets of 3 electrodes for ECG-recorder and monitoring 

53 Sterilization indicator TST control spots 

54 Paper sheets, crepe, for sterilization pack 

55 Tape adhesive, for sterilization pack 

56 Slide, microscope,76x26mm/BOX-100(2x50) 

57 Cover glass, microscope slides/BOX-100 

58 Jar, staining 

59 Counting chamber, glass, Neubauer, WBCs 

60 Solution, stain, Gram, 100ml. 

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Cost 

Training is addressed under training component. 

Cost can be broken down into capital cost and recurrent cost. While the cost will vary widely due 

to various factors, indicative costs for a 12-bed unit is summarised below: 

One-time establishment cost 

Renovations and civil works : Rs 16 lakhs. 

Equipment and furniture : Rs. 25, 00,000 

Recurring or running cost per year 

Consumables : Rs. 3, 50,000 

Maintenance cost : Rs. 6, 50,000 

Total fund required for one proposed unit is Rs.51 lakhs only. 

D. Newborn and Child Stabilization Unit (NBSU) at FRU 

Services at a stabilisation unit 

A Stabilisation Unit at an FRU would provide the following services: 

• Care at birth 

• Provision of warmth 

• Resuscitation 

• Monitoring of vital signs 

• Initial care and stabilisation of sick newborns 

• Care of low birth weight newborns not requiring intensive care 

• Breast feeding and feeding support 

• Referral services 

92

Human resources 

Training: 

One dedicated nursing staff will be made available round-the-clock for newborn care in the 

stabilisation unit. One Medical Officer skilled in newborn care or paediatrician is required for 

clinical care and oversight 

Doctors and nurses posted in the stabilisation unit will undergo skill-based training for 3-4 days 

and is addressed under training component. 

Configuration of a stabilisation unit 

• The stabilisation unit should be located within or in close proximity of the maternity ward 

• Space of approximately 40-50 sq ft per bed is needed, where four radiant warmers can be kept. 

• Provision of hand washing and containment of infection control should be there, if it is not a 

part of the delivery room 

Description of equipments. 

1. Open care system: radiant warmer, fixed height, with trolley, drawers, 


3. Laryngoscope set, neonate 

4. Scale, baby, electronic, 10 kg 

5. Pump suction, foot operated 1 

6. Thermometer, clinical, digital, 32-34C 

7. Light examination, mobile, 220-12 V 

8. Hub Cutter, syringe 

Renewable Resources 

9. I/V Cannula 24 G, 26 G 

10. Extractor, mucus, 20ml, ster,disp Dee Lee 

11. Tube feeding, CH07, L40cm, ster,disp 

12. Oxygen cylinder 8 F 

13. Sterile Gloves 

14. Tube, suction, CH 10, L50 cm, ster, disp 

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15. Cotton wool, 500g, roll, non-ster 

16. Disinfectant, chlorhexidine, 20% 

One time establishment cost 

Renovations and civil works Rs. 3 Lakhs 

Equipment and furniture Rs. 2,75,000 

Capacity building Rs. 25,000 

Consumables Rs. 25,000 

Maintenance cost Rs. 1, 50,000 

Total : Rs 7 Lakhs per unit. 

The Newborn and Child Stabilization Unit will be established at 3 functioning FRUs (GH, 

Naharlagun, GH, Pasighat and Ruksin CHC during the year. 

Activities: 

E. Establishment of Newborn Care Corner 

The NBCC guidelines will be prepared and disseminated for all the identified health facilities. 

Newborn Care Corner: Serious and concerted efforts have to be made to address the needs of a 

newborn in its first days in order to reduce Neonatal Mortality in the state. Provision of 71 New born 

care corner in the vicinity of the labour room needs strengthening, that will provides care to all sick new 

born. 

Health Facility units 

Facility 

Proposed 

24x7 PHCs Newborn 30 nos. Newborn care corner in 

Care 

Corner 

labour rooms 

CHC 

Newborn 30 nos. Newborn care corner in 

Care 

Corner 

labour rooms 

District Newborn 11 nos. Newborn care corner in 

Hospital / 

FRU 

Care 

Corner 

labour rooms. 

94 

All Newborns at Birth Sick Newborns 

Prompt referral 

Care of sick infants and 

Prompt referral to FRU 

Special Care Newborn Unit 

for care of sick infants 

Equipments: The NBCC kits will be made available to selected 11 DH / GH and 30 PHCs (24x7) 

and 30 CHCs @ one unit per facility @ Rs 1.2 Lakhs per case. The contents are:

Labour room 

Labour rooms1 in every facility at every level are available for providing essential care to newborns and 

for resuscitating those who might require it. Newborn care corner in this document refers to the space 

within the labour room for providing immediate newborn care to all newborns. 

Services at the corner 

Newborn care corner provides an acceptable environment for all infants at birth. Services provided in the 

Newborn care corner include; 

• Essential Care at birth 

• Resuscitation 

• Provision of warmth 

• Early initiation of breastfeeding 

• Weighing the neonate 

Configuration of the corner 

• Clear floor area should be provided for in the room for newborn care corner. It should be within the 

labour room, where a radiant warmer is kept. 

• Resuscitation kit to be placed in the radiant warmer. Availability of oxygen source is desirable but not 

essential. 

Equipment and renewables required for the corner 

1. Open care system: radiant warmer, fixed height, with trolley, drawers, O2-bottles 


3. Weighing Scale, spring 

4. Pump suction, foot operated 

5. Room Thermometer 

6. Light examination, mobile, 220-12 V 

7. I/V Cannula 24 G, 26 

8. Extractor, mucus, 20ml, ster, disp Dee Lee 

9. Towels for drying and wrapping the baby 

10. Sterile equipment for cutting and tyingthe cord 

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Staffing: 

11. Tube, feeding, CH07, L40cm, ster, disp 

12. Oxygen cylinder 8 F 

13. Sterile Gloves 

One staff nurse or ANM in addition to the one conducting the delivery for providing appropriate 

care at birth 

Training: 

All staff posted at the labour rooms will be trained in providing essential care at birth and basic 

resuscitation and addressed under training component.. 

Cost of setting up newborn care corner 

The following costs are indicative 

One time establishment cost 

Equipment and furniture Rs. 100,000 

Recurring or running cost per year 

Consumables Rs. 5,000 

Maintenance cost Rs. 15,000 

Total cost per unit is Rs 1.2 lakhs. 

Monitor of the progress of implementation will be done by District Monitoring Team and Quality 

Assurance Committee at the district level. The RKS will also review the progress. 

Referral of sick newborn to the referral hospitals from districts and peripheral health centre for 

neonatal Care will be provided to BPL free of cost. Each RKS will ensure that they transport the patients 

in time. The locally available ambulances will be used for the service. The referral will include those 

under treatment in the health facilities and from the villages. 

Strategy -2A.2: Training of IMNCI and f-IMNCI are addressed in training component. 

Strategy -2A.3: Improvement of skill of ASHA on home based new born care 

Activities: 

The training shall be provided to the ASHAs on home based newborn care as apart of continuing 

modular training under ASHA program. The ASHA training will be facility based and a roll out plan is 

already addressed under additionalities in details. 

96

The neonatal care kit may be provided by GoI in kinds for all the 3595 ASHAs. 

Objectives 2 B: Promote early breast-feeding within one hour and exclusive breast-feeding till 6 

months from 51.5% to 75% by 2011. 

Strategy 2 B.1: Increase awareness amongst mothers on benefits of breast-feeding up to 6 months and 

need of complementary feeding from 6 month onwards. 

Activities: 

The Communication activities on early feeding within 1 hour, Exclusive breast-feeding up-to 6 

months and its importance and the necessity to start complementary feeding from 6 months onwards will 

be augmented. The details of the IEC / BCC activities are addressed under IEC / BCC. Main area where 

the BCC / counseling activities will be addressed during VHND, RCH camps, MMU and RI outreach 

sessions. 

Objectives 2 C: To increase the use of ORS from 64.1% (DLHS-3) to 75% by 2011 

Strategy 2 C.1.:To raise awareness amongst mothers and communities on diarrhea 

Activities: 

Communication and BCC activities will be implemented laying emphasis on use of boil water, 

continuing breast-feeding even during diarrhoea, solid feeds, ORS usage, and more importantly, use of 

local / home made ORS. 

The identification of danger signs of diarrhea (identification of dehydration) by ASHAs will be 

ensured through ASHAs at village level. 

ORS packet will be made available upto ASHA level.. 

Objectives-2 D: To raise the ARI treatment and fever from 76.9% (DLHS-3) to 80% and increase 

awareness of ARI by 2011. 

Strategy 2 D.1:Management of ARI and diarrhea cases. 

Activities: 

Awareness generation programme among the mothers and communities on identification of early 

signs of Pneumonia and Diarrhoea, preparation of ORS, safe drinking water, correct feeding practices 

and hygiene will be taken up at VHND at village level through ASHA and ANM. 

Services at SC and CHC / PHC will be ensured. The IMNCI training covers the ARI component and 

the health personnel will provide the service accordingly. The ARI / Diarrhoes component will be taken 

up in re-orientation training of ASHAs. 

97

Objectives 2 E.: To reduce prevalence of anemia among children (6-35 months) from 66.3% (NFHS-3) 

to 50% by 2011. 

Strategy 2 E.1:Ensure prevention and treatment of anemia in children. 

Activities: 

The pregnant women and mothers will be counselled at village level during VHND and regular 

home visits by ASHA, AWW, ANM about importance of exclusive breast-feeding up-to 6 months, 

importance of complementary feeding from 6 months onwards and preparation of iron rich food. They 

will also undertake screening of severe malnutrition at the village and facility level. The mothers will be 

counselled at all functional facilities on the cause of anaemia and the ways to prevent / reduce it. 

Regular supply of IFA Syrup (Children below 6 months to 60 months will be given 20 mg. 

elemental iron and 100 mg of folic acid in liquid formulation ) will be ensured to treat anemia which is 

provided as a child health component. 

It will be ensured that deworming is done for children at 6 months interval. Deworming will be a 

part of School health program as well as during VHNDs. The child health drugs may be provided to 303 

SCs, 85 PHCs and 31 CHCs during the year. The drug kit may be provided in kinds. 

Objective 2 F: Improvement of health of the school going children. 

Strategy 2 F.1. Implementation of School Health Programme in the state 

Activities: 

The school health service is a personal health service which is an economical and powerful means of 

reaching student community health this should be almost the level of knowledge except in curative care of 

what any community health worker would provide. The children can be encouraged to disseminate such 

information in the community and in families. Every child has a right to preventive promotive and 

curative health care services and in addition vulnerable families require support for child care. 

Health education in the form a part of the routine life of the school contribution to the development of 

a right attitude among children towards health and to the inculcation of good health habits in them. Early 

detection of health related problems that are commonly occurring amongst primary school children and 

building of health awareness in the community through primary school children. 

Prepare and disseminate guidelines for school health programme . 

Guideline for the school health programme will be distribute at the school level for the better 

progress of the children to aware about the health and also work plan made through district by the state 

for the benefit of school children. 

Prepare detailed operational plan for school health programmes. 

1. State official/ district level to visit a government school in the area to make a comprehensive 

assessment of healthy life. 

98

2. Design a school health card which can be use for every student and a consolidation form so that 

it can have an assessment of the schools health at glance. 

3. A school responds to report of an outbreak of diseases in the village where the school is situated 

and ensure service delivery to all the school. 

4. An annual health checks with follow up and remedial action on illnesses identified and at least 

one annual checkup on dental and eye/ear. 

5. At least conduct 1/2 health awareness through health camp, health mela, health exhibitions etc. 

at the government schools under the districts especially when the challenges are greatest in the 

remote, most underdeveloped areas and in all the under-served areas of all the districts. 

6. The school health programme still not aware by the children at district level for which the IEC 

activities & preparation IEC materials to be done to promote the programme effectively in the 

state. 

7. School life provides several opportunities for health promotion and teaching. By careful 

planning, various activities can be successful. One option is to create a health club as a cocurricular 

activity. 

8. First aid kit distribute at all the schools for immediate remedy to cure at the spot and also 

distribution of IFA tablets to girls and six monthly distribution of albendazole for de-worming by 

the nodal school teacher. The school teacher will ensure the girls will consume IFA tablet in front 

of her. 

Implementation of school health programme in the state 

1 Implementing 5(five) school health programme in during the year at district level (5x8000) to 

make progress in the programme. 

2 Help children to learn health needs at particular age by organizing quiz competition/debate, role 

play/dramatization, drawing competition & visualizing a video shows/short films which all base 

on health issues, 5(five) health camps under the state during the year by selecting some remote 

and outreach areas of districts like East Kameng, Kurung Kumey, Upper Subansiri, Changlang 

and Tirap district. In basis of per programme into 2(two) days amounting Rs.1,00,000/- under the 

budget break-up:- 

a) Organizing quiz competition/debate/drawing competition. 

(Purchasing prize items for encouragement) - Rs.20, 000.00 

b) Arrangement of the camp programme & 

Materials expenses : Rs.30, 000.00 

c) Visualizing video shows/short films : Rs.10, 000.00 

d) Refreshment for the programme : Rs.10, 000.00 

e) DA/TA for the 

Health Specialists (3x1000x2days), 

ANM/GNM (2x600x2days), 

Teacher/ASHA (3x600x2), 

99

Health worker (2x600x2)and 

Medical officers (2x800x2) : Rs. 17,600.00 

f) Contingency – Rs. 12,400.00 

Total amount - Rs. 1, 00000.00 

3) Flip chart stand and exhibition board for the training, health club, meeting, camps etc. (Including 

duster) 200nos@2590. 

4) Preparation of 22000@30 monthly report card for out breaking of disease at school and to 

prevent the outcome of disease at early stage for the benefits of children especially at remote 

areas. 

5) The formation of a health club is one possible course of action to promote the health of school 

children. According to the available facilities, the individual schools may develop a suitable 

model. Health club activities yield dividends in the form of desired health behaviour changes 

among children who are future citizens. In the initial, the preparatory to formation of Health 

Club at the State Level as Core Group which would chair by Mission Director/Nodal Officer and 

also involving as a members from Professional in Health Sector, Co-ordinator of the Programme, 

Doctors, Teachers, ANM/GNM and member from Student Community by organizing a Meeting, 

Health Camp, Group Discussion and by IPC at District Level, further such health club could be 

implement at district level by forming/constitute the same. At glance child gets the benefits to 

Aware of various diseases outbreak time to time from this School Health Programme in a state 

(@30,000/- for per programme at once within the 16 districts). 

6) Preparation of health guidelines to distribute at district level to know how to promote the 

programme(2500x@170). 

7) Preparation of IEC materials like posters, pamplets/leaflet, hoardings, wall writing and wall 

board etc, to promote health awareness among the children at school level (including the tobacco 

free campaign which was initiated by the GOI in this matter). A fund lumsum amounting Rs.15, 

00,000(Fifteen lakhs) a side for this activities. 

8) Distribution of first aid kit to all the school (200 @2500). 

Monitoring progress and quality of services. 

The importance in monitoring is to be able to know at the school progress that children are making in 

relation to each other towards the goals of reduction in health care like water borne disease, universal 

access to safe drinking water and sanitation, malaria, dental, eye, Aids, TB, Leprosy, STI/RTI, 

Immunization and Adolescent. It is essential that the school health programme put in place is 

implemented with the requisite quality and scale needed to reach all students and make a significant 

impact. This system would not only measure the functioning of the programme but is an essential tool for 

further fine tuning and improvement. The fund should be keep aside for the monitoring and evaluation to 

become operational, a system needs to be developed and incorporated in the routine health monitoring 

system of 16 districts( @ 25,000/-). 

Strategy 2 F.2. Awareness on child health through IEC / BCC. 

The component is addressed under IEC / BCC separately. 

100

3. FAMILY PLANNING 

Objective 3A: To meet the unmet need of family planning from 14.3% (DLHS-3) to11% (Limiting 

15.6% to 10%and Spacing 3.5% to 1%) amongst the eligible couples by 2011. 

Strategy: 3A.1. Increase the number of service delivery points. 

Activities: 

The Depot holder of all the temporary methods will be put in place to 3595 ASHAs. The ASHAs 

will provide services at the village level except Cu T. wherever, the VHND is attended by ANM, CU-T 

insertion will also be provided. All the functional SCs (303), 85 PHCs, 31 CHCs and DH will provide the 

services on a fixed day for CU-T and every OPD day for other methods. About 30000 women will be 

covered with IUD. 

The refilling of required contraceptives will be ensured from PHC store for ASHAs and SCs. 

Compensation for IUD insertion by ANM and the beneficiary will be provided as per GoI norms 

(@ Rs. 20 for beneficiary & Rs 50 for ASHA). Necessary logistics for IUCD insertion kit at the facility 

level will be supplied (IUD kit) to SCs (303), 85 PHCs 31 CHCs during the year @ 5000/-. GoI may 

provide in kinds. 

Strategy:3A.2: To ensure availability of spacing / temporary method services in health facilities. 

Activities: Make temporary Methods available. 

All the functional health (SC, PHC, CHC and DH) will provide the temporary methods to the 

clients. Provision of IUCD, condoms and contraceptive pills will be made available in all the functional 

health facilities. The services will be provided on weekly basis at the facilities and during all outreach 

sessions, camps. The requirement has already been provided to GoI separately. 

The Emergency contraceptive pill also is provided to all the districts through ASHAs. The 

requirement for this year has also been projected already to GoI. 

The IUD camps will be organized as a part of RCH camp, MMU camp and Health Mela. The 

services will also be made available through Private Hospitals like RK Mission Hospital, Itanagar and 

Heema Hospital, Itanagar through accreditation. 

Training of manpower (MO & ANM/GNM) is underway and further training is proposed under 

training plan. 

Strategy: 3A.3 Implementation of sterilisation services by districts 

The dissemination workshop on family planning has been completed. Currently, the Sterilization 

(Laparoscope/minilap) services are provided in the FRUs and will be implemented further in all the 

101

functional facilities of the districts on fixed days weekly. The days will be notified and exhibited in the 

health facility as per the convenience of the facility. Necessary awareness generation will be created 

through IEC activities for utilizing the services. 

Provide sterilisation services on fixed days at health facilities in districts 

In 3 fully functioning FRUs and 8 DHs where Gynaecologist are in position, the sterilization 

services are provided on a fixed day weekly. In the functioning CHCs and PHCs, minilap sterilization will 

be provided. Training on minilap for MOs of CHC and PHC, and laparoscopic sterilization training for 

Gynaecologist are proposed under training section.The estimated nos of cases is 1200 during 2010. 

The minilap set will be provided to24x7 PHCs and CHCs only where trained manpower are 

available. 25 sets may be provided in kinds by GoI. Laparoscopes will be maintained by RKS. 

All the FRUs where NSV trained doctors are available will provide NSV services on the same 

day. However, no set requirement is projected. 

Strategy:3A.4 .NSV & Lap-Ligation camps. 

Activities: 

NSV camps will be organized twice every district during the year(n=32) along with female 

sterilization camp. Sufficient IEC activities will be carried out prior to these camps. However, the NSV 

procedure which is not popular and acceptable to the local population will also be combined together. 

The camp will be clubbed with sterilization camps. 

For an approximately 2000 cases of female sterilization, Laparoscopic Ligation camps will be 

organized twice a year in all the districts at GoI norm @ Rs 15000/ per camp. 

Required instruments / equipments are available for the year. Required Silastic ring will be provided 

to all the facilities where laparoscopic sterilizations are carried out. The requirement has already been 

projected and sent to GoI separately. 

Provision for Prompt payment of compensation of sterilization will be made. The total compensation 

money required is for 3200 cases @ Rs 1000/ per case for female sterilization.Due to lack of male 

sterilization cases, no compensation is budgeted. 

The mobility support to sterilization team may be provided for 32 camps @ Rs 8000/. 

Strategy: 3 A.3: To raise awareness amongst the couples and communities about the advantage of 

contraceptives and small family. 

Activities: 

Communication activities will be developed to be used by AWW, ASHA, PRIs as per need of the 

locality. Family planning counseling will be ensured by ASHA & ANMs during Post partum care, home 

102

visits and VHND and also at the sub center during visit of the women for immunization, care of the 

children etc to meet the unmet need of contraception and also need of small family. This will be taken 

during RCH camp, MMU etc. 

The details of IEC / BCC activities are provided separately. 

Strategy: 3 A.4: Monitoring progress quality and audits by QAC for all services under FP. 

Activity: 

Reviewing of reports of maternal, child health and family planning and insurance scheme 

quarterly during review meeting at state and at district level will be ensured. The estimated rate is Rs 

50000/- per review meeting.(Budgeted under QAC component) 

Inspection of facility centre 6 monthly in each facility for infrastructure and ski9ll manpower 

availability including exist interview of the beneficiary. This will be done by the respective District QA 

committee. The estimated cost would be Rs 5000/-x 16 districts. (Budgeted under QAC component) 

Test inspection by state QAC to facility of Papum Pare and East Siang District @ Rs 20000/-. 

(Budgeted under QAC component) 

Orientation training for the members of QAC at state and at Districts would be conducted during 

2010. The fund required is Rs. 20000/- for state and Rs 160000/- for districts @ Rs 10000/-.(Budgeted 

under QAC component) 

Ranking of districts as per the performance will be initiated. 

4. ADOLESCENTS REPRODUCTIVE & SEXUAL HEALTH 

Objective:4A: Establish integrated health initiative for adolescent on reproductive health, nutrition 

and reduction of anemia in adolescents. 

Strategy:4A.1: Provide adolescent health services in designated health institutions by improving 

facilities and making equipped of health institutions. 

Activities: 

Adolescent clinic established at all the 10 District Hospitals, 12 GH and 1 CHC. Required 

manpower like Counselors are already in place under APSACS. The service will be provided once every 

week on a fixed. A micro-plan will be prepared for improving the service delivery. 

Provision for providing IFA tablets during counseling to adolescents girls at the functional 

facility level will be ensured. 

The details are addressed in IEC component in details. 

103

Objective 4B: To increase awareness among the target group regarding reproductive and sexual 

health. 

ARSH services will be implemented for all adolescents, married and unmarried girls and boys as 

per the need of target groups on sexual behavior particularly unprotected sex, teenage pregnancy, child 

birth, unwanted pregnancy, unsafe abortion, risk of contacting RTI/STI, malnutrition and substance 

abuse such as alcohol, illicit drugs, tobacco etc which will all be imparted in an adolescent friendly 

manner through FGD, counseling, advocacy, IPC, plays, dramas, skits etc in the schools. 

ARSH services will be addressed as per the needs of all Adolescent sensitivity. Adolescent are of 

different ages married and unmarried adolescent, those in school and those out of school, vulnerable 

groups like street children and those experimenting with drugs. These needs are correspondingly 

heterogeneous and hence will provide different types of services according to the awareness level of the 

adolescent groups. 

Implementation of Adolescent Health Programmes has been prepared keeping in mind the 

awareness level of Adolescent groups in state. Activities have been planned and prepared as per ARSH 

guidelines to ensure adolescent friendly services in the state. 

Also programmes like Capacity building, Orientation programmes and trainings will be 

incorporated to service providers at state level in order for them to be able to provide the adolescent 

services effectively. 

ARSH programme has been incorporated along with the school health programmes. The effective 

tools are IPC, FGD, group meetings, counseling, songs, plays & dramas, extempore speech, workshop, 

seminar, exhibition etc. by making participation of various adolescent groups in the programme. 

Activities: Adolescent friendly services 

Disseminate ARSH guidelines: 

GoI guidelines have been received and necessary reprinting would be done (5000 copies) @ Rs 

160/- per piece and disseminated to the districts during the year. 

Prepare operational plan for ARSH services under the state guidance. 

• Training manuals have been received from GoI and will be reprinted (3000) each i.e. 9000 

copies @ Rs 160/- per piece to be used in training of service providers which is very vital and 

distributed in every district during the year and necessary translation done if needed. 

• In order to spread wider awareness on ARSH among the community who is still very ignorant 

about it, advertisement with various messages on ARSH will be printed in different forms and 

disseminated in the state and the districts during the year. Printing of posters 5000 nos. @ Rs 

25/- per piece, leaflets 10000 nos. @ Rs 6/- per piece, pamphlets 10000 nos. @ Rs 12/- per 

piece, calendars 5000 nos. @ Rs 80/- per piece and hoardings 3000 nos. @ Rs 15000/- per 

piece with various ARSH messages to be distributed in schools and unreached places in the 

districts during the year. 

• Capacity building/ Orientation for Service providers at state level will be conducted in order 

to better understand the importance of ARSH and thereby imparting it during training. 

104

Capacity building/Orientation programme will be organized for 2 days through Specialists, 

Senior Medical Officers and Programme officers @ Rs 151605/- per Orientation in the state 


• Orientation programme hand outs and facilitators guides have been received from GoI which 

will be reprinted, 2000 each from all the 4 (four) nos. of handouts and guides i.e. 8000 nos. 

@ Rs 200/- per piece which will be used in Capacity building/ Orientation programme of 

service providers in the state during the year. 

• Meetings/ Orientation for District Management at state level. 

• Community Mobilization programmes at unreached places. 

• Drug supplies, IEC materials will be distributed in all the schools, colleges and other 

educational institutions in every district and the state during the year. The financial 

involvement for this will be Rs 5 lakhs approximately. 

• Maintenance and up-gradation of Health facilities. 

• Inter-departmental Collabrations. 

• 

Implement ARSH services in the districts. 

The ARSH services will be implemented in the identified schools in the districts in corporation 

with District Health Society during the year. The main objective will be to provide correct information 

about their health care as per the target groups on sexual behaviour particularly unprotected sex, 

teenage pregnancy & child birth, unwanted pregnancy & unsafe abortion, risk of contacting RTI/STI, 

malnutrition & substance abuse such as alcohol, illicit drugs and tobacco etc. by using effective tools in 

the form of counseling, advocacy etc as per the awareness level. 

Setting up of Adolescent clinic at health facilities: 

All the District / General Hospitals (14) have counselors from APSACS. As per discussion with 

APSACS officials, all this 14 DH /GH will be identified as Adolescent clinic initially. Necessay training 

will be imparted by District Health Society in corporation with APSACS to the counselors and the MOs 

on various issues of ARSH. 

Monitoring progress, quality and utilization of services. 

The monitoring committee at state and district level will monitor the progress and will ensure 

quality is maintained as required under the guidelines. Further, the utilization pattern will be 

analysed by the committee. The financial involvement for monitoring will be Rs 25,000/- per 

monitoring during the year. 

105

DISTRICT QUALITY ASSURANCE COMMITTEE (DQAC) 

Objective:6A: Establishment of a Integrated Quality Assurance Committee for MH, CH and FP. 

Strategy – 6 A.1.: Formation of QA Committee at district 

The integrated QA Cell is identified at the office of the Jt DHS (FW) at state level. 

Activities Status 

Formation of the Quality Assurance Committee in the district 16 

Dissemination of manuals on standards and quality assurance in 

16 

sterilization service 

Training of the members of the Quality Assurance committee in Not done 

quality standards, quality assessment, benchmarking and grading of 

institutions 

Monitor and review the progress on implementation & dissemination Irregular 

of standards at the facilities all facility institution 

Reporting of all monitory & supervisory activities with results Irregular 

Conduct medical audit of all deaths related to sterilization and send Not done 

reports to the State QAC office. 

Strategy – 6 A.2: Formation of QA Committee at State. 

The integrated QA Cell is identified at the office of the District Medical Officer at District level. 

level. 

Activities Status 

Formation of the Quality Assurance Committee in the district Yes 

Dissemination of manuals on standards and quality assurance in yes 

sterilization service 

Training of the members of the Quality Assurance committee in Not done 

quality standards, quality assessment, benchmarking and grading of 

institutions 

The ToR for establishment of cell may be provided by GoI for implementation at state and district 

Strategy – 6 A.3: Monitoring by QA Committee at State and district. 

Reviewing of reports of maternal, child health and family planning and insurance scheme 

quarterly during review meeting at state and at district level will be ensured. The estimated rate is Rs 

50000/- per review meeting. 

Inspection of facility centre 6 monthly in each facility for infrastructure and ski9ll manpower 

availability including exist interview of the beneficiary. This will be done by the respective District QA 

committee. The estimated cost would be Rs 5000/-x 16 districts. 

Test inspection by state QAC to facility of Papum Pare and East Siang District @ Rs 20000/-. 

106

5. URBAN RCH 

The urban health scheme was implanted in the state since 2006-07. Therefore, as per GoI 

guidelines, no town in the state is eligible for such scheme. However, GoI approved the proposal for 2 

UHCs with special consideration on the basis of very low population density in the state. The proposal 

envisages upgrading and continuation of the existing health service delivery system in the identified 

urban areas of Arunachal Pradesh under Urban Health Program. 

The budget which was approved last year has been spent in toto as it was only the salary 

component. The current proposed increased is due to the equivalent increase in the pay as per 6 th pay 

commission of the manpower in position. The table is as below: 

Total Population of the State 

State Details 

10, 91, 117 

% of Urban Population 20.41% 

% of total urban slum population (taking urban slum 

population as denominator) 

NA 

% of total urban non-slum poor population (taking 

urban population as denominator) 

NA 

Total no. of urban areas/ cities with population 

1 (Itanagarbetween 

1 to 10 lakhs. 

Naharlagun) 

Out of these, no. of Cities/ urban areas covered under 

2 

urban RCH 

Total urban slum population of covered cities NA 

Total no of Urban Health Centers in covered cities Functional 2 

Non- functional 0 

Total no of Urban Health Centers in covered cities In Govt. owned buildings 2 

Total no of Health Personnel in covered cities 

(Itanagar & Pasighat) 

107 

In rented buildings 0 

Medical Officers 48 

Lab. Tech. 10 

ANMs 52 

LHV/ PHN NA 

Assistant 

Others 

Details of trainings conducted so far IMNCI, 

Details of Programmes being run by other funding 

partners 

Sl. No 

City Level Details 

1 2 

Name of cities/ urban areas 

with population between 1 to 

10 lakhs covered under urban 

RCH 

Itanagar Pasighat (Pop. Less than 1 lakh) 

Total population 121750 87397 (2001 Census) 

% of urban population 27.10% 

(61882) 

25.13% (21965) 

% of total urban slum Slum Pop. Data Slum Pop. Data NA

population (taking urban 

population as denominator) 

% of total urban non-slum 

poor population (taking 

urban population as 

denominator) 

Total no of Urban Health 

Centers 

Total no of Urban Health 

Centers 

Total no of Health Personnel 

in covered cities 

Financial status 2009-10 

Objective 

Coverage 

NA 

NA NA 

Functional 1 1 

Nonfunctional 

Nil Nil 

In Govt. owned 

buildings 

1 1 

In rented 

buildings 

Nil Nil 

Medical 

Officers 

27 21 

Lab. Asst. 8 2 

ANMs 34 18 

LHV/ PHN - - 

Assistant - - 

Others - - 

Amount proposed Approved Expenditure 

Rs 22.28 lakhs Rs 22.28 lakhs Rs 22.28 lakhs 

i. To provide integrated and sustainable system for primary health care delivery with a 

focus on urban poor living in slums and other health vulnerable groups in Itanagar- 

Naharlagun, and Pasighat. 

ii. To enhance capacities among NGOs/ stakeholders to plan and implement urban health 

program effectively. 

iii. To strengthen linkages between communities and primary health facilities and referral 

system from primary to secondary facilities. 

iv. To improve health status of the urban poor by increasing reproductive child health 

services coverage. 

v. Involvement of local NGO partners in running UHC. 

A. Itanagar-Naharlagun 

The capital complex as is popularly known bears cosmopolitan characteristics in terms of 

settlement pattern and the domicility of its inhabitants. The city has the highest urban population in the 

state and has the largest concentration of slum dwellers amounting to whooping decadal growth rate of 

100.17 %. The population of the city has increased by leaps and bounds on account of a steady trend of 

migration from the rural areas. Being a commercial hub of the state and contiguous with Assam, there is 

108

a sizeable chunk of floating population like construction workers, petty traders and daily laborers. Slum 

dwellers and floating population constitutes about 25-30 % of the population. 

There are few concentration of slums along the river Pachin. Settlement takes place during 

winter when the river bed becomes dry but in summer, the settlement areas are washed away due to 

monsoon. A few cluster of slums are found around the national highway and are vulnerable to demolition 

and eviction 

Existing Public Sector Health facilities 

There are 2 Dispensaries and 8 HSC. These centres provide irregular antenatal care and 

immunization services. Only two centres provide immunization service on weekly basis for DPT / OPV, 

DT, TT and Measles vaccine. BCG is not administered in all these centres, for which the baby has to be 

taken to FRU (General Hospital, Naharlagun). These centres are not able to provide their mandated 

services to full because of the limited staff (either due to vacancies / ANM or other staff moved to other 

health centres) 

Only one 2 nd tier Hospital (GH, Naharlagun) is running to full capacity with a considerable 

number of RCH related cases being returned due to shortage of manpower and space 

B. Pasighat 

Pasighat, the headquarters of East Siang District has the second highest urban population in the 

state and concentration of slum dwellers amounting to a decadal growth rate of 50.09% on account of a 

steady trend of migration from the rural areas, floating population particularly from the adjoining 

districts of the upper Assam and Bihar constituting about 30% of the total population. They are 

concentrated in areas like Banskota Colony, Leprosy Colony, GTC Colony, Mirku, Mirbuk , Mirsam, 

Muri line, 21 mile, Dapi, pakok, Tigra, Roing, PI Line, Solung ground colony, 2 mile area etc. 

Service Delivery Model 

The ongoing schemes and provision for the health infrastructure in the urban areas were 

focusing mainly on providing family welfare services. These facilities have been partially effective in 

delivering free vaccination services, antenatal care/ post natal care, and family planning services. 

Therefore, the Government of Arunachal Pradesh proposes this service delivery model for outsourcing to 

the already working partner NGOs at Naharlagun/Itanagar and Pasighat. 

Packages of Services 

A. Urban Health Centre (UHC) 

The proposed service that would be provided in the first tier health facility is as follows: 

1. Delivery services. 

2. Antenatal care, postnatal care, referrals for institutional deliveries. 

3. Immunizations 

4. Family planning, IUD insertion and referral for terminal methods 

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5. Laboratory services. 

6. Treatment of minor illnesses including RTI / STI. 

7. Depot holder for ORS / contraceptives. 

8. Health education and outreach service. 

9. Services under NAMP, DOTS etc. 

10. Targeted IEC, BCC and training. 

Apart from the above proposed services, the UHC staff will perform additional role in conducting 

scheduled outreach camps in coordination with link volunteer, assess field situation to develop plans with 

NGO & link volunteer, determine the process to be adopted for sustainability of the health centre (e.g. 

user fees) and conduct activities linked to National Programs. 

Each UHC will operate for 8 hours per day from 8 AM to 4 PM on 5 days a week. Outreach 

service will be conducted on every Saturday. Medicines, equipments, other consumables etc will be 

provided for the existing 2 UHCs. 

Human Resources 

The following existing filled up posts per UHCs would continue. 

LMO - 1 

ANM - 3 

PHN/SN - 1 

Data Assistant - 1 

Laboratory Assistant - 1 

Night Chowkidar - 1 

Male attendant - 1 

Female Attendant - 2 

Sweeper - 1 

Infrastructure improvement: 

On the basis of experience, it is proposed to provide a functional labour room to both the UHC 

@ 3 lakhs (Total 6 lakhs) 

Community Level Activities 

1. The identification process is completed and 30 LV will continue at Naharlagun and 19 link 

volunteers for Pasighat. The responsibility of mobilization and identification of the Link 

Volunteers would be entrusted to the partner NGOs. The link volunteers are central to the 

outreach sessions and regular updating of data in the urban area. The selection was made 

one LV per 1000 population in the original project and approved. 

2. The link volunteer will receive an amount of Rs. 500/- per month. 

3. The link volunteer will be provided all the trainings provided to the ASHAs and locally 

arranged recurrent workshop / orientation etc on NRHM. 

4. The NGO coordinator would continue. They will lead the LV for any activity planned for the 

UHC. 

110

Outreach Activities 

As per records available, there have been activities in relation to outreach service. Therefore, in 

order to further improve coverage, to provide quality service and to establish good relationship with the 

target community, a fresh outreach plan is proposed: 

1. Outreach camps would be conducted fortnightly in all the slum areas. 

2. On the basis of ‘fixed day approach’, the camp would be conducted on every Saturday. 

3. Every UHC shall constitute 2-3 teams to conduct 2-3 different camps every week. 

4. On account of mobility support, a vehicle each can be hired on camp days which will 

include delivery of vaccines. 

5. The designate partner NGO shall support the UHC staff through community 

mobilization, focused IEC and BCC activities. 

6. Along with 6 monthly report / review, monthly reports will be reviewed 

IEC/BCC Activities and Capacity Building/ Training will be covered under RCH II as a whole. 

Coordination and Convergence and Monitoring and Evaluation Plan will be same as in NRHM. The HR 

Plan will be addressed under NRHM umbrella. 

Budget requirement for this year: 

Sl Designation /Items Quantity Rate Total 

1 Manpower 

LMO 2 36000 864000 

PHN/SN 2 20000 480000 

ANM 6 15000 1080000 

Data Assistant 2 14500 348000 

Laboratory Assistant 2 15000 360000 

Night Chowkidar 2 5000 120000 

Male attendant 4 5000 240000 

Female Attendant 2 5000 120000 

Sweeper 2 5000 120000 

Contingency expenses 2 2000/month/UHC 48000 

2 Outreach session 48 800/ session 38400 

3 NGO Co-ordinator 2 6500 156000 

4 Link Volunter 49 500 294000 

6 Infrastructure 

Labour room 2 300000 600000 

Grand total 48,68,400/- 

Therefore, total amount required for 2 Urban RCH is Rs. 48, 68,400/- 

6. Tribal RCH 

7. Vulnerable Groups 

Vulnerable communities in Arunachal Pradesh include those groups who are underserved due to 

problems of geographical access, population in border areas and those who suffer social and economic 

disadvantages and the urban poor. The RCH indicators for slum population are worse than the urban 

average. Marginalization results in poorer social indicators for these groups, including maternal and 

111

child health indicators. This can be as much a result of service provider behavior as of health seeking 

behavior and capabilities due to the following: 

Poor connectivity to health centers because of distance, topography, and lack of public transport. 

2 Lack of suitable transport facility for quick referral of emergency cases 

3 Location disadvantage of Sub-Centres, PHCs, CHCs 

4 Social and cultural barriers especially for women 

5 Several areas in the state are accessible only through air sorties. 

6 Scarcity of funds for non-salary expenditures 

7 Lack of appropriate HRD Policy to encourage / motivate the service providers to work in remote 

tribal areas 

8 Poor work environments and dissatisfaction amongst the workforce; 

9 Understaffing of several remote or even semi-remote facilities; 

10 Weak monitoring and supervision systems. 

However, the issues are in separate heads and the state being a vulnerable state, all the proposal 

are for vulnerable group of population. 

8. Innovations/Public Private Partnership (PPP)/ NGO 

8.1. Public Private Partnership (PPP) for PHCs 

The PPP project has been the most successful initiative undertaken by the state under NRHM 

Program. The project was extended for another year by signing revised between state and 4 NGOs 

namely; Voluntary Health Association of India, Karuna Trust, JAC Prayas and Future Generations 

Arunachal. 

The PPP project has been evaluated by RRC –NE and the final report will be published shortly. 

Achievements 

Issues 

• Immunization, Institutional Delivery, ANC Coverage, Family planning methods etc. ANC 

coverage has increased. 

• Institutional Delivery has increased. 

• All the PHCs managed under PPP are now run on 24 x 7 basis. 

• Minor operations have also been carried out in the OT, Laboratory services are also 

being performed with facilities for pathological & biochemical investigations, like tests 

for malaria,TB etc. 

• The project has also contributed in family planning services to people for use of any kind 

of contraception. 

• Many outreach activities and Health Melas have been conducted. 

• RKS/PHC management committees have been constituted and functioning well. 

• All the SCs under PPP PHCs are functional are now functional. 

• Awarded best state for PPP by GoI in 2007. 

• VHSC and VHND are functional in all the villages falling under PPP PHC area. 

a. Manpower Drain: Turn Over of staff due to lack of job security under NGO. 

b. User charges 

c. Public participation 

d. Field visits / Outreach sessions. 

112

e. Reporting – M&E, status, manpower etc 

f. Difficult geographical terrain, communication bottlenecks, remote villages. 

g. Attractive package difficult/ limited due to resource constraints for staffs 

Duration / extension of the project. Expansion 

It is proposed to extent the PPP Project upto the Mission period i.e 2012. On approval, revised MoU 

will be signed with the NGO. 

Financial involvement 

All the 16 PHCs run by NGO under PPP are providing excellent Primary Health Care services to 

the rural population. An amount of Rs. 3008372 (Rupees Thirty lakhs eight thousand three hundred 

seventy two) only per PHC per annum is provided to the NGO. The grant in aid is made by the GoI under 

the RCH Programme. 

Public Private Partnership (PPP) For Community Health Centre as FRU 

a. The Project 

The project proposes to continue 1 (One) CHC at Deomali in Tirap District under the already 

existing Public Private Partnership on a pilot basis for improving the health care delivery system of the 

remote areas mainly border areas or Arunachal Pradesh. 

The existing health delivery system in the state relies on the Government health infrastructure. In 

the light of the increasing expectations of the people, and with the main objective of improving and 

reforming the health delivery system, the state government has envisaged the proposed model of Public 

Private Partnership. 

The strategic objective of the project is to provide to the people residing in the Community 

Health Centre area with quality clinical and preventive health services, and at the same time effectively 

implementing the National Rural Health Mission. The Project will also increase the people’s and the 

community’s participation in the community and public health management. 

Service Delivery: 

The Agency shall be responsible to provide the following services: 

a) 6 days OPD service 

b) Emergency services (24 Hours) 

c) Ante-natal and Post-natal Clinics 

d) 24 – hour delivery services 

e) Emergency Obstetric Care including surgical interventions like Caesarean Section 

f) Full range of Family Planning Services including Laparoscopic Sterilization Services 

g) Safe Abortion Services 

h) Treatment of STI / RTI 

i) Blood storage facility 

113

j) New-born care 

k) Emergency / Inpatient care of sick children 

l) Immunization Sessions 

m) Essential Laboratory Services 

n) Referral service. 

o) General Surgeries. 

p) Waste disposal arrangement as per pollution control board norms. 

q) Essential drugs. 

r) Participation in and implementation of National and State Programs of Health & Family 

Welfare including, inter alia, NRHM, RNTCP, NVBDCP, NACP etc. 

s) Outreach camps 

MANPOWER REQUIREMENT 

To provide the services , the minimum staff deployed would be as under. 

Personnel 

Minimum 

requirement 

General Surgeon (Specialist) 1 

Obstetrician/Gynecologist 1 

Medicine specialist / Pediatrician 1 

Anesthetist 1 

Medical Officer (MBBS) 3 

Medical Officer (AYUSH)) 1 

Dental Surgeon 1 

Staff Nurse 7 

Pharmacist 1 

Lab. Technician 1 

Radiographer 1 

Health Assistant 2 

Ophthalmic Assistant 1 

Statistical Assistant/Data Entry Operator/ Office Assistant / Registration Clerk 2 

Driver 1 

Ward Boy/ Nursing Assistant 2 

Dresser 1 

Chowkidar 1 

OPD Attendant 1 

OT Attendant 1 

Sweepers 2 

Cook 1 

d. Modalities of Implementation 

The State Government shall hand over the building and physical infrastructure of the CHC(s) to 

the Agency along with the existing equipment, furniture, etc. and an inventory of the same would be made 

jointly by the State Government and the Agency. The conditions of the building/equipment handed over 

114

will be duly recorded. The Agency will maintain the said building/equipment with due care as would be 

reasonably expected. 

The Agency shall provide all the Health/Medical/Family Welfare Services, curative and 

preventive/promotive, as are normally expected from any Community Health Centre, to the local 

population residing in the geographical area under the jurisdiction of the said CHC(s). The Agency will 

engage its own Medical/Paramedical/other staff for providing these services. 

e. Hospital Management Committee 

A Hospital management committee to be constituted at the CHC level comprising representatives 

of the Agency, District Medical Officer, District RCH Officer, Deputy Commissioner or his nominee (not 

below the level of Circle Officer) and not more than three representatives from the Anchal Samitis in the 

Area. When the number of Anchal Samitis is more than three, the names of the three nominees and their 

term in the PHC Management Committee will be decided by the Anchal Samiti Members themselves and 

communicated through the Deputy Commissioner. At least one of the Anchal Samiti nominees would be a 

lady. The local MLA of the area would be a permanent Special Invitee to the PHC Management 

Committee. Such other officers, as required and necessary (for example, Child Development Project 

Officer, Assistant/ Junior Engineer from Works Department) can also be special invitees to the said 

Committee. 

The RKS under NRHM will also be constituted in the CHCs and will follow the NRHM 

norms. 

f. Accountability: 

It is mandatory for every CHC to have “Rogi Kalyan Samiti” to ensure ccountability. Every CHC 

shall have the Charter of Patients’ Rights displayed prominently at the entrance. A grievance mechanism 

under the overall supervision of Rogi Kalyan Samitis would also be set up. 

g. Review and monitoring structure 

A CHC Management Committee which will also function as a Rogi Kalyan Samiti (RKS) would 

be constituted for the CHC .The said committee will include Agency representatives, District Medical 

Officer, District RCH Officer, Deputy Commissioner or his nominee (not below the level of SDO), Zilla 

Parishad Member, two representatives from Anchal Samiti and two each from each Gram Panchayat in 

the area served by the CHC. The names of these PRI members will be communicated through the Deputy 

Commissioner. At least one of the two nominees from the Anchal Samiti and each Gram Panchayat would 

be a lady. The local MLA of the area would be a permanent Special Invitee to the CHC Management 

Committee. Such other officers, in addition to those already included in the RKS, as required and 

necessary (for example, Child Development Project Officer, Assistant/ Junior Engineer from Works 

Department) can also be special invitees to the said Committee. 

The CHC Management Committee / RKS would meet at least once in every two months and will 

be responsible for guiding/monitoring the project as per RKS guidelines issued by GoI / state 

Government. It will address local issues and problems as are normally expected from such a Committee. 

115

The term CHC management committee and the Rogi Kalyan Samiti (RKS) are being used 

interchangeably. 

At the State level, a Steering Committee chaired by the Commissioner & Secretary (H&FW) 

along with suitable representation from all stake holders including the Agency, Central Government and 

other State Government Departments will be formed. This State level steering committee will meet at 

least once, every six months. It will review the work done at the CHC, suggest suitable improvements and 

midcourse corrections, and resolve the difficulties faced by the Agency in running of the CHC as FRU. 

Evaluation 

The Government would evaluate the success of the pilot project in providing improved health 

services to the people. The Agency will also be encouraged to undertake internal evaluation. 

Project Funding 

The Fund required for the purpose shall be met from the RCH II budget. The Agency will receive 

funds from the Government, towards meeting the cost of Personnel, Drugs (Medicines), Reagents, 

Surgical Material, Health Care Consumables, Administrative Charges, Civil Works, Furniture, 

Equipment (including Surgical Equipment 

The funds required, per annum, for operating and managing the CHC as FRU would be as 

follows. 

A. Manpower 

Personnel Minimum requirement 

General Surgeon (Specialist) 1 

Obstetrician/Gynecologist 1 

Medicine specialist / Pediatrician 1 

Anesthetist 1 

Medical Officer (MBBS) 3 

Medical Officer (AYUSH)) 1 

Dental Surgeon 1 

Staff Nurse 7 

Pharmacist 1 

Lab. Technician 1 

Radiographer 1 

Health Assistant 2 

Ophthalmic Assistant 1 

Statistical Assistant/Data Entry Operator/ Office Assistant / Registration Clerk 2 

Driver 1 

Ward Boy/ Nursing Assistant 2 

Dresser 1 

116

Chowkidar 1 

OPD Attendant 1 

OT Attendant 1 

Sweepers 3 

Cook 1 

34 

1. Medicines and other Healthcare Consumables: 

Items Maximum fund per annum 

Medicines - Rs.3,00,000/- 

Materials & Supplies - Rs. 30,000/- Rs. 4,53,349/- 

Laboratory Reagents, - Rs. 10,000/- 

Kits./Surgical Items - Rs. 113349/- 

2. Maintenance, Furniture, Equipment: 


Civil Works(Maintenance)- Rs.1,00,000/- 

Office furniture - Rs. 50,000/- 

Rs. 5,50,000/- 

Hospital furniture -Rs. 1,00,000/- 

Surgical Equipments -Rs. 3,00,000/- 

3. Other Administrative Charges: 


Water & Electricity - Rs. 10,000/- 

Diet - Rs 50000/- 

Rs. 1,50,000/- 

Ambulance Services - Rs. 90,000/- 

Total maximum fund per annum (Rs) = 1 + 2 + 3 

Total fund required for 1 (one) year is: 

( Rupees Fifty six lakh and SixtyNine) only 

= 453349 + 550000 + 150000 

= 1153349 / - 

= Rs 4446720 + 1153349 

= Rs 5600069/- 

Maximum funding figures indicate the maximum amount that the Government will provide under 

the respective head. 

117

Performance Monitoring and Standards of Service 

The performance of the Agency will be monitored largely on the basis of output based indicators. 

These indicators and performance standards can be suitably expanded and/or modified after mutual 

consultation and in the interest of better service delivery to the general public. The indicators and 

standards specified for the health delivery expected from the Agency are the minimum standards. The 

Agency would be encouraged to serve as a role model and to provide services at a much higher standard. 

External evaluation has been done for existing 16 PHCs under PPP and it is proposed that such 

evaluation will be carried out after 2-3 years. 

8.2. Mother NGO 

MNGO SCHEME 

There are two MNGO’s namely voluntary health association of Arunachal Pradesh (VHAAP) 

and Nani Sala Foundation (NSF) are functioning under RCH programme in the state covering 

3(three) districts.The performance has been evaluated and the recommendations will be taken care of 

in improving the services. 

The performance has been 

A) Functioning MNGO’s:- 

VHAAP 

The functioning of MNGO scheme was started from Sept’06 till the date covering two 

districts (West Kameng and East Kameng district) 

The NGO has completed baseline survey of the district and selected 6 FNGOs and 

functioning in two districts and the state has been already released Rs. 45 lakh for the said 

scheme to the VHAAP. The estimated budget required for implementation of MNGO scheme the 

two districts is Rs. 30 Lakhs for this current financial year 2010. 

NSF 

The functioning of MNGO scheme was started in the year 2007-08 covering 1 district 

(Papumpare). The NGO has completed baseline Survey of the district identified and selected 4 

FNGOs. The NGO was funded Rs. 1 lakh expenditure and utilization certificate has already been 

submitted. The NGO has submitted composite project proposal for 3 years comprising activities 

of MNGO and 4 FNGO. 

The proposal is for underserved areas. The proposal is based on baseline survey of the 

areas. The proposal has well defined objectives, strategies activities and monitoring 

arrangement. 

118

It is proposed to continue and approved the comprehensive project proposal for 

implementation of MNGO scheme in papumpare district. The estimated budget of project 

proposal is Rs. 45,21,400/-. 

B) New MNGO- 

It is process for 6 districts under MNGO scheme. 

The proposal of 5 NGOs for selection of MNGO have been already done at desk review 

and field appraisal. The baseline survey of the proposed district by MNGO will be completed and 

to be continued the said scheme. 

8.3. PNDT and Sex Ratio 

There is State and District level PC & PNDT committee at the State and district level. The 

PC&PNDT cell is in operation in the state level as well as at the district level. The cell is in place. 

Dissemination workshop on PNDT will be conducted at the state level and district level. The fund 

required will be Rs. 50,000/- for state and Rs. 25,000/- per district. 

There will be sensitization workshop 1 (one) at State level for the women in collaboration with 

Arunachal Pradesh Women Welfare Society and State Women Commission of Arunachal Pradesh for 1 

day at Itanagar and the fund required is Rs 1 Lakh. 

The State level PC & PNDT Committee review meeting will be held in the 2 nd quarter of 2010. 

Similarly, the District level PC & PNDT meeting will be held during 2nd quarter 2010. Budget 

requirement is Rs 1 lakhs for state and Rs 8 lakhs (@ Rs 50000/) per district during the year. 

In the State, 18 (Eighteen) ultra sonography clinics have been registered and 2 (two) are under 

process for registration. There is no record of violating PC & PNDT act in the state so far. 

9. Infrastructure and Human Resources 

9.1. Contractual staff & services 

9.1.1. ANMs recruited and in position 

The existing 112 numbers of ANMs recruited under RCH and will continue. 

9.1.2. Laboratory Technicians recruited and in position 

The existing 30 numbers of Laboratory Technicians will continue and new 30 LTs will be 

engaged on contract. 

9.1.3. Staff Nurses recruited and in position 

The existing 60 numbers of Staff Nurses will continue. 

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9.1.4. Specialist (Anaesthetists, Paediatricians, Obs/Gyn., Surgeeons, Physicians) recruited and in 

position 

There is no specialist recruited under RCH 

9.1.5. Others (specify) recruited and in position 

The existing 2 nos. Statistical Investigator will be continue . 

The following consultants will continue 

1. one Consultant (HMIS). 

2. One Consultant(Training) 

New proposal for engagement of the following: 

1. One Consultant (Procurement & Logistic) 

2. One Consultant (HR) 

9.2. IMEP 

As per the requirement under Pollution Control Board guidelines, the IMEP will be 

implemented at the districts. There are 13 FRUs in the state comprising 10 DHs, 2 GH and 1 CHC. Out 

of 13 hospitals, 4(four) facilities are already having Incinerators and remaining 9 FRUs are not 

implementing IMEP. 

It is proposed to establish 9 Incinerators in 9 FRUs during the year @ Rs.25 lakhs per unit 

The budget is proposed under NRHM additionalities. 

The training component will be address by the companies providing the machines. The 

recurrent expenditure for providing logistics for IMEP will be met locally through RKS. 

10. INSTITUTIONAL STRENGTHENING 

10.1. Human Resources Development/HR Plan 

Human Resource is one of the most critical issue and difficult to manage in the state. This is 

due to non-availability of skilled manpower for recruitment, uneven location of manpower in the facility 

and many facilities are located at remote and hard areas. 

10.1.1. HR Consultant(s) recruited and in position 

At present there is no HR consultant at position. As Human resource being one of the key inputs 

and keeping in view of the present status of Human Resource and future recruitment in the state on 

contract, the human resource related activities are increases many fold. Looking at this vastness, HR 

Consultant on contract is the need of the hour, while strengthening the health care workforce. 

The Human Resources Management (HRM) function includes a variety of activities, and key among them 

is deciding what staffing needs the program has, recruiting and training the best employees, ensuring 

they are high performers, dealing with performance issues, and ensuring personnel and management 

practices conform to various regulations. Activities also include managing approach to employee benefits 

and compensation, employee records and personnel policies, for all these functional activities it is 

proposed to recruit one (1) Consultant-HR on contract to manage the Human Resource. 

120

Brief Summary of job: HR Consultant shall assist and provide necessary support to the HR activities at 

state level. Consultant will manage, organize, and update relevant HR data with proper planning, 

strategy formulation, and supporting implementation of the HRM activities in coordination with Mission 

Director (NRHM) & Nodal Office/State Programme Manager. 

Detail TOR is placed below 

Further, Consultant (HMIS) and Consultant (Trg) will be continued in the programme and they will look 

after their respective assigned duty. 

Job title Consultant (HR) 

Eligibility criteria Essential MBA in Human Resource Management from any UGC 

recognized University or 2 years Post Graduate Diploma in 

Human Resource Management from UGC recognized University 

/ AICTE recognized Institute with atleast 50% marks. 

Having 3-5 years working experience in HR management/Health 

Programme Management / externally-aided 

development/population related programmes. 

Computer literacy is must for this post. 

Desirable Any Degree or Diploma in Hospital/Health Management from 

any UGC recognized University or AICTE recognized Institute, 

will be given preference. 

Nature of service Contractual 

Term of service 1 (one) year or financial year-end, whichever is earlier 

Remuneration Consolidated remuneration of Rs. 25,000/- per month 

Job responsibilities Objective To manage and improve HRM activities/issues in the state 

Appointing & 

termination authority 

Specific 

tasks 

To assist Mission Director & State Programme Manager/Nodal 

Officer (NRHM) in formulation of plans, targets, policies and 

strategies for HRM activities under RCH-II/NRHM and other 

donor-assisted programmes 


Officer (NRHM) in implementation, monitoring and evaluation 

of HR activities in the State. 

Scheduling/planning, organizing, coordinating and maintaining 

various HRM activities. 

Maintenance of HR database (Human Resource Information 

System) 

Identify areas/propose innovative ways for improving HRM 

activities at state level 

Prepare yearly plan i.e., analyze further requirement for HRM 

after assessment. 

Aid and advise Mission Director & State Programme 

Manager/Nodal Officer (NRHM) in all matters of HRM 

activities 

To undertake any such other assignments which may be 

assigned by the Mission Director & State Programme 

Manager/Nodal Officer (NRHM) from time to time. 

Chairman, Executive Committee, State Health Society 

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Transfer & posting Not transferable & Mission Directorate-specific posting 

Posting place State SCOVA Secretariat/Mission Directorate 

Travelling Allowance 

(TA) 

As per AP State Health Society entitlement norms 

Daily Allowance (DA) As per AP State Health Society entitlement norms 

Leave entitlement Casual leave As per AP State Health Society entitlement norms 

Maternity leave As per AP State Health Society entitlement norms 

Leave without pay In exceptional circumstances, up to a maximum of 30 

days, subject to sanction by Mission Director (NRHM). 

Leave granting authority Mission Director (NRHM) 

Extension of service Based on the recommendation of Performance Appraisal Board 

Authority for extension 

of service 

Chairman, Executive Committee, State Health Society 

Performance appraisal Chairman Mission Director (NRHM) 

board 

Member 

Secy 

State Nodal Officer (NRHM) 

Members Director (Finance & Accounts) 

IEC Officer/ Nodal Officer (JSY) 

One directorate official of the rank of ADHS/DDHS 

10.1.2. Mapping of human resources done 

Detail human resource situational analysis has been done above and the requirement of 

human resources is done at NRHM additionalities. 

10.1.3. Transfer and cadre restructuring policy developed 

Comprehensive HRD policy in Arunachal Pradesh has been very weak. It has been experienced 

that distribution of nursing staff and doctors in highly skewed due to various extraneous factors including 

political pressure for transfer and posting. 

Delegation of power to MD (NRHM) per case & to Secretary (Health & FW) will continue. The tenure of 

programme Officer/Staff will be ensured to continue in the same office till end of the programme period. 

This is required to maintain continuity of the program and for effective implementation. 

Alternatively, it is proposed that Govt. of India may provide necessary documents relating to established 

HR practices of other states especially in regards of formation and operationalisation of District cadre 

for reference. If it is viable for the state of Arunachal Pradesh then it will be adopted for HR practices of 

the state. 

Decentralization in HRM: 

The Human Resource Management will be decentralized to the districts. The recruitment transfer 

and posting of manpower will be done by the District Health Societies. The District Health Society will 

ensure rationality, appropriate placing of manpower to the facilities to make functional. As per the 

122

District requirement, manpower will be sanctioned from the state level and District will recruit & post as 

per the guidelines, preference will be given to local candidates. The recruitment under NRHM will be on 

contractual basis, non-transferable and district specific. 

Further, the salary of the contractual manpower under RCH/NRHM will be paid by District Health 

Society for DPMSU staffs and other technical staffs will be accountable to RKS and PRI members and the 

payment of salary and incentives will be made through respective RKS, after performance monitoring of 

the incumbent. 

Relocation of manpower: 

Excess manpower from the facilities will be relocated to the needy facilities. Relocation of staff 

especially ANMs will be taken up strongly this year so as to functionalized maximum number of SCs in 

the state. The relocation procedure has been very difficult over the years but with more efforts & support 

from policy makers, the activity will hopefully be done. 

In the event of non-availability of sufficient SNs for recruitment and overall shortage, the existing 

SNs will be located at FRU facilities and few CHC/PHCs in the remaining functional CHCs/PHCs as 

24x7. ANMs will be located in place of SNs. 

10.1.4. Performance appraisal and reward system developed 

Performance management plays a key role in enhancing the productivity and output of the 

organization. All the contractual staffs are appointed for a period of one year at a time, with the 

provision for extension in the subsequent years on the basis of performance report will continue. The 

performance of all the contractual staffs will be reviewed by a designated board at state and district level, 

on the recommendation of the board, the extension of the services of all the contractual staffs will be 

considered. 

Job description as usual, it is projected in the TOR in respect of all the categories of the 

contractual employees. 

10.1.5. Incentive policies developed for posting in under-served areas 

To motivate the manpower located at remote and hard areas will be given incentives. The 

incentives will be conditional on regular staying and performance based. 

The incentives will be given through respective RKS at facility level. 

Detail incentive policies are addressed under NRHM Additionalities 

10.1.6. Management Development Programme for Medical Officers 

The PDC training is of 10 weeks course with a batch size of seven (7) trainees per batch. 

Training is imparted at NIHFW Kolkata and the programme is planned and supported by Govt. of 

India. It will be ensured that the nomination and participation of medical officers to the training 

institute in times. 

123

10.2. LOGISTICS MANAGEMENT/ IMPROVEMENT 

The procurement and logistic management in the state is not systematic. To streamline, it is 

proposed to engage a contractual consultant (Procurement & Logistic) during 2010-11 @ Rs. 25000.00 

per month Further technical requirement may be provided by GoI through RRC-NE from time to time. 

During this year a suitable logistic management/improvement plan will be developed with the 

association/support of RRC-NE during 1 st quarter of the year. This will enable the state to implement 

PRO-MIS. 

10.3. Monitoring & Evaluation/ HMIS 

To facilitate better monitoring and evaluation of progress of NRHM in the State, State 

Programme Officer for monitoring and Supervision is entrusted and hence carried out regular 

monitoring, timely review of the RCH/NRHM and other vertical program activities. Infrastructure 

facilities like computers, software, telecommunication connectivity etc being provided to almost all 

districts headquarters (HQ). The quality of MIES in State HQ and in districts is now towards 

inclination. Real hurdle faced by the HMIS Cell is reporting and recording of NRHM/RCH formats 

which are still carried out manually in most of the districts and is inconsistent. Formats are also not 

filled up completely. The information provided needs to be properly reviewed at the PHC level so as 

to get quality reports. Feedback system has been introduced from State to the district and will be fully 

implemented from the beginning of the coming financial year. 

Notification of 1 (one) Nodal M&E Officer at the State and 16 Nodal M&E Officer from the 

existing staff in all the districts had been completed. They are entrusted with, to provide information 

on all the health statistics at the District level, to upload data on the HMIS Portal and for sending 

feedback to the lower information. Like wise, Notification of Nodal M&E Officers at the Block levels 

shall be ensured during the year. 

Now all the Districts are reporting in the revised MIS format developed by GoI. For overall 

management of the Health Information System, a HMIS Cell has already been established under the 

Mission Directorate in the state. The HMIS/M&E Cell headed by Programme Officer is responsible 

for overall monitoring and supervision of the programme in the state and the districts. 

At the district level, the District Health Society with the District Program Management 

Support Unit in place is responsible for the all data dissemination from the sub-district level to the 

district level for management of HMIS. Online reporting on the HMIS Web portal from all the 

Districts shall be ensured during the year. In order to ensure the same, training of the staffs, 

provision of internet connectivity etc. has been planned. 

There is Monitoring Team constituted each at state and district level to monitor the 

implementation of the NRHM/RCH activities. The Hospital Management Committee/ Rogi Kalyan 

Samity at all PHCs and CHCs are already in place. The team shall time to time visit and monitor the 

activities carried out. A Monitoring plan for the year is planned and shall be carried out. 

10.3.1. Strengthening of M&E Cell 

Manpower Status: 

State HMIS/M&E Cell: 

124

One State Programme Officer from the state level along with the following official on contract 

basis is available: 



3. State Data manager 1 


1 each Attached to Secretary (H&FW), MD (NRHM), Nodal Officer (NRHM), State HMIS Cell, 

RCHO Hq (Training). 

District HMIS/M&E Cell: 

At the district level District RCH officer along with the following contractual staffs are in place. 

1. District Program Manager 8 (1 each for 2 Districts) 



Data on Health received from the districts are compiled and maintained at State M&E Cell. In fact, 

the reports that are being received from the districts are found to be incomplete. Hence, a clear analysis 

can’t be drawn. For proper strengthening of HMIS in the state, integration of activities across other 

programs shall be ensured with utilization of IT infrastructure. The Web based HMIS Portal launched by 

the GoI is used only by Anjaw and Lower Dibang Valley districts. With training on HMIS under process 

at all the District levels, regular uploading of Data on HMIS Web Portal is being ensured. Uploading of 

the facility wise reports will be ensured. The Districts with non connectivity of internet shall be provided 

with Data Cards and internet facilities at the Department of NIC/CIC at district levels shall be used to 

upload data on the HMIS Portal timely. 

Since, there have been no monitoring plans so far, it had been difficult to review the progress of 

the program in an actual sense. The M&E Cell in place with the State Monitoring and Evaluation Team 

constituted shall be responsible for taking up all monitoring activities in the State. The M&E Cell shall 

focus on the monitoring of all the health facilities. The cell shall also evaluate the progress of the 

program annually. Efforts shall be initiated to introduce a routine self evaluation of the programme at 

least once a year. It is also planned to have an annual State evaluated publication in respect of the 

program, incorporating all other National Disease Control Programs. This would be a step forward in 

documentation of the achievements made so far. The State HMIS/M&E Cell in place shall be responsible 

for the purpose. Initially it is planned to bring out 300 copies of the publication @ Rs. 250.00/- 

approximately per copy amounting to a total of Rs. 75000.00/-. 

125

10.3.1.1. M&E Consultant and Data Assistant of M&E cell 

1 no. of Consultant HMIS is in position and 21 Data Assistant will continue. Out of the 21 Data 

Assistants in place, 16 are positioned at the District and 5 at the State Hq. Following remuneration is 

proposed for the year with 10% annual increment from the subsequent years. The budget mentioned 

below is incorporated under Human Resource Component. 

-1 Consultant HMIS @ 25000/- x 12 =Rs. 3, 00,000/- 

-21 Data Assistant @ 16000/- x 12 = Rs. 40, 32,000/- 

Total financial involvement = Rs. 43, 32,000/- 

10.3.1.2. Provision of equipment at state and district levels 

Due to non availability of inter communication facilities, there have always been delay in the flow 

of information from the districts to the state, state to the Centre and vise versa. In order to overcome the 

problem and the situation, it is proposed to have provision of equipments for HMIS activities at the state 

and District level. Present status of the equipments available at State and District HMIS/M&E Cell are as 

follows. 

Initially, it is proposed to procure 8 Data Cards @ Rs. 7000/- per card, during 2 nd qtr for the 

Districts to facilitate with internet connectivity. These 8 Data Cards shall be provided to the District with 

inaccessibility of internet viz. Kurung Kumey, Dibang Valley, Upper Siang, Changlang, Tirap, West 

Kameng, Tawang and East Kameng. The recurring expenses shall be met from the proposed annual 

maintenance under HMIS. 

Status of Equipment at state and district levels 


Sl. No. Equipment Nos. 

1 Computers 3 

2 Internet facility with LAN 1 

3 Fax 1 

4 Telephone 1 


Sl. No. Equipment Nos. 

1 Computers 16 

126

2 Internet facility 7 

3 Fax 16 

4 Telephone 16 

Annual maintenance for HMIS/M&E Cell 

At State HMIS/M&E Cell: 

The need for annual maintenance is highly felt. The state during the year would earmark an 

amount of Rs. 150000/- for annual maintenance of the State HMIS/M&E Cell. This would include the 

following: 

Particulars 

Monthly Exp. 

(approx) Total 

1. Maintenance of Computers, LAN connectivity etc. 2000 24000 

2. Office Stationeries 2000 24000 

3. Payment of internet, Fax, Telephone bills for the Cell 5500 66000 

4. Procurement of Computer accessories. 3000 36000 

At District HMIS/M&E Cell: 

The state during the year would earmark an amount of Rs. 400000/- for annual maintenance of the 

District HMIS/M&E Cell @ Rs. 25000/- per District annually. This would include the following: 

1. Maintenance of Computers 

2. Office Stationeries 

3. Payment of internet, Fax, Telephone bills for the Cell 

4. Procurement of Computer accessories. 

5. Regular paper works etc. 

Bottleneck under HMIS 

The reporting system in the state is flowing from SC level to the district level to State level but 

still there are lots of areas for improvement. 

Some of the major problems identified are: 

� Block level and SC level reporting authorities are not well acquainted with the reporting system 

in the present HMIS reporting format. 

127

� Lack of awareness about importance and quality of data among grass root level reporting 

personnel, i.e., the ANMs, MO i/c, etc. 

� Inconsistent, Incomplete, Inaccurate and under reporting are the major problems identified in the 

present system. 

� Lack of analysis and monitoring mechanism of periodic reports at District and Sub District level. 

� There is scope for improvement of quality of data in the reports. 

These problems shall be sorted out by organizing orientation program on HMIS and reporting system 

for different level of users. A decentralized training plan during the year 2010-11 is proposed to 

overcome the situation. 

10.3.2. Operationalising the new MIES format 

REPORTS AND RETURNS 

The Revised Monthly, Quarterly & Annual reporting formats under NRHM as per the GOI 

guidelines for each SCs, PHCs, CHCs & DH are being distributed to all health facilities including PPP 

run SCs, PHCs & CHC Hence, it is operational at all levels. The state has also started reporting on 

HMIS Web portal. Facility wise reporting in the new MIES formats is already in place and will continue 

to report in the same format. Due to non availability of internet facility at the district level, manual 

reporting to the state is in place at this stage. Reporting on HMIS portal from the district to the state shall 

be ensured during ensuing financial year with training on HMIS being planned. 

Timeline framed for submission of reports and uploading data on the HMIS Portal– 

From To Time period Type of report 

SC PHC 1 st day of following month Manually 

PHC CHC/DH/DQ 3 rd of the following month Manually 

DHQ State 5 th of the following month Online HMIS Portal 

State Nation 7 th of the following month Online HMIS Portal 

The state will ensure that all the data entered are verified and validated before forwarding to the 

Nation. At the same time feedback and suggestions will be sent to the districts for improvement. 

10.3.2.1. Review of existing registers 

All the health facilities have been provided with sufficient numbers of ANC, PNC, Delivery, 

Disease, Death, JSY, Immunization, stock indent, etc. registers for proper maintenance of data to 

generate quality information. This year too, review of all existing service delivery registers of health 

institutions will be done to have proper maintenance of Data. There will be provisions for procurement of 

the same and making it available in sufficient quantity at the facility levels. Regular updating and data 

compilation will be ensured. This shall be done during the 2 nd quarter of the financial year 2010-11. 

128

Sl. No. Health Facility Registers Nos. Rate Amount 

1 ANC 3000 110 330000 

2 PNC 1000 110 110000 

3 JSY 1600 110 176000 

4 Delivery 1600 110 176000 

5 Death 1000 110 110000 

6 Stock Indent 1600 110 176000 

7 Stock Delivery 1600 110 176000 

8 Immunization 2000 110 220000 

9 Eligible Couple 2000 110 220000 

10 Childhood Disease 1000 110 110000 

Total 1804000 

10.3.2.2.Printing of new forms 

The new MIES formats have already been made available to all the health facilities. However, 

Printing of new forms and formats will be ensured to facilitate all the health facilities of the state for 

proper and timely reporting. Printing of the new forms for tracking of pregnant women and infant and 

existing formats like MIES, Status will be done during the 2 nd Quarter. 

Sl. No. MIES Formats Nos. Rate Amount 

1 Monthly Consolidated DH 2000 Rs. 4.00 8000 

2 Monthly Consolidated CHC 3000 Rs. 4.00 12000 

3 Monthly Consolidated PHC 10000 Rs. 4.00 40000 

4 Monthly Consolidated SC 15000 Rs. 4.00 60000 

5 MIES Quarterly Report 1000 Rs. 4.00 4000 

6 MIES Annual 2000 Rs. 4.00 8000 

7 Pregnant Women Tracking Card 37211 Rs. 15.00 558165 

8 Child Tracking Card 31279 Rs. 15.00 469185 

9 NBITS reporting formats 12000 Rs. 1.50 18000 

Total 1177350 

10.3.2.3. Training of staff 

Training component on MIS Monitoring Evolution will include DHIS 2; web based online Data 

entry and Offline Data entry, quality checking of data, compilation and analysis of data, tracking of 

pregnant women and infant, feed back to filled and timely reporting to higher authority. MIS training for, 

DPM, Accountants, Data Assistant, Statistical Investigator, Data Manager and for personnel from all 

Vertical Program will be organized on total HMIS twice this year with technical support from GoI. The 

specific objectives of the intervention are: 

129

1. Reorientation of all ANMs / LHVs and other health workers on the revised HMIS formats 

with maintenance of record keeping and on timely reporting. 

2. Building skills of worker for improving quality of data, data analysis at local level and 

use the same for planning & monitoring of the programme performance. 

3. Reorientation of State & District Level Officials on use of NRHM Web Portal. 

A reorientation programme for 2 days is proposed to be organized at State HQ to orient 

the District level officers, initially District Programme Manager (DPM), District Data Assistants, 

Accountants, Statistical Investigator and Computer Assistants of all districts. The training shall be on the 

new reporting system and M&E. the training shall include orientation on the DHIS 2, Web based HMIS 

portal. The training is proposed to be conducted in 2 batches with participants from 8 districts in each 

batch. They shall be the trainers for the training programme to train the Sub district level officers & staff 

involved in reporting. 

Similarly 2 days training will be conducted at district HQ in each district to orient the Block level 

officers and staff within the same quarter to maintain the quality of training. From the state HMIS cell 

one person will attend the district level training. The training shall be scheduled during the 1st and 3rd 

quarters. From each Health Facility a person responsible for reports will be invited to the 2 Days 

training programme to be conducted at the District HQ. The orientation programme will mainly focus on 

the reporting system, reporting formats and data analysis under NRHM. The expenditure is budgeted in 

the Training head. 

1 day Reorientation of SC level Staffs at concern higher facility during 1 st & 3 rd qtr. 

NBITS 

In order to implement the Name Based Information Tracking System of Pregnant Women and Child, 

the State intends to organize 1 day training of the District Nodal M&E Officers at the State level on 

NBITS with technical support from the GoI in phase manner. The training shall be incorporated with the 

HMIS Training. These trained Personnel will further train the ANMs of the SC, PHC and CHCs of the 

concern Districts. The first phase would be completed by the 1st Quarter of 2010-11. The 2 nd phase 

training will be complete in 3 rd quarter. 

The existence staff will look after the reporting and uploading in the portal. 

Phase 1: Capacity building training on new NBITS formats upto ANM level. The process of 

information flow of the tracking system & establishing computer based NBITS application for name 

based data entry and reporting. 

Phase 2: Regular and systematic information flow established. 

The NBITS would work on manual formats from the Block levels and the online entry would be done 

from the District level. The Notified District Nodal M&E Officers would be responsible for online entry. 

130

Implementation Process 

1. Name based formats issued by the GoI shall be provided by the 1 st quarter. 

2. Identification of Health Worker (ANM) and ASHA at Block and Sub Block Levels by April 

2010. 

3. Training shall be imparted as planned by 2 nd Qtr. 

4. Training shall be incorporated with the HMIS Training. 

5. Reports being sent to the District. 

6. Online Data entry in place from the District level. 

7. Timely Monitoring of the progress by the SMET and DMET. 

131

Sl. No. 

1 

2 

3 

Total 

State 

Level 

\HMIS 

District 

Level 

HMIS 

Block 

Level 

HMIS 

Name of Training 

District 

Nodal 

M&E 

Category of participants 

Training load 

No. of Batch 

Officers 16 1 

District 

Accounts 

No. of Days 

3 

(1day 

for 

NBITS) 

TENTATIVE TRAINING PLAN 

Timeline 

1 st 

Qtr. 

Venue 

State Hq. 

132 

DA to Participants 

1920 

0 

TA to Participants 

Honorarium & TA to Guest 

Faculty 

1600 

0 1800 

Working Lunch 

Tea/Snacks 

1500 

0 3000 

Incidental Exp. 

Institutional overhead 

Total 

1200 

0 7650 74650 

1920 1600 1500 1200 

Managers 16 1 State Hq. 0 0 1800 0 3000 0 7650 74650 

DA of other 

1500 1200 

programs 8 1 State Hq. 9600 8000 1800 0 3000 0 7650 57050 

MO i/c & 

2(1day 1 

Data 26 for 

Personnel 2 16 NBITS 

st 

Qtr. District 6812 2620 1920 7860 2620 6550 1773 13100 

Hq. 00 00 0 0 0 0 75 75 

Persons 

1 

from 

reporting 27 18 

1 (MIS 

& 

SC 3 4 NBITS) 

st 

Qtr. Concern 

Higher 1092 5460 4095 2730 6825 7203 35868 

Facility 00 0 

0 0 0 8 8 

Budget estimated for 2 rounds of training in 1 st and 3 rd Qtr. = 2x 1875113= Rs. 3750226.00. The Budget is incorporated under 

Training Component. 

18751 

13 

Remarks 

TA 

as per 

actual 

or 

State 

Govt. 

Norm 

s.

The HMIS Training planned shall also incorporate training of the Staffs on Pregnant 

Women and Child Tracking i.e NBITS. The category of the staffs shall be trained on NBITS with 

technical support from the GoI. during the year. 

Review Meeting: 

Review Meetings at every level will be carried out to ensure quality and regular reporting. 

Details are as follows: 

� Block PHC Level Review Meeting on every 2 nd to 4 th day of the every quarter. 

� District Level Review Meeting on 6 th to 7 th day of the each quarter. 

� Half Yearly State Level Review Meeting. 

All the PHC, CHCs and DHs will organize a review meeting on 2 nd to 4 th Day of the quarter and send the 

minutes of the review meeting to the Mission Director (NRHM). MO i/c of the PHC will be the 

chairperson of the review meeting. The meeting shall review the following along with other matters: 

� Review of implementation of all NRHM Activities and vertical programme. 

� Review and analysis of reports submitted by the ANMs from the SCs. 

� Examine the registers maintained by the ANMs to assure quality of services and data. 

� Feedback and suggestion of improvement. 

� Analysis of data and achievement of each programme. 

� Analysis of field surveys, FGD etc. if any 

At the Districts will organize a District level review meeting on 6 th to 7 th day of the Quarter. Districts will 

compile the status of the review meeting of all the DHs, CHCs, PHC and SCs and send a quarterly report 

to the Mission Director, NRHM, along with the minutes of District level review meeting. The District 

medical Officer of the concern District will be the chairperson and District Programme Manager will be 

the convener of the review meeting. The meeting must include the review of the following along with other 

matters: 

� Review of implementation of all Programmes. 

� Review and analysis of reports submitted by health facilities. 

� Analyze the performance and quality of service & data. 



� Review of the minutes of the Block PHC level review meeting. 


Half yearly State Level review meeting is proposed to be organized at State HQ to review performance of 

all the Programmes. Review of reports submitted by the Districts will be the main objective of the 

meeting. Reports submitted by monitoring team will also be reviewed in the meeting. 

133

Sl. No. 

1 

2 


State level Half 

Yearly Review 

Meetings 

District level 

Quarterly Review 

Meeting 


load 

No. of Batch 

No. of Days 

Timeline 

134 

Venue 


DRCHO 

and DPM 22 1 2 2 nd qrt State Hq. 30800 44000 15000 3000 8000 10800 111600 

DRCHO 

and DPM 22 1 2 

MO i/c of 

PHC, 

CHC, 

DH 131 16 1 


Working Lunch 

3rd 

qrt State Hq. 30800 44000 15000 3000 8000 10800 111600 

District 

Hq. 91700 78600 22500 7500 200300 

Total 423500 

Tea/Snacks 



Total

Monitoring and Evaluation 

Schematic diagram for monitoring and evaluation 

District Programme Management 

Support Unit (DPMSU) 

Hospital Management 

Committee/RKS 

State Health Society (SHS) 

State Programme Management 

Support Unit (SPMSU) 

STATE MONITORING TEAM 

District Health Society (SHS) 

DISTRICT MONITORING TEAM 

135 

Village Health Committee

Monitoring from State Level: 

A monitoring plan has been introduced in the state which shall come into effect from the first 

quarter of this financial year. It is planned that the state Monitoring team of the State officials shall 

monitor every district twice a year with mobility support from mobility support head. Non availability of 

vehicle for monitoring has always hampered the activity. During the year it is proposed to get a vehicle 

for monitoring on hire basis @ Rs. 25000/- per month. The rate is estimated as per the existing local 

rates. The vehicle so hired shall be meant exclusively for Monitoring purpose. 

The State Monitoring and Evaluation Team (SMET) shall comprise officials from the State. 

1. The team will carry prescribed checklist for monitoring which shall be provided by the state 

HMIS/M&E Cell. 

2. A team of at least 2-3 members shall monitor all 16 Districts twice during the year. Monitoring of 

all Health Facilities up to the SC level will be ensured. 

3. This will include monitoring of activities like maternal health, Child Health, JSY, Immunization, 

IEC/BCC activities, PPP, VHND, outreach activities, monitoring of post training activities and 

other NRHM activities. 

4. A detail report shall be submitted to the Mission Director, NRHM, Arunachal Pradesh and the 

Director Health Services. 

5. Feedback and suggestion on the observations shall be sent to all the Districts for improvement. 

The State Monitoring and Evaluation Team (SMET) constituted with the officials from the State 

Health Society. A team of at least 3 members shall monitor all 16 Districts twice during the year. 

Monitoring of all Health Facilities at least up to the PHC level will be ensured. The team will carry 

prescribed checklist for monitoring and submit the detail report to the Mission Director, NRHM and the 

Director Health Services This will include monitoring of activities like maternal health, Child Health, 

JSY, Immunization, IEC/BCC activities, PPP, VHND, outreach activities, etc. A feedback and suggestion 

on the observations shall be sent to all the Districts for improvement. 

An amount of Rs. 320000/- per year shall be earmarked for SMET. This would include: 

1. DA to the Members on monitoring. 

2. Incidental Expenses like printing of Checklist, monitoring formats etc. 

3. Printing of Monitoring Reports for feedback to make it available to all the districts. 

4. POL for carrying out the activity etc. 

136

Monitoring Plan 

Sl.N 

o. 

1 

2 

4 

5 

A tentative Monitoring Plan as below is prepared for carrying out the activity. 

Monitoring Quarter Proposed 

month 

Districts Duration 

1 st (April – June 2010) April Tawang, 

Kameng 

W/Kameng & E/ 15 days 

June Lohit, Anjaw & East Siang, 10 days 

2 nd (July – September 

2010) 

3 rd (October – December 

2010) 

4 th (January – March 

2010) 

Monitoring at District Level: 

A District Monitoring Team is constituted to monitor various programmes under NRHM in each 

district. The team will carry prescribed checklist for monitoring and submit the detail report to the 

District Health Society with a copy to the Mission Director and Director of Health Services. Feedback of 

the monitoring report will be sent the concern Health Facility with suggestion for improvement. 

An amount of Rs. 320000/- per year shall be earmarked for DMET for 16 Districts @ Rs. 20000 

per District. This would include: 

1. DA to the Members on monitoring. 

2. Incidental Expenses like printing of Checklist, monitoring formats etc. 

3. Printing of Monitoring Reports for feedback to make it available to all the Blocks. 

The Official Vehicle shall be utilized for the purpose. 

July Upper Siang & West Siang 10 days 

July Dibang Valley & Lower 10 days 

August 

Dibangvalley 

Tirap & Changlang& Papum 

Pare, 

15 days 

September Kurung Kumey & Lower 15 days 

October 

Subansiri & U/Subansiri 

Tawang & West Kameng & 

East Kameng 

15 days 

November Upper Siang & West Siang 10 days 

December Lohit, Anjaw & East Siang, 10 days 

January Dibang Valley & Lower 10 days 

February 

Dibangvalley 

Tirap & Changlang& Papum 

Pare, 

15 days 

March Kurung Kumey & Lower 15 days 

Subansiri & Upper Subansiri 

137

The Districts shall prepare their own monitoring plan by the month of April 2010. 

Monitoring Indicators 

Indicators for HMIS 

Indicator for RCH/NRHM 

1. List of registered maintained 

2. No. of reporting month 

3. Time of reporting 

4. Accuracy Level ( Good/Average/Poor) 

Sl.No Indicator Remarks 

1. % ANC registered 

2. 3 ANC 

3. Pregnant women with Anaemia 

4. Institutional Delivery 

5. Pregnancy outcome 

6. Newborns breastfeed

Major Head Minor Head Rate 

Strengthening of 

M&E/HMIS 

Procurement of HW/SW 

and other equipments 

Operationalising HMIS 

at Sub District level 

@Rs. 25000 

1consultant & 

Rs. 16000 for 21 

Data Assistants 4332000 

139 

Budget in 

Rs Details 

Remarks 

Ref. 10.3.1.1 

Salaries of M&E, MIS & Data Entry 

Salary of 1consultant & 

Consultants 1.1 

21 Data Assistants 

Hiring of Vehicle for Ref. Monitoring and 

Monitoring by SMET @ Evaluation 

Mobility for M & E Officers 1.2 25000 300000 Rs. 25000 per month 

State Level, District Level 

and Block level training 

on HMIS/NBITS during 1 

Training on M & E 

1.3 

st 

& 3 rd Ref. 10.3.2.3 

Budgeted under 

Training Component 

Qtr. 

Review meeting at State, Ref. 10.3.2.3 Review 

Workshops/ Review meetings 423500 District levels 

Meeting 

Ref.10.3.1. 

Strengthening of M&E 

M&E Studies 1.4 75000 Annual M&E Publication Cell 

SMET Monitoring 

Facilities 

DMET Monitoring 

Facilities 

of 

of 

Health 

Health 

1.5 

Rs. 10000 

District 

yearly 

per 

half 

320000 

320000 

Ref. Monitoring and 

Evaluation 

Ref. Monitoring and 

Evaluation 

Hardware/Software Procurement 2.1 

Internet connectivity 2.2 7000 56000 Data Cards for 8 Districts Ref. 10.3.1.2. 

For 16 Districts @ 25000 Ref. 10.3.1.2. 

Annual Maintenance 2.3 550000 & State Hq.@ 150000 

Printing & Computer Stationery 2.4 

Others 2.5 

Review of Existing registers – to 

make them compatible with National 

Ref. 10.3.2.1 

HMIS 3.1 1804000 

Printing of new Registers/Forms 3.2 1177350 Ref. 10.3.2.2. 

Training of staff 3.3 

TOTAL 9357850

11. Training: 

RCH and NRHM has been an ambitious project to implement nation wide, through PRI, 

Administrative Officer and grass root people with a sense of ownership. Despite full time devotion by 

health functionaries of the state, difficult terrains etc, one major implementation bottleneck has been 

identified, that is nothing but lack of training, updating, up gradation of skills, continuous education 

on latest research and findings etc. Hence it is required that along side development of infrastructure, 

induction of man power and procurement of latest equipments, operationalization of health facilities 

into 24 X 7, across the state, training component is not denied to health functionaries. Both pre 

service and in service training on managerial skills for state, district health managers, block level 

health managers and programme managers should be facilitated. Clinical component too should be 

given a justice by exposing the clinicians to latest skill based/ facility based trainings. The bottom line 

is to equip the health functionaries/managers with latest technologies/policies and use the lesson 

learned in implementation of programmes and policies planned in this SPIP. 

Objective: To upgrade skill of the health personnel for providing quality service. 

State Training Policy: The state imparts two types of training which are broadly classified into a) 

In-service training ( only those which are sanctioned in NCCP Approval). B) Pre service training 

for GNM, ANM and HA 

a) In service Training policy: In the state health directorate, despite policy of inter and intrasectoral 

convergence, the different activities planned and performed by different programme division 

sometime coincides with each other and thereby forcing the officers/officials and field functionaries 

to miss out certain matters of health importance. This is equally and practically faced in training 

activity pertaining to this department. Eg. A lab technicians from RNTCP misses out training of 

malaria due to commitment and engagement in training activity of RNTCP etc, because of 

independent planning. due to this, preparation of CTP for all the trainings under NRHM is very 

difficult and collection of report from different departments of different districts is also equally 

difficult. 

Therefore instead of the activity getting disintegrated subject wise or programme wise, all the 

trainings under all the vertical programmes, NRHM, RCH and Additionalties should be streamlined 

and given an integrated approach and allow the State Training Coordinator to plan, execute and 

report the training activities of state under NRHM with consent and cooperation of programme head 

in the directorate. This will facilitate smooth reporting, easy planning. 

b) Pre-Service Training Policy: There are two Pre-Service Training Centre for MPWs 

(ANM/HA): 

140

Sl.No Institute 

1. GH Pasighat 

2. Ramakrishna 

Mission 

Every year on quota basis, candidates are selected from each district, for pre-service training 

for ANM, but the seat is very limited and it is not possible to planned for more trainees in these 

institute. One candidate for Health Assistant is selected from each of the 16 district to undergo 

training. 

Basic information: (Format TRG-A) 

Basic State Information State Total 

Total Number of district 16 

Total Population 10,97,968 

Total Number of Underserved District 3 ( Kurung kumey, East Kameng, Upper Subansiri,… 

Total Population of all Underserved district 

/ High Focus 

Situation Analysis: 

1,54,929 (East Kameng- 57,065, KK-42,518 & U/S- 

55,346) 

Activities Current Status 

Physical Infrastructures SFHWTC is under construction 

Resource Person 

Availability of Teaching Aids, computers etc. 

Assessment of availability of common audio visual aids 

at the facility 

Availability of annual training plans for the last year 

and achievements of the plan. 

Training Centre: 

141 

Master Trainer act as Resource 

Person at State & District Level 

LCD Projector, 

PA system 

Yes

Sl. 

No. 

Name of Training Centre Category of training 

done 

1 General Hospital, NLG IMNCI, EmOC, 

IUD,MTP, Minilap 

2 General Hospital, Pasighat IMNCI, 

IUD,MTP,SBA 

Status of Master Trainer: 

Sl. No. Category Number of Master 

Trainer 

SBA 1 

IMNCI 11 

F-IMNCI 2 

NSSK 5 

IUCD 11 

EmOC 1 

Status of Trained Health Personnel till date: 


Programme 

142 

Remarks 

Remarks 



SBA 


ANM/GNM 

1 

53 

EmOC 


MO 

1 

5 

LSAS MO 5 

MTP MO 64 

RTI/STI MO 20 

Child Health 

IMNCI 


MO 

ANM/GNM 

79 

60 

Karyakaram MO 5 (Child Specialist)



MO 20 

ANM 83 



DPM 60 



State HMIS 



16 

Programme 16 

District HMIS 







programme 8 


30 


audit 

Programme) 

Induction RKS 



96 

Programme) 


30 




210,90 & 84 ( during07,08 & 

audit 



09) 

Assistant 


0 

Health Facility: 


Health Facility Status Total 

Number 

Functional Non 

Functional 

143 

Remarks 

GH 2 0 2 FRU 

DH 13 0 13 

CHC 31 13 44 1 CHC ( Ruksin) is 

FRU 

PHC 85 37 116 20 PHCs are 24 X 7 

SC 273 (230functional with ANM) & 

43 functional with other 

paramedical staff 

District Wise Health Facility: ( Format TRG-B) 

293 566

Name of 

district 

Number of 


SC PH 

C 

CH 

C 

Number of Health Facility 

functional till date 

24X 7 

PHC 

Tawang 17 6 1 PHC 

Lumla 

(under 

NGO) 

West 

Kameng 

East 

Keameng 

31 4 4 Thrizino 

(Unedr 

NGO) 

44 9 2 Bameng ( 

Under 

NGO) 

Papumpare 66 8 4 Mengio 

(Under 

NGO) 

Lower 

Subansiri 

Kurung 

kumey 

Upper 

Subansiri 

39 7 2 Deed 

Neelam ( 

Under 

NGO) 

92 10 4 Sangram 

( Under 

NGO) 

37 11 4 Nacho ( 

Under 

NGO) 

West Siang 45 15 5 Gensi ( 

Under 

NGO) 

24X 7 CHC FRU 24 X 7 

CHC 

144 

Number of Health Facility 

functional till date 

24X 7 

PHC 

FR 

U 

Jang 0 0 0 DH 

Dirang DH Kalaktang 0 DH 

0 0 C/Tazo Bana DH 

0 Pakke 

Kessan 

g 

Sagalee GH Balijan Jote 

Doimukh 0 0 0 

Kimin 0 0 0 

0 DH 0 Raga, 

Yachuli 

0 Nil Palin Yangte 0 

DH 

Dumporijo DH 0 Maro DH 

Basar DH Mechuka 0 DH 

Tirbin Likhabali 0 0 0 

East Siang 43 15 5 Sille ( Boleng GH Pangin Tellam 0

Upper Siang 13 2 4 

Lower 

DibangValle 

y 

Dibang 

Valley 

Under 

NGO) 

Bilat Mebo CHC 

Ruksin 

Jeying 

145 

0 0 

Nari 0 0 0 

Jengging ( 

Under 

NGO) 

DH Mariyang 0 DH 

16 6 2 Anpum 0 DH 0 0 DH 

3 1 0 Etalin 0 0 0 0 0 

Lohit 31 8 4 Wakkro 

(Under 

NGO) 

Tirap 38 7 3 Wakka 

(under 

NGO) 

Changlang 31 8 4 Khimiyon 

g (Under 

NGO) 

Total 56 

6 

Note : 

Namsai DH Chowkha 

m 

Mahadevpu 

r 

0 CHC 

Deomal 

i under 

PPP 

0 0 0 Kharsang 0 0 

0 0 0 

Longding, 

Kanubari 

Lathao DH 

0 DH 

Maio 0 Jairampur Namtok DH 

116 44 20 15 10 10 10 11 

• 3 district ( Kurung Kumey, Upper Subansiri & East Kameng) are high focus districts. 

• GH Naharlagun, Pasighat & CHC Ruksin is fully functional as FRU. 

• 7 DHs ( West Kameny, Ziro, Daporizo, Aalo, Roing & Tezu) are partially functional as FRU.

Manpower: 

Staff Sanctioned In-Position Vacant 

District Medical Officer 16 16 0 

DRCHO 16 16 0 

Total Number of OBG _ 12 

Total Number of Anesthetic - 7 

Total number of Pediatrician - 9 

Medical Officers/from AYUSH also 

146 

560 405 (82 including 

AYUSH) 

Lab technicians 64 100(30 contractual) - 36 

Staff Nurse 170 214 (194 contractual) - 44 

ANMs 390 405( 152 contractual) - 15 

Male MPWs - 356 - 

District TB Officer 13 13 0 

Senior Treatment Supervisor (STS) 13 13 0 

Senior TB Laboratory Supervisor 13 13 0 

District Wise Manpower: 

+155 

Name of district Specialist MO SN ANM LT Pharmacist 

Tawang 2 17 9 32 5 6 

West Kameng 1 25 15 33 5 24 

East Kameng 0 20 7 (only 

Contractual) 

Papumpare 29 46 64 78 

36 1 

Lower Subansiri 4 24 17 43 5 7 

Kurung kumey 0 11 13 19 5 2 

Upper Subansiri 20 8 45

West Siang 53 40 16 11 

East Siang 5 79 54 68 11 

Upper Siang 0 26 8 26 3 5 

Lower DibangValley 0 11 23 25 7 

Dibang Valley 0 5 4 23 5 4 

Lohit 2 26 17 31 6 12 

Anjaw 0 8 11 12 3 2 

Tirap 1 27 18 36 7 

Changlang 1 27 18 16 2 13 

Total 16 

District wise training need: Plaese refer Annexure 9 (a). 

Training need Assessment (Formats TRG-D), (Health Outcome based information ) 

Name of 

trainings 

IMNCI , 

FBNC, 

NSSK, RI 

SBA ,LSAS, 

MTP, 

EmOC, 

RTI/STI 

Need of trainings ( 

Health indicators/ 

Other reason 

) 

State Kurung 

Kumey 

IMR – 61 ( NFHS-3), % 

of neonates breastfeed 

within 1 hr. – 55% Full 

Immunization – 28.4 % 

(NFHS-3), Anaemic 

Children of 6-35 age 

group- 66.3 % (NFHS- 

3) 

Delivery at home, 

Assisted by 

MO/SN/ANM-2.4% out 

of 32.8 % home 

delivery (DLHS-3), 

District ( High Focus) Remarks 

Full 

Immunization 

-23.8 (DLH 

Children 

breastfed 

within 1 hr of 

birth-20.1 

%(DLHS-3)S- 

3) 

Delivery at 

home, 

Assisted by 

MO/SN/ANM- 

3.6% (DLHS- 

147 

Upper 

Subansiri 

Full 

Immunizat 

ion-31.2 

(DLHS-3), 

Children 

breastfed 

within 1 hr 

of birth- 

35.6 

%(DLHS- 

3) 

Delivery at 

home, 

Assisted by 

MO/SN/A 

NM-1.6% 

East Kameng 

Full 

Immunization- 

17.7 , Children 

breastfed 

within 1 hr of 

birth-44.8 

%(DLHS-3) 

Delivery at 

home, Assisted 

by 

MO/SN/ANM- 

.5% (DLHS-3)

Laparoscopi 

c 

Sterilization, 

Minilap, 

IUD 

Insertion 

Safe Delivery- 68.5% ( 

DLHS-3) & Shortage of 

Specialists 

TFR- 3.03 ( NFHS- 3) 

Unmeet Need - 14. 3 ( 

DLHS-3) 

ARSH Create awareness on 

ARSH 

Blood 

Transfusion 

HMIS for 

PMSU 

Financial 

Management 

PMSU 

ASHA 

training 

Strategy & Activities: 

Functionalize Blood 

Storage at health 

Facities planned for 

FRU 

Strengthen Recording 

& Reporting system 

Strengthen financial 

Mgt. 

To strengthen health 

facility at village level. 

1. Strengthening of training institutions 

a) Infrastructure Development: 

3) (DLHS-3) 

Unmeet Need- 

7.9 (DLHS-3) 

Create 

awareness on 

ARSH 

Strengthen 

Recording & 

Reporting 

system 

Strengthen 

financial Mgt. 

To strengthen 

health facility 

at village 

level. 

148 

Unmeet 

Need-10.2 

(DLHS-3) 

Create 

awareness 

on ARSH 

Strengthen 

Recording 

& 

Reporting 

system 

Strengthen 

financial 

Mgt. 

To 

strengthen 

health 

facility at 

village 

level. 

Unmeet Need- 

19% (DLHS-3) 

Create 

awareness on 

ARSH 

Functionalize 

Blood Storage 

at 

Strengthen 

Recording & 

Reporting 

system 

Strengthen 

financial Mgt. 

To strengthen 

health facility 

at village level. 

Till now, the training activity in the state is carried out in the hotels and other governmental seminar 

halls after paying heavy rental charges. Consequent upon that, State level Training Institute has 

already been approved and construction work is in the initial phase. In the same manner, the state 

through this PIP, plans to get set up one clinical training centre each in 8 districts of the state of 

Arunachal Pradesh with the total budget of Rs 64 lacs @ 800000/- districts. It will be attached with

the district hospitals for better clinical approach during the trainings. Priority districts are East 

Kameng, Lower Subansiri, West Siang, Lohit, Tirap, Tawang, Upper Subansiri and Dibang Valley 

b) Equipment and training aids to the training institutions 

SHFWTC: Equipment and training aids for SHFWTC will be procured under 

Establishment plan of SHFWTC after competition of construction work. 

District Clinical Training Centre: Procurement of equipment for District Clinical Training Centre 

has been planned in the following way: 

Sl.No. Equipment Quantity Rate Amount (in 

Rs) 

149 

Remarks 

1. LCD Projector 6 100000/- 600000/- Tirap & west 

Siang is 

already 

equipped 

with. 

3. OHP 7 20000/- 140000/- East Kameng 

is already 

equipped 

with. 

4. White Board 16(2 / district) 5000 80000/- 

5. Table 16(2/district) 1500 19500/- 

6. Chair 800 

(100/district) 

600 480000/- 

TOTAL 13,19,500/- 

c) Training Coordinator/consultant 

At State Level: In the state level, under NRHM, one training consultant at consolidated pay 

of Rs 25,000/- is working on contractual term. The consultant needs constant guidance of an officer 

with field and programme experience. The State Mission Director and State Nodal Officer are too 

occupied and committed to over all welfare of the programme. On top of that the State Health and 

Family Training Centre are coming up. So engagement of an officer as State Training Coordinator 

with at least 10-15 years of service, experience in field and programme work with adequate 

training exposure to health management and sector reformation etc is deemed essential for 

coordinating, planning, executing and reporting on training. 

At District Level: DMO & DRCHO & Programme Officers of other vertical programme act as 

training coordinator at district level.

State Training Coordinator 

The proposed State training Coordinator will be from existing regular 

officer of the directorate and there will not be financial involvement for his/her salary and other 

perks from the mission budget. The STC will coordinate with the Mission Director, State Nodal 

Officer and DMOs and DRCHOs and carry out the training activities in the state. The responsibility 

of planning, executing and reporting of training activity will be the proposed State Training 

Coordinator. 

Detail TOR is placed below: 

Further, Consultant (HMIS) and Consultant (Trg) will be continued in the programme and they will 

look after their respective assigned duty. 

Job title State Training Coordinator 

Eligibility criteria Essential 1) MBBS 

2) 10-15 years of regular service 

3) Minimum 5 years experience on national health programme 

Desirable 1. Certificate holder on TOT in any health discipline. 

2. Certificate course in health management. 

Nature of service Regular 

Term of service Not applicable 

Remuneration Not applicable ( it is regular service, hence pay salary comes from state budget) 

Job responsibilities Objective To manage and improve training activities in the state and districts 

Appointing & termination 

authority 

Specific 

tasks 


Officer (NRHM) in 

1) Preparation of state training calendar. 

2) Planning of state training activity. 

3) Collection and dissemination of training report. 

4) Monitoring and supervision of training activity in the state 

and the districts. 

Govt of Arunachal Pradesh 

Transfer & posting Not transferable & Directorate-specific posting 

Posting place State SCOVA Secretariat/Mission Directorate/ Directorate of Health Services. 

Travelling Allowance (TA) As per AP State Health Society entitlement norms 

Daily Allowance (DA) As per AP State Health Society entitlement norms 

Leave entitlement Casual leave As per CCS Rule 

Maternity leave As per CCS Rule 

Earned Leave As per CCS Rule 

Leave granting authority DHS/Commissioner ( Health & Family Welfare) 

Extension of service Not Applicable 

Authority for extension of Not applicable 

service 

Performance appraisal 

board 

Not applicable; Promotion is through DPC as and when required or are due as per 

vacancy. 

150

d) Establishment of SHFWTC: 

Construction work for establishment of SHFWTC in progress with the release of first 

installment of Approved budgeted amount and to ensure further smooth implementation of activities 

under establishment of SHFWTC, it might be advisable to release remaining budgeted amount. 

e) Development of training packages: 

Since, all the training Modules and Guidelines under the training activities are designed by 

Government of India. These training Materials will be duplicated and multiplied at the state 

headquarter as per the requirement of the state. On multiplication of these Materials they will be 

made available to all the identified districts training centers wherein training activities will be 

conducted. Total cost of printing/duplication of training material is Rs. 7,32,240/- (@ 240 X 3051 

nos. of Books). 

f) Specialized training equipment (for skill trainings) provided. 

Since, specialized skill trainings are conducted outside the state; there is no specific 

requirement for specialized training equipments. 

g) Accredition of Institute for training: 

Following institution has been planned to be accredidated for various training purpose by Q1 

of 2010-11. 

List of institution for Accredition for training purpose: 

Sl.No. Name of Institution Type of training Remarks 

1. Ramakrishna 

Mission, Itanagar 

2. Training Proposal for the year 2010-11: 

A. Maternal Health Training 

A.1 Skilled Attendance at Birth / SBA 

A.1.1. Setting up of SBA Training Centres 

SBA 

The state has no separate SBA Training centre. The two General Hospitals established at 

Naharlagun (Papum Pare district) and Pasighat (East Siang district) will be identified for conducting 

SBA training. 

A.1.2. TOT for SBA 

The state has one Master Trainer in SBA posted at CHC Ruksin in East Siang District. 4 

additional Master trainers in SBA would be required for training more number of batches from 4 

separate districts as it has been planned to set up Clinical Training centre at district level. This will 

be completed in the Q1. 

A.1.3. Training of Medical Officers in SBA 

151

To reduce the MMR and IMR in the state, the state plans to Operationalize 15 

CHCs and 10 PHCs as 24 X 7 by the financial year 2010-11. Hence 10 MOs has been planned to be 

trained on SBA for functionalizing above mentioned numbers of CHCs and PHCs 15 Medical Officers 

has been trained in SBA in GH Pasighat in 2007-08. Training load for 2010-11 is 10 MOs which will 

be completed by Q 2 with 5 MOs per batch. 

A.1.4. Training of GNM/ANM in SBA 

Training in SBA for 120 nos. Staff Nurses and ANMs of the state will be put train in 

SBA in the year 2010-11. Of this 20 will be trained in G.H Pasighat and 20 in Gh Naharlagun, Rest 

80 will be trained AMC, Dib, GMC. Ghy and Silchar Medical College or as felt convenient by GOI to 

accredit. This will be done all through out 3 rd & 4 th quarter. 

A.2. EmOC Training 

No of Health 

Institution 

conducting EmOC 

Training 

1 ( GH 

Naharlagun) 

No trained 

till December 

2009 

A.2.1 Setting up of EmOC Training Centres 

No of trained MOs posted 

at health facility to be 

functionalized as FRU ( till 

December 2009) 

5 5 (Placed at FRU- DH 

Seppa, DH Khosa, CHC- 

Parbuk & remaining two 

are undergoing training at 

GH, Nlg) 

152 

Target for 2010-11 

1 ( Master Trainer for GH 

Pasighat) 

The state has no separate EmOC Training centre. However, General Hospital 

Naharlagun is identified for the conducting in state EmOC training. However, the state plans to set 

up General Hospital Pasighat as training centre by 2010-11 and trained one Gynecologist as TOT, 

EmOC. 

A.2.2. TOT for EmOC 

The State has one Master Trainer in EmOC. The state plans to train one 

Gynecologist from GH Pasighat by Q1. 

A.2.3. Training of Medical Officers in EmOC 

1 MO from DH Tawang has been planned for EmOC training to 

functionalize as FRU during 2010-11 by Q1. 

A.3. Life saving Anesthesia skills training. 

No of Training 

centre 

conducting 

No trained 

till December 

No of trained MOs posted at Health 

institution planned to be operational zed as 

Target for 2010- 

11

LSAS Training 2009 FRU till December 2009 

Nil 5 5 ( Placed at DH Roing, Tezu & Khonsa, 

Bomdila & Changlang.) 

A.3.1. Setting up of Life saving Anaesthesia skills Training Centres 

A.3.2. TOT for Anaesthesia skills training. 

A.3.3. Training of Medical Officer in life saving Anaesthesia skills. 

This year, four medical Officers will be trained in LSAS by Q 1. 

A.4. MTP Training: 

A.4.1. TOT on MTP using MVA 

A.4.2. Training of Medical Officers in MTP using MVA 

The training in MTP shall be imparted in the state for 55 Medical Officers in 

both the General Hospital Naharlagun and Pasighat which are two two state training centres for 

MTP using MVA, EVA by Q 3 & 4 . This training will be clubbed with training of Medical Officers on 

Mini Lap as the patient load for MTP and Mini lap is much less than required 600 cases per annum. 

A.4.3. Training of MOs in MTP using other methods (Pl. specify) 

A.5. RTI/STI Training 

A.5.1. TOT for RTI/STI training 

Master Trainer already available in the Districts, trained by APSACS. 

A.5.2. Training of Laboratory Technicians in RTI/STI 

A.5.3. Training of Medical Officers in RTI/STI 

40 MOs will be imparted training on RTI and STI with the help of APSACS by Q 2. 

A.5.4.Training of Staff Nurses in RTI/STI 

25 SNs will be imparted training on RTI and STI with the help of APSACS by Q 2. 

A.5.5. Training of ANMs/LHVs in RTI/STI 

20 ANM will be imparted training on RTI and STI with the help of APSACS by Q 2. 

A.6. Orientation of Dai/TBAs on safe delivery 

A.7.Blood Transfusion: 

A.7.1. Training of MO in Blood Transfusion. 

Training of 10 MO in Blood Transfusion has been planned to functionalize District 

Hospitals Seppa, Tawang, Tirap and Changlang, Bomdila, Ziro, Daporijo, Aalo, Yingkion, Roing & 

153 

4 (MO)

Tezu as FRU. 1 Medical Officers of DH Bomdila is already undergoing training. So in 2010-11, 10 

medical Officer will be trained in 1 st Q . 

A.7.2. Training of Lab Technician in Blood Transfusion. 

Training of 10 LT in Blood Transfusion has been planned to functionalize District 

Hospitals Seppa, Tawang, Tirap and Changlang, Bomdila, Ziro, Daporijo, Aalo, Yingkion, Roing & 

Tezu as FRU. 1 LT of DH Bomdila is already undergoing training. So in 2010-11, 10 LT will be 

trained in 1 st Q . 

B. IMEP Training 

B.1. TOT on IMEP: 

B.2. IMEP training for state and district programme managers: 

B. 3. IMEP training for medical officers: 

C. Child Health Training 

C.1. IMNCI training (pre-service and in- service) 

C.1.1.TOT on IMNCI (pre-service and in- service): 

C.1.2. IMNCI training for Medical Officers 

The training in IMNCI is divided into 8 days of Audio visual and two days of supervision 

which also includes one community visit. This year training has been imparted to 56 numbers of 

Medical Officers of west Siang. In 2010-11, 52 Medical Officers of 13 district will be trained in 

IMNCI. Other threedistricts, West Siang , East Siang and Papum Pare has already completed the 

said training. Training will be completed by Q3. 

C.1.3. IMNCI training for GNM/ANM. 

The ANMs and GNMS of three IMNCI districts are already trained in the subject. So for 

2010-11, 4 ANMs/GNMs each of 13 district will be given training on IMNCI by Q2. The total load for 

2010-11 will be 52. 

C.1.4.IMNCI Training for LHVs: 

C.1.5. IMNCI Training for Anganwadi Workers: 

C.2. F-IMNCI Training 

C.2.1. TOT for F- IMNCI: 

10 nos. of TOT for F-IMNCI has been planned during 2010-11. 

C.2.2. F-IMNCI Training for MO: 

154

60 nos. of MO already trained in IMNCI from 3 district such as East siang, West Siang & 

Papumpare (20 MOs from each district) has been planned. 

C.2.3. F-IMNCI Training for ANM/GNM: 

60 nos. of ANM/GNM already trained in IMNCI has been planned. 

C.3. ( Navjat SishuSwasthya Karyakaram) 

This training is meant to update the medical officers on latest life saving techniques and 

methods for resuscitation of new borne, this is facility based training imparted in General 

Hospitals/Medical colleges where there is separate wing /ward for new borne care. The state has 

already nominated 5 pediatricians to be trained in NIHFW new Delhi. They will act as master trainer 

in the state. The state planned to train 16 Medical Officer ( one in each dist) on NSSK. The training 

will be conducted for 2 (two) days with batch size of 6 doctors by Q3. 

C.4. Multi skilled training of MO on Pediatrics: 

Multi skilled Training of 6MOs on Pediatrics has been planned to Operationalize DH 

Bomdila, Tezu, Seppa, Khonsa, Changlang & Tawang as FRU during 2010-11. (1 MO from each 

DH) during Q 1 in Assam Medical College. 

C.5. Capacity Building for Newborn & Child Stabilization Unit at FRU: 

C.5.1. Capacity Building of MO for Newborn & Child Stabilization Unit at FRU: 

3 days Capacity Building of 6 MOs has been planned to functionalize Newborn & Child 

Stabilization Unit at 3 functioning FRU (2nos. of each GH Naharlagun, GH Pasighat & CHC 

Ruksin) by Q3. 

C.5.2. Capacity Building of SN for Newborn & Child Stabilization Unit at FRU: 

3 Days Capacity Building of 6 SNs has been planned to functionalize Newborn & Child 

Stabilization Unit at 3 functioning FRU (2nos. of each GH Naharlagun, GH Pasighat & CHC 

Ruksin) by Q3. 

C.6. Facility Based Newborn Care / FBNC: 

C.6.1. TOT on FBNC: 

C.6.2. Training on FBNC for Medical Officers 

For the year 2010-11, keeping mind functionalization of 4 FRUs, 15 CHC and 10 PHCs as 

24 X7 facilities, 30 numbers of MOs in 6 batches will be trained in operationalizing New Born Care 

Corner in the GH/DH wherever Pediatricians are available. The duration of the training will be for 3 

days per batch. The training will be completed in 2 nd quarter. 

C.6.3. Training on FBNC for SNs 

Same as in 6.5.5.2.2, 30 numbers of SNs in 6 batches will be trained in operationalising New 

Born Care Corner in the GH/DH wherever Pediatrecians are available. The duration of the training 

will be for 3 days per batch. The training shall be initiated in the 2 nd and 3 rd quarter. 

155

C.7. Home Based Newborn Care / HBNC: 

C.7.1. TOT on HBNC: 

C.7.2. Training on HBNC for ASHA: 

Has been planned for 3268 ASHAs under NRHM Additionalties. It is mentioned in Training 

Calendar and CTP. 

C.8.Care of sick children and severe malnutrition: 

C.8.1.TOT on Care of sick children and severe malnutrition: 

C.8.2.Training on Care of sick children and severe malnutrition for Medical Officers: 

D. Family Planning Training 

D.1. Laparoscopic Sterilisation Training 

D.1.1. TOT on laparoscopic sterilization: 

The training will be conducted outside the state, so there is no requirement of ToT. 

D.1.2.Laparoscopic sterilization training for Specialist/ Medical officers: 

There are 10 functioning FRUs and 4 planned FRUs in the state of which 5 facilities are 

having Lap. Sterilization trained personnel. So this year, the state plans to impart training to 9 

doctors for lap sterilization training. This training will be completed in Q3 & Q4 with 4 doctors in a 

batch. 

D.2. Minilap Training 

D.2.1.TOT on Minilap: 

The O&G Specialists in place will be the Trainers for Minilap training. 

D.2.2. Minilap training for medical officers: 

The training in Minilap will be conducted for 12 working days for Medical Officers in 

CHC/FRU&DH. Training load is 20 Medical Officers with a batch size of 2 per batch by Q2 & Q3. 

Training will be imparted by a Gyneacologist. The training will be clubbed with MTP due to less 

patient load in the training institute. 

D.3. Non-Scalpel Vasectomy (NSV) Training: 

D.3.1. TOT on NSV: 

D.3.2. NSV training for MOs: 

D.4.IUD insertion 

D.4.1. TOT for IUD insertion: 

D.4.2. Training of Medical Officers in IUD insertion. 

156

The training in IUD for Medical Officers will be imparted to all the 51 Medical Officres from 

all the 31 CHCs and 20 PHCs in the state. Training will be imparted by a master trainer. The 

training duration is of five days. Number of batches will be 13 with a batch size of 5 trainees per 

batch. Training will be completed by the fourth quarter of the year. 

D.4.3. Training of staff nurses in IUD insertion: 

D.4.4. Training for ANM/LHVs in IUD insertion: 

The training of ANM shall be imparted to 230 numbers of ANM in the state (80 from previous 

year+ 150 new). The duration of training is 5 days. Training will be imparted by a Master Trainer 

in a batch size of 23 per batch. Training will be completed by theQ2.Q3 and Q4. 

D.4.5.Contraceptive Update. 

The update on IUCD and dissemination workshop on Family Planning method has already 

completed for 80 people, comprising of DMOs, DRCHOs, Gynecologists, doctors of private 

hospitals and Dist Programme Managers under NRHM. One more such update programme 

planned for year 2010-11and is planned to be completed in third quarter. 

D.5. Adolescent Reproductive and Sexual Health/ARSH Training 

D.5.1. TOT for ARSH training: 

D.5.2. Orientation training of state and district programme managers: 

D.5.3. ARSH training for medical officers: 

Training on ARSH will be imparted to 32 MOs, 2 from each district at state level. The 

duration of training will be 5 days. The training will be imparted by Specialists, Senior Medical 

Officers and Programme officers during Q2. 

D.5.4. ARSH training for ANMs/LHVs: 

Training on ARSH of ANMs/ASHAs/LHVs will be imparted to 160 numbers of 

ANMs/ASHAs/LHVs by the trained MOs in a batch size of 10 from each district. The duration of 

training will be 5 days. Training will be completed by the fourth quarter of the year. 

D.5.5. ARSH training for AWWs: 

D.6. Other training (pl. specify) 

D.6.1. Training of ANM (placed or relocate at SC): 

2 days refresher training has been planned for all the ANMs placed or relocated at SC. The 

content of the training programme will contain: 

• Discussion on NRHM 

• Duties & Responsibilities 

• Clinical Session (MH, CH, FP etc) 

• Field Visit, VHND & Out Reach Session 

• Recording & Reporting (Physical- 8 Register, Monthly Reporting etc) 

157

• Discussion on SC Mgt. Committee 

• Recording & Reporting (Financial) 

• Working with ASHA & AWW 

• Open Discussion 

The training will be organized at block of respective district by Q1. The resource person will be MO 

I/C of respective health centre and the training programme will be monitored by District QAC. 

D.6.2. Training for Quality Assurance Committee: 

Orientation training for QAC member: 1 day orientation training for the member of QAC 

at State at district ( 16 Dist.) would be conducted. 

Dissemination Workshop: 

Dissemination Workshop for empanelled doctors and in charge of facilities (DH/CHC) 

providing sterilization services would be conducted at ATI Naharlagun by Q1. 

D.6.3. Dissemination Workshop on PNDT & Sex Ratio: 

One day dissemination workshop on PC & PNDT will be conducted at state & district level 

by Q1. Total training load will be 100. Participants will be 1MO from each district, ultra 

sonographer, Gynecologist, & Private Practitioner & MTP trained MO. 

Sensitization Workshop: 

One day sensitization workshop on PC & PNDT will be organized by Q1. Total participants 

will be 200. The category of participants will be members of PNDT Committee, women Activist from 

state & district, members of State women Commission, advocates. 

D.6.4 Professional Development Course: 

The PDC training is a 10 weeks course with a batch size of seven (7) trainees per batch. 

Training is imparted at NIHFW Kolkatta. Programme is supported by GoI. Nomination and 

participation of MO will be ensured. 

D.6.5. Ultrasound Training: 

Training in Ultrasound will be imparted to 16 number of specialist from each 16 districts in 

the state. Duration of training in ultrasound will be of 3 weeks. A batch of four specialists in a batch 

size of four will be trained during the year.Training will be completed by the fourth quarter of the 

year. 

D.6.6. MSc (Nur) course): 

D.6.7. Continuing Medical Education to all MOs and Staff Nurse: 

A two days workshop at the state level will be organized for providing continuing Medical 

Education to all the MOs and Staff Nurses.The workshop will be held at the state level. 

1. Total No. of MOs in the state: 400 (8 batches) 

Estimated Fund: Rs. 430100/- @ Rs. 1075.25 

158

2. Total No. of Staff Nurses in the state: 300 (7 batches) 

Estimated Fund : Rs. 218515/- @ Rs. 624.33/- 

This will be done on 3 rd Q 

E. Programme Management Training (HMIS) : ( SPMSU/ DPMSU /BPMSU staff) 

Training component on MIS Monitoring Evolution will include DHIS 2; web based online 

Data entry and Offline Data entry, quality checking of data, compilation and analysis of data, 

tracking of pregnant women and infant, feed back to filled and timely reporting to higher authority. 

MIS training for, DPM, Accountants, Data Assistant, Statistical Investigator, Data Manager and for 

personnel from all Vertical Program will be organized on total HMIS twice this year with technical 

support from GoI. The specific objectives of the intervention are: 

1. Reorientation of all ANMs / LHVs and other health workers on the revised HMIS 

formats with maintenance of record keeping and on timely reporting. 

2. Building skills of worker for improving quality of data, data analysis at local level 

and use the same for planning & monitoring of the programme performance. 

3. Reorientation of State & District Level Officials on use of NRHM Web Portal. 

A reorientation programme for 2 days is proposed to be organized at State HQ to 

orient the District level officers, initially District Programme Manager (DPM), District Data 

Assistants, Accountants, Statistical Investigator and Computer Assistants of all districts. The training 

shall be on the new reporting system and M&E. the training shall include orientation on the DHIS 2, 

Web based HMIS portal. The training is proposed to be conducted in 2 batches with participants 

from 8 districts in each batch. They shall be the trainers for the training programme to train the Sub 

district level officers & staff involved in reporting. 

Similarly 2 days training will be conducted at district HQ in each district to orient the Block level 

officers and staff within the same quarter to maintain the quality of training. From the state HMIS 

cell one person will be attend at the district level training. The training shall be scheduled during the 

1st and 3rd quarters. From each Health Facility a person responsible for reports will be invited to 

the 2 Days training programme to be conducted at the District HQ. The orientation programme will 

mainly focus on the reporting system, reporting formats and data analysis under NRHM. The 

expenditure is budgeted in the Training head. 

1 day Reorientation of SC level Staffs at concern higher facility during 1 st & 3 rd qtr. 

159

NBITS 

In order to implement the Name Based Information Tracking System of Pregnant Women and Child, the State intends to organize 1 day training of the 

District Nodal M&E Officers at the State level on NBITS with technical support from the GoI in phase manner. The training shall be incorporated with the 

HMIS Training. These trained Personnel will further train the ANMs of the SC, PHC and CHCs of the concern Districts. The first phase would be completed 

by the 1st Quarter of 2010-11. The 2 nd phase training will be complete in 3 rd quarter. 

Sl. No. 

1 


State Level 

\HMIS 

District 

Nodal 


Training load 

No. of Batch 

M&E 

Officers 16 1 

District 

No. of Days 

3 

(1day 


NBITS) 

TENTATIVE TRAINING PLAN 

Timeline 

1 st 

Qtr. 

Venue 

160 



Honorarium to Guest Faculty 

State Hq. 19200 16000 1800 

Accounts 

Managers 16 1 State Hq. 19200 16000 1800 

Working Lunch 

Tea/Snacks 

1500 

0 3000 

1500 

0 3000 



Total 

1200 

0 7650 74650 

1200 

0 7650 74650 

Remarks 

TA as 

per 

actua 

l or 

State 

Govt. 

Norm 

s.

2 

3 

Total 

District 

Level 

HMIS 

Block 

Level 

HMIS 

DA of other 

Programs 8 1 State Hq. 9600 8000 1800 

MO i/c & 

Data 

Personnel 262 16 

Persons from 

reporting SC 273 184 

2(1day 


NBITS 

1 (MIS 

& 

NBITS) 

1 st 

Qtr. District 

1 st 

Qtr. 

Hq. 

Concern 

Higher 

Facility 

161 

68120 

0 

26200 

0 

10920 

0 54600 

1920 

0 

1500 

0 3000 

Budget estimated for total 2no. of Rounds of training in 1 st and 3 rd Qtr during 2010-11. = 2x 1875113= Rs. 3750226.00 

7860 

0 

4095 

0 

2620 

0 

2730 

0 

1200 

0 7650 57050 

6550 

0 

17737 

5 

6825 

0 72038 

13100 

75 

35868 

8 

18751 

13

F. IEC / BCC Training: ( Capacity Building for IEC Personnel in the state) 

The success of NRHM depends on the ability to communicate effectively with each 

functionary/stakeholder with in the health system. It is understood now that the availability of the 

resources and the necessary infrastructure alone will not ensure the health of community and raise 

the standard of living and quality of life. The development communication plays very significant role 

in improving health status of the community. Therefore it is necessary for all those persons who are 

engaged in community health to know the concepts of health communication targeted at community 

mobilization and their participation in preventive & promotive health along with population control 

measures. 

Capacity building for IEC officers is felt due to inadequate understanding of key 

programmes by core personnel, capacity to carry out interventions varies from state to state and lack 

of understanding to introduce innovations in the communication process among the health 

programme & media managers. The intra communication would be useful for successful 

implementation of NRHM interventions. More over- 

1. It would ensure greater clarity with in the system on key initiatives. 

2. It would establish proper articulation of objectives and details by key stakeholders with in the 

programme. 

3. It would improve the final impact of the programme by establishing a two way 

communication process. 

4. It would help identifying definite roles & responsibilities for key functionaries with in the 


It is therefore propose to conduct 3 (three) days training course of one batch with 25 (Twenty 

five) only participants at Itanagar/Naharlagun which will be conducted in the second quarter during 

the year 2010 -11. 

G. Orientation workshop RKS/NRHM for PRI in dist level 

Since the RCH, NRHM and other vertical health programmes are one of the subjects given to 

the Panchayat., The state aims to sensitize the PRI members of the state about the all the national 

health programmes. The state plans to organize a one day workshop to sensitize the members of PRI 

( ZPM, Block Chairperson ) about the privileges of NRHM and other vertical health programmes and 

role of PRI members in implementation of programmes. (as a member of RKS & VHSC) 

The budget required will be Rs 22.0 lacs. The training will be conducted in the 2 nd Q. 

H. Orientation workshop on national health programmes for administrative officers. 

Since administrative officers like Deputy Commissioners in the district and Circle 

Officer/Eac in circle headquarter are the chairmen of the district head society and RKS, their 

involvement is there in every programme implementation, so it is advisable that they are well 

versed with the guidelines and other relevant health policy. Hence the state plan to organize a 

one day orientation workshop in the state capital for the administrative officers of the state. 

Minimum of 4 ( 64) participants from 16 districts will be made to join the workshop. The 

budget required will be 8.2 lacs. This workshop will be conducted in the 2 nd quarter. 

162

Training during 2009-10: 

Sl.No. Types of Training 

1 

2 

3 

4 

Training during 2009-10 under RCH 

Category of 

Health 

Personnel 

Phisical 

Target Acheivement 


SBA 6 0 6 

EmOC 1 1 0 

LSAS 2 2 0 

MTP 3 ongoing 0 

RTI/STI 

Child Health 

20 

No report from 

District 

IMNCI MO 56 56 0 

F-IMNCI TOT 2 

FBNC 13 0 13 

NSSK 


Laperscopic 

TOT 5 

Sterilization 2 1 


Mini Lap 20 District 


IUD Insertion 

IUD Insertion 

MO 92 District 

TOT 

Contraceptive 

47 

Update 

Other 

Continuing 

Medical & 

Nursing 

1 No. 1No. 0 

Education MO 400 0 400 

Programme Mgt 

SN 300 0 300 

HMIS State Level 1 1 0 

Dist. Level 16 3 13 

163 

Back 

Log Remarks

Training integration or clubbing of the various training ( Format TRG –F) 

Tentative plan for Integration of Training as given in Comprehensive training Plan 

Integrated 

Training 

packages 

for Staff 

A. Medical 

Officer 

B. ANM 

Sl.No. as 

given in CTP Budget Head 

RCH Flexipool MTP & IUD 

164 

State can club or 

integrate training as 

per need Remarks 

RCH Flexipool IMNCI, FBNC & NSSK 

NLEP & 

RNTCP& IDSP 

NLEP & RNTCP 

& NVBDCP 

Prevention & Mgt. of 

Leprosy, Prevention & 

Management of 

Tuberculosis, IDSP 

Reorientation on 

Leprosy, Tuberculosis, 

Malaria 

RCH Flexipool RTI/STI & ARSH 

RCH Flexipool IMNCI, RI 

RCH Flexipool IUD, ARSH & RTI/STI 

C. LT RNTCP & IDSP RNTCP, IDSP 

D. ASHA NRHM 

6th Module, 

Orientation 

NLEP, NVBDCP NLEP, Malaria

Comprehensive Training Plan: Please refer Annexure 9 (b) 

Training Calendar for 2010-11: Please refer Annexure 9 © 

Monitoring & Evaluation of Training Programme: 

It is a process which assess whether: 

• The competencies aimed for have been built up. 

• And increase in competency lead to an improvement in service delivery. 

Evaluation can be: 

Process Evaluation: 

1. Pre & Post Test Evaluation: It will be tabulated and will be documented and sent to Training 

centre at each level (State & District Hqtr.) 

2. Feed Back from trainees: 

To receive feed back from all the trainees helps to identify whether trainees are satisfied with the 

training programme and help to improve the training programme for further session. It is basically 

an evaluation of the trainer. This feed back form will be compiled for making analysis and will be 

documented and sent to Training Organizing Team. 

3. Field Monitoring visit has been planned to ensure quality of training programme. 

Outcome Evaluation / Post Training Follow up: 

• Ongoing supportive supervision: 

As soon as training has been completed, it is very much important for making learning 

stronger through supportive supervision by seniors to make the trained personnel more confident 

and comfortable to translate their learning to their work and also to monitor whether equipments, 

infrastructure etc. are available or not. 

And again after 3-6 months second supportive supervision is required to be done to assess 

whether increase in competency lead to an improvement in service delivery. 

• Proficiency Certificate: A Proficiency Certificate will be validated after assessing 

performance at the place of posting over a period of 3-6 months after the training to ensure 

training outcome. 

Quality Assurance of training programme: 

Quality Assurance Committee at State & District and Quality Circle at facility level will look 

into entire quality issues of training. 

M&E Activity: 

• Printing of Pre & Post Test Evaluation Form. 

• Printing of Feed Back form. 

• Supportive Field Supervision during ongoing training & after 2-3 months of training. 

165

Monitoring of ongoing training programme: 

Action Plan for monitoring visit: 

• Timeline for visit: Mid of every training programme. 

• Duration of visit: 2 days. 

• No. of team Member: 2 nos. 

• Filling up of monitoring format by monitoring team. 

• Monitoring report will be given to training cell ( State/ Dist.) by monitoring team. 

• Based on monitoring team’s report state training cell will take necessary steps if necessary. 

General Monitoring Indicator for ongoing training programme: (Draft) 

Sl. No. Monitoring Component Remarks 

A 

Trainers 

B Trainees 

1. Does the group of trainers chosen for the training include an 

Ob/Gyn/ Paed. Specialist. 

2. Are the “Facilitators” Guide” & Guidelines for SBA available with 

these trainers? 

3. Has the training schedule/ roster been drafted for the training: 

1. Did she/he join the training from the first day? 

2. Does she/he possess both Guidelines and Handbook: 

3. Did she/ he satisfied with training arrangement? 

4. Technical Question. 

C Training Site 

1.Are the Drugs, equipments are available? 

2. Case load is adequate or not? 

Calendar for Monitoring of ongoing training programme: Please refer Annexure 9 (d) 

Budget for monitoring of ongoing training programme: (State Level Officials) 

Sl.No. Budget Head Budget Estimation Total Budget Remarks 

1 TA/Mobility 

Support 

No. of visit to Dist. Hqtr. By State 

training official for monitoring 

166 

10000X 24 /year X 

2 Officials = 

480000 

@ Rs. 10000 each 

for 2 Officials for 

district Hqtr. 

(twice in a month)

No. of Visit to GH naharlagun/ other 

training centre 

2 DA Rs.700 x 2nos. of member x 24 nos. 

of time of various monitoring visit x 

5days 

167 

24000 @ Rs. 2000/month 

168000 

TOTAL 672000 

Monitoring/ post training follow up: 

Action Plan for monitoring: 

• State will ask every district QAC to submit post evaluation report with recommendation by 

April 10. 

• Based on District QAC report, State training cell in coordination with programme officer 

take action (such as provision of infrastructure, equipments, refresher training) if necessary 

in coordination with programme officer. 

• Field Visit by State QAC/ M&E has also been planned. 

• Timeline for visit of health institution functionalized till date by training: After 3/6 months (by 

Q1 & 2) 

• And time line for visit of health institution functionalized by training within 1 st & 2 nd Q: After 

3 month (Q3 &4). 

• Each Quarter: 6 SC, 3 FRU, 6nos. of 24 x7 PHC & 6nos. of 24x 7 CHCs will be visited. 

• Duration of visit: 1 day. 

• No. of team Member: 2 nos. 

• May be clubbed with M&E activity also. 

• Filling up of monitoring format by monitoring team. 

• Monitoring report will be given to training cell (State/ Dist.) by monitoring team. 

• Based on monitoring team’s report state training cell will take necessary steps. 

General Monitoring Indicator for post training: (Draft) 

Sl.No Issues Remarks 

1 Is infrastructure is available for practicing the upgraded skill by 

trained personnel 

2 How many days training was received by him/her 

3 Has trained personnel received certificate 

4 Is equipment other supplies are available at the facility 

5 No. of cases handled by trained personnel in the last one month 

6 No. of cases referred if any & why 

7 Any problem or recommendation by trained personnel for 

smoothly practicing the upgraded skill.

Calendar for Post Monitoring of training programme: Please refer Annexure 9(d) 

Budget for monitoring / post training follow up: ( State Level officials) 

Sl.No. Budget Head Budget 

Estimation 

(approx) 

1 TA/Mobility Support 

2 DA Rs.700 x 2 

Officials x 12 

nos. visit. 

168 

Total Budget Remarks 

200000 @ Rs. 50, 000 

each Qtr. For 

visit of 6 SC, 3 

FRU, 6 nos. 24 

x 7 CHC& 

PHCs. 

16800 

TOTAL 216800 

Note: Post training follow up visit may be clubbed with regular M&E activity by M&E cell, 

whenever possible . 

MIS under Training: 

• Recording: District will be asked to generate data on Training status (information includes 

trained personnel in various categories name wise till date on various subject and name of 

health facility they are posted) by Q1 and sent a copy to State Head Qtr. And also when new 

training take place and any trained personnel transferred update the same and sent the same 

to state mentioning the posting place which is must. 

• Reporting: District will be asked to sent Monthly/Quaterly report of training status along 

with other monitoring report prepared by QAC or District Health Society etc to state head qtr 

by 5 th of every month.

Detail Training Budget: Please refer Annexure 9 (f) 

Format TRG –E (with the intention of cumulative budget for trainings in different programs) 

Trainings under Program Funds for trainings 

(only training funds 

to be given) 

169 

Remark 

RCH 3,52,87,644/- (MH/CH/FP/ARSH/IEC 

PRI/Administrative Officer/PMSU- 

HMIS) 

NRHM 2,004037 (ASHA/PMSU-Financial Mgt.) 

RI 9268300/- 

Malaria Programme 49,40,000/- 

RNTCP 16,65,000/- 

NLEP 11195000/- 

IDSP 31,25,000/- 

NPCB 2,70,000/- 

AYUSH 8,50,000/- 

12. BCC

Behaviour Change Communication is one of the vital components under NRHM programme. 

IEC/BCC activities in the state has been planned on the basis of felt need based realistic strategy , 

local specific , prepared as per awareness level and taking into consideration the various health 

related needs of the people in the districts targeting the rural population in the state . The innovative 

IEC/BCC activity in the state has been planned keeping in view the DLHS-3 indicators and also 

District Health Action Plan. One of the major innovative BCC Strategy in the state is to develop local 

specific campaign using indigenous socio-economic background of the tribal people. It also 

emphasizes “multi media” activities using various folk media and IPC as well as group 

communication. As the state has inhospitable topography, highly dispersed and inaccessible areas so 

the use of most localized form of communication would be the best way of informing and motivating 

the rural masses in the state. The main focus of the BCC strategy in the state is promoting behavioral 

changes rather than awareness generation and to introduce well defined and culturally appropriate 

for specific district and population segment. Various rural and outdoor activities in the state will be 

undertaken through IPC, counseling, Community meeting, group discussion, workshop for PRI 

members, one-to-one interaction, folk media, Health camp/ Health mela, Electronic/ Print media and 

through other sensitization programme in the state. 

12.1. STRENGTHENING OF IEC/BCC BUREAUS (STATE AND DISTRICT LEVEL) 

IEC MANPOWER IN THE STATE AND THEIR ROLES/RESPONSIBILITIES 

Deputy Director, IEC (State level) - 1 

Mass Education and Information Officer (District Level) - 1 

Dy. Mass Education and Information Officer (District Level) - 4 

District Extension Educator (District Level) - 6 

The role of Deputy Director, IEC (State level) is to facilitate the District IEC/BCC officials to 

prepare/plan BCC activities in the district. He also reviews, monitor and supervise BCC activity in 

the district from time to time. His role is also to plan and implement Electronic/print media activity in 

the state in coordination with other departments. Planning, development and execution of various 

communication activities in respect of NRHM programme also comes under his responsibility. Mass 

Education Information Officer (MEIO), Deputy Mass Education Information Officer (Dy. MEIO) and 

District Extension Educator (DEE) prepare/plan District BCC activities which includes BCC activity 

plan for CHC/PHC and SCs. Their role is also to plan and implement mass media campaign viz. 

electronic and print media in the districts and the state. MEIO is also responsible to supervise the 

IEC activities carried out by subordinate IEC officials in the area of CHC/PHC and SCs, distribution 

system of effective IEC materials, strategy motivation and sequencing of programme. 

Strengthening of State and District IEC/BCC Bureau is utmost important in the State. Due to 

inadequate manpower, infrastructure facilities and non-availability of vehicles for monitoring 

activities are the major factors responsible for low achievement of IEC activities as desired in the 

peripheral level. Most of the district IEC/BCC wings are being run by staff drawn from other 

unrelated fields. Therefore, all the vacant posts need to be filled up urgently and responsibility of all 

the IEC activities should be handed over to the IEC personnel so that the state could translate the 

objectives into reality. 

170

IEC Data Entry Operator 

1 no. of IEC Data Operator will be recruited on contract basis at a consolidated monthly pay 

of Rs. 16000/- only for compilation of data, maintaining of reports & return from the districts and 

operation of Computer. The candidate must have Class-XII passed certificate with 1 year diploma 

course in Computer Application and preference will be given to those candidate having atleast 1 year 

experience in this profession. He/She shall be posted at the State IEC Bureau, Naharlagun. 

Recruitment will be done in the second quarter. 

IEC Equipment 

District must have adequate IEC equipments to carry out the IEC activities. Due to lack of 

these equipments Film/Video shows could not be implemented at the peripheral level. Therefore, it is 

proposed to procure 8 nos. of digital LCDs with Screen in the state @ Rs. 1.80 lakh (in 8 districts 

initially). Procurement will be done in the 3 rd Quarter. 

Exhibition Board 

Exhibition Board is essentially required in all the districts to display IEC materials during 

exhibition shows/community or group events in the districts and state HQ. Therefore, 17 nos. of 

exhibition Board will be procured in the 3 rd Qtr. @ Rs. 45,000/- per board. 

12.1.1 Contractual Staffs recruited and in position 

No contractual staffs under IEC/BCC Bureau have been recruited so far in the state. 

Therefore, 1 no. of IEC Data Operator has been proposed to be recruited in this financial year. 

12.1.2. Other activities (Capacity Building for IEC Personnel in the state) 

The success of NRHM depends on the ability to communicate effectively with each 

functionary/stakeholder with in the health system. It is understood now that the availability of the 

resources and the necessary infrastructure alone will not ensure the health of community and raise 

the standard of living and quality of life. The development communication plays very significant role 

in improving health status of the community. Therefore it is necessary for all those persons who are 

engaged in community health to know the concepts of health communication targeted at community 

mobilization and their participation in preventive & promotive health along with population control 

measures. 

Capacity building for IEC officers is felt due to inadequate understanding of key 

programmes by core personnel, capacity to carry out interventions varies from state to state and lack 

of understanding to introduce innovations in the communication process among the health 

programme & media managers. The intra communication would be useful for successful 

implementation of NRHM interventions. More over- 

5. It would ensure greater clarity with in the system on key initiatives. 

6. It would establish proper articulation of objectives and details by key stakeholders with in the 

programme. 

7. It would improve the final impact of the programme by establishing a two way 


8. It would help identify definite roles & responsibilities for key functionaries with in the 


171

It is therefore proposed to conduct 3 (Three) days training course of one batch with 25 

(Twenty five) only participants at Itanagar/Naharlagun which will be conducted in the second 

quarter during the year 2010 -11. 

12.1.3 Formative research / situational analysis / baseline study to identify focus areas 

Formation of KAP research team to carry out Knowledge, Attitude and Practice (KAP) will 

be formed under State Health Society to find out the existing Knowledge base Attitude and Practices 

in all the districts. The awareness level on various health issues among the rural population is very 

low. The BCC/IEC activities in the state could not implemented as planned and desired level in terms 

of performance primarily due to the peculiar topography and low acceptance of health services at the 

peripheral level. To prepare any messages for the community to be transmitted through the different 

media , plan for attitudinal change of the rural masses , the assessment of KAP regarding different 

vital components under NRHM programme and its services is required. Therefore, it is proposed to 

carry out a KAP study in the district through 4 (four) identified zones during the 1 st quarter @ Rs 

50,000/- (Rupees Fifty thousand) only per zone during the year. 

12.1.3. Development of state BCC strategy (IPC through Community Meeting) 

Sensitization programme through Community meetings by MOs, ANMs, ASHAs & Health 

educators will be organized involving student leaders, social activist and PRI members on Health and 

Hygiene, Sanitation, Immunization etc. as per felt need and awareness level of the Area, Block & 

Villages targeting unreached and rural population in the districts. 64 nos. of community meetings will 

be organized in the state i.e. 16 districts X 4 Qtr = 64 nos.) @ Rs 15000/- per meeting in every 

district during the year. 

12.1.4 IMPLEMENTATION OF IEC/BCC strategy (IPC through workshop for PRI members) 

IPC through workshop for PRI members at block level on RCH/FW themes will be organized 

in the district. 128 nos. of IPC will be organized in the state i.e. 2 nos. per qtr per district (16 X 2 X 4 

= 128 nos.) @ Rs 10000/- per workshop during the year. 

12.1.5 BCC/IEC activities/campaign for maternal health (Counseling through IPC during 

health camp/mela) 

Mothers who had 3 or more ANCs in the state are 48% (DLHS-3) and who had full ANC is 

only 5.4%. In order to increase ANC coverage, counseling through IPC during health camp/mela, 

VHND through MOs, ANMs/GNMs, Health educators and ASHAs involving PRI members, Self help 

groups and members of Women Welfare Society (WWS) will be organized targeting the rural 

population preferably remote and inaccessible areas in the districts with an objective to increase the 

ANC coverage and also to reduce anaemia among women and children. Combined activities of 

Advocacy, meetings etc. will be organized at the same time during the Health camp/mela making it 

cost effective. 256 nos. of IPC through counseling will be organized in the state i.e. 4 nos. of IPC 

campaign per qtr in every district i.e. 4 X 16 X 4 = 256 @ Rs 5000/- per campaign during the year. 

IFA consumption in the state is 42.9% (DLHS-3) which can be checked by generating awareness on 

the importance of its consumption to mothers during the health camp/mela, VHND etc. PNC within 

48 hrs is 38.3% (DLHS-3) which is very low. This can also be checked through counseling during the 

health camp/mela, VHND etc during the year. 

12.1.6 BCC/IEC activities for maternal health intervention (except JSY) IPC through FGD 

172

Focus group discussion (FGD) through MOs and ANMs involving MSS and Angan Wadi Workers 

(AWWs) will be organized in the rural population, un-served areas targeting woman and adolescent 

girls in the district mainly emphasizing on the importance of early breast feeding within one hour and 

exclusive breast feeding upto six months.192 nos. of FGD will be organized in the state (3 each in 

every Qtr in 16 districts i.e. 3 X 16 X 4 = 192 @ Rs 3000/- per FGD in every district during the year. 

12.1.7. BCC/IEC ACTIVITIES FOR JSY 

Communication strategies with emphasis on need of 3 ANCs, ingestion of 100 IFA (L) tablets, 

2 TT injections, birth preparedness and importance of hospital delivery early breast feeding within 

one hour and exclusive breast feeding upto six months will be organized to increase awareness 

among the mothers and communities. One- to - one interaction through ASHA will be organized by 

engaging 3595 ASHAs in every Qtr to create about JSY scheme and its services available in the 

health facilities. 64 nos. of health camps/ mela will be organized in the state (1 each in every Qtr. i.e. 

16 districts X 4 Qtr. = 64 nos. @ Rs 5000/- per camp). 2000 col. Cm of print advertisement on JSY 

messages will be published in the local newspaper and magazine as a part of publicity campaign 

targeting the urban population and educated group @ Rs 85/- per col.cm. Financial involvement for 

this activity will be Rs 1, 70,000/- 

12.1.8 BCC/IEC activities/campaign for Child Health 

As a part of awareness campaign, production and telecast of quickies/films on child health/ 

Girl child (gender equity) and recognition of danger signs and care of newborn will be produced. 4 

nos. of quickies/films will be produced (1 each in every Qtr @ Rs 3 lakh per Quickie) in the state 


It is also observed that radio jingles is one of the most effective IEC/BCC campaign in the state. 

Therefore 12000 secs of radio jingles (3000 secs per Qtr @ Rs 100/- per sec) on recognition of 

danger signs and care of the newborn will be highlighted in different local dialects involving local 

artists and broadcast at FM Radio and 5 AIR stations in the state during the year. 

Flex Hoardings with vital messages on child health with a focus on recognition of danger signs and 

care of the newborn will also be taken up. 64 nos. of Flex Hoarding i.e. 1 each per Qtr @ Rs 25000/- 

per hoarding will be produced and distributed in every district during the year. 

The communication activities to increase awareness amongst mothers on benefits of breast-feeding 

upto 6 months and need of complementary feeding from 6 months onwards will be augmented. Main 

areas where the BCC/counseling activities will be addressed are during VHND, RCH camps, MMU 

and RI outreach sessions. Awareness amongst mothers and communities on diarrhea emphasizing 

mainly on use of boil water, continuing breast feeding even during diarrhea, solid feeds, ORS useage, 

and more importantly, use of local/home made ORS will be undertaken on VHND. Also, identification 

of danger signs of diarrhea will be ensured through ASHA at village level. ORS packet will be made 

available upto ASHA level. Awareness generation on identification of Pneumonia and Diarrhea cases 

will be taken up at VHND at village level through ASHA and ANM. 

12.1.9 BCC/IEC activities/campaign for family planning 

The percentage of male sterilization in the state is as low as 0.5% (DLHS-3), Pill is 10.9% 

(DLHS-3) and Condom 3.1% (DLHS-3). Much emphasis will be given on these family planning 

methods through various media activities to raise awareness amongst couples and communities about 

the advantage of contraceptives and small family. Awareness campaign through folk songs plays and 

173

dramas will be organized during the local festivals/events involving local cultural groups on 

RCH/FW messages/themes. Rural population including young and old will be targeted to sensitize on 

family planning. 64 nos. of folk songs, plays and dramas will be organized (4 each per Qtr @ Rs 

10000/- per play) in every district during the year. Exhibition shows will also be organized during the 

local festivals/events involving village head and local youth through MOs, ANMs and projectionist. 

64 nos. of exhibitions shows will be organized in the state (4 each per Qtr @ Rs 5000/- per show in 

every district during the year). Wall writing on vital RCH/FW messages will also be done. 320 nos. of 

wall writing will be done (80 per Qtr @ Rs 3000/- per wall) in the state during the year. Since local 

channels/cable are very sought after and viewed by many, messages on RCH/Family planning will be 

telecast on those channels to generate wider awareness among the rural and urban masses. 200 nos. 

will be telecast (50 each per Qtr @ Rs 500/- per telecast) in the state during the year. 

12.1.10 IEC/BCC activities/campaign for ARSH 

Women who have heard of RTI/STI are 21.7% (DLHS-3) and Emergency Contraceptive Pill 

(ECP) is 27.9% (DLHS-3) in the state. Advocacy meeting in the schools through MOs/ANMs/GNMs 

involving student and youth leaders will be organized targeting urban and rural population on 

optimum awareness of RTI/STI and ECP among them. Communication strategies with emphasis on 

marriage after 18 years and first child after 20 years will also be organized. Main emphasis will be 

given to married and unmarried adolescent, school drop outs, street and urban slams/labour camps, 

children etc on various Reproductive Sexual Health issues. 128 nos. of advocacy meeting will be 

organized in the state (2 nos. per Qtr @ Rs 5000/- per meeting in every district during the year). 

Newsletter containing various activities under NRHM will be printed and distributed in every district. 

24000 nos. of Newsletters will be published (6000 nos. @ 160/- per piece) and distributed in all the 

16 districts at the end of 2 nd and 4 th quarter during the year. 

12.1.11 Any other activities. 

Mother’s Picnic:- 

In co-ordination with IEC Bureau and in its pilot project involving RKS, Mother’s picnic will 

be organized with its concept to generate awareness among the pregnant women and breast feeding 

mothers on various health, hygiene and sanitation and importance of mother and child’s health care. 

Picnic will be an attraction for all the mothers and pregnant women and a source to obtain their 

attention in understanding and learning the importance of their wellbeing. 35 nos. of picnic will be 

organized in all the 35 CHCs (1 no. in each CHC @ Rs 25,000/- per picnic) in the state during the 

year. 

Tableau:- 

Tableau can be displayed in the state level during the celebration of Republic Day and 

Statehood Day highlighting vital messages on various RCH/FW themes. 2 (Two) nos. of Tableau can 

be displayed @ Rs 1, 50,000 (One lakh fifty thousand) only per Tableau and this will be implemented 

in the 4 th quarter during the year. 

Bus Panel:- 

In order to spread wider awareness on various RCH/FW messages even in far flung and 

unreached places, Bus panel will be put up/hung on every APST (Arunachal Pradesh State 

Transport). 64 nos. of bus panel will be put up (16 nos. per Qtr @ Rs 2600/- per panel) in the state 


174

Street Play:- 

Plays in the street will be organized through school going children and members from local 

play club on occasions highlighting the importance of various RCH/FW messages. 64 nos. of Street 

play will be organized (16 nos. per Qtr @ Rs 15,000/- per play) in the state during the year. 

Rallies:- 

Rallies involving school going and college going students will be organized holding banners, 

posters, play carts etc. containing various messages on RCH/FW programme on different health 

related occasions. Rallies will be organized in the state during the year. 

Flip Chart:- 

Flip charts will be produced and distributed in all the districts in order to make the public 

better understand the importance of RCH/FW programme during the course of training. 1572 nos. of 

Flip charts will be produced (393 nos. per Qtr @ Rs 250/- per piece) and distributed in all the 

districts during the year. 

Poster:- 

Posters containing various messages on RCH/FW programme will be printed and distributed 

in all the districts and peripheral areas during health camps/melas, VHND and to be distributed in 

schools, colleges and other departments. 40000 nos. of posters will be printed (10000 nos. per Qtr @ 

Rs 35/- per piece) and distributed in every district during the year. 

Pamphlet:- 

Pamphlets containing various messages on RCH/FW programme will be printed and 

distributed in all the districts and peripheral areas during health camps/melas, VHND and to be 

distributed in schools, colleges and other departments. 40000 nos. of pamphlets will be printed 

(10000 nos. per Qtr @ Rs 15/- per piece) and distributed in every district during the year. 

Wall Calendars:- 

Wall Calendar containing essential health messages on RCH/FW programme will be printed 

and distributed to all the district head quarters during the year. 10,000 (Ten thousand) nos. of Wall 

Calendars will be printed @ Rs 120/- per piece in the 3 rd quarter. 

Signboard:- 

180 nos. of Signboards containing messages on RCH/FW programme will be produced and 

installed in all the PHC/CHC and DH’s in the districts involving RKS @ Rs 12,000/- (Rupees Twelve 

thousand) only during 2 nd qtr. 

Monitoring and Evaluation:- 

The State Monitoring and Evaluation Team (SMET) formed under State Health Society will 

monitor and review the BCC activities undertaken in the districts. The main objective will be to asses 

the physical performance, its feedback and evaluate the impact of IEC/BCC activities implemented in 

the districts and its peripheral areas through first hand information from the rural population. 

Review meeting/ monitoring the activity will be done in every Qtr in every district. The District 

175

Monitoring and Evaluation Team (DMET) formed under District Health Society will monitor and 

review the BCC activities in all the peripheral level on a quarterly basis. 

Progress made in the last 2 years:- 

• Health camps/melas have been organized in the state and districts involving local NGOs as 

well as the medical fraternity of the health dept. The involvement and presence of Specialist 

doctors have helped in attracting a good number of Audience and many have come forward 

to be a part of the health camps/melas, 

• Almost all the community meeting and Group discussion have been organized involving PRI 

members and other locals from in and around the districts wherein various IEC/BCC 

implementation activities have been discussed. 

• Print advertisement being a very important part and backbone of IEC/BCC activities in the 

state, much emphasis has been given and various messages on RCH/FW programmes have 

been conveyed through leading dailies, weekly and other local magazines during the last 2 

years. 

• One major progress that has seen its way under IEC/BCC component in the state during the 

last 2 years is the publishing of state’s very own NRHM Newsletter. Publishing the 

Newsletter itself is a step forward in implementation of IEC/BCC activities in the state. Not 

many are aware or informed of the functions of NRHM programme in the state which is a 

hindrance in implementing the programme effectively and achieving its optimum goal. 

NRHM Newsletter, named “Health Manoeuvre” contains all the achievements, current 

status, progress and functions of the NRHM programme in the state, thereby playing a 

pivotal role for general public in understanding the programme better. 

• Newly launched FM Radio in the state which is very commonly listened to and preferred by 

the general public in the state has been generously used in conveying various messages on 

RCH/FW themes from time to time. 

Summary of the Total Budget: 

1 st Quarter 2 nd Quarter 3 rd Quarter 4 th Quarter 

40.16 71.0935 74.944 60.144 

Total Amount: Rs 246.3415 (Two Crore Fourty Six lakh Thirty Four Thousand 

One hundred and Fifty) only. 

176

13. Procurement 

13.1. Procurement of equipment 

13.1.1. Procurement of equipment for Maternal Health 

13.1.1.1. Procurement of equipment of skills based services (anaesthesia, EmOC, SBA) 

• E-P kits for 3 DHs in kind 

• Anaesthetist equiptment for 1 DH @ 5,00,000/- 

• Delivery Kits for 31 CHCs and 85 PHCs @ 9,900/- 

• One 15 KVA Genset for DH Changlang @ Rs 430000/- 

• 16(sixteen) 5 KVA Genset for PHCs / CHCs @ Rs 250000/- 

• MVA sets@ 10 nos. Per facility for 55 health facilitites i.e., 550 nos. of MVA sets will be 

procured @Rs. 1,500/- per set. 

• 30 MTP sets for PHC / CHC @ 3000/- will be procured. 

• 50 Binocular Microscopes for PHC / CHC @ Rs 40000/- 

13.1.2 Procurement of equipment for Child Health 

• SNCU equipments & furnitures for one FRU @ Rs 2500000/- 

• 3 NBSU for 3 FRUs @ Rs 275000/- 

• 71 NBCC equipments & furniture @ Rs 100000/- 

13.1.3. Procurement of equipment for Family Planning 

• 419 IUD kits @ Rs 5000/- may be provided by GoI. 

• 25 Minilap set to be provided by GoI. 

• Silastic ring already indented to GoI separately. 

13.1.4. Procurement of equipment for IMEP 

• Budgeted under NRHM additionalities. 

13.2. Procurement of Drugs and supplies 

13.2.1. Procurement of drugs and supplies for maternal health 

• 303 x 2 SC kit A & B. 

• ANC kits for 193 SCs 

• FRU kits for 14 DH/GHs 

• 14 RTI/STI kits for FRU. 

• 116 RTI/STI Kits for PHC / CHC 

• 116 SBA kits . 

• CHC/PHC kits – 116 kits 

The above items are not budgeted. GoI may supply in kinds. 

13.2.2. Procurement of drugs and supplies for child health 

• Already proposed as above. 

177

14. Programme Management 

Programme Management under RCH-II 

Programme Management has become an integral and key component of NRHM programme 

considering the complexity and volume of activities undertaken. With the decentralization of finance 

and manpower down to the sub-district level, the cost of management has increased manifold. 

Further, with the integration of all individual vertical programmes under NRHM, the volume of 

activities particularly of the State Financial Management Group (FMG) has considerably increased 

alongwith the financial management cost. With the introduction of Concurrent Audit and Financial 

Monitoring as a regular feature of financial management under NRHM, the increase in the 

administrative expenses, especially in the Mission Directorate, cannot be overlooked. Besides this, 

the frequency of monitoring visit of MoHFW and RRC-NE officials to the State has increased, which 

further leads to increase in the cost of management. 

In order to ensure smooth and effective implementation of the programme in the State, the 

minimum requirement for office and administrative expenses are spelt out below: 

1. POL : The present number of programme vehicles provided by the State Department of 

Health & Family Welfare for NRHM and kept at the disposal of the State Health Society and 

District Health Societies is 23 (16 in districts & 7 Mission Directorate). The requirement of 

POL is estimated @ 4 litres per day per vehicle at Rs. 50 per litre for normal station duty as 

prescribed by the A.P. State Health Society, along with Society norms for repair and 

maintenance of vehicle @ Rs 45,000/- per vehicle per year. 

Table shows annual requirement funds of POL during the Year. 

Agency No. of vehicle Consumption 

/month @ 4 

litre/day 

178 

Rate (approx.) Annual fund 

requirement (Rs.) 

Mission Directorate 7 124 ltrs. 50/- 5,20,000/- 

Distt. Health Society 16 124 ltrs. 50/- 11,90,400/- 

(Say 12,00,000/-) 

Total 17,20,000/- 

Table shows annual requirement fundsfor Repair & Maintenance of Vehicle during the Year. 

Agency No. of vehicle Maintenance rate per vehicle Annual fund 

requirement (Rs.) 

Mission Directorate 7 45,000/- 3,15,000/- 

Distt. Health Society 16 45,000/- 7,20,000/- 

Total 10,35,000/- 

2. Mobility Support: It is estimated that 10 Officers/Consultants/Managers of the State HQ 

would be required at least 6 official tours outside the State and 16 DRCHOs and 16 DMOs 

would be required to undertake at least 2 (two) official tours within the State and 1 (one) 

outside the State during the year. The approximate requirement of fund for Mobility Support 

would be as follows: 

Table showing annual requirement of funds for Mobility Support. 

Agency No. of Officials No. of POL/TA DA (Rs.) Total

tours (Rs.) requirement of 

fund (Rs.) 

Mission Directorate 10 6 15,000/- 10,000/- 15,00,000/- 

Distt. Health Society 32 3 10,000/- 5,000/- 14,40,000/- 

Total 29,40,000/- 

3. Stationery and postage: Keeping in view the day-to-day workload in the State HQ and 16 

districts, it is estimated that an amount of Rs. 4 lac and 8 lac for State HQ and 16 dsitricts 

(50,000 per district) respectively would be required during the year. 

Estimated Requirement: Mission Directorate = Rs. 4,00,000/- 

Distt. Health Society = Rs. 8,00,000/- 

Total = Rs. 12,00,000/- 

4. Computers, Furniture & Office equipments: The Mission Directorate is confronted with 

frequent load shedding and power failure throughout the year which ultimately hampers 

smooth working of the office. Therefore, a Generator/Gen Set of sufficient capacity would be 

required to mitigate this recurrent problem. It is therefore proposed that this machine may 

be procured at Rs. 6,50,000/- (including installation charges) during the year. 

5. Contingency Expenses: The State HQ has engaged 10 Nos. of contingency staffs such as 

Peons, Chowkidars, Sweepers etc. at Rs 3,500/- per month . (Estimate:- Rs. 4,20,000/- per 

year) to support the SPMSU officials. Apart from this, petty expenses and other 

miscellaneous expenses such as advertisement cost, telephone & mobile bills, water charges, 

meeting expenses, minor repair & maintenance of Mission Directorate Office, Incentives of 

FMG staff etc. for which an amount of Rs. 5,00,000 (appox.) would be required.(Total fund 

requirement = Rs. 9,20,000/-) 

6. Technical Assistance: It has been observed that officials from Ministry of Health & Family 

Welfare, Govt. of India, and other agencies such as RRC-NE use to visit our State for 

technical support from time to time. Apart from this, the Mission Directorate would require 

technical knowhow and expertise from outside sources. Therefore, to bear all the expenses 

like TA/DA, accommodation etc an amount of Rs. 9,20,000/- (approx.) needs to be earmarked 


Technical assistance may be required from outside expert agencies for preparation 

for State PIP and from CA firms for finalization of accounts during audit. For this purpose, 

some fund would be required under this head of account. Alternately, this job can also be 

performed by the existing programme management and finance staff of NRHM, if the 

required expertise is found available internally, by putting in additional work hours. In such 

a case, the fund will be utilized for paying incentives to the staff for overtime work. This is 

intended to boost efficiency and dedication in the work of the contractual staff engaged under 

NRHM 

(Total fund requirement = Rs. 9,20,000/-) 

7. Strengthening of Financial Management : Apart from the quarterly review meetings the 

Society has engaged monthly Concurrent Auditor for proper maintenance of accounts and 

streamlining the records of book keeping at State HQ and 16 District Health Societies 

including all the vertical programmes. Moreover, a Statutory Auditor will be appointed for 

Statutory Audit by following prescribed GoI norms for appointment. 

179

Apart from this, it has been decided by A.P. State Health Society that the audit of the NGO 

running PHCs under PPP project should be conducted by a single audit firm in order to ensure 

efficiency, uniformity and transparency in the process. 

Consequently in the NGO-Govt. Co-ordination meeting, it was decided to engage a common 

auditor. It was also agreed that the fee for the purpose would be centrally paid by the State Health 

Society from the RCH-II flexipool budget under the head of account “Strengthening of Financial 

Management”. It is estimated that an amount of Rs. 6, 00,000/- per annum would be required for the 

purpose. 

Financial Involvement: 

a) Monthly Concurrent Audit = Rs. 17,28,000/- (Rs. 9,000/month for 16 DHSs) 

Rs. 2,00,000/- (State HQ) 

b) Statutory Audit = Rs. 14,00,000/- (appox.) 

c) NGO Audit = Rs. 6,00,000/- (Approx) 

Total = Rs. 39,28,000/- (appox.) 

TABLE SHOWING SUMMARY OF PROGRAMME MANAGEMENT 

BUDGET UNDER RCH-II 

Sl.No. Activity Proposed 

amount (Rs.) 

1. POL 17,20,000/- 

2. Repair & Maintenance of 

Vehicle 

10,35,000/- 

3. Mobility Support 29,40,000/- 

4. Stationery & Postage 12,00,000/- 

5. Computers, Furniture & Office 

equipments 

6,50,000/- 

6. Contingency Expenses 9,20,000/- 

7. Technical Assistance 9,20,000/- 

8. Strengthening of Financial 

Management System 

39,28,000/- 

Grand total 1,33,13,000/- 

180

A. ASHAs 

Sl. 

No. 

Issues in 

Planning in 

ASHA 

1. Selection of 

ASHA 

2. Training of 

ASHA: 

a) I-V back 

log 

training 

b) On 6 th 

Sector 

Training 

3 Refresher 

Training for 

3862 ASHA 

for 12 days 

4 ASHA Drug 

Kit 

5 Replenishment 

of ASHA drug 

PART B: NRHM ADDITIONALITIES 

Current Status as per evidence from 

data triangulation 

181 

Activities to 

be 

undertaken 

to achieve 

targets 

3580 282 ASHAs 

will be 

identified 

and 

- Module I- 3226 

- Module II-2894 

- Module III- 2579 

- Module IV-2229 

- Module V-890 

The back log training of the ASHAs 

in Mod I-V is expected to be 

completed by end of 4 th qrt 09-10. 

- Not yet Started 

Not yet initiated. State has identified the 

thematic areas in which ASHAs should 

be re-trained, e.g.: Maternal Health, 

Child Health, Family Planning, Malaria, 

etc. For developing the State specific 

pictorial based booklet, inputs from 

different NGOs are being actively 

explored. 

Drug 

Kit 

procure 

d 

Drug 

Kit 

distribut 

ion to 

ASHAs 

200 

7- 

08 

170 

0 

170 

0 

2 

0 

0 

8- 

0 

9 

1 

5 

8 

2 

7 

7 

6 

2009- 

10 

Tot 

al 

3542 68 

24 

3039 55 

15 

selected. 

- 282 

ASHAs 

will be 

trained 

in I-V 

mod. 

- 3862 on 

6 th 

Module 

Training 

will be 

conducted 

at PHC 

once in 

month 

Half Yearly 

procuremen 

t of 3862 

ASHA drug 

kit 

Balance with the districts 13 

09 

3226 ASHAs are with drug kits Refilling of 

drugs from 

Outputs to 

be achieved 

100% 

ASHAs will 

be in place. 

100% 

trained 

ASHAs 

(Mod I-VI) 

will be in 

place. 

100% 

ASHAs will 

be oriented 

in State 

specific 

health 

related 

issues. 

100% 

ASHAs will 

be with 

drug kits. 

100% 

ASHAs with 

Time 

Frame 

for 2010- 

11 

Q1 

Q2 

2010-11 

(for 282 

new 

ASHAs). 

Q2-Q4 

10-11 

(for 6 th 

Sector 

Training) 

Q1 – Q4. 

Q2 & Q4

A1. Selection & Training of ASHA: 

Progress of Training for ASHA Trainer in Arunachal Pradesh as on Jan ‘10 

State Category Training 

load 

Arunachal 

Pradesh 

kit PHC/CHC 

level on 

requirement 

of 3862 

No. of 

trained in 

Module I 

182 

No. of 

trained in 

Module 2 

ASHA 

6. VHND Poor Appointmen 

t of ASHA 

Facilitators 

to hand 

hold the 

7. Tracking of 

Pregnant 

Women and 

infant 

ASHA 

resource 

Centre in the 

districts 

ASHAs 

Not done Appointmen 

t of ASHA 

Facilitator 

to hand 

hold the 

ASHAs 

Nil To position 

ASHA 

resource 

Centre at 

Dist. Hq. 

To appoint 

one District 

community 

mobiliser 

To appoint 

one Data 

Assistant 

both will be 

under 

DPMU 

No. of 

trained in 

Module 3 

drug kits 

No. of 

trained in 

Module 4 

State 

trainers 

5 2 2 2 2 

District 

trainers 

32 - - - - - 

Block 

trainers 

207 - - - 

- - 

ASHA 3862 3226 2894 2579 2229 890 

Progress regarding training of ASHAs in Arunachal Pradesh as on Jan ‘10 

60% Q2 

40% Q2 

1 District 

community 

mobiliser 

appointed 

1 Data 

Assistant 

appointed 

Q1 

No. of 

trained in 

Module 5

State No. of ASHA Proposed Selected No. of ASHA trained in Modules 

1 2 3 4 5 

Arunachal 

Pradesh 

05 – 06 

- - - - - - - 

06 – 07 

1700 

- 93 - - - - 

District Wise 

Sl. 

No 

07-08 

08 – 09 

Name of the 

District 

1200 

962 

- 1813 93 93 93 - 

- 692 714 636 636 - 

09-010 - - 628 2087 1850 1500 890 

Total ASHAs 

trained till date 

3862 3580 3226 2894 2579 2229 890 

Total No. of ASHA 

No. of ASHA Trained in Prototype Module and Drug 

Kit. 

Proposed Selected M-I M-II M-III M-IV M-V Drug Kit 

1 Tawang 189 189 189 189 189 189 189 

2 W/Kameng 215 215 215 200 200 200 200 150 

3 E/ Kameng 288 201 112 - - - - 18 

4 P/ Pare 274 274 222 222 222 222 112 222 

5 L/ Subansiri 216 255 255 255 255 255 108 255 

6 K/Kumey 471 325 187 185 185 185 185 185 

7 U/Subansiri 398 454 410 344 308 204 - 308 

8 W/Siang 399 399 399 399 399 399 - 399 

9 East Siang 132 132 132 132 132 132 30 132 

10 U/ Siang 76 92 88 88 88 88 - 84 

11 LD Valley 127 130 146 101 101 66 66 127 

12 D/ Valley 111 111 111 111 111 - 111 111 

13 Lohit 225 208 212 211 211 211 - 172 

14 Anjaw 281 214 214 213 - - - 188 

15 Changlang 304 225 200 110 44 - - 115 

16 Tirap 156 156 134 134 134 78 78 78 

Total 3862 3580 3226 2894 2579 2229 890 2622 

ASHA status Table at a glance of Arunachal Pradesh as on Jan ‘ 10 

Issues of ASHAS A. Pradesh 

No. of ASHA selected 3580 

No. of ASHA selected in % 92.7% 

Training Material production (round wise) English copy reproduced 

TOTs trained (mention round of ASHA training) 2 

Total Number of training Days completed for 19 days for 4 modules + 4 days of 5 

ASHAs 

th module (8 

districts) = 23 days 

No. of ASHA trained on selection 3226 ( as per 1 st Module coverage) 

No of trained as % on selection 90.11% 

Status of translation of ASHA Module, if any and 

no. of languages 

Nil 

Drug Kit procurement Yes, 6824 kit procured during 2007-08, 2008-09, 

183

2009-10. 

Drug Kit distribution to ASHAs 5098 distributed during 2007-08, 2008-09, 2009-10. 

Payment Scheme Integrated package for ASHA incentive is done (no: 

184 

APRHM-2009/108, Dt: 20 th July, 2009) 

Availability of integrated schedule of ASHA Integrated package for ASHA incentive is done (no: 

payment 

APRHM-2009/108, Dt: 20 th July, 2009) 

JSY From health facility – Cash payment incentive given 

Immunization Rs 50/- per outreach session given for community 

mobilization. 

Level of payment delivery with limited complaints Not yet institutionalised at the State/ District level 

(1 – 10 scale) 1 for less complaint, 10 maximum 

Constitution of State ASHA Resource Centre Under process 

Constitution of State ASHA Mentoring Group Constituted. 

Constitution of District ASHA Monitoring Units DPMSU only – no team in place 

Monitoring & Support System Run from DPMU under DRCHO. 

Meeting schedule happenings of ASHA It is initiated in the areas of PHCs run by Karuna 

Trust. 

Monthly meeting of ASHAs conducted by MO of the 

concerned PHC. ASHA’s Drug Kit monthly re-filled 

from the PHC stock of medicines, supervised by the 

pharmacist of the PHC. Expired medicines if any in 

the kit of ASHA are checked & replenished by the 

pharmacist on the spot. During the monthly meeting, 

ASHAs are trained as per their requirement / query 

that come-out through the discussion during the 

Indicator defined (What are the jobs exactly 

ASHAs are doing) 

meeting. 

Escorting pregnant women for ANC & delivery & 

PNC support, awareness generation activities, 

ITBN, RD Kit, TB pt. escorting. 

A.1. Training of ASHA on 6 th Sector (Home Based Newborn Care – HBNC): 

Training of Trainers on Book – 6 for State: 

Once the VI Sector is finalized, reprinting will be necessary for undertaking the training. The State 

level Training for State Trainers will be completed by 1st quarter of 2010. 

Activities: 

1. Preparatory Phase: Training of HBNC for State trainer (for 10 days). Eight trainers will be 

Medicos, Nurses and members of the civil society. 

2. 1 st Phase: The State level trainers will return to the State to impart training to the district 

trainers of 10 days duration of 16 districts X 10 trainers (Medicos, Nurses and members of 

the civil society) = 160 district level trainers. 

3. 2 nd Phase: Training to 387 ASHA Facilitators & 3862 ASHAs in Home based new born care 

for the year 2010-11 in all the districts in phased manner, duration of the training being 10 

days. 

4. 3 rd Phase : Implementation of HBNC in 3862 villages by ASHAs

Preparatory Phase: Training in HBNC for State trainer (for 10 days). A request for The schedule, 

holding of the training all inclusive will be made to Regional Resource Centre – NE States. Not 

budgeted 

1 st Phase: The State level trainers will return to the State to impart training to the district trainers of 

10 days duration of 16 districts X 10 trainers (Medicos, Nurses and members of the civil society) = 

160 district level trainers. 

Training of district level trainers on ASHA module -6 th : 

Training of 10 trainers from 16 districts will be brought to the state for providing training on 

VIth Sector (HBNC). It will be started in Second quarter of 2010-11. 

Total no 

of 

members 

proposed 


training 

No. of 

Batch 

160 4 (40 

each) 

No. of 

ASHAs for 

Training + 

ASHA 

Facilitators 

Duration DA for 

trainees 

@ Rs. 

100/per 

day 

Total no 

of 

members 

x 100 x 

10 days 

Honorarium 

to resource 

person @ Rs 

100/- per day 

Maximum of 

5 trainers x 

Rs. 100 x 10 

days x 4 no 

of batches 

185 

Food @ 

Rs 100/- 

per 

member 

plus 5 

trainers 

per day 

No of 

trainers 

+ no of 

trainee x 

100 x 10 

days 

Training 

materials 

@ Rs. 

70/- per 

trainees 

TA as per 

state 

government 

rule (approx) 

Rs. 500 x 1 

time 

Total 

Budget 

10 days 160000 20000 165000 11200 82500 438700 

2 nd Phase: Training to 387 ASHA Facilitators & 3862 ASHAs in Home based new born care 

for the year 2010-11 in all the districts in phased manner, duration of the training being 10 days. 

Already selected and trained 3862 ASHA will be having training in HBNC for 10 days in 

2010-11. This training will be provided by the identified 160 district trainers of 16 districts trained on 

HBNC. 

Rs 100/- for 

to & fro 

travel: once 

in a year. 

Rs 100x 1 x 

(No. of 

ASHA+ 

ASHA 

Facilitator) 

DA for 10 

days @ 

100/per 

days per 

ASHA + 

ASHA 

facilitator 

Training 

Material@ 

70/- per 

ASHA + 

Facilitators 

Honorarium 

to 5 trainers 

@ Rs 100/- 

per trainers 


for 97 

batches (= 

970 days) 

Food & 

Lodging @ Rs 

100/- per 

ASHA + 

Facilitators 

per day as per 

RCH 

Guidelines 

under 

Contingency 

(4249x10 days 

x Rs 100) 

Providing 

Weighing 

machine to 

3862 ASHAs 

on 

completion 

of HBNC 

training @ 

Rs. 580/- 

Total 

Budget 

(Rs)

3862 

(97 batches 

of 40 

ASHAs 

each) 

+ 387 

ASHA 

Facilitators 

= 4249 

4,24,900 42,49,000 2,97,430 4,85,000 42,49,000 2239960 11945290 

3 rd Phase : Implementation of HBNC in 3862 villages by ASHAs: Real execution of activities by 

ASHAs in field. 

Total Budget for HBNC: 

Amount Remarks 

Preparatory Phase - RRC budget 

1st Phase 4,38,700 

2 nd Phase 11945290 

Total 12383990 

A2. ASHA Kit 

Status as on January 2010: 

2007-08 2008-09 2009-10 Total 

Drug Kit procured at State level 1700 1582 3542 6824 

Drug Kit distribution to District 1700 776 3039 5515 

Drug Kit distribution to ASHAs 1700 776 2622 5098 

Balance with the districts 1309 

The following items with quantity of each will be procured and supplied in the ASHA – kit annually: 

Sl. No Item Quantity 

required per 

six month per 

186 

ASHA 

Quantity 

required per 

annum per 

ASHA 

1 Tab. Iron 600 1200 

2 Tab. Folic Acid 600 1200 

3 ORS Sachets 750 1500 

4 Tab. Paracetamol 1000 2000 

5 Povidone Oint. 5gm 500 1000 

6 Tab. Chloroquine 120 240 

7 Tab. Oral Contraceptive Pills (Cycle) 300 600 

8 Cotton Roll 30 60 

9 Bandage 4cm wide 300 600 

10 DD Kit (Clean Delivery) 12 24 

11 Thermometer 1 2 

12 Syrup Iron (100 ml) 30 60 

13 Gention Violet 50 ml 12 24 bottles 

14 Benzyl Benzoate Emulsion 1% (10 ml) 12 24 bottles 

Out of these above mentioned items, in case of re-filling is required, will be done from the respective 

PHC/ CHC from the regular stock of the facility.

The procurement will be done at the State level and the delivery will be made at the District HQ. 

ASHA drug kit replenishment: 

The drug kit for ASHAs will be replenished yearly as required as given above in 2010. For that 

budget requirement is @ Rs. 1300x 3862= Rs. 50,20,600/-. 

In case of re-filling is required, will be done from the respective PHC/ CHC from the regular stock of 

the facility. 

A3. ASHA Incentives: 

Performance related incentive has been linked up with other vertical programs and to the 

schemes of line departments determining the health e.g. Sputum collection & transport under 

RNTCP, Blood slide collection under NVBDCP, total sanitation campaign under PHED etc. Rogi 

Kalyan samiti will decide on release of performance related incentive to ASHAs as decided by the 

committee. Under Convergence, it is being ensured that incentives are provided to ASHAs as may be 

applicable by the different Disease Control Programmes and related departments. 

The Integrated ASHA Incentive package has been notified in the State and has been in effect 

from the 1st August 2009. The Incentive package is shown below: 

Sl.No Heads of Compensation Expected Source of Fund / Fund 

1. RCH-II 

Compensation 

Linkages. 

1.1 JSY 

1.1.1 JSY – Institutional delivery including 2 

(two) PNC 

@ Rs. 600/- Fund from JSY 

2. Sterilization 

2.1 Tubectomy @ Rs. 150/- Sterilization Compensation 

funds. 

2.1.1 Vesectomy /NSV @ Rs. 200/- Sterilization Compensation 

funds. 

2.1.2 Immunization @ Rs. 150/- Routine Immunization. 

2.1.3 Pilse Polio Day @ Rs. 25 /- IPPI 

2.1.4 

3. RNTCP 

Organizing Village Health & Nutrition 

Day 

@ Rs. 150 /- VHND 

3.1 DOTs @ Rs. 250/- RNTCP Fund 

3.1.1 

4.NLEP 

Household toilet promo fee @ Rs. 100/- 

4.1 Detection, referral, confirmation and 

registration of leprosy case 

@ Rs. 100/- 

4.1.1 After complete treatment for PB leprosy @ Rs. 200/case 

NLEP Fund 

4.1.2 After complete treatment for MB leprosy 

case. 

@ Rs. 400/- 

5. NVBDCP 

5.1 Blood smear collection & transportation to 

nearby PHC 

@ Rs. 50 /- NVBDCP fund 

5.1.1 

6. NPCB 

RKD Test @ Rs. 50 /- 

6.1 Detection and escorting of cataract cases @ Rs. 175/- NPCB fund 

187

A5. ASHA Resource Centre 

Objective: Strengthening of ASHA Support Mechanism 

Strategy: Positioning the ASHA resource centre 

Activities: 

1. Positioning of ASHA Resource Centre: 

ASHA Resource Centre (ARC) is being planned to be made operational by end of December 

this year. This will help the State to streamline the ASHA related processes and monitor the activities 

carried out and the progress made by the ASHAs in the field. 

Apart from the ASHA program, ARC will also undertake activities related to all the community 

processes and mobilisation viz. implementation of JSY, RKS, Untied fund, VHSC, VHND, Household 

survey, field based planning exercises, community participation, community monitoring, social 

planning & village health planning using PRA technique. 

The ARC will have four functional levels. At the State HQ, there will be a Community 

Mobiliser (MSW/ MSSc), a Statistical Assistant and an Office Assistant. The State team will be lead 

by a Nodal Officer who will be an Ex-Officio. 

The District HQ will have a District Community Mobiliser who will be from social work/ 

social science field. 

At the Block there will be a Block ASHA Coordinator who will be an Ex-Officio. The Block 

Accountant of the BPMU will be handed over this responsibility. 

At the village level there will be an ASHA Facilitator (AF) (1 AF for 10 ASHAs), who will 

be mandatorily a local resident. ASHA facilitators in no way should be selected from other district. 

The AF will act as the link between the ASHA and the Block/ District/ State. The AF will report the 

performance of the ASHAs and also the field level constraints faced by the ASHAs. 

The AF will be chosen from the Community Based Organisations (CBOs) for example 

NGOs/ Self-Help Groups/ Women Associations/ Mahila Swastha Sangh/ Youth Associations etc. 

which are actively involved in carrying out health related activities for their community. 

The DRCHOs of the respective districts will first identify these CBOs in the respective block/ 

village and weigh them against the work and the nature of work being carried out by them. After 

identifying them, a list of the potential CBOs will be sent by the DRCHOs to the State Nodal Office 

addressed to the MD. These CBOs will then be contacted by the NRHM Office and the interested 

parties will be asked to appoint/ select an appropriate candidate with 2-3 years field experience for 

the job of AF(no funds will be provided by the State HQ for this purpose). The DRCHO of the 

concerned districts will be a member of the appointment/selection board. 

DRCHO will also identify the contiguous villages wherever possible for which the Facilitator 

will work along with the ASHAs of those villages. Depending on the topography and socio-cultural 

situation, the number of villages may increase or decrease under one facilitator. 

188

It should be noted that in those areas where there are no CBOs, the DRCHOs will identify a 

CBO which is nearest to that area. 

Strategy: To facilitate regular meeting of ASHA and related officials including regular 

handling of grievances of ASHAs. 

Activities: 

1. Monthly meeting with ASHA facilitators and Block ASHA Coordinator (MO i/c of PHC/CHC 

as an ex-officio): 

Above a set of 10 ASHAs, one ASHA facilitator will be there by which Arunachal will have 

387 ASHA facilitators in the whole state. So, on an average, there will be 5 ASHA facilitators in a 

block for 86 blocks. 

It is proposed to have monthly meeting of ASHA facilitators at the block level, where each of 

the facilitator will share the cluster level performances of ASHAs and field level constraints will also 

be discussed so as to decide the future course of action for more effective performances of ASHAs. 

Activity Unit cost Budget requirement 

Monthly meeting of ASHA 

facilitators at Block level 

Rs. 150x 387x12 Rs. 696600 

Fooding @ Rs. 50x 20x6 Rs. 6000 

Total Rs. 702600 

2. Bi-Monthly meeting with ASHAs and Block ASHA Coordinator (MO i/c of PHC/CHC as an 

ex-officio): 

All the ASHA under each block will have meeting with their respective ASHA facilitators, 

ASHA block coordinators and ANMs bi-monthly once on a fixed day. The day will be called as 

“ASHA Day”. Each of the ASHA will share their field level performances and also issues and 

concerns. Accordingly necessary suggestions & supports will be given. In the ASHA Day, the back 

log incentives of the ASHAs will be met by MO i/c of the respective PHC / CHC. This will also 

address the vital question of submission of timely UC by block to district & district to state. 


Bi-Monthly meeting of 

ASHAs at Block level 

Rs. 150x 3862x6 Rs. 3475800 

Fooding Rs. 50x 3862x6 Rs. 1158600 

Total Rs. 4634400 

3. Monthly meeting of facilitators at district level: 

It is proposed to have monthly meeting of ASHA facilitators at the district level, where each 

of the facilitator will share the block / cluster level performances of ASHAs and field level constraints 

will also be discussed so as to decide the future course of action for more effective performances. 


Monthly meeting of ASHA 

facilitators at district level 

Rs. 300x 387x12 Rs. 1393200 

Fooding Rs. 100x 387x12 Rs. 464400 

Total 1857600 

189

4. State level meeting of District Community Mobilizers: 

District Community Mobilizers will meet bi-monthly, preferably in a fixed date at state level, 

where each district community Mobilizers will make a formal presentation on the activities performed 

in the district regarding community processes. The person will also highlight what are the given 

activities could not be performed and the reasons for non completion. Based on the presentations 

made by each of the District community mobilizers the degree of support to be extended to the 

respective district would be decided. 


Bi-Monthly meeting of 

district community 

mobilizers at state level 

Rs. 500x16x6 

Rs. 48000 

Fooding @ Rs. 100x 20x6 Rs. 12000 

Total Rs. 60000 

5. Performance incentive for the ASHA facilitators: 

It is planned that ASHA facilitators will be paid on the basis of their performance. It is 

expected that each ASHA facilitators will go to field for maximum 15 days and for that each of them 

will be paid @ Rs 100 / day x no of days visited. They will also be paid a fixed monthly honorarium of 

Rs. 1000/- ( One thousand). 


Honourarium @ Rs 1000 x 387 Rs. 387000 

Per day allowance @ Rs. 100x 15x12 x 387 Rs. 69,66,000 

Total Rs 7353000 

6. Monthly Honourarium for 16 Dist Community Mobilizers & 1 state Community Mobilizer: 


Monthly Honourarium of 

district Community 

Mobilizers 

@ Rs 12000 x 16x 12 Rs. 2304000 

Honourarium of State 

Community Mobilizer 

@ Rs. 14,000 x 1 x 12 Rs. 168000 

Total 

. 

Rs. 2472000 

7. Monitoring plan: Considering the Fund constraint, it is decided for effective monitoring 

under ASHA resource center the existing monitoring mechanism of SPMSU and DPMSU will be 

used by the State & district Community mobilizers. Thevother programmatic review meeting plat 

form will also be used to assess the effectiveness of the ASHA programme in the state. 

Strategy: 

To provide mentoring support to ASHAs by ASHA mentoring Groups at State and regional 

levels. 

ASHA need to stay in touch, to share, to strengthen her role and need to develop support 

mechanism. There is an urgent need now to provide social infrastructure, build a supporting 

environment and develop the right practices. Support from professional as well as from other civil 

societies can be successful in demonstrating a quality model programme. 

190

One ASHA mentoring group is formed at State level with members from NGOs, Academic 

institutes and other state programme mangers. One NGO named as Voluntary Health Association of 

India (VHAI) has already attended the regional mentoring meeting at Guwahati as arranged by RRC 

and NHSRC together during November’ 2008. The members of the mentoring group are expected to 

make field visit bi-monthly in the mutually agreed districts and furnish the report to the MD (NRHM). 

For carrying out such activity, it is proposed that the members should be paid TA on actual and Rs. 

1000/- as DA per day. 


TA for Field visit by AMG Rs. 3000x 2 daysx 6 timesx 9 Rs. 324000 

member 

memb ers 

DA Rs 1000 x 2 daysx 6 x 9 Rs. 108000 

State Level Meeting quarterly 

(TA + Food + DA + Misc) 

Rs. 1000 x 9 x 4 Rs. 36000 

Total 468000 

Training / Orientation of State Community Mobiliser , District Community Mobiliser, ASHA 

Facilitators: 

Since these persons would be newly given engament under ASHA programme , so, it is 

proposed to impert training / orientation for three days to these members so that they get to know in 

detail regarding the ASHA programme and also what is expected out of them. The no of trainees : 1 

ASHA State Community Mobiliser + 16 District Community Mobiliser + 387 ASHA facilitators = 

404. In each batch there will be 40 trainies for 10 batches. The budget is shown below: 


TA for participants on 

actuals 

@ Rs. 800/- 404x800=323200 

DA for participants @ Rs. 100 /- for 3 days 100x3x404= 121200 

Training Matterials @Rs. 100/- 100x 404 = 40400 

Over Head (Venue hiring, 

generator etc) 

@ Rs. 15000 x 10 batch 15000 x 10= 150000 

Rs. 634800 

Reorientation Training of 3862 ASHA for 12 times for 1 days each 

(12 days training in a year for all 3862 ASHAs): The ASHA facilitators, District Trainers, Mo i/c 

community mobilisers will trained the local ASHAs. 

No. of ASHAs for 

Reorientation 

Training 

No. of 

Batch 

Rs 100/- 

for to & 

fro travel: 

12 times in 

the year. 

Rs 100x 12 

x No. of 

ASHA 

DA for 12 

days @ 

100/per 

days per 

ASHA 

191 

Training 

Material@ 

100/- per 

ASHA 

Total 

Budget 

(Rs) 

3862 97 4634400 4634400 386200 9655000 

(Budgeted 


here, rest 6 

days from 

Bi-monthly 

ASHA 

meeting) 

4827500

Total activity based budget requirement for implementing proposed activities under ASHA 

Scheme: 

Narration In Rupees 

Training for 6 th sector (HBNC) for 160 district trainers 438700 

Training of 6 th sector (HBNC) for 4249 trainees (3862 ASHAs+387 ASHA Facilitators) 11945290 

ASHA drug kit replenishment: 5020600 

Monthly meeting of ASHA facilitators at Block level 702600 

Monthly meeting of ASHA facilitators at district level 1857600 

Bi-Monthly meeting of district community mobilizers at state level 60000 

Performance incentive for the ASHA facilitators 7353000 

Monthly Honourarium of district Community Mobilizers 2304000 

Honourarium of State Community Mobilizer 168000 

Field visits by AMG members and quarterly review meetings 468000 

Training of newly recruited ASHA facilitators & Community Mobilisers 634800 

Training of 12 days (Budgeted for 6 days here, rest 6 days from Bi-monthly ASHA 

meeting) 

4827500 

Total 40414490 

A6. Others: 

1. Promoted the ASHA Help Desk Concept in Doimukh CHC. One ANM is the incharge of it 

who looks after different issues of ASHAs. She is displaying the Pregnant women’s list with 

their EDD and village and their concerned ASHAs name with contact number in the ASHA 

notice board. She is also coordinating with the JSY disbursing office incharge of the CHC 

Doimukh under the supervision of MO (i/c) of Doimukh CHC. This model is proposed to br 

replicated by ASHA facilitators in the PHC /CHC through concerned RKSs. 

2. Idea of Eco-Tourism is being promoted through ASHAs in area of Walong – PHC, Anjaw 

District. (Tourist will stay in the house of ASHA whose toilet is a sanitary one. Govt water 

supply is available in these toilets though Walong is situated at the height of 5000 ft (approx) 

from the sea level. Already 60 tourists have booked for the session of 09-10 starting from 1st 

Oct 09 which will last upto March 10. [Walong is the hot tourist spot for visiting 1962 china 

war battle field, bunkers, war memorial, Helmet Top, Hot Water Spring with Sulphur 

ingredients for curing skin diseases, Dong village- Indias first village where sun light falls, 

scenic beauty]. Their craft and handloom items are also displayed in their houses/shop in 

front of their own residence (made of Pine wood, CGI sheet). Temperature ranges from 5-30 

degree Celsius there. There is another possibility coming up during this initiatives to motivate 

the ASHAs and their children to be educated enough to work as a tourist guide and earn their 

livelihood in a very easy way. At present ASHAs are in a very low literacy level and had to 

face a tough time to educate the ASHAs. SPMU is interested to promote it as a self – 

sustaining financial support to ASHA while they work for Health & Hygiene. Later on, this 

192

kind of no investment scheme is planned to be linked with ARC for technical support. At 

present this initiative is supported by Karuna Trust run PHC staff of Walong. SPMU has 

asked Karuna Trust to maintain a database of this innovative no-investment scheme. 

B. Infrastructure related matters 

B1-2 : New Construction / Renovation / Upgradation of DH/FRU 

Activities: 

A) Construction of Residential Quarter for CHC Ruksin 

The only CHC functioning as FRU has only 3 Type IV quarters and rest are staying in 

temporary OBTs. The FRU is having all the required manpowers. Therefore, it is proposed to 

construct 5 Type III residential quarters @ Rs 12 lakhs during 2010-11. 

B) Installation of Incinerators 

6 incinerators @ Rs 25, 00,000/- will be installed in the following fully/partially functional 

DHs/FRUs for implementation of IMEP. The company will train the manpower on it. 

1. DH Bomdila 

2. DH Daporijo 

3. DH Yinkiong 

4. DH Roing 

5. DH Tezu 

6. CHC Ruksin 

Incinerators are already installed at 4 DHs: Along, Ziro, Pasighat, Naharlagun. The 

maintenance cost for these incinerators will be managed from RKS fund. 

B3-5: New Construction / Renovation / Upgradation of CHC 

New building: 

Out of 31 functional CHCs, the existing buildings may not be as per the requirement of a 

CHC except CHC Ruksin. The details are as below: 

Category Existing Required 

Building SPT/RCC 

31 CHCs 

The buildings are very old and need repair and 

maintenance. It is proposed to repair and maintain these 

buildings from RKS fund. 

Relocation of rooms are being planned this year. 

The upgradation of CHC Koloriang in Kurung Kumey district is under construction through 

RWD of the state Government. Sanction of Rs 8.15 Crores has been approved during 2009-10. The 

remaining amount of Rs.9.96 Crores may be released during 2010-11. The progress of the activity 

will be shared with GoI from time to time. 

193

Residential Quarters: 

Due to lack of Residential quarters in these facilities (15 functioning as 24x7) and proposed 

10 CHCs to be made 24x7 are having quarters but it is not enough for all the existing manpower. 

5 Type 3 residential quarters each will be constructed for each of the following 8 CHCs @ Rs 

12 lakhs. 

1. Jang (Tawang) 

2. Dumporijo (upper Suabansiri) 

3. Nari (East Siang) 

4. Jengging (Upper Siang) 

5. Mahadevpur (Lohit) 

6. Palin (Kurung Kumey) 

7. Mechuka (West Siang) 

8. Maryang (Upper Siang) 

Labour room: 

Out of 31 CHCs, 27 CHCs are having good labour rooms and 4 CHCs are providing delivery 

services in makeshift LR. It is proposed to provide 4 LRs this year @ Rs 6 Lakhs in the following 

CHCs: 

1. Balijan (Papum Pare) 

2. Mechuka (West Siang) 

3. Maryang (Upper Siang) 

4. Kanubari (Tirap) 

Operation Theatre: 

One CHC at Deomali being run by NGO under PPP as FRU will require new OT complex 

urgently. The NGO has already put in specialist required for FRU and are providing services from 

makeshift / temporary OT @ Rs 12 lakhs. 

Rest of the CHCs is having OT but needs improvement. As per survey report, 15 OTs require 

repair and maintenance. This will be done through RKS from RKS fund. 

B6-7: New Construction / Renovation / Upgradation of PHC 

Residential quarters: 

It is proposed to functionalise 10 more PHCs to 24x7 during this year. There are 20 PHC 

already functional providing 24 hours services. 

23 out of these 30 PHCs expected to be 24x7 by 2010-11 will require additional residential 

quarters. 85 new residential quarters is required. However, barrack will be constructed to reduce 

cost and space required.The cost per building is Rs 12 lakhs per 2 UNIT barrack. The details are as 

below: 

194

District Name 

of PHCs 

195 

No. of Barracks to be 

constructed 

East Kameng 

PHCs already functional as 24x7 

Bameng 3 

Papum Pare Mengio 5 

Kurung Kumey Sangram 5 

Upper Subansiri Nacho 3 

East Siang Sille 1 

Upper Siang Jeying 6 

Lower Dibang Valley Anpum 3 

Dibang Valley Etalin 3 

Lohit Wakro 1 

Anjaw Wallong 5 

Changlang 

Khimiyong 

Nampong 

6 

2 

Tirap Wakka 

PHCs to be made functional as 24x7 during 10-11 

5 

East Kameng 

Bana 

Pakke Kessang 

4 

2 

Papum Pare Jote 5 

East Siang Tellam 1 


Raga 

Yachuli 

2 

5 

Kurung Kumey Yangte 7 

Upper Subansiri Maro 3 

Lohit Lathao 1 

Changlang Namtok 7 

PHC new building: 

Category Existing Required 

Building RCC /SPT/ 

Local 

94 PHCs. About 56 PHCs are without 

proper maintenance and repair and will 

be taken up from RKS funds. 

No new PHC 

building 

proposed. 

PHC Labour room: Out of the functional 30 PHCs, 10 new labour rooms will be required. @ Rs 6 

Lakhs. 

Sl. No. District Name 

of PHCs 

1 Papum Pare Mengio 

2 Kurung Kumey Sangram 

3 Upper Siang Jeying 

4 East Kameng Pakke Kessang 

5 Papum Pare Jote 

6 Lower Subansiri Raga

7 Yachuli 

8 Kurung Kumey Yangte 

9 Upper Subansiri Maro 

10 Changlang Namtok 

PHC repair & maintenance: 

The repair/maintenance will be made locally through RKS from RKS fund. 

Waiting rooms: 

As the PHCs were constructed without actually following guidelines and requirements, all the 

PHCs are without proper waiting area for patient and patient party. The waiting area will be 

provided in all the 30 PHCs expected to be functional 24x7 @ Rs 3 Lakhs for civil works and Rs 

25000/- for benches and chairs. 

B8-9: New Construction / Renovation / Upgradation of SC 

There are 592 nos. of Sub-Centres notified by the State Government, but only 273 SCs are 

functional and manned by Health Workers. 

201 SCs are with 1 ANM and 29 with 2 or more ANMs (A total of 230 ANMs in the SCs). The 

rest are manned by other paramedics like HW (Male), Pharmacist etc. 

Out of these 273 SCs, 211 are functioning in their own building and the rest (62) are located 

in other buildings such as local community constructed OBT building, panchayat building, schools 

etc. New SC buildings (with ANM residential facilities) are being proposed for the 62 SCs functioning 

in other buildings @ 12 Lakhs 

The following table is a summary of the status and gap analusis of the 273 functional SCs 

Sl.No District No.of Functional SC Own Building Gap ANM Qtr Gap 

1 Tawang 12 10 2 7 5 

2 West Kameng 20 12 8 5 15 

3 East Kameng 13 5 8 2 11 

4 Papum Pare 22 19 3 10 12 

5 Lower Subansiri 19 10 9 6 13 

6 Kurung Kumey 12 8 4 0 12 

7 Upper Subansiri 20 12 8 4 16 

8 West Siang 30 23 7 5 25 

9 East Siang 30 30 0 20 10 

10 Upper Siang 10 9 1 2 8 

11 L/ Dibang Valley 14 10 4 4 10 

12 Dibang Valley 3 3 0 2 1 

13 Lohit 19 17 2 5 14 

14 Anjaw 14 14 0 9 5 

15 Changlang 20 15 5 8 12 

16 Tirap 15 14 1 10 5 

Total 273 211 62 99 174 

196

Only 99 SCs have ANM quarters at present and extension of SC Building is going on at 122 

SCs to provide residential facilities for ANMs. Proposal for additional new SC quarters for most 

inaccessible and border areas reflected in a separate chapter on differential planning for ‘difficult, 

most difficult and inaccessible areas’ 

B10. MMU: 

Supports for Mobile Medical Unit 

Mobile Medical Unit 

Sl.No Name of District MMU Fund Release MMU Activity 

1 Tawang Yes Yes 6 

2 West Kameng Yes Yes 0 

3 East kameng Yes Yes 0 

4 Papum Pare Yes Yes 4 

5 Lower Subansiri Yes Yes 0 

6 Kurung Kumey Yes Yes 4 

7 Upper Subansiri Yes Yes 0 

8 West Siang Yes Yes 1 

9 East Siang Yes Yes 1 

10 Upper Siang Yes Yes 0 

11 L/Dibang Valley Yes Yes 1 

12 Dibang Valley Yes Yes 0 

13 Lohit Yes Yes 7 

14 Anjaw Yes Yes 3 

15 Changlang Yes Yes 0 

16 Tirap Yes Yes 0 

The MMU operationalized last year did not perform well. During the year, the MMU activities will be 

scaled up and in that direction; action has already been taken up. The concern of the ministry on the 

performance of MMU is taken seriously and to that effect, notice from the Ministry of Health & FW 

has already been issued. During 2009-10, 27 MMU camps were organized providing MCH services. 

The MMU plan has been planned at the district level and the activities will be carried out 

during 2010-11. The detail breakup of requirement is as below: 

- MMU drugs will be provided @ Rs 5 lakh per district for 16 districts. 

- Maintenance/repair fund of Rs 2 Lakhs per district will be provided to 16 districts. 

- POL @ Rs 2 lakhs for all 16 districts will be provided. 

- Provision of contractual driver already in place (n=48 Nos) may be continued @ Rs 

5000/- per month. 

Therefore, total requirement @ 9 lakhs for 16 districts= 144 lakhs+28.8 lakhs=172.8 lakhs 

197

B11. Emergency & Referral Services: 

Ambulance for PHC / CHC / DH 

There are 81 basic ambulances & 4 critical Care ambulances in the state. The referral of any 

kind of emergencies are tackled through the ambulances available with the Department under the 

disposal of RKS. The priority is to transport complicated pregnancies, severely sick children 

especially belonging to BPL. In the state, there is no private player to provide transport / referral 

facilities to be outsourced as is done in developed state. Overall, the referral depends fully on Govt. 

facility. 

Further, For DH / GH which are FRUs, better equipped ambulances will be provided with 

facility for caring cardiac and neurological cases since number of patients are increasing day by day. 

It is felt that well equipped ambulances should be made available in all the FRUs. 

The ambulances will be placed under the direct supervision of the RKS. Requirement of fuel 

and maintenance will be met through RKS. Proper record keeping will be ensured. However, due to 

scarcity of drivers in the state, it is proposed to provide 20 contractual drivers @ Rs 5000/- per 

month. These ambulances will have the following equipments:- 

Items Qty. 

PATIENTS HANDLING SYTEMS 

Automatic Loading Stretcher 1 No. 

Head Immobilization System 1 No. 

Folding Stretcher 1 No. 

Scoop Stretcher 1 No. 

Vacuum Splint Kit 1 No. 

Anti shock trousers (Imported) 1 No. 

KED Extrication device 1 No. 

Vacuum Mattress 1 No. 

EMERGENCY EQIPMENTS 

Automatic Suction Pump 1 No. 

Mouth to Mouth Respirator 1 No. 

Resuscitation Bag for Adults & Children 1 No. 

Resuscitation Kit (Imported) 1 No. 

Syringe Infusion Pump 1 No. 

Defibrillator/ Monitor/Pacer. 1 No. 

Therefore, it is proposed to provide 9 PHCs / CHCs and 4 critical care ambulances to be 

placed at functional FRUs this year. 

District Facility 

Upper Subansiri Dumporijo CHC 

West Siang Likhabali CHC 

Upper Siang Jengging CHC 

Lohit Mahadevpur CHC 

Kurung Kumey Palin CHC 

Changlang Nampong PHC 

East Kameng Bana PHC 

Kurung Kumey Yangte PHC 

Changlang Namtok PHC 

198

District Facility (FRU) 

Upper Subansiri Daporijo DH 

West Siang Aalo DH 

Lower Subansiri Ziro DH 

Lohit Tezu DH 

The total estimated cost of 9 basic ambulances @ Rs 6 lakhs per unit and 4 critical care 

ambulances @ Rs 19 Lakhs per unit. 

C . Human Resources related matters: 

Continuing with the policy of decentralization at the district level, the manpower on job and 

the newly proposed manpower will be engaged as per facility wise need. The payments whatever is 

due, will be decentralized upto RKS level. Certain monitorable process indicators will be put in place 

for use by the RKS members and DPMSU. The payments will be made only on qualifying the 

minimum required activity to be performed at the facility level. Overall control of manpower will be 

with the District Health Society and RKS. Continuation & new requirement of contractual Specialist/ 

MO/ AYUSH/GNM/ANM /LT/Pharmacist /Radiographer/ Ophthalmic Assistant 

Contractual Specialists 

Contractual Doctors 

BDS 

Contractual GNM 

1 OBS & Gyn specialist will continue in Along DH @ Rs 35000/ 

per month. 2 new Paediatrician for 2 FRUs is proposed this year 

at the above rate. This proposal is made on the basis of such local 

manpower available with the state. 

82 No of Contractual MBBS / AYUSH MOs will continue in 

different PHC / CHCs to keep those functional @ Rs 30000/- per 

month. 

15 No of Contractual Dentist will continue in different PHC / 

CHCs to keep those functional @ Rs.30000. No new requirement 

is proposed. 

134 GNMs will continue under NRHM additionalities this year @ 

Rs 18000/ per month. No new proposal is made. 

Contractual ANM 

40 nos of ANM will continue under will continue under NRHM 

additionalities this year @ Rs. 14000/- 

Contractual paramedical Addressed under RCH component. 

Others: 

16 Radiographer will be appointed at district level one each for 

Health Assistant 

Refrigerator Mechanic 

MMU Dirver 

FRUs and MMU @ Rs 14000/ per month. 

20 HAs will continue for Immunization activity in the remote 

areas of the State. Male workers are preferred due to the terrain 

and uncertainty of weather and road condition. This proposal may 

be approved on priority.@ Rs. 12000/- per month 

4 RMs will continue during the year. Due to shortage of RMs and 

non sanctioning of new post by the state Govt. the proposal is 

absolutely on priority. @ 16000/- per month 

48 Nos. of approived MMU drivers will be continued this year 

also @ Rs. 5,000/- per month = Rs. 28,80,000/- 

199

D. PROGRAMME MANAGEMENT RELATED MATTERS: 

D1 State Programme Management Supporting Unit: 

The State Programme Management Supporting Unit (SPMSU) is in position since the 

inception of the programme in the State. The entire planning and the decision making process is 

evaluated by the State Nodal Officer (NRHM)-cum-SPM and Director (F&A) under NRHM. The 

technical support and assistance has been provided by the existing State Finance Manager, 

Consultants (MIS & Training), State Accounts Manager, State Data Manager, Data Assistant and 

others. The remuneration of these staff has been fixed keeping in view the implementation of 6 th Pay 

Commission in the State and the exorbitant cost of living in the State, as depicted in the following 

table: (Refer the detail write up in RCH-II under Programme Management) 

Table shows the position of SPMSU and the proposed revised remuneration. 

Sl. 

No. 

Name of Post No. in 

position 

200 

Fixed Monthly 

remuneration 

(Rs.) 

Total 

remuneration for 

the Year (Rs.) 

1. State 

Manager 

Programme Nil 30,000/- Nil 

2. State Finance Manager 1 30,000/- 3,60,000/- 

3. State 

Manager 

Accounts 1 25,000/- 3,00,000/- 

4. State Data Manager 1 25,000/- 3,00,000/- 

5. State Accountant 1 18,000/- 2,16,000/- 

Total 11,76,000/- 

The proposed enhancement of pay rates of Contractual staff working under NRHM has been 

necessitated by the need to procure and maintain quality manpower required for the successful 

implementation of the programme. On account of exorbitant rise in the cost of living in the State, 

particularly in the rural areas, it is very difficult to get eligible candidates for various managerial 

and technical post on the meager salary offered presently. For instance, it would not be possible for 

an ANM to sustain herself in a remote rural Sub-Centre on a fixed salary of Rs. 5,500/- per month. 

Due to this problem, the State Health Society has not been able to attract qualified and dedicated 

candidates for various posts, even as the turnover rate of contractual staff working under NRHM has 

increased considerably during the last one year. Hence, the proposed enhancement of pay rates is 

inevitable for the smooth implementation of the programme in Arunachal Pradesh. This is more 

relevant in the case of Doctors and Programme Managers for which local candidates are not 

sufficiently available and have to be hired from outside the State. A case in point is the pending 

appointment of State Programme Manager due to non-availability of suitable candidate on the 

below-par salary offered by the State Health Society. A comprehensive calculation in respect of 

revised remuneration of the existing manpower has been shown in the table below.

Sl. 

No. 

Name of Post Name of equivalent 

regular post 

Pay scale of equivalent post (Rs.) Proposed Pay (Rs.) 

Pay in pay 

Grade Total 

Adjusted figure* 

band 

pay emoluments 

Programme Management Staff 1 2 3 5=(3+4) 

1 State Programme Manager APCS Entry Grade 9,300 - 34,800 5,400 27,720 30000 

2 State Finance Manager APCS Entry Grade 9,300 - 34,800 5,400 27,720 30000 

3 Consultants Administrative Officer 9,300 - 34,800 4,600 22,511 25000 

4 State Accounts Manager Administrative Officer 9,300 - 34,800 4,600 22,511 25000 

5 State Data Manager Administrative Officer 9,300 - 34,800 4,600 22,511 25000 

6 State Accountant UDC 5,200 - 20,200 2,800 15,459 18000 

7 Distt. Programme Manager Administrative Officer 9,300 - 34,800 4,600 22,511 25000 

8 Distt. Accounts Manager Health Education Officer 9,300 - 34,800 4,200 18,070 20000 

/Cold Chain Officer 

9 Data Assistant UDC 5,200 - 20,200 2,800 15,459 16000 

10 Computer Assistant UDC 5,200 - 20,200 2,800 15,459 16000 

11 Statistical Investigator UDC 5,200 - 20,200 2,800 15,459 16000 

12 PA to MD UDC 5,200 - 20,200 2,800 15,459 16000 

13 Block Accountant-cum-DA UDC 5,200 - 20,200 2,800 15,459 16000 

Technical Staff 

14 Specialist Specialist 15,600 - 39,100 6,600 35,480 35,000 

15 Medical Officer Medical Officer 15,600 - 39,100 5,400 33,020 30,000 

16 Staff Nurse Staff Nurse 9,300 - 34,800 4,200 18,070 18000 

17 ANM ANM 5,200 - 20,200 2,400 13,690 14000 

18 Lab. Technician Lab. Tech 5,200 - 20,200 2,400 13,690 14000 

19 Health Assistant Health Assistant 5,200 - 20,200 1,900 12,931 12000 

20 Refrigerator Mechanic UDC 5,200 - 20,200 2,800 15,459 16000 

• The adjusted figures have been arrived at after considering workload, internal parity, job responsibilities, eligibility requirements and suggestions of 

the Ministry at the Sub-Group PIP Appraisal Meeting held at RRC-NE, Guwahati. 

201

D2 District Programme Management Supporting Unit: 

The District Programme Management Support Unit comprises the DRCHO/DFWO, who is 

the Chief Executive Officer of the Executive Committee, and District Programme Manager, District 

Accounts Manager, Data Assistant and Computer Assistant. They are collectively responsible for 

formulating District Health Action Plan, providing technical support to the department in its 

implementation, ensuring smooth flow of fund and monitoring the implementation of the programme 

at district and sub-district levels. 

Table shows the position of DPMSU and the proposed revised remuneration. 

Sl. 

No. 

Name of Post No. in 

position 

202 

Fixed Monthly 

remuneration (Rs.) 

Total remuneration 

for the Year (Rs.) 

1. District Programme Manager 16 25,000/- 48,00,000/- 

2. District Accounts Manager 16 20,000/- 38,40,000/- 

D3. Block Programme Management Support Unit. 

Total 86,40,000/- 

The Govt of India has already approved recruitment of Block Accountants-cum-Data 

Assistants. The A. P. State Health Society will consequently constitute 84 Block Programme 

Management Support Units (BPMSU) during the financial year 2010 -11 for as many Blocks of the 

State in order to ensure proper maintenance of accounts and prompt reporting from the sub district 

level to district level. The BPMSU will be the accounting centres for all the implementing agencies 

including SCs, PHCs and CHCs under the respective Blocks. 

The consolidated pay will be Rs. 14,500/- (Rupees fourteen thousand five hundred) Only per 

month. Local candidates of a particular Block with the requisite qualifications will be preferred for 

the post. Payment of salary to the Block Accountant-cum-Data Assistant will be strictly on the basis 

of a certification by the local Rogi Kalyan Samity to the effect that the incumbent has regularly 

attended his/ her duties. The concerned RKS will be responsible for monitoring and evaluating the 

performance of the Block Accountant-cum-Data Assistant strictly as per the terms of reference. The 

staff will be responsible for formulating block level micro plans, proper maintenance of books of 

accounts and MIS data bank, and periodical reporting of financial and HMIS data to the District 

Health Society. He/She will be responsible for advising the RKS, particularly the Medical Officer, in 

judicious utilization of RKS fund in accordance with the financial norms issued by GoI. The staff will 

be required to closely monitor the activities of ASHAs and collect, record, maintain and report the 

physical and financial performance of VHSCs under the jurisdiction of his/her block. 

Table shows the position of BPMSU and the proposed revised remuneration. 

Sl. Name of Post No. in Fixed Monthly Total remuneration 

No. 

position remuneration (Rs.) for the Year (Rs.) 

1. Block Accountant-cum- 84 16,000/- 1,61,28,000/- 


Total 1,61,28,000/-

TABLE SHOWING SUMMARY OF PROGRAMME MANAGEMENT BUDGET UNDER 

NRHM 

Sl.No. Activity Proposed amount (Rs.) 

1. State Programme Management Supporting Units 11,76,000/- 

2. District Programme Management Supporting Units 86,40,000/- 

3. Block Programme Management Supporting Units 1,61,28,000/- 

Grand total 2,59,44,000/- 

D4. District Health Action Plan: 

D5. Monitoring & Evaluation: 

1. Preparation of DHAP will require (Rs 50,000 x 16) 

= Rs 8,00,000/-. 

2. Preparation of SPIP & State level reports on NRHM 

= Rs. 2,00,000/- 

State & District level Monitoring team will conduct program component wise monitoring 

during the year. The States will monitor availability of quality services to vulnerable population 

including those who are underserved due to problems of geographical access, and those who suffer 

social and economic disadvantages and the urban poor up to district level. The districts will monitor 

performance at CHCs / PHCs and Sub-Centre levels. 

The monitoring will not be restricted to physical and financial achievements but will also 

include the following: 

Process Indicators 

- Percentage of districts having identified vulnerable groups and having these groups included 

in their PIPs. 

- Percentage of districts having conducted facility survey and mapping up of available 

infrastructure and manpower etc 

Output Indicators 

- Percentage of Ante-Natal/Post Natal coverage from vulnerable groups as compared to the 

rest of the population 

- Percentage of deliveries conducted by skilled providers (doctors, nurses, ANMs) among the 

vulnerable groups as compared to rest of the population. 

- Percentage of institutional deliveries among the vulnerable groups 

- Percentages of children among vulnerable groups fully immunized-age group-wise 

- Number of cases provided transport facilities in cases of emergencies including obstetric 

emergencies. 

203

D6. OTHERS: 

Village Health & Sanitation Committee 

Sl.No Name of District VHSC Bank Account Fund Release 

1 Tawang 189 145 Yes 

2 West Kameng 198 198 Yes 

3 East kameng 200 0 Yes 

4 Papum Pare 274 274 Yes 

5 Lower Subansiri 98 60 Yes 

6 Kurung Kumey 154 151 Yes 

7 Upper Subansiri 436 436 Yes 

8 West Siang 399 399 Yes 

9 East Siang 132 132 Yes 

10 Upper Siang 92 92 Yes 

11 L/Dibang Valley 100 100 Yes 

12 Dibang Valley 25 25 Yes 

13 Lohit 200 200 Yes 

14 Anjaw 154 19 Yes 

15 Changlang 205 106 Yes 

16 Tirap 156 105 Yes 

Total 3012 2442 

E. Untied Funds, Annual Maintainence Grants and RKS funds related matters: 

It is proposed to implement the activities as mentioned in the RKS guidelines and will be 

monitored more vigorously. 

E1-4: Rogi Kalyan Samiti (RKS) Fund for DH/ CHC / PHC: 

For 14 DH/GHs @ 5lakhs = 70 lakhs 

For 31 CHCs @ Rs 1 lakh for 31 CHCs = 31 lakhs. 

204

For 85 PHCs @ Rs. 1 lakh = 85 lakhs. 

E 5-7: Untied Fund for CHC / PHC/SC / VHSC: 

For 31 CHC @ Rs 50000 per CHC, total required= 15.50 lakhs. 

For 85 PHCs @ Rs 25000/, total required=Rs. 2125000/-. 

For 273 SC @ Rs 10,000/ as untied fund , total required Rs 2730000/- 

E8: Untied grants to Village Health and Sanitation Committees: 

For 3012 VHSC, required fund @ Rs 10000/- is Rs 30120000/- 

E9-14: Annual Maintenance Grant CHC / PHC/ SC: 

AMG for 31 CHCs @ Rs. 1 lakhs is Rs 31 lakhs. 

AMG to 85 PHCs @ Rs 50000/ PHC is Rs 4250000/- 

AMG @ Rs. 10,000/ - for 273 SC = 2730,000/-. 

F. Training & Capacity Building related matters 

F.1.Management Development Trainings: 

The Training Centre under NRHM was approved last year. The Original proposal was for 

Rs. 2 Crores to be completed in two years. The First installment amounting to Rs. 60 lakhs for 2009- 

10 was approved and the construction activity is going on through RWD under State Govt. The 

proposal includes civil component, equipments & instruments required for training and furniture. 

Therefore, it is proposed that the remaining amount is Rs. 1.5 crore may be approved during 

2010-2011. 

Due to lack of training centre, the state is facing severe backlog of training activities. With 

the completion of the training centre, it is hope that the training activity will be carried out for 

smoothly all through out the year. 

F2.Capacity Building/ Orientation Workshops: 

Program management & Finance workshops at state & district level will be organized is 

addressed under RCH component in details. 

Training of Accounts Personnel 

In order to upgrade the skills of accounts personnel, the following trainings for Finance and 

Accounts officials of all Verticals Programmes under NRHM will be conducted during the financial 

year 2009-10: 

1. 1-day orientation training on financial management and accounting for district & 

state programme officers of vertical programmes under NRHM will be undertaken 

during the end of 1 st quarter. The in-house resource persons will be inducted for 

this training such as Director (F&A) and State Finance Manager 

2. 3-days skill upgradation training on finance, accounts, audit for accounts 

personnel of District and State SCOVAs including vertical programmes, twice 

205

during the year and will be undertaken during the end of 2 nd & 4 th quarter. The 

in-house resource persons will be inducted for this training such as Director 

(F&A), State Finance Manager & State Accounts Manger. 

3. 3-days induction training for all Block Accountants will be conducted during the 

first week of 2 nd quarter. The in-house resource persons will be inducted for this 

training such as Director (F&A), State Finance Manager & State Accounts 

Manger etc. 

4. 3-days skill upgradation training on customized TALLY for accounts personnel of 

District and State SCOVAs including vertical programmes will be taken up during 

the last week of 3 rd quarter. The resource persons will be outsource from a 

Bangalore base Tally Solution Limited firm or from Guwahati. The 

accommodation, TA/DA will be borne from Technical Assistance head of account 

under RCH programme management. 

206

Sl. No. 

Name 

of Training 

1 Orientation 

training on 

Financial 

Management 

& 

Accounting 

2 Skill 

Upgradation 

Training on 

Finance, 

Accounts & 

Audit 

Category of 

participants 

Programme 

Officers of 

Vertical 

Programme 

Accounts 

personnel of 

State & 

Distt. Health 

Society 

(including 

Vertical 

Programmes) 

load 

No. of Batch 

105 1 1 

105 1 3 

Table showing estimated budget for Training 

No. of Days 

Timeline 

1st Qtr. 

2nd Qtr. 

Location 

State HQ 

State HQ 

DA to 

Participants 

207 

TA to 

Participants 

Honorarium to 

Guest Faculty 

Working 

Lunch 

Tea/Snacks 

Incidental 

Exp. 

Institutional 

overhead 

147000 157500 1800 19500 6500 26250 43958 8000 410508 

336000 210000 10800 117000 39000 157500 100516 16000 986816 

Venue charges 

Total

3 Induction 

Training of 

Block 

Accountant 

4 Skill 

Upgradation 

Training on 

Customized 

Tally 

Block 

Accountant 

Accounts 

personnel of 

State & 

Distt. Health 

Society 

(including 

Vertical 

Programmes) 

84 1 3 2nd Qtr. State HQ 131200 84000 5400 54000 18000 63000 54000 8000 417600 

105 1 3 3rd Qtr. State HQ 168000 105000 5400 58500 19500 78750 66473 8000 509623 

208 

Total 2324547

F3: OTHERS: 


Quarterly financial review meeting of programme & finance officials of NRHM and vertical 

programmes will conducted at Mission Directorate in every first week of the subsequent quarter in 

order to review the financial achievement of the previous quarter. For this purpose, the POL and 

mobility support expenses will be borne by the Distt. Health Society. However, in order to meet up the 

other expenses for conducting the Review Meetings an amount of Rs. 10,00,000/- (Rs. 2,50,000/- for 

each meeting) would be required. 

G: INNOVATION 

G 1: Health Melas: 

Introduction: 

The previous health melas held in our state have attracted people desiring to avail quality 

health care services with essential pathological tests and medicines, along with information without 

any cost. They got actual health care services in doorstep who otherwise had limited access to health 

facilities. 

Arunachal Pradesh has decided this year to conduct 16 Health Melas in 16 districts as it is 

demographically a weaker state. The National Population Policy (NPP) 2000 has also adopted the 

idea of holding such melas, popularly known as “Parivar Kalyan Avam Swasthya Melas”. 

Such Health Melas will aim at providing quality services, with converging and integrated 

delivery of services for all segments of population in the state. People will become aware of a number 

of options before them in terms of the different systems of medicine (allopathy, homeopathy, ayurveda 

and unani etc). They also begin to comprehend the linkages between preventive, promotive, curative 

and rehabilitative health care as well as between the primary, secondary, and tertiary health sectors. 

The health care services also involved national programmes for control of tuberculosis, malaria, 

blindness, leprosy, cancer, and HIV/AIDS, apart from services relating to maternal health, child 

health, immunization and Family Planning. They get sensitized to the roles of Central Government, 

State Government, elected local bodies, health determinant departments, NGOs and professional 

organizations. 

Above all, it seeks to improve access of rural people, especially poor women and children, to 

equitable, affordable, accountable and effective primary healthcare. Through health mela with a 

strategic public health management & services along with referral & follow-up services, basically it 

will be an OPD / day care pattern of service. Different components of all National Programme will 

also be available in the mela for 3 days with a provision of medicine of 5 days or full course. 

The state has a total population of10, 91,117 (Census 2001) with male constituting 573951 

and 517166 females. The percentage of population below poverty line in 1999-2000 is 33.47 (SRS 

Bulletin, April 2001) with a percentage decadal growth of 26.21 and Average Annual Exponential 

Growth Rate of 2.33. The decadal growth rate of urban population is a staggering 101.29 %. 

The administrative set up of Arunachal Pradesh and its changing district boundaries 

correspond broadly to natural boundaries of river basin. Even the boundaries of Sub-Divisions, 

Community Development Blocks and Administrative Circles within the districts have also been 

209

directly affected by the terrain features, though there is no cadastral survey conducted till date for 

clear cut demarcation of administrative boundaries. 

There are 16 Districts, 37 sub-divisions, 155 circles, 17 towns, 69 blocks and 3862 villages 

constituting an elaborate administrative structure for diffusing developmental activities in the state. 

The State has 2 constituency represented by 2 Lok Sabha MPs from the State. 

Stake Holder analysis: 

Major stake holders: 

Health & FW Deptt, State Govt. SCOVA society, DHS, IEC bureau, Media Units of the 

Ministry of Information and Broadcasting e.g. Song. Drama Division, Dte. Of Field Publicity, DAVP, 

Doordarshan, AIR etc. Medical College / Nursing Training Institute, VHAI, Local MP, District 

Administration, District Magistrate, Volunteers and IMA local branch, 

Internal Clients: 

Doctors from Govt. & Pvt and IMA, ASHAs, NYK, Local Youths, Nursing Students, 

Pharmacists etc. 

External Clients: 

Whole community of the locality, Special care for women, girl child, vulnerable etc. 

Duration: Only 3 days. In case the local Administration feels that some programme needs to be 

carried on even after the 3-day mela, appropriate arrangements for the same may be made locally. 

Services: 

Both tangible & intangible product/services will be made available to the external clients as 

below : 

1. Publicity- at least from 15 days before the start of Mela through leaflets, hoarding, posters, wall 

writings, banners, film slides, video-vans, advertisements in newspapers. 

2. Health cards to be printed locally. 

4. An enquiry office, with duty chart of doctors and other staff with layout map should be functional 

at least from 3 days before start of the mela. 

5. Registration counters –at least 25 so that the crowd is spread. 

6. At least 40 stalls for different diseases/disciplines/exhibitions listed below. If the stalls are in the 

open space, each stall may be of size 15’X15’ and should be ready with all furniture, fixtures, posters, 

equipment etc. one day before the start of the mela. 

i) General Medicine (at least 4 stalls) 

ii) Maternal Health 

iii) Child Health 

210

iv) Immunization 

v) Family Planning counseling } arrangement for sterilization, if OT is available 

vi) Non Scalpel Vasectomy } arrangement for operation, if OT is available 

vii) IEC- Family Welfare 

viii) ENT check up 

ix) Dental Check up 

x) Cardiac check up 

xi) Skin 

xii) Counseling for Nutrition 

xiii) Counseling for RTI/STI/AIDS Control 

xiv) Leprosy control 

xv) TB control 

xvi) Malaria 

xvii) Prevention of blindness (eye check up) 

xviii) Bad effects of smoking 

xix) Cancer control 

xx) Personal / environmental hygiène 

xxi) Diabètes control 

xxii) Rehabilitation 

xxiii) Indian Systems of Medicine-Ayurveda, Unani, Homeopathy 

xxiv) .Pathological investigation (urine, sugar, blood sugar, Hb, BCG, Sputum 

test) and arrangement for diagnostic tests (X-ray, Ultra Sound, ECG etc.) 

xxv) National programmes for control of Cancer, HIV/AIDS, Tuberculosis, 

Blindness, Malaria and Leprosy; and the Ministry of Health & Family Welfare 

will participate in various melas. 

xxvi) Programmes of Song and Drama Division, Dte. Of Field Publicity 

xxvii) DAVP exhibition. 

7. One page site map showing location of stalls for different disciplines with numbers will be printed 

in sufficient number for distribution among volunteers and doctors to guide patients. 

211

8. Adequate number of volunteers for guiding the people to the concerned stall. 

9. Adequate number of Resident Doctors and Medical Students for manning these stalls 

10. Medicines for 5 days or full course will be distributed by pharmacists posted at each stall. 

Adequate store and distribution facility should be arranged. 

13. The organizers will take due care of hygiene at the Mela site. Arrangements for drinking water, 

sanitation at the mela site will be made through PHED. They may arrange the demo of different 

health determinant schemes and items. 

14. Stalls for quality, hygienic food may be put up for sale at reasonable prices. 

15. Referral services. Directory of functional health institutions should be readily available in the 

health Mela so that the Doctors attending the patients can refer the case for subsequent follow up. 

16. Counseling: Counseling facility of following: 

Venue: 

* Family Welfare (including immunization & contraceptive services) 

* Counseling for RTI/STI. 

* Prevention of Blindness 

* Rehabilitation of the disabled 

* Leprosy control 

* TB control 

* Nutrition 

* Bad effects of smoking 

* Cancer control 

* Personal hygiene, environmental hygiene 

* Diabetes control 

* Ill effects of alcohol 

* Indian System of Medicines etc. 

The venue of the Health Mela will be selected so that it is in the vicinity of a Medical 

College/Civil Hospital/CHC in order to provide facilities of ultrasound, pathological tests, etc. The 

venue should be centrally located and easily accessible to the general public. The venue and dates of 

the Health Mela shall be selected in consultation with the Member of Parliament, District Magistrate 

and Chief Medical Officer. The venue should be divided into stalls, with clear indication of location 

of each service like maternal care, child care, family planning, NSV, RCH, blindness control etc. 

Printed map, indicating the layout of the stalls at the mela venue will be made available. 

Logistics: 

212

Generator, Telephone (mobile), uninterrupted water supply, Hygienic toilet, waste disposal 

pit, bleaching power, Medicines, consumables of diagnostics, Registration counters Health cards, 

Duty Chart of Doctors and other staff, registers for 25 Registration counters, referral registers. 

Medicine: 

Medicines for 5 days or full course will be distributed by pharmacists posted at each stall. 

Adequate store and distribution facility will be arranged. 

Directory of Health Institutions for referral services and follow-up will be displayed and 

communicated during the mela. 

Staff and duty roster: 

Allocation of stalls and duty would be fully explained to the Doctors/pharmacists/ANMs and 

other health staff. A detailed briefing may be given to them about their role/duties. Duty Chart of 

Doctors and other staff will be prepared in advance. 

Publicity: 

Information, Education and Communication (IEC) Division will arrange publicity with the 

Media Units of the Ministry of Information and Broadcasting e.g. Song. Drama Division, Dte. Of 

Field Publicity, DAVP, Doordarshan, AIR etc. A health promotion and health education campaign by 

way of health exhibition to be held in the Mela. . 

Publicity about the Health Mela will be done at least from 15 days before the start of mela 

through leaflets, hoarding, posters, wall writings, banners, film slides, video-vans, advertisements in 

newspapers. 

Funding arrangement: Rs. 8 lakhs per district from GoI. 

Budget: 

Sl. Activities/ head Amount No. of Total 

No. 

Districts 

1 Camp arrangement 50000 16 800000 

2 Transport arrangement (POL, Man, Material 80000 16 

movement from district & state HQ) 

1280000 

3 Mobility support (TA/DA to specialists & other 80000 16 

staff from outside & district) 

1280000 

4 Procurement of medicines 200000 16 3200000 

5 Procurements of surgical materials 80000 16 1280000 

6 Procurements of reagents & other investigation 80000 16 

materials/ diagnostic consumables 

1280000 

7 Publicity 50000 16 800000 

8 IEC/ BCC in the camp 40000 16 640000 

9 Generator / Water supply / Telephone provision 50000 16 800000 

Total 7,10,000 16 1,13,60,000 

Grand total Rs. 1, 13, 60,000/- @ Rs. 7, 10,000/- per district for 16 districts) 

213

G2-3: Incentive Scheme: 

A. DIFFERENTIAL PLANNING FOR HEALTH FACILITIES IN DIFFICULT AREAS 

IN ARUNACHAL PRADESH 

The following table shows the different categories of areas according to accessibility in to 

difficult, most difficult and inaccessible areas. 

DISTRICT-WISE LIST OF FACILITIES IDENTIFIED AS DIFFICULT, MOST DIFFICULT 

& INACCESSIBLE AREAS 

IN ARUNACHAL PRADESH 

District Facility Normal area 

Tawang 

West 

Kameng 

Difficult 

area 

A Category 

214 

Most Difficult 

area 

B Category 

Inaccessible area 

C Category 

DH Tawang 

SC Seru 

Lemberdung 

Kitpi 

PHC Lumla 

SC Thongleng Dudunghar Bonglung 

Zemithang 

PHC Jang 

SC Lhou Mukto Mago 

Thinbu 

Rho 

Sub 

Total 

Jagda 

5 SCs and 2 PHCs in Difficult, 3 SCs in Most Difficult and 5 SCs in 

Inaccessible areas. 

CHC Kalaktang 

SC Morshing Balemu 

Ankaling (NF?) Boha 

CHC Dirang 

SC Mandlaphudung Thembang Nyukmadung 

Namshu 

CHC Rupa 

SC Mukuthing 

PHC Thrizino 

SC Palizi Khuppi (NF?) Janachin (NF?) 

PHC Nafra 

SC 

PHC Bhalukpong 

SC Kamenbari

East 

Kameng 

Papum 

Pare 

Doimara 

PHC Chinchung 

SC Jamiri 

New Kaspi 

Buragaon 

DH 

D=8 SC , 2 PHC, 1 CHC MD= 6 SC, IA= 2SC 

Seppa 

SC Pipu 

CHC Chyang Tajo 

SC L Bagang 

Yongfo 

PHC Pakke-Kessang 

SC Rilo 

PHC Bameng 

SC Paksa Lada 

Sekong(NF?) 

PHC Khenewa 

SC Nari Camp 

PHC Veo 

SC Saba 

PHC 

Sub 

Risokorong 

Total D= 4SC, 4PHC, 1 CHC, MD= 5 SC, 1 PHC IA= 1 SC 

CHC Sagalee 

SC Ompuli 

Gyai 

Parang 

Kamreng 

Neopang 

Toru 

CHC Kimin 

SC Kakoi 

CHC Doimukh 

SC Hoj telam 

Dakte and Hog 

PHC Tarasso 

PHC Leporiang 

215 

Jyang 

Bagang(NF?) 

PHC Basernello 

SC Kanebum Habia 

Byate Tapiaso 

Mebiasso 

PHC Balijan

Lower 

Subansi 

ri 

Kurung 

Kumey 

SC Denka 

Boguli (NF?) 

PHC Mengio 

SC 

Sub 

Karoi 

Total D= 14 SC, 4 PHC, MD= Nil , IA=3 SC 

PHC Deed Neelam 

SC Dem Sito 

Pania Miya Vill 

PHC Yachuli 

SC Tallo Tayo 

Tadarko 

Genia(NF?) 

Loth 

Mai 

PHC Pistana 

SC Ambam Bello 

PHC Boasimla 

SC Kamporijo 

PHC Raga 

SC Godak Tay Simla 

Mengio Kabak 

Yorkum 

PHC Yazali 

SC Kust-kut 

PHC Poru 

Dolungmuk 

CHC Koloriang 

SC Yumlam 

CHC Nyapin 

SC Phassang 

Sango 

CHC Palin 

SC Yaglung 

Joru Galang 

PHC Sarli 

PHC Tali 

SC Pipsorang(NF?) 

PHC Yangte 

SC Lingdom(NF?) 

PHC Damin 

PHC Sangram 

PHC Parsi Parlo 

216

Upper 

Subansi 

ri 

West 

Siang 

PHC Pania 

PHC Rongtey 

PHC Chambang 

DH Daporijo 

SC Jeram 

Mite 

Jigi 

CHC Dumporijo 

SC Riba Hali 

Param 

PHC Muri-Mugli 

SC Lilidong 

PHC Taliha 

SC Nogi (NF?) 

PHC Limeking 

PHC Taksing 

PHC Puchigeko 

PHC Nacho 

PHC Paying 

SC Pakpumaling 

PHC Baririjo 

SC Lebri 

PHC Siyum 

SC Jingbarai 

PHC Giba 

SC Reddy 

Lingdam 

PHC Maro 

SC Yatekripa 

Panimori 

Dula 

Lakbak Gongo 

PHC Gusar 

SC Bui 

PHC Chetam 

SC Dadi 

DH Aalo 

SC Yigi Kaum 

CHC Yomcha CHC 

CHC Likabali 

SC Kangku 

CHC Rumgong 

SC Damda 

Rise 

217

East 

Siang 

PHC Liromoba 

PHC Monigong 

SC Pidi 

PHC Payum 

SC Gasheng (NF?) 

Yashing 

Yagong 

PHC Gensi 

SC Yachugi 

PHC Darak 

CHC Boleng 

CHC Pangin 

SC Tarak Jorsing 

Komsing-Kumku 

CHC Mebo 

SC Bodak 

Ayeng 

Silluk 

Mottum 

CHC Ruksin 

SC Ngorlung 

Mikong 

Debing 

Depi 

PHC Nari 

PHC Yembung 

SC Rottung Yemsing 

PHC Dite Dime 

SC Parong Sitang 

Riew 

Beggeng 

PHC Riga 

SC Pangkang 

Ugeng 

Riga Village 

PHC Borguli 

PHC Namsing 

PHC Rebo-Perging 

PHC Rani 

SC Berung 

PHC Supple 

218

Upper 

Siang 

Lower 

Dibang 

Valley 

SC Pareng Yibuk 

Sine 

PHC Sille 

SC Magnang 

PHC Telam 

SC Old Deka 

Old Seren 

PHC Koyu 

SC Saku 

PHC Korang 

PHC Bilat 

SC Ledum 

Mirem 

PHC Yagrung 

SC Takilalung 

PHC Balek 

CHC Tuting 

SC Migging Singa 

Gelling 

Paling 

Nyokong 

CHC Mariyang 

SC Damro Adipasi Dalbing 

PHC Jengging 

SC Jembo 

Ramsing 

Karko 

PHC Jeying 

PHC Katan 

DH Roing 

SC Chidu 

CHC Parbuk 

PHC Dambuk 

SC Bomjir 

PHC Bolung 

SC Jia 

PHC Anpun 

SC Bizari 

Keba 

Paglam 

PHC Hunli 

219

Dibang 

Valley 

Lohit 

Anjaw 

Chan- 

glang 

SC Brinli New Elope Desali 

PHC Iduli 

SC Abali 

Rukmo 

PHC Koronu 

DH Anini 

SC Alinye 

PHC Etalin 

SC Aneli 

Arzoo 

CHC Chongkham 

SC Empong 

PHC Piyong 

SC Wingko 

PHC Mahadevpur 

SC Dharampur 

Sitapani 

PHC Yealiang 

SC Bhekuliang 

PHC Wakro 

SC Tillai 

PHC Lathao 

SC Solungthoo 

CHC Hayuliang 

SC Goiliang Manchal 

Siet 

Chilliang 

Mohikong 

PHC Hawai 

SC Halaikrong Wamliang 

PHC Walong 

SC Kibithu 

PHC Chaglagam 

SC Metengliang 

Chipru 

Kromna 

DH Changlang 

SC Watlom Ranglom 

CHC Miao 

SC Lewang Vijaynagar 

Deban Gandhigram 

PHC Diyun 

SC Punyobhumi (NF?) 

PHC Khimiyang 

220

Tirap 

SC JungHavi 

Sungkho Havi 

PHC Nampong 

SC Lungpang 

DH Khonsa 

SC Lamsa 

Charju 

Kolagoan 

CHC Longding 

SC Pumao 

CHC Deomali 

SC Natun Kheti Kenon 

Phinting 

PHC Kanubari 

SC Banfera 

Wannu 

Raho Chopnu 

PHC Lazu 

SC Nagna 

PHC Pongchau 

SC Konnu Kamhua Noknu 

Staff Planned: 

SN Staff Category Difficult 

Area 

(A Category) 

141 74 87 

Most 

difficult area 

(B Category) 

221 

Inaccessible 

area 

(C category) 

Total 

1 ANM 83 57 74 214 

2 MO 41 16 13 70 

4 Specialist 2 - - 2 

6 Pharmacist 57 21 13 91 

7 Radiographer 1 - - 1 

8 Lab. Tech 24 4 5 33 

9 Staff Nurse 115 41 26 182 

Total 323 139 131 593 

Incentive for Difficult Area (A Category): 

SN Staff Category Number of Incentive Difficult Areas Total 

Staff (@Rs 2000 per month) 

1 ANM 83 Rs. 24,000 yearly 1992000 

2 MO 41 -do- 984000 

4 Specialist 2 -do- 48000 

6 Pharmacist 57 -do- 1368000 

7 Radiographer 1 -do- 24000

8 Lab. Tech 24 -do- 576000 

9 Staff Nurse 115 -do- 2760000 

Total 323 -do- 77,52,000 

Incentive for Most Difficult Area (B Category): 

SN Staff Category Number of Incentive Difficult Areas Total 


1 ANM 57 Rs. 48,000 yearly 2736000 

2 MO 16 -do- 768000 

4 Specialist - - - 


7 Radiographer - - - 

8 Lab. Tech 4 -do- 192000 

9 Staff Nurse 41 -do- 1968000 

Total 139 -do- 6672000 

Incentive for Inaccessible Area (C Category): 

SN Staff Category Number of Incentive Difficult Areas 

Total 


1 ANM 74 Rs. 72,000 Yearly 5328000 

2 MO 13 -do- 936000 

4 Specialist - - - 


7 Radiographer - - - 

8 Lab. Tech 5 -do- 360000 

9 Staff Nurse 26 -do- 1872000 

Total 131 -do- 9432000 

Total Budget: 

Category of Areas Amounts 

Category A 77,52,000 

Category B 6672000 

Category C 9432000 

Total 2,38,56,000 

Payment Mechanism for the Performance based incentive plan: 

Payment will be made from respective RKS and PRI after receiving Performance Report. It is 

hoped that this performance based activities will bring healthy competition for staff of both NGO & 

Govt. run facilities. Monitoring of the above activities may be jointly done by the concerned MO & 

DPMSU as per field monitoring plan of the DPMU. 

HR Policy: 

222

1. Decentralised engagement: The DHS have been empowered to engage or select staff at the 

local level. ASHAs are also being selected by the DHS in coordination with the local PRI 

members. The RKSs are also involved in decision making processes. 

2. Retention of Skilled staff through incentive scheme: This year onwards, as advised by the 

MoHFW, Govt. of India, the State is planning to provide monetary incentives to staff posted 

at difficult/ most difficult/ inaccessible areas. 

3. Staff Training of state , districts & block level: The State plans to provide regular training to 

all the staff as per requirement by well trained Trainers in the State and also outside the State 

for example LSAS, EmOC etc. The objective being to provide quality care to the 

beneficiaries. 

4. Supportive supervision: The State will provide continuous support to the Districts after follow 

up of different kinds of training for different staff categories and also on the guidelines as 

provided by the MoHFW. 

5. Residential facility for Staff (infrastructure of Barrack for Paramedics): The State plans to 

make available staff quarters/ barracks for various levels of facilities with special focus on 

PHCs and SCs and with emphasis on the High Focus Districts. Proposal for construction of 

residential quarters for health staff in border area health facilities projected in the PIP which 

are mostly either in difficult, most difficult and inaccessible areas. Type I=46, Type II=42 

Type III=43, Type IV= 32 quarters are proposed to construct in border areas. More over 52 

quarters are proposed to be constructed in CHC level. 

B. RESIDENTIAL QUARTERS FOR HEALTH STAFF IN BORDER AREA HEALTH 

FACILITIES IN ARUNACHAL PRADESH 

1. Overview of the proposal 

Due to acute shortage of residential quarters, required manpower is not available in the 

place of posting. This endeavor to provide quarters to these staff especially at the international 

border area health facilities will improve the working condition and will also help achieve certain 

acceptable level of coverage in all fronts. Therefore, approval may be accorded for immediate 

construction of quarters in Arunachal Pradesh. 

2. List of facilities located at international border 

3. Distance from International Border 

CHC PHC SC 

Chayang Tajo Zemithang Morshing 

Kalaktang Tali Thingbu 

Mechuka Taksing Lada 

Tuting Lemiking Sewa 

Hawai Monigong Sarli 

Lumla Damin 

Chaglagam Pipsorang 

Walong Gelling 

223

Vijoynagar Palling 

Nampong Singa 

Khimyong Kibitho 

Laju Desali 

Wakka Dadam 

Pongchou Khenewa 

Sangram 

Bameng 

Nacho 

Etalin 

CHC Road from Dist Hq Porter track to Border 

Chayang Tajo No 150Km 

Kalaktang Yes 25Km 

Mechuka Yes 50Km 

Tuting 

Yes 50Km 

Hawai Yes 70Km 

PHC 

Zemithang Yes 25Km 

Tali No 100Km 

Taksing No 20Km 

Lemiking Yes 70Km 

Monigong No 15Km 

Lumla Yes 30Km 

Chaglagam Yes 40Km 

Walong Yes 25Km 

Vijoynagar No 30Km 

Nampong Yes 12Km 

Khimyong Yes 15Km 

Laju Yes 30Km 

Wakka Yes 10Km 

Pongchou Yes 25Km 

Sangram Yes 150Km 

Bameng Yes 150Km 

Nacho Yes 160Km 

Etalin Yes 130Km 

SC 

Morshing Yes 40Km 

Thingbu No 60Km 

Lada No 90Km 

Sewa No 120Km 

Sarli Yes 120Km 

Damin No 100Km 

Pipsorang No 90Km 

Gelling No 10Km 

Palling No 50Km 

Singa No 40Km 

Kibitho yes 2Km 

224

Desali No 40Km 

Dadam No 50Km 

Khenewa No 100Km 

5. Infrastructure requirements 

Residential quarter available 

Facilities 

Type I Type II 

CHC 

Type III 

Chayang Tajo 3 2 2 

Kalaktang 2 2 3 

Tuting 

2 3 2 

7 7 7 

PHC 

Zemithang 1 2 2 

Tali 2 1 2 

Taksing 1 2 2 

Lemiking 2 2 2 

Monigong 2 2 2 

Chaglagam 2 2 2 

Vijoynagar 2 1 2 

Laju 2 1 2 

Pongchou 2 2 1 

16 14 17 

SC New Sub-Centre Building 

Thingbu 1 

Lada 1 

Sewa 1 

Sarli 1 

Damin 1 

Pipsorang 1 

Gelling 1 

Palling 1 

Singa 1 

Kibitho 1 

Desali 1 

Dadam 1 

Khenewa 1 

Total quarter required Rate per Quarter Total Fund Required 

Type-I =23 400000 9200000 

Type-II=21 600000 12600000 

Type -III=24 900000 21600000 

Sub Centre Building=13 1200000 15600000 

225

G4: PPP INITIATIVE: 

Public Private Partnership (PPP) for PHCs 

Rs. 59000000 

The PPP project for running 16 PHCs, 1 CHC as FRU and 2 Urban Health Centres outsourced 

to PPP NGO partner as a major stake holder. Details are under RCH component. 

OTHERS: 

SUMMARY OF HIGH FOCUS DISTRICT PLANNING 

Based on few critical indicators [Female literacy, % of household with low standard of living, % of 

girls married below 18 years, Use of contraceptives, Institutional birth, Full immunization, Proximity 

to health facilities (villages) and road connectivity], as per selection from the MoHFW, GoI, the 4 

districts were selected as High Focus Districts in Arunachal Pradesh, namely Upper Subansiri, East 

Kameng and Kurung Kumey. The comparison of those districts with average status in State level for 

above selected indicators is as follows: 

Process of DHA Plan Development: 

A decentralized participatory planning process has been followed in development of this State PIP 

2010-11. This bottom-up planning process began with consultations with block stakeholder groups, 

Block /core Group members and village communities in all villages of each Block of the District. 

Block Action Plans were developed based on the inputs gathered through village action plans 

prepared by Village Health & Sanitation Committees. 

The health facilities in the block viz. SCs, PHC and, CHC were surveyed using the templates 

developed by Government of India earlier. Those are updated now (Facility Survey update). The 

inputs from these facility surveys were taken into account while developing the Block Action Plan. 

The District Health Action Planning Team (DHAPT) provided technical oversight and strategic 

vision for the process of development of District specific Health Action Plans for 2010-11. 

The members of the DHAPT had also taken the responsibility of contributing to the selected thematic 

areas such as RCH, newer initiatives under NRHM, immunization etc. Assessment of overall situation 

of the District and development of broad framework for planning was done through a series of 

meetings of DHAPT and PRI leaders with consent from DC of the districts. 

These DHAPs 2010-11 has been prepared through a process of integration of Block Health Action 

Plans including Health Facility Surveys. An initial meeting was held in which the current status of the 

District Health Action Plan was presented and suggestions and feedback taken. Based on the inputs 

received from the Blocks, a draft of each chapter was developed after discussions. These were further 

improved upon through individual consultations with Teams and MO i/c of the Blocks and health 

centre. Specific dates and times were fixed for this purpose. Dates were also proposed for a meeting 

during which the individual chapters would be discussed and approved before the final DHAPs were 

prepared for presentation to the District Health Society for approval. Technical assistance from State 

level was provided to complete these DHAPs as and when required. 

Following were the main activities conducted for the preparation of DHAPs 2010-11: 

226

2. Village level: 

Consultative meeting with VHSC members at village level. 

Data collection through ASHA ( Population, eligible couple, pregnant women, Immunization Status, 

Sanitation , drinking water, electricity, AWC, common disease prevalence etc. to update the House 

Hold Surveys. 

Preparation of VHAP by ANM, PRI leaders and ASHA with guidance of Block MO I/C. 

2. Block level: 

• Formation BHAP team at the Block level in Sept 2009. 

• Update of facility survey of the Health centre. 

• Incorporation of VHAP for BHAP, mapping, tabulation. 

• BHAP approval meeting at the Block. 

3. District level: 

h. Constitution of Dist Health Action Plan Team in Sep-Nov. 2009. 

i. Collection of BHAP and facility survey from Block MO i/c. 

j. PRI (ZPM) level meeting at Dist. Hq. on 8/12/09 for the finalization BHAP for DHAP. 

k. Final discussion of BHAP for developing DHAP at Dist Hq. from 1 st to 15 th Dec. ’09 

l. Re view of DHAP of all NE & Sikkim at Guwahati on 18 th & 19 th Dec. 2009. 

m. Capacity building workshop on DHAP at Itanagar on 22 nd & 23 rd Dec. 2009. 

n. Final approval was obtained from Dist Health Society. 

Some of the indicators of the 3 High Focus Districts on which ground these were classified as 

High Focus: 

INDICATORS STATE STATE DIST. -1 DIST. -2 DIST. -3 India 

Average Average Upper East Kurung 

DLHS 3 DLHS 2 Subansiri Kameng Kumey 

(DLHS -3) (DLHS -3) (DLHS -3) 

Female literacy - - 40.70 28.58 17.45 

% of household 

with low standard 

of living 

% of girls 

married below 18 

years 

42.7 52.8 49.3 73.4 68.8 

8.2 26.7 5.2 25.3 3.1 

Use of 

contraceptives 49 35.2 54.5 33.7 46.4 

Institutional birth 

Full 

immunization 

47.7 33.7 59.1 30.6 52.1 

40.3 21.3 31.2 17.7 23.8 

227 

36.9 

(RHS 98- 

99) 

48.5 

(NFHS – 

3) 

33.6 

NFHS-3 

(34.0 

RHS) 

42 

NFHS-3 

Remark 

Any 

modern 

method

(54.2 

RHS) 

STRATEGY FOR HIGH FOCUS DISTRICTS: Promotion of PPP at Block / District level. 

Activities: 

1. The NGO running the PHC (Bameng, Sangram of Karuna Trust and Nacho of VHAI) in the 3 

high focus districts (East Kameng, Kurung Kumey, Upper Subansiri) will be identified as 

Nodal NGO of the Districts. The Block where Nodal NGO is there will be considered as 

Core-Block and other Blocks as Peripheral blocks. Core-Block will have more focus for 

implementation of any program related activities. 

2. Block-wise Mapping of grass root NGOs / CBOs with experience in Health & its related 

sector in first qrt of the FY 2010-11. 

3. One day orientation of those mapped NGO / CBOs will be done under the Nodal NGO on 

community health in 1 st qrt. 

4. Training of key personnel of those NGOs / CBOs on program activities related to maternal & 

child health through nodal NGO of the district on 2 nd qrt in different blocks. 

5. Mapping of common resources like cold chain etc. will be distributed to the NGO / CBOs 

through Nodal NGO. 

6. Allocation of areas / villages of the Block / District to NGO / CBOs. 

7. Mapping of all VHSC & SC with concerned manpower (like AWW, ANM, ASHA, ASHA- 

Facilitator etc) & committee for adoption by concerned grass root NGO / CBOs. 

8. Development of micro work plan with those NGO / CBOs by RKS / Nodal NGO. Activity 

based common cost (as per SPMU’s decision regarding difficult area-most difficult areainaccessible 

area etc.) for field activities like VHND, Outreach Session, monitoring etc will 

be released to RKS of the PPP run PHC from SPMU through DPMU. 

9. Financial support to those NGOs / CBOs through RKS of the PHC running the PHC which is 

identified as Nodal NGO of the District. RKS will have to include DRCHO & district 

community mobiliser as the 2 special advisers of the RKS. Proper letter about it will be 

issued from MD. 

10. Monitoring of Nodal NGO by state monitoring team on new assignment of intra district PPP. 

11. Joint monitoring of NGO / CBOs by Nodal NGO and State monitoring team. 

12. Monitoring report furnished in RKS of PHC run by Nodal NGO with a copy to SPMU. 

13. Action research points will be developed based on those findings of the monitoring. 

14. All policy decisions will be re-examined and corrected if any. Those will be then adopted by 

district health society for the next year. 

15. All above activities will be initiated & implemented by District Community Mobiliser (as an 

extended part of District ASHA Resource Center) with assistance & support from DPMU 

and SPMU. He will have to sit with the RKS of the PPP run PHC once in a week & visit with 

ASHA – Facilitator once in every 15 days in the initial period. Later on, it will be as per the 

joint decision of Nodal NGO & DRCHO as decided in the RKS executive body’s meeting. 

SPMU will issue necessary papers / informations to the main officials of the Nodal NGO 

whose state office is at Itanagar. 

228

SITUATIONAL ANALYSIS 

KURUNG KUMEY DISTRICT: 

Sl. Background Characteristics Kurung Kumey 

No. 

Number Source 

1 Geographic Area (in Sq. Kms) 6,230 

2 Number of Blocks 09 DC office 

Size of Village (2001 census) 325 National village code 

3 

1-500 325 (As per 2001 census) 

501-2000 

2001-5000 Nil 

5000 above Nil 

4 Number of towns Nil 

Total Population (2001) 42,518 (As per 2001 census) 

5 

Urban Nil 

6 

Rural 42,518 (As per 2001 census) 

Sex Ratio (F/M * 1000) 

Population Sex Ratio 1009/1000 

Male (undivided 

district data) 

Child Sex Ratio NA 

229 

(As per 2001 census) 

7 Density per Sq.km 15 per sq km 

8 Decadal growth rate 28.75% (As per 2001 census) 

9 Literacy rate: 

24.31% 

Male 

15.94% (As per 2001 census) 

Female 

8.37% 

10 % SC population 

% ST Population 92% 

No. of schools 361 Education Deptt. 

No. of AWW 586 (Record from office of the 

Director of women & 

child development, Nlg) 

11 Length of road per100 sq. Km NA 

12 % of villages having access to safe drinking 

water facility 

Nil 

13 % of households having sanitation facility 

specify Type-sewage, safety tank etc) 

0.7% 

14. % of population below poverty line 95% BDO office 

15. * Health Status 

* Morbidity 

* Male 

NA

* Female 

* Child 

* Mortality 

* MMR 

* IMR 

* TFR 

16. Health Resources 

Facilities (Specify level of facility like Subcentres) 

-personnel (Sanctioned Vacancy) 

-Finances (Requirement releases) 

17. 1. Birth Rate & Death Rate 

2. Fertility Rate 

3. Diseases maximum disability 

4. High Risk Groups 

18. To link with the nutritional determination: 

1. % of infants with low birth rate 

2. Weight of Age no. above 90% 

3. No. between 60% to 80% 

4. No. below 60% weight for age 

19. 1. No, of Primary School 

2. No. of primary school teachers 

3. No. of children enrolled (age wise) 

PUBLIC HEALTH INFRASTRUCTURE IN THE KURUNG KUMEY DISTRICT: 


Government 

Buildings 

Number 

Rented Remark 

District Hospital Nil Nil 

Medical College & Hospital Nil Nil 

AYUSH Colleges and Hospital Nil Nil 

Rural Hospitals Nil Nil 

CHC including Identified 24x7 

3 Nil Recently CHC 

functional 

Koloriang is 

approved for 

upgradation to 

FRU. 

PHC 6 Nil 

Sub Centre 15 Nil 

Ayurvedic Dispensary Nil 

Homeopathic Dispensary Nil 

MATERNAL HEALTH IN KURUNG KUMEY DISTRICT: 

230 

NA 

NA 

3.75% 

NA 

NA 

NA 

301 

NA 

NA 

RHS- 1998 

Education department 

Sl. 

No 

Indicators Figure Source 

1 Mothers registered in te first trimester when they were pregnant with last 

live birth/still birth(%) 

33.8 

2 Mothers who had at least 3 Ante Natal care visits during the last pregenancy 

(%) 

48.7 DLHS-3 

3 Mother who got at least one TT injection when they were pregnant with their 49.6

4 

last live birth/still birth (%) 

Istitutional births (%) 52.1 

5 Dilivery at home assisted by a Doctor/Nurse/LHV/ ANM(%) 3.6 

6 Mother who received post natal care within 48 hours of delivery of their last 

child (%) 

38.9 

FAMILY PLANNING IN KURUNG KUMEY DISTRICT: 

Indicator Figure Source 

Any Method(%) 47.2 

Any Modern method(%) 46.4 

Female Sterilization 36.7 

Male Sterilization 0.5 

IUD(%) 3.8 

Pill(%) 3 

Condom(%) 2.5 


Total unmet need (%) 7.9 

For spacing 1 

For limiting(%) 6.9 

231 

DLHS-3 

Sl. 

No 

Indicators Figures Source 

1 Children (12-23 months) fully immunized 23.8 

DLHS-3

2 Children (12-23 months) who have received 

BCG(%) 

3 Children (12-23 months) who have received 3 

doses of Polio Vaccine(%) 


doses of DPT Vaccine(%) 


doses of Measles Vaccine(%) 

CHILD HEALTH IN KURUNG KUMEY DISTRICT: 

DIFFICULT AREAS SELECTED IN KURUNG KUMEY 

Facility Difficult Most Difficult Inaccessible 

CHC - Koloriang 

SC - Yumlam 

CHC - Nyapin 

SC - Phassang 

- Sango 

CHC - Palin 

SC - Yaglung 

- Joru Galang 

PHC - Sarli 

PHC - Tali 

SC - Pipsorang(NF?) 

PHC - Yangte 

SC - Lingdom(NF?) 

PHC - Damin 

- 

PHC - Sangram 

PHC - Parsi Parlo 

PHC - Pania 

PHC - Rongtey 

PHC - Chambang 

232 

66.7 

38.1 

47.6 

40.5

FACILITIES SELECTED FOR FUNCTIONING AS 24 X 7 SERVICE AND FRU: 

Districts No. of 

24 x 7 Service Facilities 

Proposed 

Kurung Kumey 2 

(Palin CHC & 

Yangte PHC) 

233 

No. of FRU Proposed 

1 (CHC Koloriang) 

MAJOR ACTIVITIES BEING UNDERTAKEN IN KURUNG KUMEY DISTRICT: 

1. The upgradation of CHC Koloriang in Kurung Kumey district is under construction 

through RWD of the state Government. Sanction of Rs 8.15 Crores has been approved during 

2009-10. The remaining amount of Rs.9.96 Crores has to be released during 2010-11. 

2. 5 Type III residential quarters have been planned to be constructed this year at Palin 

CHC @ Rs. 12 Lakhs per quarter. 

3. 5 barracks are being planned to be constructed in 2010-2011 in Sangram PHC as it 

is running as 24 X 7 PHC under PPP. 

4. 2 new labour rooms are being planned in Sangram PHC (already functioning as 24 

X 7) & Yangte PHC @ Rs. 6 lakhs. 

5. Palin CHC & Yangte PHC are being planned to be provided with Basic Ambulance 

@ Rs. 6 lakhs. 

6. Type I, II & II quarters will be constructed in the Border Areas of Sarli PHC, Damin 

PHC, Pip- Sorang SC & Sangram PHC. 

7. Incentive Scheme for the Difficult, Most Difficult & Inaccessible areas will be 

implemented form 2010-2011. 

8. Extra emphasis on health camps, outreach sessions and health mela for the whole 

district. 

9. Extra effort will be given on reporting and HMIS for proper and valid data. 

EAST KAMENG 

SITUATIONAL ANALYSIS IN EAST KAMENG DISTRICT: 

Sl. No 

Background Characteristics 

District 

Number 

Source 

1 Geographic Area (in Sq. Kms) 4134 

2 Number of blocks 

Size of Villages (2001 Census) 

7 

1-500 286 

501-2000 19 

2001-5000 0 

5000+ 1 

4 Number of towns 1 

Total Population (2001) 57179 

-Urban 26.2% 

-Rural 73.8%

Sex Ratio (F/M*1000 985/1000 Census 2001 

Decadal growth rate 13.24 Census 2001 

7 Density- per sq. km. 14.0%sq Km. Census 2001 

Literacy Rate (6+ Pop) Census 2001 

-Male 76.7% DLHS 3 

-Female 66.3% DLHS 3 

9 ST population 86.72% Census 2001 

10 Length of road per 100 sq. km. 

12 % of villages having access to safe drinking water 

facility 

234 

96.4% DLHS-3 

13 % of households having sanitation facility 90.5% DLHS-3 

14 % of population below poverty line 74% DSH 2005-06 

PUBLIC HEALTH INFRASTRUCTURE IN EAST KAMENG DISTRICT 


Number 


Civil Hospital NA 

Medical College Hospital NA 

AYUSH Colleges and Hospitals NA 

District Hospitals 1 

Rural Hospitals NA 

UFWC NA 

CHC including Identified FRUs 2 

PHC 9 

Sub Centre 43 

Ayurvedic Dispensary NA 

Homeopathic Dispensary NA 

MATERNAL HEALTH IN EAST KAMENG DISTRICT: 

Sl. 

No. 

Maternal health Indicators Figure 

1 Mothers registered in te first trimester when they were pregnant with 

last live birth/still birth(%) 

15.4 

2 Mothers who had at least 3 Ante Natal care visits during the last 

pregenancy (%) 

27.0 

3 Mother who got at least one TT injection when they were pregnant 

with their last live birth/still birth (%) 

52.9 

Source 

DLHS-3

4 Istitutional births (%) 30.6 

5 Dilivery at home assisted by a Doctor/Nurse/LHV/ ANM(%) 0.5 

6 Mother who received post natal care within 48 hours of delivery of 

their last child (%) 

22.9 

FAMILY PLANNING IN EAST KAMENG DISTRICT: 


Any Method(%) 36 




IUD(%) 1.1 

Pill(%) 6.5 

DLHS-3 

Condom(%) 


1 

Total unmet need (%) 19 

For spacing 7 

For limiting(%) 12 

CHILD HEALTH IN EAST KAMENG DISTRICT: 

Sl. 

No. 



2 Children (12-23 months) who have received BCG(%) 43.1 

3 Children (12-23 months) who have received 3 doses of 

Polio Vaccine(%) 


DPT Vaccine(%) 


Measles Vaccine(%) 

DIFFICULT AREAS SELECTED IN EAST KAMENG DISTRICT: 

Facility Normal Difficult Most Difficult Inaccessible 

DH Seppa 

SC Pipu 

CHC Chyang Tajo 

SC L Bagang Jyang Bagang(NF?) 

Yongfo 

235 

33.9 

38.3 

38.7 

DLHS-3

PHC Pakke-Kessang 

SC Rilo 

PHC Bameng 

SC Paksa Lada 

Sekong(NF?) 

PHC Khenewa 

SC Nari Camp 

PHC Veo 

SC Saba 

PHC Risokorong 

FACILITIES SELECTED FOR FUNCTIONING AS 24 X 7 SERVICE AND FRU EAST 

KAMENG DISTRICT: 


24 x 7 Service Facilities 

Proposed 

East Kameng Bana PHC, 

Pakke Kesang PHC 

ACTIVITIES BEING UNDERTAKEN IN EAST KAMENG DISTRICT: 

236 

No. of FRU Proposed 

DH , Seppa 

1. In Bameng PHC (under PPP) 3 barracks are to be constructed, 4 in Bana PHC and 2 in 

Pakke Kesang. 

2. A new labour room @ Rs. 6 lakhs has been planned in Pakke kesang PHC. 

3. A basic ambulance has been planned to be provided at Bana PHC @ Rs. 6 lakhs. 

UPPER SUBANSIRI DISTRICT 

SITUATIONAL ANALYSIS : 

Indicators Data Source 

Sl. 

No. 

1 Population Total 

55346 

Census 2001 

Male 

28240 

Female 

27106 

Urban 

15756 

Rural 

39590 

Projected Population 2010* 60423 

2 Census size of villages 

1 – 500 

501-2000 

415(17no uninhabited) 

436 villages 

396 

38 

2 

Census 2001 

District Survey (2006)

2001-5000 

Above 5000 

Sex ratio 

0 

973:1000 (F/M) 

3 Growth rate (decadal) 9.8% Census 2001 

4 Density 7.8/Sqkm 

5 Literacy rate Total 

50.09% 

Male 

58.81% 

Female 

42.47% 

6 Schedule Caste 10.8% 

7 Census economic classification 65.5% 

8 % of households electrified 42% DSHB-2003 

9 % households having drinking water 69.6 Nos. 

District statistical hand 

facility (tap) 

book 2002-03. 

10 % households with sanitation facility 16.3% District statistical hand 

book 2002-03. 

11 Climate and Temperature 

Annual rainfall (2002-03) 

149.25 

Dist. Statistics 

Maximum Temp 

42 Deg.Celsius 

handbook-2002-03 

Minimum Temp 

15 Deg Celsius 

12 Development Blocks 9 

13 Full immunization 31.2 DLHS-3 

14 BCG (12-23 months) 63.8 DLHS-3 

15 Measles vaccination (12-23 months) 52.3 DLHS-3 

• Projected population calculated on 2001 census population of 55346 with Decadal Growth rate 

of 9.8% 

PUBLIC HEALTH INFRASTRUCTURE IN THE UPPER SUBANSIRI DISTRICT: 


Number 


District Hospital 1(SPT) 

Medical College Hospital Nil 

AYUSH Colleges and Hospitals Nil 

Sub District Nil 

Rural Hospitals Nil 

UFWC Nil 

CHC 

4 (SPT) 

CHC Identified FRU’s 

Nil 

PHC 6 SPT (Out of11PHCs) 

Sector PHC Nil 

Sub-centre 

4 SRCC, 6 SPT ,5 MIBT, 

8 OBT=23 (Out of 37 SCs) 

Ayurvedic Dispensary 

Homeopathic Dispensary 

Attach to District hospital 

MATERNAL HEALTH IN UPPER SUBANSIRI DISTRICT: 

Sl. 

No. 

Maternal health Indicators Figure Source 

237 

Nil

1 Mothers registered in te first trimester when they were 

pregnant with last live birth/still birth(%) 

FAMILY PLANNING IN UPPER SUBANSIRI DISTRICT: 

CHILD HEALTH IN UPPER SUBANSIRI DISTRICT: 

238 

27.8 

2 Mothers who had at least 3 Ante Natal care visits 

during the last pregenancy (%) 

52.4 

3 Mother who got at least one TT injection when they 

were pregnant with their last live birth/still birth (%) 

58.1 

4 Istitutional births (%) 59.1 

5 Dilivery at home assisted by a Doctor/Nurse/LHV/ 

ANM(%) 

1.6 

6 Mother who received post natal care within 48 hours 

of delivery of their last child (%) 

42.9 


Any Method(%) 60.2 




IUD(%) 3.9 

Pill(%) 4.2 

Condom(%) 4.6 


Total unmet need (%) 10.2 

For spacing 2.9 

For limiting(%) 7.3 

DLHS-3 

DLHS-3

Sl. 

No. 



2 Children (12-23 months) who have received BCG(%) 63.8 

3 Children (12-23 months) who have received 3 doses of Polio 

Vaccine(%) 

4 

Children (12-23 months) who have received 3 doses of DPT 

Vaccine(%) 

5 Children (12-23 months) who have received 3 doses of Measles 

Vaccine(%) 

DIFFICULT AREAS SELECTED IN UPPER SUBANSIRI DISTRICT: 

Facility Normal Difficult Most Difficult Inaccessible 

CHC Dumporijo 

SC Riba Hali 

Param 

PHC Muri-Mugli 

SC Lilidong 

PHC Taliha 

SC Nogi 

PHC Limeking 

PHC Taksing 

PHC Puchigeko 

PHC Nacho 

PHC Paying 

SC Pakpumaling 

PHC Baririjo 

SC Lebri 

PHC Siyum 

239 

46.0 

36.3 

52.3 

DLHS-3

SC Jingbarai 

PHC Giba 

SC Reddy 

Lingdam 

PHC Maro 

SC Yatekripa Lakbak Gongo 

Panimori 

Dula 

PHC Gusar 

SC Bui 

PHC Chetam 

SC Dadi 

FACILITIES SELECTED FOR FUNCTIONING AS 24 X 7 SERVICE AND FRU IN UPPER 

SUBANSIRI DISTRICT: 


No. of FRU 

24 x 7 Service Facilities Proposed Proposed 

Upper 

Subansiri 

PHC Maro Nil 

ACTIVITIES BEING UNDERTAKEN IN UPPER SUBANSIRI DISTRICT: 

1. An Incinerator has been planned to be installed at District Hospital, Daporijo @ Rupees. 

Twenty Five lakhs (Rs.25, 00, 000/) 

2. 5 Type III quarters will be constructed in CHC Dumporijo (already functioning as 24X7) @ 

Rs. 12 Lakhs each. 

3. In Nacho & Maro PHCs 3 barracks eachwill be built in 2010-2011. 

4. A new labour room @ Rs. 6 lakhs has been planned in Maro PHC. 

5. A Critical Care Ambulance will be provided at District Hospital, Daporijo @ rs. 19 lakhs. 

6. A basic ambulance has been planned to be provided at CHC Dumporijo @ Rs. 6 lakhs. 

DISTRICT WISE TRAINING NEED 2010-11(RCH, RI & NRHM) 

Name of 

Trainning 

Programme 


Categories of 

Participant 

E/Kameng k/Kumey U/Subansiri 

240 

Total 

Training 

load 

Master Trainer 1 1 

MO 2 2 2 6 

SBA 

ANM/GNM 15 15 15 45 

LSAS MO 1 1 2 

MTP MO 4 2 3 9 

MO 2 3 3 8

ANM 2 2 1 5 

GNM 1 1 1 3 

Blood 

MO 1 1 2 

Transfusion 

Child Health 

LT 1 1 2 

MO 2 4 4 10 

IMNCI 

ANM/GNM 2 4 4 10 

F-IMNCI TOT 1 1 1 3 

F-IMNCI ( 11 

MO 4 4 4 12 

Days) 

Navjat 

SishuSwasthya 

ANM/GNM 4 4 4 12 

Karyakaram MO 1 1 1 3 

MO 2 2 2 6 

FBNC 

Multi skilled 

training on 

ANM/GNM 2 2 2 6 

Pediatrics 


Laparoscopic 

MO 1 1 

sterilization Gyneocologist 0 

Minilap MO 2 2 2 6 

IUD MO 4 4 4 12 

ANM 

DMO, DRCHO, 

16 16 16 48 

Contraceptive Gyneocoligist& 

Update 

ARSH 

DPM 5 5 5 15 

MO 2 2 2 6 

Other 

ANM/GNM 10 10 10 30 

Ultasound MO 1 1 1 3 

Medical 

MO 20 11 20 51 

Education 

GNM 

ANM Placed/ 

7 15 8 30 

Refresher Relocate at SC & 

Training posted at new SC 20 20 20 60 

QAC District Level QAC 9 9 9 27 


District Nodal M&E 

Officer 

District Accounts 

1 1 1 3 

Manager 


1 1 1 3 

State HMIS of other Programme 

Block Level 

0 

District HMIS Participant 8 8 8 24 

Block Level Reporting Person of 

HMIS 

Other Trainining 

SC 17 17 17 51 

241

Workshop for 

Administrative 

Officer on 

NRHM DC/SDO/EAC/CO 4 4 4 12 

Workshop for ZPM/Block 

PRI on NRHM Chairperson 20 20 20 60 

ASHA 6th Module 288 471 398 1157 

Re-orientation 288 471 398 1157 

G-5: COMMUNITY MONITORING 

The State intends to initiate Community Monitoring on a Pilot Project basis from this 

financial year onwards. Two (2) districts namely Tawang and Lower Subansiri are proposed 

Districts to be taken up as the Project area. Three blocks in each district, one PHC in each block and 

two villages under each PHC have been chosen for this phase. 

Objectives;- 

1. To provide regular and systematic information about community needs. 

2. To enable the community and other stakeholders to become equal partners in the planning 

process. 

3. To develop awareness about determinants of health 

4. To create a feeling of ownership of health services in the community 

Activities;- 

1. Orientation workshops on community monitoring to districts managers (all DPMU staff, 

ASHA facilitators, ASHAs and Block accountant of District ASHA Resource Center), 

stakeholders, PRI and NGOs / CBOs. 

2. Discuss and develop a village health plan after completing HH survey in collaboration with 

concerned VHSCs. 

3. Participatory Assessment to ascertain major health problems and health related issues. 

4. Maintain village health register and calendar. 

5. To get qtrly health delivery reports. 

6. Conduct village sharing meeting [key findings of the Community Monitoring exercise / 

Adverse experiences and adverse outcome / To improve service delivery & not fault finding 

with health care service providers / To discuss key problems & suggest action points etc. 

7. Jan-Samvad (public dialogue) [ Conducted at Block and PHC level / Presentation of 

Cumulative Village Report Card & Facility Report Card / Presentation of Denial of Care / 

Adverse Outcomes / Discussion on implementation of outreach services, improving Facility 

level service utilization & support to denial of care/adverse outcome cases etc. 

Processes:- 

242

There will be formation of planning and monitoring committees at the level of village, PHC 

and block. Each of these committees would have representation from service providers, panchayati 

raj institutions, community and civil society organizations, women representatives, SHG. 

Village Health & Sanitation Committee (VHSC) at every village level. This is the first but very 

important unit of operation and interaction. ASHA facilitators will generate the report to be 

submitted to the Block Accountant or MO (i/c) CHC / PHC 

Block / PHC Health Planning & Monitoring Committee at selected Block/PHCs comprising of 

MOs, Block Accountant, ASHA Facilitators, NGO/ CBO representatives 

Block Accountant or MO (i/c) PHC / CHC will generate the report to be submitted to the DPMU. 

The District and state mentoring groups will provide continuing support to the committees in 

capacity building and discharging their functions. 

Role of State in Capacity building: 

• Develop consensus among state and local communities about the aspects of Health issues in 

particular and the Program in general. 

• Provide training and technical assistance to communities on how to use data on risk, protection, 

and outcomes in planning and programs. 

• Create coordination, comprehensive systems to address the issues, assist communities in collecting 

the data, and organize them so that communities use it. 

• Collect and organize data and make these data available to the communities through District ASHA 

Resource Center . 

• Develop a community consensus about promotion of health seeking behaviors. 

• Develop a coordinated strategy among relevant local agencies at district level to collect, share, 

organize, and make use of available data; to the extent that the use of such data becomes a standard 

practice in the community, a greater number of effective preventive practices will be shaped over 

time. District ASHA resource team will initiate and monitor the progress. 

• Encourage and to describe the efforts that community leaders are making to respond to the findings. 

• Use data to guide prevention and treatment practices in the community. When evidence of progress 

in reducing a problem in the programs and policies previously implemented to achieve the outcome 

will receive increased support. 

Advantages: 

• Provides the opportunity for decision-makers to describe their information needs and the 

chance to maximize collaboration between partners. 

• As communities become skilled, they can use data to guide them in making plans and 

policies in important ways. 

• By focusing attention on measurable outcomes, community-monitoring systems can help 

bring about genuine and critical improvements in the lives of children and adolescents in 

every community. 

243

• The combination of skill sets, shared values, respect and trust within a community of 

people that allow for cooperation for mutual benefit. 

• Information needs are identified, monitoring becomes demand-driven, which informs the 

development of more effective tools and solutions for local issues. 

• The decision-makers then feed this knowledge and skill into appropriate local choices 

that are adaptive. 

• VHSC will be enabled to come up with their respective village health plan in time. 

Tools for monitoring:- 

Village Level :- 

• Review of Village health register and activity – calendar, 

and collates reports from the selected VHSCs 

• Review of performance of ANM, MPW, AWW, ASHA etc. 

• Sends Quarterly report to the Block / PHC-CHC Committee 

At PHC/CHC Level 

• Reviews and collates reports from the selected PHCs / CHCs. 

• Members visit PHC / CHCs, discuss with RKS members. 

• NGO/PRI sub team visits at least one PHC / CHC, and make observations. 

• Sends Quarterly report to the District Committee 

At District Level:- 

• Sends quarterly report to the State Committee. 

• Takes corrective measures down the line for development. 

Financial Management: 

The Process of Community Monitoring shall involve fund requirement. It is proposed that an 

amount of Rs. 75000.00/- (Rupees Seventy five thousand) only for Tawang district and Rs. 435000/- 

(Rupees four lakh thirty five thousand ) only for Lower Subansiri district and making a total of Rs. 

510000.00/- (Rupees Five Lakhs ten thousand) only shall be earmarked for Community Monitoring. 

The fund shall be provided on the basis of the details mentioned below. The fund shall be meant for 

carrying out different activities relating to Community Monitoring like field visits, reporting, 

conducting meetings, preparation of charts, calendars, etc. 

Sl.No. District No. of Pilot Areas Estimated fund 

requirement 

Total 

a) Tawang 3 PHCs (management cost) Rs. 5000.00 Rs. 15000.00 

6 Village Rs. 10000.00 Rs. 60, 000.00 

Sub Total for Tawag:- Rs. 75, 000.00 

244

) Lower Suibansiri 3 PHCs (management cost ) Rs. 5000.00 Rs. 15000.00 

6 villages Rs. 10000.00 Rs. 60, 000.00 

Sub-Total for Lower Subansiri:- Rs. 75, 000.00 

Grand Total of 2 districts :- Rs. 1, 50, 000.00 

Orientation workshop for 2 days shall be imparted on Community Monitoring at the Block 

Level. The members of the Community Monitoring Committee shall attend the Orientation. 

Total Fund estimated = A+ B 

= Rs. 1, 50,000.00 + Rs. 3, 73,750.00 

= Rs. 5, 23, 750.00 

H . INTERSECTORAL CONVERGENCE ( PART E): 

Convergence/ Coordination 

A convergence committee has been constituted at the state level under the chairman ship of 

the Chief Secretary which includes secretaries/ Directors from related department and 

representatives from NGO, PRI etc are the members. This committee will overseas the activities 

which are to be convered at all level. However, activity of the committee needs to be up-scaled. 

Sl Particulars Rate Qty Unit Days Amount 

1 TA to participants 500.00 40 Nos 2 days 

Rs. 80000.00 

2 DA 400.00 40 Nos 2 Rs. 32000.00 

3 Honorarium for Resource 

Persons 

1000.00 4 Nos 2 

Rs. 8000.00 

4 Training Material (Study 500.00 40 Nos 1 

material, Pen, Note Book, 

Folder) 

Rs. 20000.00 

5 Lunch 250.00 45 Nos 2 Rs. 22500.00 

6 Contingency 15 % of the total amount Rs. 24375.00 

Sub Total Rs. 186875.00 

No of Batch 2 

Total Estimated Cost (Rs) Rs. 373750.00 

The executive committee of the state health society constitutes different program officer 

within the department to look into this activity. The DCs and the other administrative officers are the 

chairman of DHS & RKSs and are regularly involved in NRHM Programs. 

However, the committee is weak and needs improvement in the proposed year. Better plan for 

convergence at intra-departmental and inter-departmental level has been proposed. 

The National Population Policy 2000 and the National Health Policy, 2001, include 

decentralization and convergence of service delivery at village levels and recognize the PRI as the 

agency responsible to ensure this. In the context of health and family welfare, perhaps the most 

significant impact is the ability of women to get elected to local bodies. In some areas, women PRI 

members take an active role in polio eradication, health camps, mobilize women for services and 

monitor attendance of staff. 

245

Several factors influence the progress of decentralized planning and implementation, not the 

least being political will, and peoples’ readiness to engage with decentralization. 

The National Rural Health Mission (NRHM) is seen as a vehicle to ensure that preventive 

and promotive interventions reach the vulnerable and marginalized through expanding outreach and 

linking with local governance institutions. PRIs are seen as critical to the planning, implementation, 

and monitoring of the NRHM. At the District level a District Health Mission will coordinate NRHM 

functions. 

ASHA, (Accredited Social Health Activist), the mechanism to strengthen village level service 

deliveryare in place. The Village Health Committee (VHC) will form the link between the Gram 

Panchayat and the community, and will ensure that the health plan is in harmony with the overall 

local plan. 

Capacity building of PRI is required in thematic areas and leadership skills, negotiating, 

monitoring, ability to withstand patronage and political interference. Capacity building processes 

need to be tailored to literacy levels, sex and circumstances of PRI members. Joint orientation and 

sensitization meetings between PRI and health and medical professionals could help to bridge the 

gap in education and social strata. Developing Citizen Charter of Rights and Codes of conduct also 

lay down guidelines for boundaries of operation and accountability which is already addressed under 

RKS. NGOs could be involved in PRI strengthening in a variety of ways, including: consciousness 

raising, provision of technical advice, support in participatory planning, capacity building and 

facilitating monitoring processes, such as community and social audits to improve accountability. 

SWWCD 

The slow pace of progress in infant mortality and child malnutrition is an area of serious 

concern and maximum infant deaths occur in the neonatal period. Proximate determinants of infant 

and child survival include a mix of preventive and curative interventions which can be successfully 

implemented through a mix of actions at the village level 

Community level action for increasing mobilization, action and behavior change processes, 

supported by well organized primary and secondary health systems, are required to enable women 

cross a range of barriers, including gender inequity and poor access to quality health services. 

The SWWCD covers the Integrated Child Development Services (ICDS), to provide 

supplementary nutrition for pregnant and lactating mothers and children under six, and non-formal 

preschool education; programmes to ensure social and economic empowerment of women through 

collectivization, welfare and support services etc. At the village level, it is represented by a village 

level honorary worker, the Anganwadi Worker (AWW) and her assistant, an Angnawadi helper. At 

the block Level, the Child Development project Officer is the functionary in charge of DWCD 

schemes. 

The AWW under the purview of the SWWCD performs the duties of frontline grass roots 

workers along with the ASHA. The AWW is also involved in several programs like RI, Blindness 

Control, Leprosy, Pulse Polio Immunization, and the RCH programme. Coordination is immensely 

needed in areas such as health services, nutrition, immunization, and referral. Both are having 

overlapping goals, and thus complementary programming is essential. 

246

The National Rural Health Mission (NRHM) is seen as a vehicle to ensure that preventive 

and promotive interventions reach the vulnerable and marginalized through expanding outreach and 

linking with local governance institutions. 

The child health strategy concentrates on the: essential newborn care, breastfeeding, 

immunization, and care of the sick newborn and child through outpatient/home based care and 

inpatient care. This approach is called the Integrated Management of the Neonatal and Child hood 

Illness (IMNCI). 

Child Health 

SWWCD Interventions DHFW Interventions 

-Monthly Weighing of children under six 

-Maintaining Growth chart 

-Child cards for children below six (for 

medical history) 

-Nutrition supplementation 

-Referral of children with 2SD and 3SD 

malnutrition to the PHC 

-Non-formal pre school education 

-Health and nutrition education 

-Elicit community support and participation 

in running the programme 

-Assist PHC staff in immunization of 

children- House visits to ensure appropriate 

feeding practices and attendance at AWC. 


-Nutrition supplement to a sub-sect of all 

pregnant and lactating women (BPL) 

-Enables all pregnant and lactating mothers 

to collect at the AWC for ANM visit 


Child Health 

- Identify malnutrition among children (0-5) and 

manage or refer to PHC 

-Provide ORS to children with diarhoea 

-IFA to infants and young children 

-Vitamin A solution 

-Immunization 

-Weigh and examine newborn as son as possible 

after birth. 

-Health Education 


-Register and provide care to all pregnant women 

throughout pregnancy 

-Urine and Hb test, BP and three abdominal 

examinations 

-Refer complications and facilitate referral 

-Conduct three postnatal visits 

-Health education 


-Family planning motivation 

247

-Distribution of contraceptives 

-Referral for IUD or terminal methods 

-Follow up of users for side effects 

-RTI/STI education, recognition, and referral 

-Minor ailments treatment/referral 

They will be responsible for ensuring that all children 0-6 and children for immunization 

and other health services are brought to the AWC on a fixed day, when ANM and MO visit to provide 

immunization, and other health care services. Services to be provided on the Health & Nutrition Day 

include: ANC, Newborn check up, Postnatal care, Immunization of mothers and children, IFA and 

Vitamin A administration, treatment for minor ailments, and health education. 

They will mobilize women and children, with support from community to access services 

through a fixed Village Health & Nutrition Day held every month at the AWC. They will counsel 

women for institutional deliveries and facilitate referral. It will be emphasized that AWW and/or 

ASHA to be present at all home deliveries (as second attendant) to provide care and advice for the 

newborn. 

They could motivate newly married women and recently delivered women to use family 

planning. The AWC would serve as the depot for pills and condoms and also facilitate referral for 

other methods. 

They would participate in routine immunization and special campaigns like pulse polio and 

also provide Vitamin A 

In order to ensure effective functioning of the two areas of convergence discussed above, 

joint planning of between the two at various levels is necessary. 

Other cross cutting areas: 

Success of convergence in health, nutrition, and empowerment requires convergence of approaches 

in: planning modalities, monitoring and information systems, capacity building and training inputs. 

Additionally the Health Department must ensure that convergence efforts are backed by a strong 

service delivery system, responsive to community needs. 

School 

There may not be direct scheme / activities linked to the health indicators but as a major 

Department having capacities and establishment across the state, it will be ensured that there 

resources are being utilized for improving health indicators. This includes using of students in health 

programs, school health programs in the schools in sensitizing the students etc to health needs. 

Teachers may also be utilized for propagation of health information to the students in turn who will 

disseminate the messages to the parents and community. 

PHED 

248

Under NRHM it is to help and to promote sustainable and equitable access to water, particularly safe 

drinking water and sanitation facilities in urban and rural areas. It also promotes effective 

management in order to reverse unsustainable exploitation of water resources. 

The Community seeks to promote knowledge sharing and inter-agency collaboration as the means to 

achieve this end. By tapping into the collective knowledge of diverse practitioners across the sector, 

the Community helps members increase the effectiveness of water and environmental sanitation 

operations and development initiatives. There are issues which is covered 

• Access, quality and effectiveness of water and sanitation service delivery 

• Responsible management of water as a natural resource 

• Unsustainable use of water 

• Water pollution and contamination 

• Inadequate delivery mechanisms and infrastructure 

• Inefficient institutional and governance structures 

• Financial resource constraints 

• Socio-economic and cultural barriers to water access 

The facility survey also indicates that majority of the households are not provided with 

potable and safe drinking water. Similarly, sanitation facilities are also very scarce. Under the 

convergent efforts of the line departments, it is hoped that these issues also would be sddressed 

during the program period. 

VH&ND is another area where convergence has started. The committee will oversee under 

the aegis of SHM & DHM. This committee will not only address the health need but also covering all 

the aspects of sanitation. 

Administration 

Involvement of General Administration in RCH and NRHM activities is indispensable to the 

success of the programme, beginning from the State level down to the village level. Active 

participation of the district administration in required in mobilizing manpower and arranging 

transport facilities during IPPI campaigns and other health camps. At the decision making level, 

Chief Secretary is the chairman of SHS governing body and the Secretary (HFW) is the chairman of 

executive body of SHS. They are regularly in touch with the DCs in the districts, while at the district 

level Deputy Commissioners are the chairman of governing body of District Health Society and 

holding regular meetings and monitoring the progress of the programs with major emphasis on RCH 

activities. Administrative officers at all levels are the chairman of Rogi Kalyan Samity. By virtue of 

their position in various institutions of NRHM, their involvement in decision and policy making has 

become vital. At the implementation stage, their participation is invariably required for ensuring 

inter-departmental coordination and convergence of activities related to health programs. 

H 2. MAINSTREAMING OF AYUSH: 

Co location of AYUSH and allopathic services has almost been completed in the state. 25 

AYUSH MOs under NRHM will continue. 

H3. OTHERS: 

249

Verticals in ADDITIONALITIES part RNTCP 

SL. 

No. 

1 

Additionality Funds from NRHM-Details of the activities with justification for which 

Additionality Funds are proposed to be sought. 

Account head Activity Amount Justification 

Procurement of 

vehicle for STDC 

cum IRL 

4 wheeler 

Mini Bus 

2 Miscellaneous Digging of Bore 

Well 

Transformer for 3 

phases electric 

connection. 

250 

Rs.6,00,000.00 

Rs. 10,00,000.00 

Rs. 3,00,000.00 

Rs. 8,00,000.00 

4 -wheeler require for 

STDC/IRL Director for 

Supervision, Monitoring and 

EQA activities in the state also 

for official duties. As hire 

vehicle is more expansive in the 

hilly and difficult terrain state. 

Mini Bus require for training 

activities of STDC. 

Running water connectivity is 

necessary for IRL Activity, for 

which bore well is needed. 

For 3 phase electricity 

connection is require for IRL, 

for which one no. 100 KVA 

transformer is required. 

3 Procurement of Mini Incinerator Rs. 10,00,000.00 1. Mini Incinerator is require for 

equipment 

Bio waste disposal of IRL. 

4 IEC Activity Publication of Rs. 5,00,000.00 1. It is proposed to publish 

Booklet on TB. 

Total 

Rs 42,00,000.00 

Update TB booklet with detail 

activities of RNTCP in 

Arunachal Pradesh for general 

awareness. 

H. 4 IDSP 

FINANCIAL SUPPORT TO IDSP ARUNACHAL PRADESH UNDER NRHM FLEXI-POOL 

AS PER THE APPROVED PROJECT FOR THE FINANCIAL YEAR 2010-2011 


A Financial Support for manpower under IDSP: 

I STAFF UNDER STATE SURVEILLANCE UNIT (SSU) 

SL Name of post 

No 

s 

TOTAL 

REQUIREMEN 

T of the state 

MONTHLY 

CONSOLIDATED 

REMUNERATIO 

N 

ANNUAL BUDGET 

REQUIREMENT 

1 Epidemiologist 1 1 30,000.00 360,000.00 

2 Microbiologist 1 1 20,000.00 240,000.00 

3 Entemologist 1 1 15,000.00 180,000.00 

4 Consultant(Finance) 1 1 14,000.00 168,000.00 

5 Consultant(Training) 1 1 28,000.00 336,000.00

6 Data manager 1 1 14,000.00 168,000.00 

7 Data Entry Operator 2 2 8,500.00 204,000.00 

8 Administrative Asst 1 1 7,500.00 90,000.00 

II STAFF AT DISTRICT SURVEILLANCE UNIT (DSU) 

1 Epidemiologist 1 16 30,000.00 5,760,000.00 

2 Data managers 1 16 13,500.00 2,592,000.00 

3 Data Enrty Operators 1 16 8,500.00 1,632,000.00 

4 Microbiologist 1 16 20,000.00 3,840,000.00 

5 Accountant 1 16 9,500.00 1,824,000.00 

6 Administrative Asst 1 16 7,000.00 1,344,000.00 

B Financial support for mobility under IDSP 

1 

1 

Mobility support to all 

district of the state/SSU 

at the rate of rs1000/- 

per visit for a maximum 

of 4 visits in a month 

17 

4 x 12 months x 

17 DSU/SSU 

@1000.00 

251 

68,000.00 816,000.00 

Grand Total 19,554,000.00 

(Rupees one crore ninety five lakhs fifty four thousand)only 

Certified that the requirement has been projected as per the approved plan and the state 

requirement for 16 district and one SSU, pending clarification form GOI. 

Training component 

Influenza-A H1N1 17 1,00,000 17,00,000 1700000 

Grand Total 21,254,000.00 

I . NURSING SCHOOL 

A. 1 Nursing School at General Hospital, Pasighat was approved last year. The detail 

proposal was sent to Nursing Division, GoI. for final approval. The state is waiting for 

communication from the Nursing Division, GoI. for implementation. The project proposal 

amounting to Rs. 17,34,29,806/- may be revalidated and approved . 

B. One ANM training School at District Hospital, Ziro would be established during 2010-11. 

the detail proposal is being prepared and will be sent to the Nursing Division, GoI, for final 

approval.

PART C: IMMUNIZATION 

1. Situation Analysis of the State Immunization Programme 

Background 

Improvement in Child survival and maternal health are important goals under National 

Rural Health Mission. Significant reduction in infant and child mortality rates has been achieved 

with the implementation of interventions like Universal Immunization Program, Oral Re-hydration 

Therapy Program and other maternal and child health Schemes during 1985-90 and subsequently 

under the CSSM Program. Interventions like antenatal, Institutional delivery and postnatal care, 

prophylaxis and treatment of nutritional anemia and referrals of women with complications are the 

major focus area for maternal health. Among the child health interventions the focus is now to 

improve newborn care, prevention and treatment of diarrhea and control of deaths due to pneumonia 

etc. 

Under the Strengthening of Routine immunization program, focused attention is being given 

to full immunization coverage of all children with antigens that is available under RI. 

In Arunachal Pradesh, as a distinct program, the EPI was implemented to provide 

vaccination to all the pregnant women and children. In 1985-86, it was further expanded to achieve 

100% vaccination for pregnant women and 85% of all the children and it was launched in 2 districts 

only. Then the CSSM was launched in 1992-93 but due to reasons unknown, the program was not 

very successful as expected. 

The rationale of the proposal is to strengthen outreach services by providing inputs to 

increase coverage and improve quality of Immunization, child health interventions and maternal 

health services by addressing gaps in service delivery and creating demand through IEC and social 

mobilization both in urban and rural areas of the state. 

Socio-demographic situation 

Arunachal Pradesh is situated in the northeastern part of India, bounded by international 

boundaries with China in the north, Myanmar in the southeast and Bhutan in the west. The state is 

situated at latitude of 90.36 0 E to 97.3 0 E and longitude of 26.42 0 N to 29.30 0 N covering a total land 

area of 83,743 sq. km. It has a total population of 1097968 (Census 2001) with an average 

population density per square kilometer of 13 persons. The sex ratio of the state is 901 females per 

1000 males as per census 2001. Due to its peculiar topography and difficult terrain, there is widely 

dispersed settlement pattern of the population wherein rural population constitutes 79.59% and the 

urban only 20.41 %. The percentage of population below poverty line in 1999-2000 is 33.47 (SRS 

Bulletin, April 2001) with a percentage decadal growth of 26.21 and Average Annual Exponential 

Growth Rate of 2.33. The total literacy rate in the state is 54.74% with a male literacy rate of 64.07% 

and female literacy rate of 44.24%. The per capita income (97-98) of the state is Rs. 13424. [Source: 

Provisional Census of India 2001]. The MMR for the state is not available. The IMR is 61 (NFHS 

III), 37 (SRS 07) and the TFR is 3 (NFHS III)

State Profile: 

Population 1097968 2001 Census 

Rural 79.59% 2001 Census 

Urban 20.41% 2001 Census 

Sex Ratio 901 Female per 1000 Male 2001 Census 

Population BPL 33.47% SRS April 2001 

Decadal Growth Rate 26.21 % SRS Bulletin 

Literacy Rate 54.74 2001 Census 

No. of General Hospital 2 

No. of District Hospital 13 

No. of CHC (Functional) 31 

No. of CHC (Functional with Cold Chain) 31 

No. of PHC (Functional) 85 

No. of PHC (Functional with Cold Chain) 57 

1. Current Scenario of Implementation of Immunization Programme. 

The objective of the immunization programme is in line with the objectives framed under 

NRHM with additional inputs from GOI, it is envisaged to attain a level of immunization coverage in 

line with the National goals. 

1. a. Implementation Status: 

Despite the tireless effort being made to improve the immunization coverage level in the state, 

there are certain obstacles which make it difficult to achieve the target as per plan. The climatic 

condition and topography of the state play crucial role in hindrance to the carrying out of activities. 

Lack of dedicated and well trained personnel, shortage of personnel etc. also result in low outcome of 

the activities. 

The immunization program covers all townships of the state by regular routine EPI program 

and special Vaccination Program like Immunization Month staring from November 2008 to cover 

mainly the un-reached children. The Out Reach Immunization Sessions are being carried out from 

PHCs/CHCs to improve the coverage level of immunization in the rural areas. However, due to lack 

of awareness on values of vaccinations among the parents, the target cannot be achieved as per 

planned. However, in order to accelerate the immunization activities and to increase coverage level, 

253

Routine Immunization Month was introduced in November 2008 in which there were rigorous 

immunization activities covering all the villages of the state and since then this programme is still 

continued in many districts. 

For implementation of various activities under Routine Immunization programme, funds are 

released to the Districts according to the target set by them. However, reports performances and 

achievements are still awaited from the district. 

1.a.1. Manpower Status dedicated in immunization programme: 

Sl. No. Particular Sanctioned Post In Position Additional 

Requirement 

1 State EPI Officer 1 1 

2 Deputy Director, Immunization 

3 District Immunization Officer 16 16 

4 Medical Officers (Regular) 

5 Medical Officers (Contractual) 

6 State Cold Chain Officer 1 1 

7 Technical Assistant 1 1 

8 District Cold Chain Officer 16 

9 Refrigerator Mechanics (Regular) 12 4 

10 Refrigerator Mechanics (Contractual) 1 1 

11 Computer Assistant 17 17 

12 Health Assistant 132 

13 Health Assistant (Contractual) 20 

14 ANM (Contractual) 118 

15 ANM (Regular) 173 

16 Health Inspector 

17 Pharmacist 

Insufficiency in number of trained staff in particular and overall staff as a whole causes delay 

in implementation of programme as per plan. 

254

1. A.2. COLD CHAIN SYSTEM: 

Managing and maintaining Cold Chain System in Arunachal Pradesh is one of the most 

difficult tasks for the Health Department due to uneven physical and geographical distribution of this 

hilly state. Erratic power supply, dismal transportation and communication facilities in Arunachal 

Pradesh are the main hindrance to the establishment of a stable cold chain system in the state. The 

uneven topography of the State practically limits the reach of Cold Chain staff for timely maintenance 

of cold chain system and EPI personnel to reach the remote and difficult areas. 

� Managing Spare Parts 

The state has been instructed by GoI to procure the spare parts for cold chain equipments 

locally. However, the shortage of fund for cold chain maintenance is one of the areas where the State 

is facing problem in proper maintenance of cold chain system. For the years together it is seen that 

the fund approved by GoI for cold chain maintenance is not insufficient. Further, though the fund is 

approved in the PIP, it is not received in the state. The cold chain system is the vital part under 

Immunization Programme, yet little attention is seen to be given by GoI on cold chain system. The 

inadequacy of the fund for cold chain maintenance leads to delay in timely and proper maintenance 

of cold chain equipments in want of spare parts and ultimately it may lead to increase breakdown 

rate of cold chain equipments. Due to non-availability of spare parts for equipments in the market 

within the state, the required spare parts are to be arranged from outside the state for which funds 

are not sufficient due to higher cost index of articles in the state and rising inflation rates. However, 

efforts are always being made to maintain the cold chain system so that minimal breakdown of 

equipments occurs. 

� Repairing and Maintenance of Equipments 

The transportation of cold chain personnel and spare parts to the breakdown site is the 

biggest problem for proper maintenance of cold chain. Every year, the proposal is placed before 

Govt. of India for providing vehicle for transportation of cold chain technicians and other necessary 

items from one place to another in case of cold chain breakdown. Until and unless a vehicle is 

provided, if not for all district, at least for State Headquarter, the response time to the cold chain 

breakdown may increase to maximum. It is not always possible to rely on the Departmental Vehicle 

for transportation of Technicians as it is required to go through series of official process for approval 

that further delays timely maintenance. However, the breakdown rate of cold chain equipments is 

negligible. Whenever there is breakdown of cold chain equipments in those districts without Cold 

Chain Technicians, Technicians are deputed from the State Headquarter for repair and maintenance 

work. 

Another factors leading to difficulties in maintenance of cold chain system is lack of AMC. 

GoI is learnt to have Annual Maintenance Contract (AMC) with the suppliers of Cold Chain 

255

Equipments, but there is no relevant information available with the State Government regarding the 

Annual Maintenance Contract (AMC) for cold chain equipments. Supply of cold chain equipments 

have been made directly to districts, but no such information of AMC is available either with the 

district authority or the state. 

� Transportation and distribution of Vaccines and other logistics 

The transportation of vaccines up to PHC level and storing them there is also one area where 

the state is facing problem. As most of the PHCs are situated in remote and hilly areas, road 

connectivity to some of PHCs is almost nil. In it is very difficult to maintain the vaccines in effective 

cold chain system. During monsoon season most of the road connectivity are blocked frequently 

which hinders the smooth flow of vaccines to PHC/CHC which affects the carrying out of 

immunization activities. 

� Solar Refrigeration System 

In state like Arunachal Pradesh where the power supply is erratic, solar power refrigeration 

system has been the backbone of Immunization System. There is the extension of cold chain network 

using 30 solar power refrigerators for irregular or unreliable and no electricity area in the state. 

These were installed during 1999-2000 and out of these only 18 are functional and the remaining are 

non-functional either want of battery, plates, charge controller or other spare parts. As most of the 

Refrigerator Mechanics are not trained on repair and maintenance of solar powered refrigeration 

system, they are unable to repair the same. 20 more Solar Refrigerators had been proposed in the 

SPIP of 2007-08, the location and planned site of which had already been furnished to GoI but the 

state is yet to receive the same. 

� Status of Central Cold Chain System (State HQ) 

One CFC WIC is installed in the state Headquarter (Central Cold Chain room, Naharlagun). 

As the number of beneficiaries increases year after year, the demand of the vaccine volume, storage 

and preparation of ice packs have increased almost three folds for routine immunization activities, 

NIDs over the year and at times it is not enough for storage and distribution of vaccines for all the 

districts in the state. Due to ageing of the same, the cooling is sometime not effective. On many 

occasions, there have been breakdown of cooling unit. During last two years, the compressors of 

cooling units have been changed three times. Therefore, new WIC is required. However, there is no 

new site for installation of new WIC. Therefore, either the existing site will be extended or a new one 

will be constructed. 

� Status of Cold Chain Equipments in the State 

Present status and position of cold chain equipments is exactly not known due to non- 

availability of Cold Chain Technicians in some districts. Reports from the districts also do not reflect 

exact status and position of cold chain equipments. Staffs other than Cold Chain Technicians are not 

256

familiar with the names and model of equipments. Thus, it is difficult to get correct information 

pertaining to cold chain equipments from those districts where there are no Cold Chain Technicians. 

In order to assess the exact position and status of cold chain equipments throughout the state, one 

time crash inspection by the State Headquarter personnel to every district is required. 

Total number of Cold chain equipment (ILR/DF) in use under EPI program in the state as 

reported is 325 units. Since most of the equipments in use are CFC based equipments, sensing the 

non-availability of CFC gases, it is planned to phase out these CFC equipments and replaced by non- 

CFC equipments. But, as not much NON-CFC equipments are available for replacement in the state, 

these CFC equipments are still in use in many PHCs and CHCs. However, as on 15. 02.2010, 129 

Nos. of the CFC free equipments out of 139 allocated by GoI vide Ministry R.O No. Y-11013/6/2008- 

CC&V, dated 16 th July 2008, have been received in the State. However, testing and installation in 

some district are yet to be done. The detail status of equipments are given below. 

� Cold Chain Equipments (CFC) 

Equipments Available Working 

ILR (Small) 31 24 

ILR (Lagre) 1 

ILR-cum-Deep Freezer 20 13 

Deep Freezer (Small) 22 16 

Deep Freezer (Large) 37 27 

Total 111 80 

� Non- CFC Equipments: 

Equipment 

Available Working 

257 

Received in 2009-10 as on 

31.12.2009 (all CFC free) 

ILR (Small) 138 98 32 

ILR (Large) 9 3 9 

Deep Freezer (Small) 54 48 74 

Deep Freezer (Large) 13 9 14 

Total 214 158 129 

Solar 30 18 0

� Others Equipments: 

Equipments Available Working 

Voltage Stabilizers 251 195 

Cold Box (Small) 209 198 

Cold Box (Large) 135 134 

Vaccine Carrier 2398 2173 

Non-CFC Toolkits* 17 15 

CFC Toolkits 

Vide issue voucher No. INT/UIP/97-98/2579, dated 19 th Dec. 1997, five numbers of NON- 

CFC Toolkits and vide Ministry RO. No. Y.11013/1/2008-CC&V, dated 30.06.2008, 12 Nos. of NON- 

CFC Toolkits had been received from Govt. MSD. Kolkata on 30 th Dec. 1997. Out of these five 

numbers, two are not working now. 

In the state, there are 57 PHCs and 35 CHCs having Cold Chain System. The remaining 

PHCs and CHCs are functioning without Cold Chain System. However, the number of Health 

Facilities will increase after installation of all the equipments on complete receipt of all equipments 

from MSD Kolkata. 

� Health Facilities with Cold Chain System: 

Facilities 

Total in 

the State 

Functional 

258 

With Cold Chain 

System 

Without Cold Chain 

System 

General Hospital 2 2 2 Nil 

District Hospital 13 13 12 Nil 

CHCs 50 31 31 15 

PHCs 119 85 57 28 

� Training of Cold Chain Technicians 

There are only 13 Refrigerator Mechanics (One contractual) in the state out of which 3 are 

stationed at the state headquarter and still 6 (six) districts more without Refrigerator Mechanics. So

far all the technicians have been trained on repair and maintenance of NON-CFC equipments at 

SHTO, Pune. 

Vaccine Vans 

Every district in the state is hilly due to which the heavy and bulky vaccine vans supplied by 

GoI are not suitable. There are 16 (sixteen) vaccine vans supplied by GOI but only 6 (six) of them are 

in running condition but not used for transportation of vaccine because of their unsuitability for 

zigzag and narrow tracks and unreliability of the vehicle itself. Remaining 10 (ten) are not running 

for want of maintenance and authorized dealers in the state. 

� Status of Generators: 

In the state, as of now, 17 Generator sets are available in the districts and all are in working 

condition. One 7.5 KVA generator is attached to WIC in Central Cold Chain Room at State HQ, 

Naharlagun. 

1. a.3. Vaccines and Logistics: 

The vaccines are supplied by GOI through Zonal Depot in Kolkata and are delivered at 

Guwahati airport which more than 500 Kms away from the State Cold Chain Room at Naharlagun. 

At times, it is very irregular but overall, the vaccines are supplied most of the time in sufficient 

quantity. Due to untimed supply, unavailability of transportation support for collection from 

Guwahati, there is always problem for timely collection. 

The vaccines and logistics need to be supplied by GoI to the state cold chain centre at 

Naharlagun as the collection of vaccines from Guwahati Airport has to go through series of official 

process which further causes delay and inconvenience for both MSD Kolkata and the State. 

� Status of Vaccines in the State till 31. 12. 2008: 

Vaccines 

Opening 

Balance as on 

01.04.2009 

Received during 

the year till 

30.11.2009 

259 

Closing Balance 

as on 30.11.2009 

Quantity consumed 

during the year till 

30.11.2008 

OPV 74140 110000 102640 81500 

BCG 175000 0 113500 61500 

Measles 2750 70000 38500 34250 

DPT 48000 114000 99000 63000 

DT 23000 15000** 12000 26000 

TT 81500 60000 87000 54500

**20000 doses of DT vaccines were actually issued by GMSD Kolkata vide Issue Voucher 

No. INT/VACC/20/07/09, dated 20.07.2009. But while receiving the same from Guwhati Airport, 

5000 doses were missed at the Airport which were later collected by CCO Assam on suggestion from 

MSD Kolkata. 

� Logistics: 

The overall logistic support has been satisfactory except some occasion when it was not 

available. The supply may be made in such a way that there is no gap with logistics. The delivery may 

be made on a particular routine so that the state can plan accordingly. 

Auto Disable and Disposable Syringes: 

Syringes 

Opening 

Balance as on 

01.04.2009 

Received during 

the year till 

30.11.2009 

260 

Closing 

Balance 

as on 

30.11.2009 

Quantity consumed 

during the year till 

30.11.2008 

0.1 ml 5400 18000 5100 18300 

0.5 ml 87000 120000 140400 66600 

5 ml DS 1400 9000 6400 4000 

1.a.4. Trainings: 

The training component on immunization was mixed up with regular RCH training program. 

Therefore, specific subject relating to immunizations were not properly addressed. Training on use of 

AD syringe was conducted 2005-06. 

Training of Medical Officers on RI was planned in 2007-08, 2008-09 in each district and in 

2009-10 the plan is to train 332 Medical Officers on RI and is expected to be completed by March 

2010. Training of Paramedics on RI was planned during 2008-09. In 2009-10, training of 958 

Paramedical staff on RI was planned. However, due to shortage of fund, the training could not be 

materialized. 

The training of 52 Cold Chain and Vaccine Handler was conducted at State Headquarter, 

Naharlagun during 2008-09. The training for another 66 Cold Chain and Vaccine Handlers has been 

planned in 2009-10 and training for another 51 Vaccine Handlers will conducted in 2010-11. 

Training status under RI till 31.12.2009

RI Staffs 

2007-08 2008-09 2009-10 

Planned Trained Planned Trained Planned 

261 

Trained (as on 

31.01.2010) 

Medical Officers 239 210 93 90 332 151 

Paramedics 958 798 

Cold Chain and 

Vaccine Handlers 

85 52 66 

Could not be 

materialized due 

lack of fund at 

State HQ 

Training of Medical Officers and Paramedics on RI is in progress in the districts and is 

expected to be completed by March 2009. 

1.b. District wise coverage level of all antigens for 2008-09 and 2009-10 till Dec. ‘09 

The full immunization coverage of the state is 28% (NFHS 3) and 44% (CES 07). There are 

several reasons to the very low performance level: 

Baseline information 

Sl. No. Category of Beneficiaries 

Target 

2008-09 2009-10 2010-11 

1 Total Population 1321289 1356700 1393059 

2 Pregnant Women 36468 37445 38448 

3 Infants (0 - 1 yrs ) 30654 31475 32319 

4 Children ( 1 -2 yrs ) 30390 31204 32040 

5 Children ( 0- 5 yrs ) 184980 189938 195028 

6 Children ( 0 - 3 Years ) 105703 108536 111445 

7 Children at 5 yrs 31975 32832 33712 

8 Children 10 at yrs 32239 33103 33712 

9 Children at 16 yrs 28011 28762 29533

Sl. 

No. 

1 

2 

Category 

Session planned in Urban 

Areas 

Session planned in Rural 

Areas 

2008-09 2009-10 

262 

Target 

2009-10 as per approval of 

NPCC 

384 384 96 

22800 12096 4729 

3 Total sessions planned 23184 34560 4825 

4 

No. of session with hired 

vaccinators 

5 No. of hired vaccinators 

**However, the fund approved by GoI in SPIP 200-10 for Out Reach Immunization Session 

in Rural areas was not sufficient for holding 12096 Out Reach Immunization Session. Therefore, 

actual number ORS planned that may be materialized till the end of financial year 2009-10 is 4729 

ORSs.

Particulars 

1.b.2. District-wise Vaccination Coverage Reports as per DLHS-III: 


fully immunized 


who have received 

BCG(%) 



doses of Polio 

Vaccine(%) 



doses of DPT 

Vaccine(%) 



doses of Measles 

Vaccine(%) 

Tawang 

West Kameng 

East kameng 

Papum Pare 


Kurung Kumey 


West Siang 

East Siang 

50.6 43.4 17.7 63.3 48.8 23.8 31.2 28.0 39.8 12.4 40.5 61.7 68.2 41.5 64.4 50.0 

88.4 85.9 43.1 91.4 60.0 66.7 63.8 53.3 68.6 59.2 95.7 90.0 91.9 56.1 84.4 75.0 

62.8 51.5 33.9 74.8 53.2 38.1 46.0 44.4 43.6 24.3 52.5 70.0 68.7 39.0 66.8 75.0 

65.8 55.8 38.3 74.5 54.8 47.6 36.3 39.7 45.7 30.0 38.5 65.0 77.1 48.8 80.1 83.3 

77.2 84.4 38.7 73.1 59.0 40.5 52.3 43.4 54.1 44.7 77.4 88.3 77.1 53.7 81.7 66.7 

Upper Siang 

Lower Dibang 

Valley 

Dibang Valley 

Lohit 

Anjaw 

Changlang 

Tirap

Name of State/UTs: Arunachal Pradesh Year:2009-10 (Till quarter-II) Table 1.b 

Name of District 

Yearly Target Yearly Target 

(2008-09) 2009-10 

Pregnant Infants Pregnant Infants 2008- 

09 

BCG OPV-1 OPV-3 DPT-1 DPT-3 

Tawang 1235 1038 1281 1077 657 257 749 258 620 232 749 258 620 232 

West Kameng 2567 2158 2649 2227 752 357 775 354 601 278 776 354 602 278 

East Kameng 1724 1449 1746 1468 556 0 596 0 405 0 576 0 371 0 

Papum Pare 5291 4447 5645 4745 2835 1716 2788 1200 2041 925 3013 1200 1826 925 

Lower Subansiri 1730 1454 1761 1481 967 302 1066 305 1151 318 1066 305 1151 318 

Kurung Kumey 1426 1198 1467 1233 831 192 1193 147 649 233 1199 147 644 233 

Upper Subansiri 1627 1368 1644 1382 1185 370 1304 486 641 473 1233 469 690 420 

West Siang 3440 2892 3532 2969 1847 728 2271 796 2002 717 2183 796 2069 717 

East Siang 2810 2362 2872 2414 1595 672 1607 713 1260 474 1616 713 1225 455 

Upper Siang 1051 883 1072 901 561 148 667 149 470 198 646 149 423 197 

L/Dibang Valley 1843 1549 1918 1612 1350 298 1404 362 936 280 1402 362 936 280 

Dibang Valley 248 208 256 215 118 100 126 102 113 96 122 102 102 96 

Lohit 3843 3692 4760 4001 2649 1106 2474 930 2230 794 2474 930 2230 794 

Anjaw 626 526 644 542 261 43 279 74 352 47 279 73 352 50 

2009- 

10 

264 

2008- 

09 

2009- 

10 

2008- 

09 

2009- 

10 

2008- 

09 

2009- 

10 

2008- 

09 

2009-10

Changlang 4272 3591 4404 3702 2704 1120 2910 884 2164 757 2698 884 2167 757 

Tirap 3113 2616 3166 2661 1476 415 1538 590 1484 587 1538 548 1484 665 

Total 36846 31431 38817 32630 20344 7824 21747 7350 17119 6409 21570 7290 16892 6417 

Name of District 

Tawang 

Hep B 

Birth 

Hep B- 

1 

Hep B- 

3 Measles TT2+Booster JE-routine Vita A- 1st Dose 

265 

Table 1.b. 

(Wherever applicable) 2008-09 2009-10 2008-09 2009-10 2008-09 2009-10 2008-09 2009-10 

612 265 163 102 

607 320 

West Kameng 673 543 503 307 590 292 

East Kameng 491 0 87 0 821 0 

Papum Pare 1826 869 750 469 1819 299 

Lower Subansiri 1361 305 461 197 1301 108 

Kurung Kumey 1425 81 121 41 1469 28 

Not applicable 

Not applicable 

Upper Subansiri 924 672 556 337 531 122 

West Siang 2200 578 938 574 2575 536 

East Siang 1145 412 688 496 1501 322 

Upper Siang 433 167 244 156 218 51 

L/ Dibang Valley 1097 200 613 350 1170 129 

Dibang Valley 98 62 83 30 176 13

Lohit 2141 680 2112 975 1904 752 

Anjaw 300 78 253 85 299 47 

Changlang 1967 624 1941 819 1808 457 

Tirap 2058 546 864 563 1695 260 

Total 18751 6082 10377 5501 18484 3736 

# Coverage for 2009-10 till Sept.’ 09 

1.c. Reporting and incidents of VPD and outbreaks for 2007-08 and 2008-09 till Dec. ‘08 

The reporting system at all level in the state on RI activities has been lacking and need urgent intervention. There is a response system established in 

the state to cope with outbreaks on VPDs and AEFIs. There is a peculiar reporting mechanism in the state that outbreaks are often reported from the 

community and the media. The current form of intervention in all cases of outbreak is epidemiological intervention by the state epidemiologist and constitution 

of rapid action team to manage out-breaks from among the doctors in the hospitals in few occasions. 

District-wise VPD reports in 2009-10 (in numbers) 

Sl. 

Diptheria Pertusis 

Neonatal 

Tetanus 

No Name of District Case Death Case Death Case Death Case Death Case Death Case Death Case Death Case Death 

266 

Teatanus 

(other) Measles Polio -P1 Polio -P3 AES 

1 Tawang 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 

2 West Kameng 2 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0

3 East Kameng 6 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 

4 Papum Pare 2 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 

5 Lower Subansiri 17 0 2 0 2 0 0 0 54 0 0 0 0 0 0 0 

6 Kurung Kumey 24 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 

7 Upper Subansiri 2 0 0 0 4 0 0 0 36 0 0 0 0 0 0 0 

8 West Siang 5 0 3 0 0 0 0 0 44 0 0 0 0 0 0 0 

9 East Siang 9 0 0 0 1 0 0 0 13 0 0 0 0 0 0 0 

10 Upper Siang 0 0 2 0 0 0 0 0 20 0 0 0 0 0 0 0 

11 L/ Dibang Valley 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 

12 Dibang Valley 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 

13 Lohit 0 0 0 0 3 0 0 0 14 0 0 0 0 0 0 0 

14 Anjaw 0 0 6 0 0 0 0 0 6 0 0 0 0 0 0 0 

15 Changlang 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 

16 Tirap 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 

Total 67 0 13 0 10 0 0 0 325 0 0 0 0 0 0 0 

Total reported VPD outbreaks in State/UT 

267

VPDs 

No. of outbreaks 

reported 

No. of outbreaks 

investigated 

No. of Cases in 

outbreaks 

268 

No. of Deaths in 

outbreaks 

2008-09 2009-10 2007-08 2008-09 # 2007-08 2008-09 # 2007-08 2008-09 # 

Measures 

taken 

Diptheria 67 1. Immediate acute case management 

done in all affected areas. 

Pertusis 89 13 

2. Special Measles Imm. Round 

Measles 2161 325 

conducted after the outbreak. 

AES 

# Report for 2009-10 till Sept’ 09 

3. Blood sample sent for analysis

1.c. Routine Immunization Month. 

As per NFHS-III, the full immunization coverage is 28% and as per CES-07 full 

immunization coverage is 45%, which is a very poor status. On the basis of the analysis of the report, 

it has been surfaced that backlog for measles has become very high in the State. 

In order to increase the full immunization coverage level, the backlogs and dropout has to be 

reduced. Therefore, in order to increase the full immunization coverage level and to catch up the 

backlogs, the Routine Immunization Month has been introduced in the State during 2008-09 along 

with the normal immunization session in the health centres and out reach immunization sessions. 

Routine Immunization Month is a massive special program observed continuously for four months, 

starting in October and ending in January to coincide with NID. The plan is to visit every village to 

immunize every child either eligible or missed out. However, no additional fund is required for this 

activity as it is covered under Out Reach Immunization Sessions. 

1.d. Trends of IMR of the States for last 5 years. 

The trend of IMR in the state has gone down from 146 (1951) to 61(NFHS-3) for the state of 

Arunachal Pradesh. The trend of IMR for the last five years in the State is as below: 

Sl. No. Year IMR of the State 

1 2003-04 63 (NFHS-II) 

2 2004-05 63 (NFHS-II) 

3 2005-06 61 (NFHS-III) 

4 2006-07 61 (NFHS-III) 

5 2007-08 37 (SRS-07) 

1.e. Status Report and Plans for AEFI: 

So far, the entire sixteen Districts have constituted AEFI Committee with the District Medical 

Officer/Medical Superintendent as chairman to strengthen the AEFI system in the District Level. The 

committee so constituted will investigate all reported cases of Adverse Event Following 

Immunization. 

2. Supervision and Monitoring: 

The RI activities in the state are under the direct supervision of Joint Director of Health 

Services (FW) supported by State Immunization Officer / Deputy Director (MCH), Cold Chain 

Officer, Technical Assistant, Senior Refrigerator Mechanic and Computer Assistant especially for 

planning and implementation of RI Programme. In the districts, the supervision and monitoring of RI 

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activities are headed by DIOs (District RCH Officers) with the assistance from DPM, District 

Account Manager (RCH-II) and other RI related staffs. At the implementation end i.e. at 

PHC/CHC/SC level, the program is planned and implemented by the Medical Officers In-charge and 

other paramedics. 

2.1. Status of Routine Immunization Cell in the State: 

In the state level the Immunization Cell consists of State Immunization Officer, Cold Chain 

Officer, Technical Assistant (Cold Chain), Refrigerator Mechanics, Data Assistant RI and Computer 

Assistant. Planning for implementation is made by the State Immunization Cell on the basis of 

requirements and proposals from the districts. Progress and performance reports from the districts 

are compiled and crosschecked timely and submitted to GoI. The State Immunization Officer timely 

supervises and monitors the RI activities in the State. The Cold Chain Officer along the Refrigerator 

Mechanics timely monitors the cold chain system in the districts. In this current financial year 2009- 

10, cold chain systems of five districts have been monitored in which 25 cold chain stores have been 

visited. In those districts where there are no Refrigerator Mechanics repair and maintenance of cold 

chain system are looked after by the Mechanic adjacent district. It becomes a very tedious job in the 

part of a Mechanic to look after two districts due to which the response and breakdown time may be 

high in near future. 

2.2. Review Meeting. 

In the State the Review Meeting on RI is held twice a year. In this current financial year no 

review meeting on RI could be held in the State HQ due to financial crunch under RI Programme. On 

receipt of additional fund from GoI the Review Meeting on RI will be held soon. However, the 

District level Review is on progress in districts as the fund has been released to districts. 

2.3. Data Analysis and action taken at all levels: 

The district data furnished are analysed at the state level and from time to time, feedback is 

provided to the districts for mid course correction. Similarly, even though not effectively practiced, 

the facility data received at district level are analysed for corrective action at district level. 

3. Status of RIMS: 

In the RIMS Arunachal Pradesh is registered in the name of Changlong which does not exist 

in the State whereas the state headquarter of Arunachal Pradesh is Naharlagun. Thus for the RIMS, 

Arunachal Pradesh may be registered either in the name State or State Headquarter. The matter has 

been highlighted to GOI for early action. However, RIMS has been uploaded up to March 2007 and 

for rest of the months could not be uploaded due to software failure. 

270

However, it intimated by GoI that RIMS have been abolished and instead, HMIS Portal is to 

be used for reporting RI activities and this will require training to the personnel dealing on the 

subject. 

4. Co-ordination with Partners: 

In Arunachal Pradesh 16 PHCs are run by NGOs under Public Private Partnership (PPP) 

Project. In this financial year one CHC is run by NGO as pilot project. In all these Health Facilities 

immunization activities are undertaken by NGOs. In other health facilities other than those 

undertaken by NGOs, immunization activities are carried out with the involvement other partners. 

The SWWCD has been coordinating in immunization programs in all the districts. However, there is 

enough scope for increasing the coordination effort and involvement at all level. During Out Reach 

Immunization Sessions Anganwadi Workers are involved for mobilization of children to session site 

and they are paid honorarium as per norms. PRIs are involved in creating awareness among the 

parents to get their children immunized. However, the coordination among various partners as on 

date has been very minimal except in IPPI program. 

5. Strategies for Improving Routine Immunization: 

Current Status and Goal : The objective of the immunization programme is in line with 

the objectives framed under NRHM with additional inputs from GoI, it is envisaged to attain a level 

of immunization coverage in line with the National goals. 

OUTCOMES STATE INDIA 

Current status 

Goal Current Goal 

08-09 10-11 

status 

06-07 09-10 

MMR 306 (NFHS 3) 285 200 306 200

ACTIVITIES PROPOSED AND FUND REQUIREMENT UNDER ROUTINE 

IMMUNIZATION 

5.1. Mobility Support for Supervision of RI activities in the State. 

To ensure quality service output at the implementation end, timely monitoring and 

supervision must be ensured up to the lowest level. Supervision of RI activities in the districts by State 

team lead by SEPIO at least once in a month per district would be ensured from the State 

Headquarter. The supervision RI activities in the PHC/CHC/SC are to be ensured by the DIOs once a 

month. 

Therefore, GoI may provide fund required @ Rs 2,00,000/- for the State HQ and Rs 50,000/- 

per district for 16 districts for financial years 2010-11. 

5.2. Cold Chain Maintenance: 

The cold chain system being the most vital part of health sector, it needs utmost care to 

ensure effective vaccination. The proper maintenance of cold chain equipments rely on the 

availability of funds for cold chain maintenance. At times it is felt that the fund approved by GoI is 

very much insufficient. 

In the State, there is 1 State Cold Chain Depot, 16 District Cold Chain Stores, 2 General 

Hospitals, 12 District Hospitals, 31 CHCs and 57 PHCs, functioning with Cold Chain System. 

Therefore, the fund as proposed in the SPIP for all above facilities may kindly be considered 

by GoI @ Rs 3,00,000/- for State Headquarter per year, Rs 10,000/- for each District Headquarter 

per year and Rs 1,000/- each for General Hospitals, District Hospitals, CHCs and PHCs per year. 

Therefore, the total fund requirement is Rs 5,60,000/- 

5.3. To provide immunization to all children in Urban Areas 

As the District Headquarters being very large in area, there are number of children 

(especially slum area children) who are not vaccinated at District Hospitals. Therefore, in order to 

cover all the un-reached children, it is proposed to hold 2 Out Reach Immunization camps at slum 

area of District Headquarter per month using the manpower from District Hospital or society run 

health facilities, apart from the proposed 4 outreached sessions per month under urban health 

program (Itanagar-Naharlagun and Pasighat). Therefore, total number of Out Reach Immunization 

Camps in the urban area will be 384 Out Reach Camps. 

The mobility support would be provided as per GoI norms @ Rs 1,400/- per camp along 

with other logistics as per GoI norms and total fund requirement is Rs 5,37,600/-. 

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5.4. To improve coverage by increasing the Immunization Sessions. 

5.4.1. Alternate Vaccine Delivery: 

In all 273 functional sub-centres, Out Reach Sessions (ORS) would be held two times per 

month per sub-centre using the logistics from the PHC/CHCs, (546 ORS per month or 6552 ORS per 

year). 

In the surrounding pockets of PHCs/CHCs, it is often seen that children are missed out of 

immunization. In order to increase the full immunization coverage level and to catch the missed 

children, 2 Out Reach Immunization Session per month will be held in peripheral areas of all 85 

PHCs and 31 CHCs (232 ORS per month or 2784 ORS per year). 

Therefore, there will be total of 9336 Out Reach Immunization Session (ORS) iIn a year. In 

all 9432 ORS, an amount of Rs 200/- would be provided for alternate vaccine delivery (AVD) per 

session which is absolutely essential considering the peculiar geographical nature of the State and 

effective cold chain. The districts place detail work plan at the SC and PHC/CHC level for 

conducting ORS and it would be ensured that the activities are implemented as per the plan. 

Therefore, GoI is required to have special consideration to provide support by funding the 

required of Rs 18,67,200/-. 

5.4.2. Mobility Support for all Out Reach Session. 

A PHC level team / district level immunization team is in place comprising of MOs, ANM, 

LHV, HA, AWW, ASHA for providing outreach sessions in all SC area every month wherever there is 

no manpower. 

In all, 9336 out reach immunization sessions, Rs 1,500/- per session will be provided to 

immunization team as mobility support (POL and TA/DA as admissible) for organizing out reach 

immunization sessions, considering the peculiar geographical terrain and topography of the state. 

This is absolutely necessary due to lack of staff at the sub-centre level and lack of 

transportation facilities in majority of PHC/CHCs. 

Therefore, GoI may consider the funding with special consideration for a total fund 

requirement of Rs 1,40,04,000/-. 

5.4.3. Mobilization of children by AWW / ASHA to the Immunization site 

Naturally in every village of the State most of the people are unaware of Vaccination 

schedule and also the importance of the vaccines to the life of their children. In such cases Link 

273

Workers like ASHAs/AWWs can be used as medium to create awareness and mobilize the children to 

the session site. 

Therefore, in all the 9336 ORS sites, village-wise mobilization of children would be done 

through AWW /ASHA/Link worker etc. and the support involved would be provided @ Rs 200/- per 

AWW / ASHA per session for all sessions and the total amount required for mobilization of children 

through ASHAs/AWW for all sessions will be Rs 18,67,200/- per year. 

5.5. Support (Salary) for Computer Assistants under Routine Immunization. 

In the State, as of now, there are 17 Computer Assistants in position under Routine 

Immunization Program. They will be paid revised consolidated amount of Rs 16,000/- per month for 

district and total amount required in a year for 17 Computer Assistants will be Rs 29,58,000/-. 

5.6. Printing and Dissemination of Immunization Cards, Tally Sheets etc. 

The total estimated beneficiaries of 0-1 year in the State for 2010-11 is 32319. It is felt that 

JE Vaccine be included in the Immunization Card from this financial year 2010-11 onward and the 

Immunization Card format be changed. Therefore total number of Immunization Card required will 

be around 60000 in number and it is proposed to print same at the state level at the rate of Rs. 5/- per 

beneficiary (as per GOI norms) including wastage and the total amount required will be Rs. 

3,00,000/- 

5.7. Tracking Bags for Immunization. 

Instead of Tickler Boxes, it is also proposed to use Tracking Bags, which the ANM can carry 

with them to trace the missed children, under Routine Immunization similar to Chattisgarh model. 

Therefore, 2000 Nos. of Tracking bags will be required @ Rs 200/- per bag which the GoI is 

requested to consider by funding an amount of Rs. 4,00,000/- 

5.8. Review Meeting: 

5.8.1. Review Meeting at State Level. 

A 3 days half yearly State Level Review Meeting on progress and achievement of Routine 

Immunization will be held at the State Headquarter involving 3 participants (DIO, Accountant and 

Computer Assistant) from each district of 16 Districts in the State. Total expected participants from 

the district per meeting are 48 in number. 

The necessary support will be provided as per GoI norms @ Rs 1250/- per participant per 

day and the total amount required in a year will be Rs 3,60,000/-. In addition to this amount, Rs. 

200/- per participant per day for working lunch and Rs 200/- per participant per day for contingency 

will be required, making the total to Rs 1,15,200/-. 

274

Therefore, total required to be funded by GoI is Rs 4,75,200/-. 

5.8.2. Review Meeting at District Level. 

One day quarterly Review Meeting on RI will be held at each District Headquarter of 16 

Districts for one day involving a total of 16 DIOs, 85 MO i/c of PHC, 31 MO i/c of CHC, CDPOs of 

86 Blocks and about 200 other stakeholders like PRIs, NGOs. In all there will be 32 Review Meetings 

at district level in all 16 districts. 

The financial support @ Rs 300/- per participant per day for meeting will be required, as the 

GoI norm of Rs 100/- per participant per day cannot be practically materialized. 

Therefore GoI may like to support an amount of Rs 5,01,632/- per year for one day quarterly 

Review Meeting at District level. 

5.8.3. Review Meeting at PHC/CHC Level. 

Apart from Review Meeting at District Level, a one day half yearly Review Meeting, 

exclusively on RI, will be held at Block Level in which all MO i/c of (85 PHCs and 31 CHCs) and all 

3387 ASHAs will be involved. In all, there will be 232 Review Meetings at PHC/CHC level in a year 

in the State. 

The financial involvement, as per the GoI norms @ Rs 50/- per ASHA as honorarium and Rs 

25/- per person at the disposal of MO I/C for refreshment is too less in practical. Therefore, it is 

propose to provide at least @ Rs 150 per participant. Therefore financial requirement for meetings at 

all PHC/CHC level in a year will be will Rs 10,50,960/- only which the GoI needs to consider.. 

5.9. Orientation Training under Routine Immunization: 

5.9.1. Orientation training to Paramedics on RI: 

Unless the paramedics are trained on Routine Immunization, expected outcome of 

immunization program cannot be achieved. Hence training of paramedics (HA/ANM) on RI is an 

important component under Routine Immunization Program. 

During the financial year 2009-10, focus was to impart training on Routine Immunization to 

958 paramedical staffs. However, due to shortage of fund, the training could not be materialized. In 

the financial year 2010-11, the same number of Paramedical Staff will be trained on RI. The training 

will be held at each district headquarter in 64 batches of 15 participants size in order to impart 

quality training as per the training guidelines of GoI. At least 4 facilitators will be required for each 

batch and the total number of facilitator will be 256 in number. 

275

Fund requirement for the training will be as per revised RCH-II norms for training, 

considering an average DA as per State Govt. Rate @ Rs 300/- per participant per day, average TA 

@ Rs. 1,500/- per participant, working lunch @ Rs 200/- per day per participant and contingency @ 

Rs 200/- per day per participants. Therefore, amount required for one participant in 3 days will be Rs 

3,600/- and the amount required for one batch of training, with 15 participants in one batch will be 

Rs 54,000/- 

For facilitators, the honorarium for lecture will be as per revised RCH-II norm given in 

facilitators guide for RI Training @ Rs 600/- per day and TA will be as per actual @ Rs 3,000/- 

(Average) and DA will be as per RCH norms @ Rs 700/- per day and working lunch @ Rs. 200/- per 

day. Therefore, fund required for one facilitator in 3 days will be Rs. 7,500/- and amount required for 

4 facilitators in one batch will be Rs. 30,000/- 

The venue hiring charge will be as per training norm @ Rs 8,000/- per training. 

Therefore, the fund required for one batch training will be Rs 92,000/- and the total fund 

required for training in 64 batches will be facilitators and venue hiring among the participant 

trainees, the amount required per trainee will Rs 6,139/- only and total fund requirement of Rs 

58,88,000/- for training of Paramedics may be provided by GoI. 

5.9.2. Orientation Training of Medical Officers at State 

In current year 2010-11, focus will be to impart 3 days orientation training on Routine 

Immunization to 332 Medical Officers of all PHC/CHC/District Hospital whoever is involved in 

Routine Immunization Program in size of 20 participants in a batch and number of batches will, thus, 

be 17. 

Fund requirement for the training will be as per revised RCH-II norms for training, DA as 

per training norm @ Rs 700/- per participant per day, average TA @ Rs. 3,000/- per participant, 

working lunch @ Rs 200/- per day per participant and contingency @ Rs 200/- per day per 

participants. Therefore, amount required for one participant in 3 days will be Rs 6,300/- and the 

amount required 20 participants in a batch will be Rs 1,26,000/- 

For 17 batches, total number of facilitators will be 68 with 4 facilitators per batch as per GoI 

Training guidelines. The fund requirement will be as RCH Training of GoI, DA @ Rs. 700/- per day 

per facilitator, average TA @ Rs 4,000/- per facilitator, honorarium for lecture @ Rs 1,000/- per day 

per facilitator and working lunch @ Rs 200/- per day per facilitator. The amount required for one 

facilitator in 3 days will be Rs. 9,700/- and that for 4 facilitators will be Rs. 38,800/- 

The venue hiring charge will be @ Rs 8,000/- per batch as per RCH training norms. 

276

Therefore, total fund required training of one batch with 20 participants will be Rs. 

1,72,800/- and the total fund requirement for training of Medical Officers on RI in 17 batches with 20 

participants and 4 facilitators will be Rs. 29,37,600/-. 

5.9.3. One Day Refresher Training for RI Computer Assistants. 

One day Refresher Training will be organized at State Headquarter for 17 Computer 

Assistants to impart training on HMIS Portal, Pregnant Women and child tracking under NRHM in 

2010-11 as the same could not be materialized in 2009-10 due to less fund received from GoI. The 

trainer will be hired from outside the State so as to impart quality training. 

The fund requirement 17 participants, considering the DA @ Rs 500/- per day per participant 

as per State Govt. norms, an average TA @ Rs. 2,000/- per participant, working lunch @ Rs 200/- 

per day per participant and contingency @ Rs 200/- per day per participant, will be Rs 49,300/- 

The fund required for 4 facilitators as per training norms, DA @ Rs 700/- per facilitator per 

days, average TA @ Rs 4,000/- per facilitator, honorarium for lecture @ Rs 600/- per facilitator, 

working lunch @ Rs. 200/- per facilitator and venue hiring charge @ Rs 8,000/- will Rs. 30,000/- 

by GoI. 

Therefore, the total fund required for above training is Rs 79,300/- which may be considered 

5.9.4. Orientation Training of Cold Chain and Vaccine Handlers. 

Apart from RI training to paramedics, 2 days training on Cold Chain Management and 

Vaccine Handling will be imparted to paramedics (preferably the Health Assistant), dealing in cold 

chain, vaccines and logistic management, one from each PHC, CHC, District Hospital, General 

Hospital and District Cold Chain Store wherever cold chain system is in place. In 2009-10, this 

training was proposed for 66 numbers. However, due to less fund received from GoI under RI 

Programme, the training could not be materialized. 

As of now there are 123 health facilities in the state where cold chain system are available. 

Out of 123 health facilities with cold chain system, a 2 days training on Vaccine Handling and Cold 

Chain Management was planned for 52 numbers had been trained in 2008-09. In 2010-11, the 

training will be imparted to 71 Vaccine Handlers in 3 batches. 

Based on the revised RCH norm, considering an average DA @ Rs 500/- per day per 

participant, average TA @ Rs 2000/- per participant, working lunch @ Rs 200/- and contingency @ 

Rs 200/- fund required for 71 participants in 2 days will be Rs 2,69,800/- 

For imparting quality training, 4 facilitators in each batch and 12 facilitators for 3 batches 

will be required. The fund requirement for 12 facilitators as per training norm, DA @ Rs.700/-, 

277

average TA @ Rs. 4,000/-, working lunch @ Rs 200/- facilitator and venue hiring charge for 3 

batches @ Rs 8,000/- per batch will be Rs. 93,600/-. 

Therefore, total fund required for 2 days training of Cold Chain and Vaccine Handlers will 

be Rs. 3,63,400/- which the GoI requires to fund. 

5.9.5. One Day Training of Block Level Data Handlers. 

In Arunachal Pradesh, separate block level data handlers as of now do not exist. The data in 

all PHC/CHC are handled and managed by the paramedics at PHC/CHC level. Therefore, this type 

of training will be incorporated with the training of paramedics. 

Therefore, no specific fund for training of block level data handlers is required. 

5.10. Microplanning. 

For effective implementation of Routine Immunization as per plan, preparation of proper 

microplan is absolutely essential. In all 273 functional Sub-Centres, 87 PHCs, 35 CHCs and 13 

District Hospital in 16 districts, microplans will be prepared using the grass root information with 

the participation of ANM, ASHA and AWW. 

5.10.1. Microplanning at sub-centre level. 

In all 273 sub-centres, support will be ensured for preparation of microplan @ Rs 100/- per 

sub-centre. Total fund requirement for microplan at sub-centre level is Rs 27,300/- 

5.10.2. Microplanning at PHC/CHC/DH/GH level 

Financial support will be provided to 130 PHC/CHC/District Hospitals @ Rs. 1,000/- per 

PHC/CHC for preparation of microplans at PHC/CHC level and the total fund required for the same 

will be Rs 1,30,000/-. 

5.10.3. Microplanning at District Headquarter. 

Support will be provided to 16 Districts @ Rs 2,000/- per District Headquarter for 

preparation of microplans at District Headquarter and the total fund required for the same will be Rs 

32,000/-. 

5.11. Vaccine Lifting POL: 

5.11.1. Vaccine lifting from Guwahati Airport to State Headquarter, Naharlagun. 

Vaccines required for the State are airlifted up to the nearest Airport, Guwahati and from 

there these are to be collected by the State by road which is a long way drive of more than 500 Kms. 

278

The matter has been addressed to GoI several times for dropping the vaccines up to the State 

Headquarter, but no action is seen to be initiated by GoI. 

As the State does not have insulated Vaccine Van, vaccines are to be transported in hoodless 

truck and sometime the truck remains in off road condition. 

Every time it happens that the intimation of dispatch of vaccines comes suddenly from MSD 

Kolkata by telephone. In such cases, if the truck is in off road condition, we are compelled to 

outsource the vehicle for collection of vaccines. Several occasions it has been experienced that 

vehicle for outsourcing is not available even. In such cases vehicle has to be outsourced at much 

higher rate, as no fixed rate for hiring exists in the State. 

Therefore, GoI may either arrange to drop the Vaccines and other logistics up to the State 

Headquarter or proposal for additional support of Rs. 2,00,000/- for collection of vaccines from 

Guwahati Airport for minimum of 10 collections per year as mobility support (Vehicle hiring, POL 

support or TA/DA for staff) as well as to meet up financial requirement for outsourcing of vehicles 

may be approved. 

5.11.2. Vaccine lifting from State Store to District Store/PHC/CHC. 

Lifting of vaccines from the state cold chain room to 16 districts whenever required would be 

ensured once every quarter and from district store to all the CHCs/PHCs once every month. 

An amount of Rs 1,00,000/- per district per year for all 16 districts as POL/DA support as 

required will be provided as per GoI norms. Supportive provision in terms of fund may be provided 

by GoI. The total fund requirement is Rs 16,00,000/-. 

5.12. Consumables for Computers including for internet access. 

In all 16 districts and State Headquarter stationary items consumable for computers 

including internet access charge are to be provided. 

In view of raising inflation and cost index of materials in the State, the rate given in GoI 

norm @ Rs 400/- per district per month, is too insufficient at least for one cartridge and two rims of 

paper per month. 

Therefore, special consideration may be made by GoI in terms of funding @ Rs 3,000/- per 

Month for State Headquarter and Rs 1,500/- per month per district for 16 districts. Therefore, the 

total fund required for the year will be Rs 3,24,000/-. 

279

5.13. Injection Safety. 

5.13.1. Plastic Bags (Red/Black). 

Injection safety is an important component under Routine Immunization. For safe handling 

and safe disposal of waste products during out reach and normal immunization session plastic bags 

are required. Therefore, availability plastic bags will be ensured at all 9336 session sites and 

required number of plastic bag will be 18672 Nos. However, it is proposed to procure 20000 Nos. of 

plastic bags in view of the wastage. 

The GoI norm @ Rs 2/- per bag is not practically feasible in the State. Therefore, GoI may 

support the requirement by providing fund @ Rs. 3/- per (red) bag Rs 3/- per (black) bag per session 

as per GoI norm (Rs 6/- per session) and total amount required is Rs. 60,000/- 

5.13.2. Bleach/Hypochlorite Solution. 

Provision for Bleach/Hypochlorite solution will be ensured at all 85 PHCs and 31 CHCs, 12 

District Hospitals and 2 General Hospitals at GoI norm of Rs. 500/- per PHC/CHC per year which 

the GoI may provide support by funding. The total fund requirement will be Rs 65,000/-. 

5.13.3. Twin Bucket. 

Twin bucket ensured to all 85 PHCs and 31 CHCs 12 District Hospitals and 2 General 

Hospitals at GoI norm of Rs 400/- per PHC/CHC per year which the GoI may provide monetary 

support of Rs 52,000/-. 

5.13.4. Biomedical Waste Pit: 

Waste disposal mechanism would be put in place in all the PHCs, CHCs and wherever cold 

chain systems are in place. In the State there are 2 General Hospitals, 13 District Hospitals, 35 

CHCs and 57 PHCs functioning with Cold Chain System and another 30 PHCs functional without 

cold chain system, making the total to 133. 

In 2009-10 proposal for waste disposal pit was approved for 30 numbers. In this financial 

year focus will be for another 32 number of waste pits at the rate of Rs 20,000/- per pit. Therefore the 

fund requirement is Rs 6,40,000/-. 

5.14. State Specific. 

5.14.1.Mobility Support for Cold Chain Personnel for Cold Chain maintenance. 

As we are aware that cold chain system is a vital part under RI Programme. The effectiveness 

of the programme relies on the efficacy of the Vaccines which again depend upon the timely 

monitoring and effective cold chain maintenance. 

280

In the State there are still 6 Districts where there is no Cold Chain Technician. Therefore, for 

repairing and maintenance of cold chain equipments Technicians are to be either deputed from the 

State Headquarter or from the adjacent districts. However, due to non payment of TA/DA to the 

Technicians either from NRHM or Family Welfare fund, they are reluctant to go for repairing work. 

For TA/DA of Cold Chain Technicians Family Welfare Section dumps the responsibility on NRHM, 

as the cold chain system being the part of Routine Immunization under NRHM. The NRHM also 

denies them TA/DA, as the Technicians are regular service staff. At the end the Technicians are the 

ultimate sufferer. 

Therefore, it is highly felt that the mobility support cold chain Technicians be included in 

NRHM under Routine Immunization Programme and GoI may provide @ Rs 30,000/- per district for 

10 districts with cold chain Technicians and Rs. 50,000/- for State Headquarter, the total amount 

being Rs. 3,50,000/- 

5.14.2. Requirement of New Generator for WIC at Central Cold Chain Room. 

In the State, the power supply is inconsistent and unreliable. In order to support the WIC and 

5 numbers of large Deep Freezers in the central cold chain room at State Headquarter, one 

Generator may be supplied by GoI along with the new WIC that would be supplied by GoI or Rs 

8,00,000/- may be considered for procurement of generator. 

5.14.3. Salary for Health Assistant and Refrigerator Mechanic. 

In 2006-07, 20 Health Assistants and 1 Refrigerator Mechanic were recruited under the 

Routine Immunization Program on contractual with prior approval from GoI. Since then, the salaries 

for of these contractual staffs have been met from the Routine Immunization fund and it is proposed 

to continue the salaries for these 20 Health Assistants and one Refrigerator Mechanic under Routine 

Immunization in 2010-11 @ Rs 14,500/- per month. 

Total fund required for salary of Health Assistant for financial year 2010-11 is Rs 

36,54,000/-, which has, however been is proposed under NRHM Additionalities. 

5.14.6. Batteries and Solar Plates for Solar Powered Refrigerators. 

The provision of solar refrigerators in the state of Arunachal Pradesh has been a great boost 

to operationalize cold chain system in different health facilities. Out of 30 units of Solar Powered 

Refrigerators supplied by GoI during 1999-2000, only 17units are functional and 13 units are not 

functional either due to damage of solar plates or batteries. Due to ageing of the units, all the 

batteries of all 30 numbers need to be replaced and new plates for 12 units are required. 

281

The proposal was approved in the SPIP 2009-10. However, due to less fund received from 

GoI, the activity could not be materialized. Therefore, proposal is once placed before GoI for 

replacing all the ageing batteries by funding @ Rs 20,000/- per battery for 90 batteries and Rs 

25,000/- per solar plate for 65 plates. 

Therefore, total fund required will be Rs 34,25,000/- which GoI may consider keeping in view 

the importance of solar refrigeration system in the state where the electricity is not reliable. 

5.14.7. Special requirement of Vaccines and AD Syringes. 

5.14.7.1. Vaccines. 

It has been planned to start JE vaccine on campaign mode for two districts; Lohit and 

Changlang districts with 59245 and 54291 estimated beneficiaries of 0-15 years of age and the total 

number of beneficiaries is 113536. The programme will be started from the 2 nd week of March 2010 

tentatively. The training to the vaccinator has to be given y GoI by the end of February 2010. 

However, from 2011-2012 onward, JE vaccine will be introduced under Routine Immunization 

Programme for beneficiaries of 0-1 year. Therefore, the JE Vaccine required for campaign mode will 

be 1,51,005 doses or 30201 vials of 2.5 ml. GoI may supply the required quantity of JE Vaccine 

within February 2010. 

Therefore, 1,13,536 number of vaccination cards have to be printed at the rate of Rs 5/- per 

piece and all other expenditure pertaining to campaign mode of JE vaccination will be met from 

Routine Immunization fund in these two districts. 

5.14.7.2. AD Syringes. 

For JE vaccination on campaign mode 151000 Nos. of 0.5 ml AD Syringes and 30000 Nos. of 

5 ml Reconstitution syringes will be required. Therefore, GoI may supply the required quantity of 

syringes within February 2010.In 2009-10 the supply of 0.5 ml Auto Disable Syringes have been 

excess and there is storage problem in th state. However, the supply of 0.1 ml AD Syringes and 5 ml 

Disposable (Re-constitutional ) Syringes have been very low as compared to the supply of BCG. 

Therefore, GoI may increase the supply of 0.1 ml AD Syringes and 5 ml Re-constitutional Syringes as 

per the State requirement. 

5.14.8. Requirement of New Cold Chain Room 

There is no new site in the State for installation of new WIC allocated by GoI. As the size of 

the new WIC to be provided by GoI is 18’(L)x12’(B)x8’(H), the existing Cold Chain Room, whose 

size is 26’(L)x16’(B)x10’(H) only, will not be able to house the new WIC. Further, the existing room 

houses 5 DFs (Large) and one 5 KVA backup generator. 

282

Therefore, it is proposed either to extend the existing Cold Chain Room so that it houses the 

new WIC and all the existing equipments or to construct a new Room of size 15 (L) x 8 (B) x 3 (H) 

cubic metre. If new one is constructed, the existing room will be used for cold chain store, as there is 

no separate cold chain store in the state and the cold chain items, such as AD Syringes, Cold Boxes, 

Vaccine Carriers etc are kept in haphazard manner. 

The fund requirement for extension and new construction are proposed separately under 

NRHM Additionalities. The fund for new construction will include the cost of civil works, internal 

wiring and earthing. Thus, either of the proposal may be considered by GoI. The estimation of fund 

requirement is given below. 

Estimate of the Civil Works Cold Chain Room for WIC: 

Sl Description of the works Area in sq. mtrs. 

1 A new construction of (12 X 8) sq.mtr of standard height to 

accommodate a Walk in Cooler (WIC) 18' (L) x 12' (B) x 

12' (H), going to be provided by MoHFW, Govt. of India, 

generator and other cold chain equipment. One separate 

room under this building will be used for Cold Chain Store 

for AD Syringes, Spare Parts etc. 

96 

Total 96 

Total plinth Area of the proposed Cold Chain Room 96 

Sl Narration Rs. In Lakhs 

1 Cost @ Rs. 10000.00 per sq. mtrs 9.6 

2 Addl.architectural features (1% of sl 1) 0.1 

3 Addl. Site development including surface drain, internal 

roads, etc.(5% of sl 1) 

0.48 

4 Addl. Internal electrification (15% of sl 1) 1.44 

5 Addl. Water supply & sanitary installation (12.5% of sl 1) 1.2 

6 Addl. External Service line water, electrical, sanitation, 

etc.(5% of sl 1) 

0.48 

7 Addl furnishing (10% of sl 1) 0.96 

8 Anti termite treatment @ Rs.75.00 per sq.mtrs 0.07 

Additional 30% escalation of 1 2.88 

9 Sub Total 17.21 

10 Addl. Contingency charges (3% of sl 9) 0.52 


12 Addl. Agency charges (11% of sl 12) 1.95 


5.15. Technical Assistance 

For further improvement of immunization coverage and for imparting skill mechanism to the 

supportive staffs, technical assistance is required from GoI in terms of manpower. The GoI may 

depute manpower from other programme partners who are expert in immunization mechanism, for 

technical assistance. 

283

6. Additional support required in kinds from GoI to improve Routine Immunization. 

6.1. Walk-in-Cooler. 

1995. 

In the State one CFC Walk-in-Cooler (Huurre HRC-100) is in position and it was installed in 

Several times the breakdown of compressors of cooling unit occurred and replaced. CFC gas 

R-12 is not easily available as the production of these gases has been banned in view of 

environmental effect world wide. There are leakages occurring in the wall of the existing WIC due to 

ageing and same is in use by using M-Seal. As the number if beneficiaries have increased many folds, 

the chamber is not enough to house vaccine requirements. 

However, it learnt that a new WIC will be in place very soon in the State. 

6.2. Walk-in-Freezer. 

Till date the State is using 4 Deep Freezer for preparation of Ice Packs in the State 

Headquarter. As the requirements have increased many fold, the Deep Freezers are not sufficient for 

preparation of ice packs especially during NIDs (IPPI), there is a recurrent shortage of ice packs. 

Therefore it is felt that one WIF (NON-CFC) is urgently required in the state and GoI may 

consider the proposal and immediately install the same in the State. 

The required civil works have been proposed under NRHM. 

6.3. Cold Chain Equipments. 

Recently GoI has allocated 36 nos. of ILR (Small), 10 Nos. of (ILR (Large), 78 Nos. of Deep 

Freezer (Small) and 15 Nos. of Deep Freezer (Large), making the total 139 Nos. of equipments of 

which 63 have received in the State. 

There is a cold chain expansion plan for 30 PHCs and 3 CHCs which are functional without 

cold chain system. Therefore, along with the equipments already allocated by GoI, another 33 ILRs 

(Small) and 33 Deep Freezers (Small) will be required, the consignee address of which will be 

furnished separately. 

Plan is also to set up two new Zonal Stores, one at Bhalukpong in West Kameng District and 

another one at Namsai in Lohit District. Therefore, 4 ILRs (Large) and 4 Deep Freezers (Large) 

along other necessary accessories are required. The required civil works have been proposed under 

NRHM PIP. 

284

Stock Replacement 

Requirement Already 

Sl. No. Items (Functional)** for CFC Expansion in 2010-11 allocated 

1 WIC 1 1 1 

2 WIF 1 1 

3 ILR-140 (Small) 122 24 33 57 36 

4 ILR-300 (Large) 16 13 8 21 10 

5 DF-140 (Small) 64 25 33 83 78 

6 DF-300 (Large) 

Cold Boxes 

36 27 8 22 15 

7 

Large) 134 392 392 

8 

Cold Boxes 

(Small) 198 652 652 

9 Vaccine Carrier 2173 3400 3400 

10 Vaccine Van 17 17 

6.4. Solar Powered Refrigerators 

In view of the non-reliability of supply of electricity in the State, solar operated refrigerators 

have been the most reliable support to the cold chain system. In the State PIP 2006-07 and 2007-08, 

proposal were made for 20 solar powered refrigerators with consignee addresses but till date, the 

matter remains unattended. 

Therefore, GoI is requested to allocate 20 units of solar operated refrigerators along with 

other necessary accessories for the State. 

6.5. Annual Requirement of Vaccines, AD Syringes and Logistic Support. 

6.5a. Beneficiaries 

Category 2009-10 2010-11 2011-12 

135670 139305 143039 

Total Population 

0 9 3 

Pregnant Women 37445 38448 39479 

Live Birth 33918 34826 35760 

Infants (0 - 1 yrs ) 31475 32319 33185 

Children ( 1 -2 yrs ) 31204 32040 32899 

Children ( 0- 5 yrs ) 189938 195028 200255 

Children ( 0 - 3 Years ) 108536 111445 114431 

Children at 5 yrs 32832 33712 34616 

Children 10 at yrs 

Children 1 to 15 years (Lohit and Changlang District for campaign 

33103 33991 34902 

mode) 113536 

Children at 16 yrs 

6.5b. Annual Vaccine Requirements. 

28762 29533 30324 

The requirements of BCG and Measles Vaccines are as per the State Specific based on the 

vulnerability of vaccines to heat as well as to catch up the backlogs of the Measles. All the vaccine 

requirements include 25% Wastages and 25% Buffer Stock. 

285

Sl. No. Antigens 2010-11 (in doses) 2011-12 

1 BCG 53730 55170 

2 DPT 259850 277754 

3 TT 232984 239705 

4 Measles 53730 55170 

5 OPV 268652 275851 

6 Hep. B 

7 JE (Campaign Mode) 151000 55170 

6.5c. Annual AD Syringes Requirements: 

stock. 

All the requirements are based on the State Specific including 25% Wastages and 25% buffer 

AD Syringe 2010-11 2011-12 

0.1 ml 53730 55170 

0.5 ml 546564 627799 

5 ml 16119 22068 

6.5d. Requirement of Other Logistics 

Sl. No. Items 

Quantity 

Required 

1 Voltage Stabilizers (Low voltage input, 100 Volt) 200 

2 Voltage Stabilizers (Normal voltage input) 200 

3 Cold Box (Large) 392 

4 Cold Box (Small) 652 

5 Vaccine Carrier 3400 

6.6. Vaccine Vans 

All the 16 Vaccine Vans are off road due to lack of fund for maintenance. In the meantime, 

these vaccine vans are so bulky that they are not suitable for zigzag and narrow roads of the State. 

Therefore, the State is facing problem in transportation of vaccines in effective cold chain. However, 

maximum care is taken while transporting vaccines in cold box such that the T-series vaccines do not 

come in contact with the frozen icepacks. Further, the topography of state is such that the 

temperature remains low that suits the vaccines. 

The immediate repair of cold chain equipment in case of breakdown should be always 

prioritized. However, immediate follow up action is not feasible as there is no separate vehicle under 

cold chain cell for immediate transportation of cold chain personnel. 

Therefore, GoI may supply the following Vaccine Vans and vehicles immediately for the 

State. If the supply of vans is not feasible, GoI may consider fund for maintenance of existing off road 

vaccine vans @ Rs. 2,00,000/- per vaccine van, the total of which is Rs. 32,00,000/-, within three 

286

months. However, one new vaccine van and one light vehicle with rear carrier are urgently required 

and must be supplied. 

SN Vehicle Description Quantity Remark 

1 Vaccine Vans 

2 Light Vehicle 

6.7. Requirement of Hub Cutter. 

Small, but four wheel 

drive 

Four wheel drive with 

rear carriage 

287 

17 

1 

Big vans are not suitable for 

hilly region with narrow and 

zigzag tracks 

For transportation of Cold 

Chain items and also for 

movement of repairing team 

from headquarter to those 

districts without mechanics. 

Hub Cutters should be supplied by GOI in sufficient quantity. The requirement is based on 

the number outreach sessions planned. Following are the requirement of Hub Cutters for the year 

2009-10 

Sessions/ Qnty. reqd/ Qnty. reqd 

Health facilities 

District Hospital/ 

No. of facilities facility/month month in a year 

General Hospital 

14 0 

CHC 35 2 70 840 

PHC 87 2 174 2088 

Sub-Centres 273 2 546 6552 

Total 9480 

6.8. Annual requirement of cold chain equipments spare parts. 

In the state, non-availability of spare parts in the local market leads to delay in repair and 

maintenance of NON-CFC equipments and also CFC equipments. However, on priority, Non-CFC 

equipments will be repaired. Therefore, GoI may provide the following spare parts on priority. 

Sl. 

No. 

Code Part Name Qnty. 

Spare parts for NON-CFC VESTFROST ILRs/DFs 

1 

0801 COMPRESSOR FR 10G COMPLETE FOR MF-304 10 Nos. 

2 0802 COMPRESSOR FR 8.5G COMPLETE FOR MK-304 10 Nos. 

3 0803 COMPRESSOR FR 6G COMPLETE FOR MF-144 20 Nos.

4 0804 COMPRESSOR TL 5G HST COMPLETE FOR MK-144 30 Nos. 

5 0805 STARTING DEVICE FOR FR 10G & FR 6G COMPRESSORS 100 Nos. 

6 0806 STARTING DEVICE FOR FR 8.5G COMPRESSOR 20 Nos. 

7 0807 STARTING DEVICE FOR TL 5G HST COMPRESSOR 100 Nos. 

8 0808 THERMOSTATE (FREEZER) 100 Nos. 

9 0809 THERMOSTATE (ILR) 100 Nos. 

10 THERMOMETER (DIAL) 300 Nos. 

11 0821 FILTER DRIER 20 G = 50 Nos.& 10 G = 200 Nos 250 Nos. 

12 0825 

FAN COMPLETE FOR COMPRESSORS MF 304/MK 304 

AND FOR MF-144 

288 

100 Nos. 

13 0826 STARTING CONDENSOR ILR-304 15 Nos. 

14 0827 STARTING CONDENSOR FOR ILR-144 100 Nos. 

15 STARTING CONDENSOR FOR FREEZER-304 15 Nos. 

16 STARTING CONDENSOR FOR FREEZER-144 100 Nos. 

17 Charge Controller for 30 Solar Refrigerator 60 Nos. 

6.9. Requirement of Charging Units for NON-CFC Toolkits (Small): 

Vide MoHFW allocation No. Y.11013/1/2008-CC&V, dated New Delhi, the 30 th June 2008, 

one unit of NON-CFC Toolkit (Large) and 11 units of NON-CFC Toolkit (Small) were received from 

Govt. MSD, Kolkata, on 4 th Nov, 2008. 

It has been found that the 11 units received during 2008-09 are completely different from that 

received during 1997-98. The new Toolkits received in 2008-09 do not have Charging and Recycling 

Units, without which, these Toolkits are of no practical use and are not yet issued to the RMs. 

Therefore GoI may either arrange to allocate and supply 11 numbers of Charging Units and 

11 numbers of Recycling Units for the State immediately or may provide fund @ Rs. 25000/- per unit. 

6.10. POL and Maintenance Fund for Generator under RI. 

One 7.5 KVA (Kirloskar) Generator is installed along with the WIC in the Central Cold 

Chain Room at State Headquarter. Due to inconsistent and non-reliability of the power supply, the 

generator has to be operated frequently so as to support the cold chain system. The GoI suggested 

that fund for maintenance of generator can be met from RKS. However, it is worth to mention that

there is no RKS fund at State Headquarter and further, there is no concrete guidelines from GoI 

circulated to State officially in this regard. In the meantime, the cold chain maintenance fund 

approved by GoI is very low. Therefore, GoI may consider Rs 50,000/- for maintenance of generator 

attached to WIC at State Headquarter. 

7. Component wise expenditure of funds received and achievements. 

7.1. Expenditure report from 2005-06 to 2008-09 

Till 2007-08, there were no bifurcations of funds for RI Program either by GoI or by the 

state. It was during 2007-08; the fund received from GoI had been bifurcated activity-wise and 

released to the district. However, the expenditure report from the districts had not been received as 

per activity wise funding. There were no formats designed for reflecting achievements along with the 

expenditure report either. It was only during April 2008 the reporting formats for component wise 

expenditure and achievements had been received from GoI. However, the efforts were being made in 

the State level during 2007-08 for receiving expenditure report along with the achievements from the 

districts, but reports received were either incomplete or incorrect. Therefore, consolidated audited 

report of expenditure since 2005-06 to 2007-08 is as furnished below. 

Year 

Opening 

Balance on 

1 st day of 

financial 

year 

Fund 

received 

from GoI 

Reported 

Expenditure 

during the 

year 

289 

Closing balance 

at the end of the 

financial year 

Remark 

2005-06 15,546 40,26,626 31,80,469 8,61,703 Audited Expenditure 

2006-07 8,61,703 94,89,948 89,38,923 14,12,728 Audited Expenditure 

2007-08 14,12,728 81,99,373 72,05,277 24,06,824 Audited Expenditure 

2008-09 24,06,824 82,50,000 1,26,62,399 20,50,575 Audited Expenditure 

Component wise expenditure report in 2008-09 

Sl. 

No. Activity Head 

Districts 

1 

Bifurcated 

fund Expenditure Target Achievement 

Mobility Support for District 

Supervisin of RI Activities 395000 210092 350 times 

2 Alternate Vaccine Delivery for 

1140000 992513 5700 

2215 sessions

ORS sessions 

3 Mobility Support for ORS 5700000 1809411 

4 

5 

290 

5700 

sessions 1799 sessions 

Mobility Support for Imm. 

Session in Urban (Slam) area 105000 62,624 84 sessions 28 sessions 

Mobilization of Children 

through 

link workers 570000 294450 

1963 

sessions 

6 Bio-medical Waste Pit 645000 264773 43 pits 18 pits 

7 Vaccine Lifting 240000 61703 

8 

Emergency advance to Dibang 

valley District 35800 

Total fund status for RI Activities 8830800 3695566 

9 Training of Medical Officers 215510 134435 100 Doctors 57 Doctors 

10 Training of Paramedics 1588661 984082 

Total Status in Districts 10634971 4701335 

State HQ 

1 

Mobility support for 

supervision 39328 

2 Cold Chain Maintenance 27886 

3 Review Meetings 197634 

4 Cold Chain Handlers Training 197284 

5 Printing of Immunization Card 300000 

6 Printing of Training Module 252500 

7 Vaccine Lifting from Guwahati 15596 

Total Status in State Headquarter 0 1030228 

Total in the State 10634971 5731563 

958 

Paramedics 

540 

Paramedics

7.2. Expenditure report of RI in 200-10 

The audited unspent balance of financial year 2008-09 as on 01.04.2009 was Rs 20,50,575/-. 

Based on the approval by NPCC, total fund calculated for activities under RI for the 16 Districts was 

Rs. 1,59,70,720/- and for the activities under RI in the State Headquarter the total fund was Rs. 

32,43,500/-. Therefore, prior to received of fund from GoI, total amount of Rs 89,02,933/- had been 

released to the 16 districts after deducting the unspent balance of 2008-09. However, an amount of 

Rs. 49,00,000/- only has been received from GoI during September 2009 which is far less than 

amount released to districts. Therefore, the State is running under financial crunch for RI fund and 

no activity could be performed in the State Headquarter under Routine Immunization Programme. 

As on 31.12.2009, no report on activity and expenditure has been received from the districts 

except for few activities, i.e. the Out Reach Immunization Session. 

The activity wise bifurcation of fund based on NPCC approval 2009-10 is given below. 

Activity wise distribution of fund under Routine Immunization Programme 2009-10 

Code Activities Target 

1 Mobility support for 

Supervision & 

Monitoring at the 

district level 384 800000 

District State HQ 

Amount 

Calculated 

for District Achievement 

291 


District 

Fund 

calculated 

for State 

HQ Achievement 


Supervision & 

Monitoring at State 

level 128 100000 43 Visits 

3 Cold chain 

maintenance 

1 76500 


District 186500 

4 Focus on urban slum 

& underserved areas 336 117600 160 0 

5 Mobilization of 

children by 

ASHA/Link workers 4730 709200 1742 0 

6 Alternate vaccine 

delivery to session 

4730 945600 1742 0 

Activity could 

not be perform 

due to lack of 

fund in State 

HQ

sites 

7 Computer Assistants 

support at State & 

District level 17 1440000 

292 



Salary is being 

paid to CA 

8 Printing of 

immunization cards 50000 0 250000 50000 Nos. 

9 Quarterly review 

meeting at State level 2 0 240000 24000 Nos. 


meeting at district 

level 32 120400 


meeting at Block level 215 1028000 


District 0 


District 0 

12 Two days training of 

Health Workers 

(ANM, LHV, MPHW 

etc 958 0 0 

13 Three days training of 

Medical Officers on 

RI 332 1829320 

14 One day refresher 

training of Computer 

Assistants 

15 Two day training of 

Cold Chain handlers 

16 Micro planning at SC 

level 273 27300 

17 Micro planning at 

District 14 28000 

18 POL for vaccine 

delivery from the 

State to the district 

and from the district 

to the PHC/CHC level 

19 Consumables for 

computer including 

internet access 

85 MOs have 

been trainedas 

on 31.12.09 0 

17 0 63000 

65 0 293000 

Target 

couldn't 

be set 1260800 

Target 

couldn't 

be set 46000 


District 0 


District 0 








fund in State 

HQ 




fund in State 

HQ 

10 times from 

Guwahati to 

Naharlagun 




fund in State

20 Purchase of red/black 

polythene bags 24000 0 48000 48000 Nos. 

21 Purchase of 

bleach/hypochlorite 

solution 

22 Purchase of twin 

buckets 

23 Construction of waste 

disposal pits 30 450000 

106 0 53000 

130 0 52000 

293 


District 0 


ORS 4730 7092000 1742 0 

25 Hanging trekking 

bags 

26 Solar plates & solar 

batteries 

2000 0 300000 

0 0 1332000 

27 Helicopter sorties 0 0 0 

28 POL & maintenance 

of generators 0 0 0 

29 Generators for cold 

chain rooms 0 0 0 

30 Salary of HA & 

Refrigirator 

mechanics 0 0 0 

TOTAL 15970720 3243500 

HQ 




fund in State 

HQ 




fund in State 

HQ 




fund in State 

HQ 




fund in State 

HQ

8. RI Work Plan for 2010-11 

Sl. No Activities Qtr-I Qtr-II Qtr-III Qtr-IV 

C.1 Supervisions 

C.1.1 Supervision of RI activities in District by DIOs 

C.1.2 

Supervision of RI activities in District by State Level 

Officer 

C.2 Cold Chain Maintenance 

C.2.1 Cold chain maintenance fund for State Headquarter 

C.2.2 Cold chain maintenance fund fo District Headquarter 

C.2.3 Cold chain maintenance fund fo PHC/CHC/DH/GH 

C.3 

Immunization Session in Urban slum areas (Focus on 

urban slum area) 

C.4 Out Reach Immunization Session 

C.4.1 Alternate Vaccine Delivery 

C.4.2 Mobility Support for Out Reach Sessions 

C.4.3 Mobilization of Children through ASHA/AWW 

C.5 Support for Computer Assistants 

C.6 Printing and Dissemination of Immunization Cards etc. 

C.7 Procurement of Tracking Bags 

C.8 Review Meetings 

C.8.1 3 days Review Meeting at State Level 

C.8.2 Review Meeting at District Level 

C.8.3 Review Meeting at Block Level 

C.9 Training under Routine Immunization 

C.9.1 

3 days training of Paramedics on Routine 

Immunization 

C.9.2 3 days training of Medical Officers at District Level 

C.9.3 One Day Refresher Training to Computer Assistant 

C.9.4 

2 days Training on Vaccine Handling and Chain 

Managements 

295

C.10 Microplanning 

C.10.1 Microplanning at Sub-Center level 

C.10.2 Microplanning at PHC/CHC/DH/GH 

C.10.3 Microplanning at District Headquarter 

C.11 Vaccine Lifting 

C.11.1 

Vaccine lifting from Guwahatri Airport to State 

Headquarter 

C.11.2 From State Store to District Stores and 

C.12 Stationeries Support for Computers 

(a). Stationery support for State Headquarter 

(b). Stationery support for District 

C.13 Injection safety 

C.13.1 Plastic Bags (Red/Black) 

C.13.2 Bleaching/Hypochloric Solution 

C.13.3 Twin Bucket 

C.13.4 Bio-medical Waste Pit 

C.14 State Specific 

C.14.1 Helicopter Sorties. 

C.14.2 

C.14.3 

C.14.4 

C.14.5 

(a). Mobility for Cold Chain Personnel for cold chain 

maintenance for State HQ staff at district where no 

Technician is available 

(b). Mobility for Cold Chain Personnel for cold chain 

maintenance for State HQ staff at district where no 

Technician is available 

POL and maintenance for WIC generator at State 

Headquarter 

A noiseless new generator for Central Cold Chain 

Room 

Salary for Contractual Health Assistants and 

Contractual Refrigerator Mechanic 

C.14.6 (a). Procurement of solar plates 

(b). Procurment of batteries for solar refrigeration 

system 

C.14.7 (a). JE Vaccines for campaign mode in 2 districts 

296

(b). AD Syringes 0.5 ml 

(c). Re-constitutional Syringes of 5 ml. 

C.14.8 Extension/Construction of new cold chain room 

C.15 Additional Support from GoI in kinds 

C.15.1 NON CFC Walk-in-Cooler 

C.15.2 New Walk-in-Freezer 

C.15.3. Cold Chain equipments 

C.15.4 Solar Power Refrigerator 

C.15.5 

Annual Requirement of Vaccines and AD Syringes and 

other logistics 

C.15.6 (a). Supply of Vaccine Vans by GoI 

(b). Maintenance of existing Vaccine Vans by GoI 

C.15.7 Supply of Hub Cutter 

C.15.8 Supply of cold chain equipment spare parts 

C.15.9 Supply of charging units for NON CFC Toolkits 

8. Budget. 

The budget portion is the direct reflection of the financial requirements proposed in the 

strategies for improving Routine Immunization. 

Sl. 

No 

Activities 

C.1 Supervisions 

C.1.1 

C.1.2 

Target 

297 

Unit of 

activities 

Rate per 

activity 

Fund 

required 

(in lakh) 

Implementing 

end 

Supervision of RI activities in 

District by DIOs 16 District 0.5 8 District level 

Supervision of RI activities in 

District by State Level Officer 

C.2 Cold Chain Maintenance 

C.2.1 

Cold chain maintenance fund 

for State Headquarter 

1 

1 

State 

Headqua 

rter 2 2 State level 

State 

Headqua 

rter 3 3 State

C.2.2 

C.2.3 

C.3 

C.4 

C.4.1 

C.4.2 

C.4.3 

C.5 

C.6 


fo District Headquarter 


fo PHC/CHC/DH/GH 

16 

100 

298 

District 

Cold 

Chain 

store 0.1 1.6 District 

Health 

facilities 

with 

cold 

chain 

system 0.05 5 District 

Immunization Session in 

Urban slum areas (Focus on 

urban slum area) 384 Sessions 0.014 5.376 District 

Out Reach Immunization 

Session 

Alternate Vaccine Delivery 

Mobility Support for Out 

Reach Sessions 

Mobilization of Children 

through ASHA/AWW 

Support (Salary) for Computer 

Assistants 

9336 

9336 

9336 

17 

Out 

Reach 

Sessions 0.002 18.672 District 

Out 

Reach 


Out 

Reach 


Compute 

r 

Asssista 

nt 1.92 32.64 

State and 

Districts 

Printing and Dissemination of 

Immunization Cards etc. 60000 Pieces 0.00005 3 State 

C.7 Procurement of Tracking Bags 2000 Pieces 0.002 State 

C.8 Review Meetings 

C.8.1 

C.8.2 

C.8.3 

C.9 

C.9.1 

3 days Review Meeting at State 

Level 2 

Review Meeting at District 

Level 64 

Review Meeting at Block Level 

Training under Routine 

Immunization 

232 

Review 

Meetings 2.376 4.752 State 

Review 

Meetings 0.07838 5.01632 District 

Review 

Meetings 0.0453 10.5096 District 

3 days training of Paramedics 

on Routine Immunization 64 Batches 0.92 58.88 District

C.9.2 

C.9.3 

C.9.4 

3 days training of Medical 

Officers at District Level 17 Batches 1.728 29.376 District 

One Day Refresher Training to 


17 

2 days Training on Vaccine 

Handling and Chain 

Managements 71 

C.10 Microplanning 

C.10. 

1 

C.10. 

2 

C.10. 

3 

Microplanning at Sub-Center 

level 273 

Microplanning at 

PHC/CHC/DH/GH 

130 

299 

Compute 

r 

Asssista 

nts 0.04665 0.79305 State 

Particip 

ants 0.05118 3.63378 State 

Subcentres 

0.001 0.273 District 

Function 

al 

Health 

facilities 0.01 1.3 District 

Microplanning at District 

Headquarter 16 Districts 0.02 0.32 District 

C.11 Vaccine Lifting 

C.11. 

1 

C.11. 

2 

C.12 

Vaccine lifting from Guwahatri 

Airport to State Headquarter 

1 

State 

Headqua 

rter 2 2 State 

From State Store to District 

Stores and 16 Districts 1 16 District 

Stationeries Support for 

Computers 

(a). Stationery support for 

State Headquarter 

1 

State 

Headqua 

rter 0.36 0.36 State 

(b). Stationery support for 

District 16 Districts 0.18 2.88 District 

C.13 Injection safety 

C.13. 

1 

C.13. 

2 

C.13. 

3 

Plastic Bags (Red/Black) 

Bleaching/Hypochloric 

Solution 

Twin Bucket 

20000 Nos. 0.00003 0.6 State 

130 

130 

Function 

al 

Health 

facilities 0.005 0.65 State 

Function 

al 

Health 

0.004 0.52 State

C.13. 

4 

Bio-medical Waste Pit 

300 

facilities 

32 Nos. 0.2 6.4 District 

Sub Total 1 395.864 

C.14 State Specific 

C.14. 

2 

C.14. 

3 

C.14. 

4 

C.14. 

5 

C.14. 

6 

C.14. 

7 

C.14. 

8 

(a). Mobility for Cold Chain 

Personnel for cold chain 

maintenance for State HQ staff 

at district where no Technician 

is available 1 

(b). Mobility for Cold Chain 

Personnel for cold chain 

maintenance for State HQ staff 

at district where no Technician 

is available 

10 

State 

Headqua 

rter 0.5 0.5 State 

District 

with 

Cold 

Chain 

Technici 

ans 0.3 3 District 

POL and maintenance for WIC 

generator at State 

Headquarter 1 No. 0.5 0.5 State 

A noiseless new generator for 

Central Cold Chain Room 1 8 0 

Salary for Contractual Health 

Assistants and Contractual 

Refrigerator Mechanic 

21 0 0 

(a). Procurement of solar 

plates 65 0.25 16.25 State 

(b). Procurment of batteries 

for solar refrigeration system 90 0.2 18 State 

Proposed 

under NRHM 

Additionalitie 

s 

(a). JE Vaccines for campaign 

mode in 2 districts 30200 vials 0 GoI to Supply 

(b). AD Syringes 0.5 ml 151000 Nos. 0 GoI to Supply 

(c). Reconstitutional Syringes 

of 5 ml. 30200 Nos. 0 GoI to Supply 

(a) Cold Chain Room 

extension 

(b) Construction of new Cold 

Chain Room 

1 No. 0 0 

1 No. 0 0 

Fund 

proposed 

under NRHM 

Fund 

proposed 

under NRHM

C.15 

C.15. 

1 

C.15. 

2 

C.15. 

3. 

C.15. 

4 

C.15. 

5 

C.15. 

6 

C.15. 

7 

C.15. 

8 

C.15. 

9 

Sub Total 2 38.25 

Additional Support from GoI 

in kinds 

NON CFC Walk-in-Cooler 

New Walk-in-Freezer 

Cold Chain equipments 

Solar Power Refrigerator 

1 Nos. 0 GoI to Supply 


301 

Nos. 0 GoI to Supply 


Annual Requirement of 

Vaccines and AD Syringes and 

other logistics Nos. 0 GoI to Supply 

(a). Supply of Vaccine Vans by 

GoI 17 Nos. 0 GoI to Supply 

(b). Maintenance of existing 

Vaccine Vans by GoI 16 No 2 32 

Supply of Hub Cutter 


Supply of cold chain 

equipment spare parts 0 GoI to Supply 

Supply of charging units for 

NON CFC Toolkits 0 GoI to Supply 

Sub Total 3 32 

Grand Total 452.514

Part D: National Disease Control Programmes 

1. NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME 


NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME 

A. Population:1456182 

B. Status of Health facilities 

S. No Health facility No 

1 District Hospital 14 

2 Block PHC/ CHC 88 

3 Add PHC/ Mini PHC 28 

4 Sub centre 443 (273) 

5 Villages 3682 

6 Rapid response team 16 

C. Human Resource 

S.No Health facility 

Sanctioned In Place 

302 

Trained as 

per new 

Malaria 

guidelines 

Required to be 

Trained 

a B C d= (b-c) 

1 DMO (Full Time) 3 4 3 1 

2 DVBDC Consultant NIL 

3 AMO 9 9 9 NIL 

4 Block PHC/ CHC-MO 560 560 360 200 

5 PHC-MO 522 522 322 200 

6 Other MO 55 55 10 45 

7 Lab Technician 19 19 19 NIL 

8 Lab Technician 

(contractual)* 

11 11 11 NIL 

9 Health Supervisors (M) 69 69 69 NIL 

10 Health Supervisors (F) NIL NIL NIL NIL 

11 MPW (M)

12 MPW (M) (contractual) 356 356 200 156 

13 MPW (F) NIL NIL NIL NIL 

14 Malaria Technical 

Supervisor (contractual)* 

15 15 15 NIL 

15 ASHA 3862 3862 2592 1270 

16 Other (Project specific 

staff) 

* GFATM/World Bank 

GFATM States (Arunachal Pradesh):- 

- - - - 

State PMU Sanctioned In Position 

Consultant M&E 1 no. 1 no. 

Project Director/ Programme Officer 1 no. 1 no. 

Finance Consultant 1 no. 1 no. 

IEC Consultant 1 no. 1 no. 

Data entry operator 1 no. 1 no. 

Accountant/Statistical Assistant 1 no. 1 no. 

Based on training need (column D) no of batches to be trained: 

Sl.NO. Batches to be trained No. of batches Remarks 

1 PHC M.O. 4 batches 1 batch = 25 Nos. 

2 Other M.O. 2 batches 1 batch = 25 Nos. 

3 MPW (Contractual) 3 batches 1 batch = 50 Nos. 

4 ASHA 26 batches 1 batch = 50 Nos. 

303

District Name 

D. District wise Epidemiological Situation: a brief analysis on the following parameters to assess performance (ABER- Surveillance) & 

impact (API, cases, deaths etc) may be given so as to identify gaps and areas requiring improvement. 

D1. The States are to hold meetings for development of district wise Action Plan by analyzing the data on following parameters. 

Year Pop. BSC/BSE ABER 

Total 

Malaria 

Cases Pf. Cases API SPR SFR 

Tirap 1 2004 106362 20577 19.35 1361 41 12.8 6.61 0.2 

2005 108489 20294 18.71 1558 38 14.36 7.68 0.19 

2006 110659 25331 22.89 2230 216 20.15 8.8 0.85 57 

2007 112872 25323 22.44 2477 309 21.95 9.78 

2008 115129 23865 20.73 1740 178 15.11 7.29 0.75 

Changlang2 2004 132645 29746 22.43 4687 1619 35.33 15.76 5.44 

2005 135298 25340 18.73 2600 986 19.22 10.26 3.89 

2006 138003 33360 24.17 4144 2215 30.03 12.42 6.64 3 

2007 140764 27930 19.84 2197 1121 15.61 7.87 

2008 143579 32423 22.58 2232 1251 15.55 6.88 

Lohit 3 2004 128338 31599 24.62 3974 938 30.97 12.58 2.97 

2005 130905 40610 31.02 4327 1811 33.05 10.66 4.46 2 

2006 133523 44298 33.18 5242 2007 39.26 11.83 4.53 14 

2007 136194 39641 29.1 4874 1747 35.79 12.3 4 

2008 138917 31176 22.44 3125 1195 22.5 10.02 3.86 

Anini 2004 7881 

2005 8038 

2006 8199 

2007 8363 961 11.49 41 7 4.9 4.27 

2008 8530 240 2.81 37 13 4.34 15.42 5.42 

Roing 2004 53185 22880 43.02 2465 166 46.35 10.77 0.73 

2005 54248 23928 44.11 1938 130 35.72 8.1 0.54 9 

2006 55333 34893 63.06 4201 318 75.92 12.04 0.91 4 

304 

Deaths 

due to 

malaria

2007 56440 33374 59.13 4773 328 84.57 14.3 7 

2008 57569 25299 43.95 2718 312 47.21 10.74 1.23 5 

Pasighat 2004 92781 46560 50.18 7193 1087 77.53 15.45 2.33 14 

2005 94637 60538 63.97 8213 1879 86.78 13.57 3.1 

2006 96530 51604 53.46 8538 2824 88.45 16.55 5.47 

2007 98460 46734 47.46 7002 2174 71.12 14.98 8 

2008 100430 50756 50.54 7386 3031 73.54 14.55 5.97 

Aalo 2004 109915 26229 23.86 7969 4 72.5 30.38 0.02 

2005 112113 24890 22.2 4409 119 39.33 17.71 0.48 

2006 114355 21080 18.43 3572 15 31.24 16.94 0.07 

2007 116642 16405 14.06 3898 69 33.42 23.76 

2008 118975 18735 15.75 3648 82 30.66 19.47 0.44 

P/Pare 2004 129202 19166 14.83 1108 181 8.58 5.78 0.94 

2005 131786 32564 24.71 4685 927 35.55 14.39 2.85 

2006 134422 41286 30.71 6314 2401 46.97 15.29 5.82 50 

2007 137110 32611 23.78 3418 901 24.93 10.48 17 

2008 139852 31804 22.74 2505 441 17.91 7.88 1.39 10 

Daporijo 2004 58361 5728 9.81 159 1 2.72 2.78 0.02 

2005 59528 12220 20.53 920 75 15.45 7.53 0.61 

2006 60719 7955 13.1 1215 142 20.01 15.27 1.79 5 

2007 61933 3763 6.08 721 113 11.64 19.16 

2008 63172 3624 5.74 781 114 12.36 21.55 3.15 

Ziro 2004 57392 2335 4.07 159 12 2.77 6.81 0.51 

2005 58540 3151 5.38 129 3 2.2 4.09 0.1 

2006 59711 2362 3.96 142 5 2.38 6.01 0.21 

2007 60905 2513 4.13 142 - 2.33 5.65 

2008 62123 3553 5.72 203 3 3.27 5.71 0.08 

Seppa 2004 60558 617 1.02 105 6 1.73 17.02 0.97 

2005 61769 5776 9.35 1739 449 28.15 30.11 7.77 

2006 63004 8739 13.87 3057 1202 48.52 34.98 13.75 44 

305

2007 64264 6309 9.82 1786 638 27.79 28.31 

2008 65550 10637 16.23 2947 1160 44.96 27.71 10.91 12 

Bomdila 2004 79161 1534 1.94 60 4 0.76 3.91 0.26 

2005 80744 3482 4.31 198 57 2.45 5.69 1.64 

2006 82359 5154 6.26 454 192 5.51 8.81 3.73 5 

2007 84006 4040 4.81 241 117 2.87 5.97 

2008 85686 4723 5.51 154 79 1.8 3.26 1.67 

Yingkiong 2004 35175 6302 17.92 609 - 17.31 9.66 0 

2005 35878 6190 17.25 499 - 13.91 8.06 0 

2006 36596 1400 3.83 124 - 3.39 8.86 0 

2007 37328 4232 11.34 453 - 12.14 10.7 0 

2008 38074 6454 16.95 515 79 13.53 7.98 

K/Kumey 2004 46197 

2005 47120 

2006 48063 

2007 49024 93 0.19 29 4 0.59 31.18 

2008 50005 6435 12.87 1099 346 21.98 17.08 5.38 

Anjow 2004 23922 

2005 24400 

2006 24888 

2007 25386 752 2.96 19 11 0.75 2.53 

2008 25894 1160 4.48 42 14 1.62 4.83 1.21 

State Total 2004 1121073 213273 19.02 29489 4059 25.87 13.83 1.9 - 

2005 1143494 258983 22.65 31215 6474 26.85 12.05 2.5 11 

2006 1166364 277462 23.79 39233 11537 33.09 14.14 4.16. 196 

2007 1189691 244681 20.59 32071 7539 26.52 13.11 3.08 36 

2008 1213485 250884 20.67 29146 8219 24.02 11.62 3.28 27 

306

D2. High Risk Areas: Based on the epidemiological data in the above table identify the high risk areas according to definition in Malaria Action 

Programme (As per MAP 1995) for the prioritization criteria developed by expert committee 2002 (enclosed) 

Name of District High Risk PHC High risk sub-Centre High risk Village High risk Population Tribal Population 

Taliyang (Sonpura) 4 40 19964 19964 

Lohit 

Wakro 3 46 7646 7646 

Seppa 6 65 11425 11425 

seijosa 3 25 6684 6684 

East Kameng 

Bana 10 2462 2462 

West Kameng Bhalukpong 4 20 7198 7198 

Tirap Deomali 2 16 9338 9338 

Papum Pare Kimin 1 8 8459 8459 

Bassar 29 16363 16363 

Likhabali 3 45 12507 12507 

West Siang 

Daring 4 20 6628 6628 

U/Subansiri Daporijo 6 38 17386 17386 

Pasighat 15143 15143 

Boleng 7 5929 5929 

Ruksin 9 7847 7847 

Bilet 3 10 5942 5942 

Sille 1 11 8661 8661 

Telem 2 8 2170 2170 

Nari 1 7 4000 4000 

Suple 1 8 1575 1575 

Rani 1 4 2250 2250 

Borguli 1 9 5528 5528 

East Siang 

Yagrung 6 3471 3471 

Mia 14 28064 28064 

Khimyong 1 5 3645 3645 

Changlang 4 15226 15226 

Changlang 

Jairampur 1 15 11116 11116 

307

Innao 2 16 12180 12180 

Nampong 1 15 4994 4994 

Diyun 1 17 18020 18020 

Sub Total:- 

Kharsang 

8 

1 

54 

19 

546 

10573 

292394 

10573 

292394 

D3. Classify the areas as per following API ranges 

S. No API District (No) PHCs (No) Sub centre (No) Villages (No) Population @ Village 

(No) 

% population of State 

1 47.21 L/D/Valley 6 17 119 428 4.63 

2 73.54 East Siang 16 22 144 607 10.01 

3 22.5 Lohit 9 27 193 257 8.13 

4 30.66 West Siang 11 33 198 260 6.31 

5 44.96 East Kameng 2 25 210 184 7.14 

6 17.91 Papum Pare 6 35 197 456 8.12 

7 15.11 Tirap 6 31 167 600 13.02 

8 15.55 Changlang 10 24 189 372 12.75 

9 13.53 Upper Siang 5 13 92 360 4.25 

10 12.36 Upper Subansiri 11 29 118 138 7.07 

11 4.34 U/Dibang Valley 1 7 94 79 0.6 

12 1.8 West Kameng 6 24 92 351 2.48 

13 3.27 Lower Subansiri 6 28 43 103 3.31 

14 2.16 Anjaw 1 12 46 194 2 

15 21.98 Kurung Kumey 6 34 129 338 3.96 

Total:- 102 361 2031 

308

E. Outbreak: Yes/ no if yes; 

• No of outbreaks :- 1 

• Area affected :- Diyun 

• Period of outbreak :- June & July 2009 

• No of deaths reported during outbreak :- Nil ( 5 unconfirmed death) 

• Reasons for outbreak :- Refuse to spray DDT 50%l 

• Containment measures taken :- Yes 

• Out break containment report submitted by State to Center? Yes. 

Lohit District is the high risk District in malaria cases in Arunachal Pradesh. During the month 

of June/July/ 2009, there was an out break of malaria cases in Piyong circle. Under this circle only 

one PHC i.e. at Diyun with Lab. Facilities is running, where as the entire circle was affected. 

Though the DHV/MPW are working , but the Radical treatment could not be done at the earliest due 

to late receive of result. 

I would like to draw your kind attention that for supervision of the malaria work in the 

PHC/CHC there is no sufficient staffs. 

Only 9 (Nine) AMO and 43 (Forty three) M.I in the state are supervising the work, 

which is at any cost not possible for the supervision of the work. Advance steps for out break could be 

taken only when the malaria staff could supervise the village of the PHC/CHC. 

Detail has been shown above. 

However, during the out break the below mentioned action were taken : 

1. AMO and Medical team including Doctors were sent immediately. 

2. DMO has visited the area to study the situation. 

3. The Medial team visited all the affected villages in Piyong circle for health check up and 

awareness campaign. 

4. Mass blood slide were collected. 

5. Intensified Mass blood slide collection was done. 

6. Beside regular DDT spray team two more additional team were sent. 

7. Fogging operation was also done in the area. 

8. R.T given to all positive cases. 

9. Impregnations of Mosquito net were done. 

10. RMT Kits were purchased for prompt diagnosis. 

11. R.D. Kits were issued in sufficient quantity. 

12. Awareness campaigns were intensified and IEC materials were distributed. 

9 

309

In spite of all the awareness created it is learnt that the villager never allow the medical team 

to spray DDT inside their houses as instructed and report receive that many people are living 

in unhygienic condition. There was no malaria death reported during out break. 

F. Specific activities: 

a) RD Kits (selected Pf endemic districts only) 

A. of Rapid Diagnostic Kits for the plan year based on epidemiological and operational data 

S.N 

o. 

District 

No. PHCs 

where 

RDTs are 

to be used 

in 

emergency 

hours 

No. subcentre 

areas with 

Pf > 30% 

& SFR>1% 

and no 

microscopy 

result 

within 24h 

No. blood 

examinatio 

ns in those 

sub-centre/ 

PHC areas 

last year 

(A) 

310 

Expected 

RDT 

requirem 

ent in 

remote 

high Pf 

areas and 

PHCs 

[Ax 1.25] 

(B) 

RDTs for 

buffer 

stock and 

distributi 

on to 

other 

areas: [B 

x 0.20] 

(C) 

Total 

annual 

RDT 

supply 

[B+C] 

1 Changlang 8 Nos 28 11175 13968 2793 16761 20 

2 Lohit 6 10 9352 11690 2338 14028 7 

3 W/Kameng 1 5 1180 1475 295 1770 5 

4 East Siang 10 13 14437 18046 3609 21655 13 

5 Tirap 2 12 8949 11186 2237 13423 10 

6 Papum Pare 9 13 10500 13125 3072 16197 13 

7 East Kameng 7 15 5668 7085 1417 8502 12 

8 Kurung Kumey 6 17 5434 6792 1358 16652 13 

9 

Upper 

Subansiri 8 33 3624 4530 906 5436 22 

10 W/Siang 6 8 5472 6840 1368 8208 6 

Total 63 154 75791 94739 18948 113687 121 

*Planning for RDTs is based on annual blood examinations in areas and health facilities, where 

it is not possible to obtain a microscopy result within 24 hours (no later than day after slide is 

taken and where the risk of P. falciparum rate is >2%. 

Nos to be 

distribute 

d in 

prioritize 

d areas

* Villages planned to be equipped with RDTs should have trained ASHA/ CHVs ( including A W 

W) 

* In the above, sub-centre area means the sub-centre and the villages under it, while PHC means the 

PHC health facility, e.g. “PHC (new). The distinction is made, because in some cases, the PHC has 

microscopy, but many of the sub-centre areas under it do not. 

* In general, it should be assured that as a minimum. RDTs are supplied to cover all blood 

examinations in the eligible PHCs and sub-centre areas. The number of blood examinations is 

estimate by adding 25% to the number of blood examinations during the last complete calendar year, 

because RDTs may attract additional patients. 

* If possible, a buffer stock of approximately 20%, depending on the availability of supplies is added, 

to cover needs in other areas and health facilities, where individual patients may be considered 

highly suspect of falciparum malaria on account of symptoms or travel history, or where microscopy 

may be temporarily unavailable and to provide a reserve for supplies to the eligible areas. 

B. Requirement of Rapid Diagnostic Kits based on epidemiological data for next Plan Year 

S. 

No. 

b) Areas for supply of ACT 

A. Allocation of ACTs and quinine for a plan year based on epidemiological and operational data 

Data latest complete year Allocation for plan year 

Details 

Details 

Name of district or 

block/ district 

Slide 

Collection 

Total Pop. 

Sub 

centre 

(no) 

311 

Pf cases 

reported in 

previous 

year 

Village (no) Total 

Population 

ACT 

Blister for 

Adults, 

ACT 

Blister for 

Children 

AS Tabs 

Tribal 

Population 

1 Areas with high Pf % 250884 443 3682 1456182 1164946 

2 

3 

Of the above prioritized to 

be equipped with RDT 

during the year 

No of RDTs Required for 

Next Plan Year 

363782 443 3682 1456182 1164946 

527484 (25% 0f TBSC last year+20% Buffer stock) 

Pregnant 

Women 

Quinine

District 

identified 

for roll out 

of ACT 

Cluster of 

PHCs 

(Blocks) 

around Pf 

resistance 

foci 

312 

Tablets 

Please see calculation norms given at 

Annexure-H 

1.Changlang 143579 1251 937 637 525 

2. Lohit 138917 1195 886 607 502 

3.E/Siang 100430 3031 2272 1550 1273 

4. P/Pare 139852 441 330 222 185 

5 E/Kameng 65550 1160 870 591 487 

6.K/Kumey 50005 346 258 172 145 

7.W/ Kameng 85686 79 58 38 33 

8.L/ D/Valley 57569 312 233 157 131 

Total 781588 7815 5844 3974 3282 

* Planning for ACTs is based on the number of falciparum cases found in eligible areas in previous 

year. Like for RDTs, 25% is added to account for RDTs, 25% is added to account for increasing 

patient -loads resulting from more attractive services and an extra buffer quantity of approximately 

20-25%. This leads to the multiplication factor, 1.5 

* The additional multiplication factors for non-pregnant adults and children are based on the number 

of tablets required for different age-groups and the age-distribution in the general rural populations. 

• The additional multiplication factors for quinine tablets for pregnant women are based on the 

assumption that 2% of all 

• cases occur in pregnant women, and that each of these cases required 21 tablets of quinine 

suplhate 650 mg

Sl. 

No 

Name of 

district 

c) Bed nets: 

All planning should be based on enumeration of bednets in households by Bednet 

Survey. 

Eligible 

SC 

(Use the IVM Annual Plan Format for detailed planning) 

PLANNING FOR DISTRIBUTIOIN OD BED NETS:- 

Eligible 

Vill 

Eligible 

Pop 

Tribal 

Pop 

Total 

Bed net 

required 

313 

No. of bed nets 

available 

Required 

in 

current 

year 

Total planned 

to be 

distributed in 

the year as 

allocation 

ITNs LLINs 

D=A- 

INTs LLINs 

A B C 

(B+C) 

E F 

Total 

plan to 

treated 

G=B+E 

1 Tirap 17 160 81500 81500 81500 30000 Nil 51500 51500 30000 

2 Changlang 28 293 35772 35772 35772 15000 Nil 20772 20772 15000 

3 Lohit 

B. Allocation of ACTs and quinine for Next Plan Year 

Data latest complete year Allocation for Next plan year 

S. 

No. 

50 (+ 

Anjaw 

446 90000 61426 61426 29000 Nil 32426 32426 29000 

4 Anjaw Nil 

5 U/D/Valley Nil 

6 L/D/Valley 

District/ PHC 

Clusters 

identified for 

roll out of 

ACT 

9 (+ 

U/D/ 

Valley 

Total 

Population 

Pf cases 

reported in 

previous 

year 

ACT Blister 

for Adults, 

Children Pregnant Women 

AS Tabs Quinine Tablets 

Please see calculation norms given at Annexure-H 

1 15 Districts 1456182 8219 7305 4968 4103 14 

127 14948 10000 10000 2000 Nil 8000 8000 2000 

7 East Siang 26 116 28927 28927 28927 8606 Nil 20321 20321 8606

8 West Siang 29 300 110000 60000 60000 34045 Nil 25955 25955 34045 

9 

Upper 

Subansiri 

10 Lower 

Subansiri 

11 Kurung 

Kumey 

12 Papum 

Pare 

13 East 

kameng 

14 West 

kameng 

15 Upper 

Siang 

33 228 32890 32890 32890 1500 Nil 31390 31390 1500 

9 168 25000 25000 25000 7173 Nil 17827 17827 7173 

93 129 26553 26553 26553 15 

800 Nil 25753 25753 800 

27 

164 

62000 

62000 

62000 

314 

8600 

Nil 53400 53400 8600 

17 274 35485 35485 35485 5500 Nil 29985 29985 5500 

24 183 36951 36951 36951 11732 Nil 25219 25219 11732 

12 

38 

26000 

26000 

26000 

7438 

Nil 

18562 

18562 

Total 374 2626 606026 522504 522504 161394 361110 361110 161394 

NB: Requirement is calculated in terms of single bed net, half may be supply double nets. 

7438

Name of 

District 

d)Planning for IRS: INDOOR RESIDUAL SPRAY 

CHC PHC 

Sub - 

centre 

selected 

Village 

selected 

Population 

selected 

Tribal 

Population 

315 

Spray 

squads 

required 

Trainings 

batches 

of spray 

squads 

Equipment 

required 

Tirap 2 5 21 157 100227 83940 7 2 15 pumps DDT 

Lohit 2 7 22 49 132549 40552 9 2 20 pumps “ 

East Siang 4 15 27 116 87397 60428 5 2 12 pumps “ 

Upper Siang 2 3 7 81 35173 26094 2 1 5 pumps “ 

West Siang 4 9 43 371 103918 84922 7 2 15 pumps “ 

East Kameng 1 10 32 274 57179 49585 4 1 10 pumps “ 

K/Kumey 4 5 6 129 42518 41619 3 1 7 pumps “ 

Upper 

Subansiri 

2 6 30 228 55346 49552 4 1 10 Pump “ 

L/D/Valley 1 4 11 127 50448 222005 3 1 7 pumps “ 

Lower 

Subansiri 

1 8 8 147 55726 46893 4 1 10 pumps “ 

Changlang 3 7 30 322 124264 45351 8 2 17 pumps “ 

Papum Pare 1 7 27 179 121750 69007 8 2 17 pumps “ 

West Kameng 3 7 24 144 74599 36951 5 2 11 Pumps “ 

Anjaw 1 2 18 37 18441 14249 2 1 5 pumps “ 

Name of 

Insecticide 

Insecticide required 

(MTs) 

DDT Malathion 

(Tech) 

SP

U/Dibang 

valley 

0 1 3 27 7272 4827 1 1 3 pumps “ 

Total:- 31 96 309 2388 1066807 875975 72 22 200 pumps “ 150 5 

316

N.B. Details of Micro planning for Spray squads to be done as per tables in Annexure 22 and 

summated above 

e) Associated activities for IRS: 

S. 

lNo. 

- Specify what IEC activity will be carried out for sensitization & mobilization of community 

for Spray also in also in advance information regarding spray dates operations:pre-spray 

sensitization will be done through involving PRI Members,GBs,Local administrations, NGOs, 

FBOs, by various BCC & training. 

- Supervision Plan: within the PHC and from district level (Sub centre/ village wise) 

Supervision Plan with village level date of spray and SC/PHC district level supervision(Yes) 

- Selection of sites for dumping insecticides completed? Yes 

- Whether safeguards for storage & handling of insecticides ensured? Yes 

- Certification on functional status of equipment by DMO by yr. 

- Spare parts of spray equipments like lance available yes 

- Provision of protective gear for spray workers present yes 

- No of functional stirrup pumps (HC Pump) 200 

- No required to be repaired 50 

- Certification by panchayat for coverage of IRS – planned 

- Innovations 

Innovations Describe details Fund Allocated (Rs) 

1 Patient referral e.g. 

Like use of NRHM/ 

RKS flexi funds for 

transport of severe 

cases 

2 Transportation of 

slides 

E g. Use of Public 

transport system 

Transportation for referred cases:- 

a) Per patient from road side Rs. 

350/- 

b) From interior villages per patient 

Rs. 500/- 

c) ASHA incentive has been reflected 

under budget proposal for 2010-11. 

It can also meet up from V.H.S committee 

under NRHM 

a. For each slide transportation and 

collection of report within 48 hours Rs. 5/- 

each slide 

b. 70% of the total sub-Centre do not have 

road connectivity. RDT used for only Pf 

cases, Laboratory facilities should be 

provided to Sub-Centre for diagnosis and 

treatment. 

317 

So far no such fund has 

been allotted. As such 

allocation of fund 

under transportation is 

to be released to meet 

up such cases. 

a) Fund should be 

released for effective 

implementation. ASHA 

incentive has been 

reflected under budget 

proposal for 2010-11 

3 NGO/ CBO Training of ASHAs has been given by Remaining untrained

involvement Refer to 

PPP guidelines on 

www.nvbdcp.gov.in 

VHAI, Arunachal Pradesh Branch. ASHA are to be 

trained, fund required 

urgently. 

318

g) Commodity Requirement 

Item Previous year’s 

utilization (no) 

Requirement 

for current 

year(no) 

319 

Balance 

Available(no) 

Net 

requirement 

Choloroquine 

Tab. (no) 

Nil 752652 600000 152652 

Combi Blister 

Pack (CQ+PQ) in 

nos 

Nil 0 0 0 

Primaquine 2.5 

mg Tab. (no.) 

213000 462650 Nil 462650 

Primaquine 7.5 

mg Tab. (no.) 

Nil 539758 Nil 539758 

ACT Comb. 

(Artemisinine+SP) 

(no.) 

21575 7378 4325 3053 

Artesunate Tab. 

(no.) 

190600 28460 9400 19060 

Arteether Inj (no.) 11198 17606 3109 14497 

Quinine Sulphate 

Tab. (no.) 

Nil 117375 Nil 117375 

Quinine Injection 

(no.) 

4020 39125 Nil 39125 

S+P Comb. Tab. 

(no.) 

Nil 7115 Nil 7115 

R.D. Kits (no.) 136150 363782 63450 300332 

DDT 50% ( in Kg) 150 MT 150 MT Nil 150 MT 

Malathion 25% 

wdp (in ltrs.) 

0 0 0 0 

Malathion 

Technical (in ltrs) 

0 0 0 0 

Temephos 50% (in 

ltrs.) 

0 0 0 0 

Pyrethrum Extt. 

2% 

(in ltrs.) 

0 0 0 0 

Primiphos methyl 

(in ltrs) 

0 0 0 0 

Synthetic 

Pyrethroid for IRS 

wdp (in Kg) 

0 0 0 0 

Synthetic 

Pyrethroid for 

ITNs (Liquid in 

ltrs.) 

4138 4069 4580 0 

ITNs (no) 0 0 0 0 

LLINs (no) 361110 

Micro Slides 

(No.) 

0 752652 0 752652 

Stirrup Pumps 

(No.) 

0 0 0 0

SL. NO. NAME OF ITEM QUANTITY AMOUNT REMARKS 

1 PRICKING NEEDLES 3,00,000 Nos. Rs. 6,00,000.00 As per 3 years 

2 MICROSLIDES 3,00,000 Nos. Rs. 7,00,000.00 average BSC 

& addl. 10% 

3 MICROSCOPES 80 Nos. Rs. 36,00,000.00 

4 STAIN-i & ii 2000 Litres Rs. 6,00,000.00 

5 H.C. PUMP 200 Nos. Rs. 14,00,000.00 

6 SPARE PARTS FOR 

H.C. PUMP 

Rs. 8,00,000.00 

7 OIL IMMERSION 

LENSE (100x) 

50 Pieces Rs. 3,50,000.00 

8 EYE PIECE (5X 10x) 150 Pieces Rs. 3,75,000.00 

9 MICROSCOPE 

MAINTENANCE 

Rs. 5,00,000.00 

10 AMC FOR 

COMPUTERS 

16 district s Rs. 5,00,000.00 

11 ISDN (INTERNET 

CONNECTION) 

16 districts Rs. 5,00,000.00 

12 SALARY OF SPRAY 

STAFFS 

360 Nos. Rs. 48,60,000.00 

13 12 MONTHS 

CONTINGENCY 

75 Nos. Rs. 24,30,000.00 

14 TA FOR SPRAY 

STAFFS 

360 Rs. 18,00,000.00 

15 SYNTHETICE 2000 Litres Rs. 40,00,000.00 Calculation of 

PYRETHROID LIQUID 

medicine as 

per guidelines 

16 CHLOROQUINE 8,30,000 Rs. 5,81,000.00 “ 

PHOSPHATE-250 MG 

Tablet 

Tablets 

17 PRIMAQUINE -7.5 6,00,000 Rs. 10,00,000.00 “ 

Tablet 

Tablets 

18 PRIMAQUINE-2.5 5,20,000 

Tablets 

Rs.6,76,000.00 “ 

19 QUININE SULPHATE 1,40,000 Rs. 5,60,000.00 “ 

Tablet 

Tablets 

20 QUININE Injection 33,000 

Ampoules 

Rs. 3,96,000.00 “ 

21 PARACETAMOL-500 5,00,000 Rs. 3,00,000.00 “ 

Tablet 

Tablets 

Grant Total:- Rs. 2,29,28,000 

g. Training: mention number of batches to be trained 

Cost 

per 

Batch 

320 

Current year 2010-2011 

Total 

Cost 

(Rs) 

Previous Q1 Q2 Q3 Q4 Total 

S. No Trainings 

year (no) (no) (no) (no) (no) (no) 

Capacity building Under GFATM 

1 Medical specialists at 

District Hospital 

2 Medical Officers 1.2 1 1 1 1 1 4 4.8 

3 Laboratory 0.76 2 1 1 1 - 3 2.28

Technicians (induction 

& reorientation) 

4 MTS 0.76 1 1 - - - 1 0.76 

Grand total of GFATM 7.84 

5 MPWs 0.2 3.2 8 4 4 - 16 3.2 

6 Health Supervisors 

(M) 0.2 0 4 4 4 4 16 3.2 

7 Spray worker/ 0.15 2.4 12 4 - - 16 2.4 

8 Health Workers/Ento. 

Asstt. 0.2 16 12 4 - - 16 3.2 

9 Spray team 0.15 0 8 4 4 - 16 2.4 

10 ASHA 0.15 64 30 34 - - 64 9.6 

Grand total of DBS 24 

h. BCC/ IEC: mention number of each 

S. No Activities 

Unit 

Cost 

(Rs) 

Previous 

year 

(no) 

321 

Q1 

(no) 

Q2 

(no) 

Current year 2010-2011 

Q3 

(no) 

Q4 

(no) 

Total 

(no) 

Total 

Cost 

(Rs) 

A. Print Media 

1 Posters 20 20000 10000 20000 - 10000 40000 8 

2 Hoardings/Glow 

sign board 8320 100 50 50 - 100 8.32 

3 Newspaper 

advertisement 10000 30 10 15 10 10 45 4.5 

4 Various 

Pamphlets 12 50000 20000 30000 - 10000 60000 7.2 

5 Sticker 13 10000 5000 15000 - 5000 25000 3.25 

6 Wall Hanging 65 5000 5000 5000 - - 10000 6.5 

7 Various 

guidelines 150 1000 500 1000 1000 - 2500 4.5 

8 Calendar 180 2000 - - - 2500 2500 4.5 

B. Electronic 

Media 0 

4 TV campaigns 150000 0 2 - - - 2 3 

5 Radio 

campaigns 15000 4 2 3 1 - 6 0.9 

C. Community 

level 0 

6 Health camps 20000 6 5 3 2 - 10 2 

7 Village level 

awareness 

camps for IRS 2000 150 150 150 50 - 350 7 

8 Others (specify) 

a. advocacy 

woskshop & 

intersectoral 

meetings 

Various 

rates - 17 

Total 76.67

1. PPP involvement 

S. No. Schemes 

1 Scheme I 

a. Provision of EDPT 

for the population of 

PHCs in high risk 

areas. 

b. In Urban sector 

2 Scheme II 

Microscopy and 

treatment centres 

- 

- 

- 

Previous year 

(no) 

322 

Planned in Current 

year (no) 

40 nos. @ Rs. 0.11 

each 

3 nos. @ Rs. 3.07 lakhs 

each 

5 nos. @ Rs. 0.31 each 

3 Scheme III - - - 

4 Scheme IV 

ITBN (Community 

owned and distributed) 

a. In High risk 

villages/PHC wise) 

b. Urban Sector 

5 Promotion of use of 

Larvivorous fish 

6 

Scheme VI 

IRS (2 rounds) 

High risk Sub - Centres 

- 

- 

- 

- 

30 nos. @ Rs. 0.19 

each 

2 Nos. @ Rs. 4.43 lakhs 

each 

Cost 

3.30 

9.21 

1.55 

5.70 

8.86 

59 nos. 10.93 

59 Nos. @ Rs. 0.25 

each 

14.75 

Total 54.30

S. 

No. 

Strengths- 

J. Larvivorous Fish 

L) Others: Specify any other planning to be undertaken 

M. Do a SWOT analysis of the districts as below 

1. All PHCs/ CHCs must have microscopist for EDPT 

(whereas this could not be provided due to shortage of Lab.Tech) 

2. Spray teams should cover whole the district in stipulated 

period 

3. All FTD/ASHA is to be trained for use of RDK and 

presumptive treatment. (for ASHA Rs.5/- per BSC &Rs. 

50/- for complete treatment) 

Weakness:- 

District Hatcheries 

Seasonal 

water 

bodies 

1. During peak malaria season MO is busy in curative 

aspect and unable to supervise IRS. 

2. Spray team I/C don’t properly liaise with villagers before 

start of operation and there is poor supervision on the 

FW 

3. Heavey monsoon & road blocks make supervision activity 

difficult. 

Early diagnosis & prompt treatment- ASHA not yet 

completely trained in use of RTK and ACT 

323 

Perennial 

water 

bodies 

Water bodies 

released 

with fish 

previous 

year (no) 

Actions to be taken:- 

1. Re-Orientation for detection of M.P to 

all microscopists. 

2. Training to all Spray in charges 

3. Re-orientation to all FTD holders 

1. Village Health & Sanitation committee 

members need to be trained for monitoring IRS 

activities. 

2.Pre Spray & IEC 

3BCC to PRI & Head GBs 

Planned in 

Current 

year (no) 

1 Pasighat - Plenty Plenty 7 20 3.70 

2 Tezu - Plenty Plenty - 5 0.93 

3 Roing - Plenty Plenty 4 10 1.85 

4 Ziro - Plenty Plenty - 7 1.30 

5 Changlang - Plenty Plenty - 5 0.93 

6. Papum Pare - Plenty Plenty 5 12 2.22 

Total 59 10.93 

Cost 

4. MTS should be sanctioned more in every 

Districts with providing Motor cycles and more 

Pol money. 

5. Sufficient fund should be provided for quality 

traing & re-orientation.

Opportunities:- 

1. Malaria laboratories are to be established in each 

CHC/PHC and Sub. Centre. (Provided Binocular 

Microscope with man power to be sanctioned. 

2. Each PHC need good quality microscope required for 

100% detection of M.P 

3. More synthetic pyrothroid is required for coverage of all 

households. 

4. One pick up van is required for each district for mobility 

support during epidemic and lifting of DDT. 

5. Tablet form of K-Othrine could be introduced for easy 

transportation. 

K. Proforma for Urban Malaria Scheme 

324 

1. Director NVBDCP, New Delhi has 

assured for supply of good quality 

microscope (Binocular) and Hand 

Compression Pump, still awaited. 

2. Early action on the subject may please 

be taken. 

3. LLIN:- should be supplied urgently. 

Status of hatcheries/ up-scaling of Larvivorous fish in the States:- Arunachal Pradesh 

S.No Name of states/UTs. 

1 Arunachal Pradesh Capital 

town, 

(Naharlagun & Itanagar) 

No. of 

hatcheries at 

District level 

No. of hatcheries at 

Block/PHC/ Village 

level 

No. of water 

bodies seeded 

4 nos. 4 nos. Nil 

MONTH-WISE EPIDEMIOLOGICAL REPORT FOR THE YEAR 2008 

Population Jan 

1213485 

Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec 

No.of 

BSC/BSE 

9481 10242 12169 15559 20567 29804 33573 34210 31022 25327 17008 11922 

No. of Pv 567 658 858 923 1503 2786 3050 3420 3123 2013 1223 803 

No. of Pf 167 194 245 293 484 860 1218 1397 1413 949 775 224 

No. of 

total 

positives 

734 852 1103 1216 1987 3646 4268 4817 4536 2962 1998 1027 

SPR 7.74 8.32 9.06 7.82 9.66 12.23 12.71 14.08 14.62 11.7 11.75 8.61 

SFR 1.76 1.89 2.01 1.88 2.35 2.89 3.63 4.08 4.55 3.75 4.56 1.88 

MBER 0.78 0.84 1 1.28 1.69 2.46 2.77 2.82 2.56 2.09 1.4 0.98

RT given 734 852 1103 1216 1987 3646 4268 4817 4536 2962 1998 1027 

Deaths 1 10 3 6 5 2 

Guidelines for preparation of micro action plan for IRS Appendix 1 

Table 1 Training Programme 

Training of Supervisors and Spray Squads 

Total Number Training 

Sessions (No) 

MPWs and other Supervisors 32 

Spray squads 72 32 

Table 1 Spray Programme 

PHC Spray Programme 

325 

Dates Venue 

Sub-centre village Date of spray Squad No. Dumping site for 

insecticide 

309 2388 01/04/2010 to 

30/08/2010 

Table 1 Village wise beat for spray squads 

72 Yes 

Village wise Beat of Spray Squads 

Squad No. village Population Date of Spray 

72 2388 1066807 01/04/2010 to 

15/06/2010 

Templates 15 

15.1 National Vector Borne Disease Control Programme (Malaria) 

I Round II Round 


16/06/2010 to 

30/08/2010 

API for Malaria (per 1000 population) 26.84 District Data 

Slide Positive rate 12.39 -do-

Plasmodium Falciparum Rate (PFR) 3.06 -do- 

Annual Blood Examination rate (Per 100 population) 21.65 -do- 

Fever Treatment Depots and DDCs 615/546 -do- 

INCENTIVE TO ASHA’s 

Total No. of ASHAs in Arunachal Pradesh – 3862 nos. 

Activity Incentive 

rate 

Preparation of slide Rs. 5/- per 

slide 

Slide preparation without RTD 

i.e. 

>Preparation of slide 

>Taking them to PHC for 

complete treatment 

RD test and complete treatment 

of PF malaria 

Accompanying a severe & 

complicated Pf case to a nearest 

health facility including 

transport 

NO DEATH INCENTIVE TO ASHA’s 

Rs. 50/- per 

+ve case 


complete 

treatment 

Rs. 20/- per 

case 

Rs. 75/- per 

case 

% of the total 

slide 

326 

Fund 

requireme 

nt 

125442 cases 627210 

8744 cases 437200 

8744 cases 174880 

7287 cases 546525 

1 year no death Rs. 250/- 2946 736500 

2 year no death Rs. 1000/- 2577 2577000 

Grand total 3313500/- 

Remarks 

/Justification 

Rs. 5 x 50% of total 

BSC i.e 250884 

Rs. 50 x 30% of the 

total positive i.e. 29146 





Rs. 250/- x 80% of total 

village i.e. 3682 

Rs. 250/- x 70% of total 

village i.e. 3682

Fund requirement as per Financial Guidelines of J.E. in Lohit District:- 

Particulars Actual amount Amount 

Required for the 

District 

Rs. 700/= per day for hiring of Vehicle 

per block for Vaccine logistic movement 

from Block PHC to Vaccination site 

Rs. 75/= per member per day during 

campaign 

Rs. 150/= per ASHA for mobilization of 

children for vaccination 

Rs. 75/= honorarium per day and TA of 

Rs. 100/= per day for Supervisor 

Rs. 3/= for printing of forms/ vaccination 

card and banner 

Rs. 4/= per poster (1 poster for 50 

household) 

Rs. 300/= per day for Miking for 3 days 

per Sub Centre area 

Rs. 50/= per participants in training 

materials, refreshment etc. (Vaccinators 

& Supervisors) 

18 S/C + 182 Anganwadis = 200 Nos. x Rs. 

700 x 2 days=Rs. 2,80,000/= 

200 members x 5 days = 1000 x Rs. 75= 

Rs. 75,000/= 

327 

Rs. 3,00,000/= 

Rs. 1,00,000/= 

182 ASHA x Rs.150= Rs. 27,3000/= Rs. 50,000/=) 

50 Centre x Rs.175 = Rs. 8750/= Rs. 10,000/= 

47,421 pop. x Rs. 3= Rs. 1,42,263 + 10% 

additional= Rs. 1,56,489/= 

Rs. 2,00,000/= 

Rs. 10,000/= Rs. 10,000/= 

200 Centre x Rs. 300 x 3 days=Rs. 

1,80,000/= 

Rs. 2,00,000/= 

1000 participants x Rs.50= Rs. 50,000/= Rs. 50,000/= 

Rs. 200/= honorarium per trainer Rs.200 x 2 trainers x 100 trainings=Rs. 

40,000/= 

Re. 1/= per team per day for Campaign 

days for additional Ice pack 

Rs. 50,000/= 

Rs. 10,000/= Rs. 10,000/= 

Rs. 6,97,539/= Rs. 9,80,000/= 

BRIEF NOTE ON JAPANESE ENCEPHALATIS IN ARUNACHAL PRADESH 

Japanese Encephalitis is occurring in some districts of the State especially in 

Changlang, Lohit and East Siang district. There are some dead cases also from Changlang district; the 

other two has only suspected cases. These districts are close border with Assam. There are no cases 

from the other districts. In Changlang district there are some death cases also which were confirmed by 

Hospitals in Assam. It is to mention here that the State has no Laboratory facility to confirm Japanese 

Encephalitis. The ‘AES’ in the State is in place but they are not fully activated. Special training is 

required on this matter for the vulnerable districts.

1. DBS : 

Expenditure (Financial Performance) – Budget Proposal 

2009-10 

(Expenditure) 

2010-11 

(Proposed) 

Malaria (Rs. In Lakhs) 

328 

Support to be met 

from 

NVBDCP/GOI or 

State resources or 

NRHM flexi fund 

a. Salary for contractual MPW (Male) 201.10 400.32 NVBDCP 

Remarks/Justification 

For existing 356 nos. of MPW and 

additional 200 nos. 

2. INCENTIVE TO ASHA 0.00 33.14 See Page-28 above 

3. Operational Expenses ( Please specify) 

i. Equipments & Materials 

Pricking needles 

Microslide 

Microscopes 

Stain – i & ii 

H. C. Pump 

Spare parts for HC pump 

Oil Immersion lenses (100x) 

46.52 

6.00 

7.00 

36.00 

6.00 

14.00 

8.00 

3.50 

NVBDCP 

Commodity Requirement , see at page-20 

above

Eye piece ( 5x, 10x) 

Microscope maintenance 

ii. Operational Expenses 

Salary of spray staff 

12 month contingency 

TA/DA for spray team 

POL 

Motor Vehicle (Repairing) 

Office expenses 

iii. TA/DA for state & Dist 

Regular/contractual staff 

117.90 

3.75 

5.00 

48.60 

24.30 

18.00 

10.00 

10.00 

17.00 

329 

NVBDCP 

12.01 25.00 NVBDCP 

For 360 nos. of FW during spray 

seasons.(72 Squads) 

For 75 nos of 12 months FW workers. 

Rs. 1 lack per dist. & Rs. 2 lac for state hqtr. 

(15 +2) 

There is still large no. of TA/DA bill are 

pending due to the non availability of fund 

in the districts. The hilly terrain and 

sparsely populated makes a very difficult for 

the field workers to do the job in time. Some 

places are there where foot march is the 

only source of means of communication. 

Due to this above region a huge amount of 

money is required as TA/DA for the field 

workers. So our proposed requirement in 

TA/DA head may be allotted for smooth 

functioning of malaria activities.

4. NAMMIS 6.75 10.00 NVBDCP 

5. Anti Malaria Drugs 

Chloroquine phosphate 250 mg tab 

Primaquine – 7.5 mg tab 

Primaquine – 2.5 mg tab 

Quinine tab 300 mg 

Quinine injection 

Paracetamol 500 mg tab 

6. IEC 

10.01 

i. News Paper Advert. 1.40 4.20 NVBDCP 

ii. Print Media 

Poster, Hoardings, Pamphlets, Sticker, 

Leaflet, guidelines, TV campaign, Radio etc at 

State as well as District level. 

7. Training 

8.00 

9.50 

5.00 

6.50 

6.00 

2.00 

8.68 59.00 NVBDCP 

330 

(AMC for computer & ISDN for state Hqtr. 

And 16 dist) 

Commodity Requirement , see at page-19 & 

20 above 

To enhance the dissemination as how to 

prevent and control malaria in the rural 

population through NGOs, ASHAs, Health 

Workers etc

i. MPW 4.00 3.20 NVBDCP 

ii. Spray workers 0.00 3.20 NVBDCP 

iii. Health Supervisor 0.00 3.20 NVBDCP 

iv. Health Worker 0.00 2.40 NVBDCP 

v. Spray team 0.00 2.40 NVBDCP 

vi. ASHA 0.00 9.60 NVBDCP 

8. Procurement of vehicle 0.00 25.00 NVBDCP 

9. Rental Charges of Store room 2.32 11.40 NVBDCP 

Sub Total of DBS 846.21 

331 

The proposed training is prepared & may 

see at page 21 above 

Due to the higher hiring rate and even non 

availability of taxi on hire the proposed 5 

nos. of vehicle may be approved. The other 

recurring expenditure of Driver and POL 

has been incurred from the state share. 5 

nos. of vehicle required are as follows. 

2 nos. for state Hqtr, 2 nos. of ZMO and 1 

no. for Entomological unit. Procurement of 

vehicle will be cheaper than that of hiring of 

vehicle in hill state like A.P 

For 16 district @ Rs. 5000/- PM x 12 

months and for State Hqtr. @ Rs. 15000/- 

PM x 12 month. Due to non availability of 

separate building for storing the Anti 

Malarial items it is propose to hire a room 

for storing purposes.

Human Resource (State level) :- 

� Project Coordinator 

� M &E/MIS Project Manager 

� Finance & Accounts Officer 

� BCC/PPP Managaer 

� Stastistical Asst../Accountant 

� Secretarial Asstt/Computer 

Operator 

� PSCM Manager 

Human Resource (District Level) 

� District VBD (Mal) 

� MTS 

� Secretarial Asstt. Cum Data 

Entry Operator 

� LT 

� Accountants 

- 

- 

5.51 

1.50 

1.00 

0.60 

0.00 

10.72 

GFATM (IMCP) 

6.00 

6.00 

3.00 

6.00 

1.80 

1.20 

3.00 

54.00 

81.00 

332 

NVBDCP 

As per the round IX approved by the Global 

fund. 5% annual increment may be given 

and approved for the contractual staff as per 

the other vertical programme. 


fund

Capacity Building 

6.60 

1.60 

18.00 

13.20 

1.80 

333 

The proposed training is prepared at above 

in Page-21 

Medical Officer 2.40 4.80 NVBDCP For 2 nos. batch training 

MTS 0.96 0.76 NVBDCP For 1 no. of batch (re-orientation) 

LTs 0.00 2.28 NVBDCP For 3 no. of batch (re-orientation) 

Establishment state society & District 

Society 

Monitoring & Evaluation : 

� Travel (State) 

� Review Meeting (State with 

Districts) 

� Quarterly Meeting at District 

level 

� Travel (Distrcts) 

� Hiring of Vehicle 

� MTS bike/POL money 

� TA/DA for state & 16 Dist 

� DA to MTS 

32.98 37.00 

14.78 

4.50 

2.26 

7.80 

4.00 

15.00 

36.00 

19.50 

NVBDCP 5 lakhs for state and 2 lakhs for district 

societies including printing of M&E format 

NVBDCP 


fund. 

The proposed hiring rate is meant for the 

entire district for monitoring @ Rs. 1.30 per 

dist per annum. If the procurement of 

proposed 2 nos. vehicle for state head qtr. is 

not approved than an additional amount of 

Rs. 5.00 lac may be approved for SPO & M 

&E consultant to compensate for the hiring.

5.10 

1.80 

4.50 

21.90 

Additional Motor bike for MTS 0.00 15.00 NVBDCP 

5.40 

POL money for 30 MTS bikes 0.00 9.00 

Planning & Administration for state 17.98 

Planning & Administration for 

District 

BCC/IEC activities (Miking, 

infortainment, wall writing dubbing 

IPC session, Group meeting etc) 

61.35 

67.50 

IEC/PPP/Soc. Mkt 9.78 71.00 NVBDCP 

IEC( camps for treatment of bednets) 0.00 10.00 NVBDCP 

Operational cost for treatment of 

0.00 20.00 NVBDCP 

334 

30 nos. of Motor bike is required to procure 

@ Rs. 50000/- each for the additional MTS 

MTS pol money @ Rs. 2500/- PM for 

additional 30 nos.x 12 mth 


fund 


fund 


fund 

It includes Advocacy workshop, intersect 

oral meeting at state level, dist level, PHC, 

SC and village level, awareness campaign, 

PPP scheme & Larvivours fish. 

For awareness during distribution of 

bednets 

To impregnate the 200000 nos. bednet @

ednets Rs. 10/- per bednet 

Sub Total of GFATM (IMCP) 625.77 

Fogging Machine 0.00 6.00 NVBDCP 

Elisa Kits 0.00 10.00 NVBDCP 

IEC Materials 0.00 5.00 NVBDCP 

Training 0.00 10.00 NVBDCP 

Technical Malathion 0.00 5.00 NVBDCP 

For vaccination of Lohit District 9.80 

For vaccination of Changlang District 9.80 

Sub Total of JE 0.00 55.60 

Grand Total of Malaria + GFATM 

(IMCP) + JE 

JE 

1527.58 

NRHM Additionalilities 

LTs 78.00 NRHM 

335 

Fund requirement as per Financial 

Guidelines: may seen at page-29 above 

The proposed additional 65 nos. of LTs is 

required to fill up the gap in prioritized 

PHC 

AMO 0.00 14.40 NRHM Out of 15 dist only 9 dist are having AMO in 

position. 6 nos. of contractual AMO is

Procurement of bednets 0.00 180.58 NRHM 

Sub Total of NRHM Additionalities 272.98 

Grand Total of Malaria + GFATM 

(IMCP) + JE+ NRHM Additionalities 

1800.56 

Outstanding balance as 01/01/2010 - Rs. 22.01 

Committed expenditure (till March’2010) - Rs. 228.52 

Balance expected as 01.04.2010 - Rs. 2.00 

336 

required to fill up on contractual basis @ 

Rs. 20000/- Pm 

For procurement of LLIN in the coming 

year.

1. REVISED NATIONAL TUBERCLOSIS CONTROL PROGRAMME Annual Plan for 

Programme Performance & Budget for the year 

Objectives: 

1 st April 2010 to 31 st March 2011 

State: ARUNACHAL PRADESH 

1. To achieve and maintain a cure rate of at least 85% among newly detected infectious (New 

sputum smear positive) cases, and 

2. To achieve and maintain detection of at least 70% of such cases in the population 

This action plan and budget have been approved by the STCS. 

Signature of the STO 

Name: Dr. B. Tada, DDHS (TB) cum STO 

Section-A – General Information about the State 

1 State Population (in lakh) please give projected population for next year 12 Lakh 

2 Number of districts in the State 16 

3 Urban population 3 Lakh 

4 Tribal population All are hilly population 

5 Hilly population All are hilly population 

6 Any other known groups of special population for specific interventions 

(e.g. nomadic, migrant, industrial workers, urban slums, etc.) 

(These population statistics may be obtained from Census data /State Statistical Dept. / District 

plans) 

No. of districts without DTC: 3 (three) namely:- Upper Dibang Valley, Anjaw & Kurung Kumey 

No. of districts that submitted annual action plans, which have been consolidated in this state plan: 

13 

Organization of services in the state: 

Please indicate 

number of TUs of Please indicate no. of DMCs of 

Projected each type 

each type in the district 

Name of the Population 

Public 

Private 

S. No. District (in Lakhs) Govt NGO Sector* NGO Sector^ 

1 DTC Bomdila, 

W/Kameng 0.82 1 3 

2 DTC Tawang, 

Tawang dist. 0.39 1 2 1 

3 DTC Seppa, 

E/Kameng 0.63 1 1 

Nil 

337

4 DTC Ziro, L / 

Subansiri 1.07 1 2 

5 Kurung 

Kumey 1 

6 DTC Naharlagun, 

P/Pare 1.33 1 2 1 

7 DTC Daporijo U/ 

Subansiri 0.61 1 1 

8 DTC Along, W/ 

Siang 1.13 1 4 

9 DTC Pasighat, 

E/Siang 0.96 1 3 

10 DTC Yingkiong, 

U/Siang 0.37 1 2 

11 DTC Tezu, Lohit 1.58 1 2 

12 Anjaw 1 

13 DTC Roing, D/ 

Valley 0.64 1 1 

14 L/Dibang Valley 1 

15 DTC Deomali, 

Tirap 1.1 1 3 

16 DTC Changlang, 

Changlang 1.37 1 3 

Total 12 13 32 2 

*Public Sector includes Medical Colleges, Govt. health department, other Govt. department and 

PSUs i.e. as defined in PMR report^ Similarly, Private Sector includes Private Medical College, 

Private Practitioners, Private Clinics/Nursing Homes and Corporate sector 

RNTCP performance indicators: 

Important: Please give the performance for the last 4 quarters i.e. Oct 2008 to Sept 2009 

338

Name of the 

District (also 

indicate if it 

is notified 

hilly or tribal 

district 

Total 

number of 

patients put 

on 

treatment* 

Annualised 

total case 

detection 

rate 

(per lakh 

pop.) 

No of new 

smear 

positive 

cases put 

on 

treatment 

* 

Annualised 

New smear 

positive case 

detection 

rate (per 

lakh pop) 

Cure rate for 

cases detected 

in the last 4 

corresponding 

quarters 

Plan for the next year 

Annualized 

NSP case 

detection 

rate 

Cure 

rate 

Proportion 

of TB 

patients 

tested for 

HIV 

No. of 

MDR TB 

suspects 

identified 

and 

subjects to 

C/DST of 

sputum 

DTC 

Bomdila, 

126 154/Lakh 54 66/Lakh 95% 75 < 85% 0 1 0 

DTC 

Tawang, 

96 253/Lakh 37 97/Lakh 95% 75 < 85% 0 0 0 

DTC 

Seppa, 

153 243/Lakh 32 51/Lakh 64% 75 < 85% 0 0 0 

DTC 

Naharlagun 

629 469/Lakh 143 106/Lakh 92% 75 < 85% 0 3 0 

DTC Ziro, 143 134/Lakh 48 45/Lakh 77% 75 < 85% 0 3 0 

DTC 

Daporijo 

94 157/Lakh 42 70/Lakh 83% 75 < 85% 9% 0 0 

DTC 

Along 

141 124/Lakh 62 54/Lakh 87% 75 < 85% 0 0 0 

DTC 

Pasighat 

254 265/Lakh 83 86/Lakh 93% 75 < 85% 0 4 0 

DTC 

Yingkiong 

42 117/Lakh 21 58/Lakh 77% 75 < 85% 0% 0 0 

DTC Tezu 280 177/Lakh 122 77/Lakh 86% 75 < 85% 0 1 0 

DTC 

Roing 

124 197/Lakh 54 86/Lakh 95% 75 < 85% 0 0 0 

DTC 

Deomali 

169 154/Lakh 76 69/Lakh 61% 75 < 85% 0 0 0 

DTC 

Changlang 

163 119/Lakh 75 55/Lakh 76% 75 < 85% 0 0 0 

Total 2414 201/lakh 849 71/lakh 86% 75 < 85% 9% 12 0 

No. of 

MDR TB 

cases 

diagnosed 

& put on 

treatment 

339

* Patients put on treatment under DOTS regimens only are to be included. 

Section B – List Priority areas at the State level for achieving the objectives planned: 

S.No. Priority areas Activity planned under each priority area 

1 Training 

1 a) Training of Medical Officers 

1 b) Re-training of STS, STLS & LTs 

1 c) Training of Community Volunteers 

2 Lab. Material 2 a) Purchases of IRL Equipment 

2 b) Purchases of LAB materials 

3 IEC / Publicity 3 a) Awareness Generation Meeting 

3 b) Media Activities. 

4 Procurement of 4 wheeler & 2 

wheelers 

3 c) Placement of Hoarding in prominent places. 

4 a) Replacement of 4 wheeler 5 nos & 2 wheeler, 

13 Nos. 

Priority Districts for Supervision and Monitoring by State during the next year 

S No 

District Reason for inclusion in priority list 

1. All the District of Arunachal 

Pradesh 

For better supervision and better result, STO want to 

visit the entire district 2 times in a year. 

Section C – Consolidated Plan for Performance and Expenditure under each head, including 

estimates submitted by all districts, and the requirements at the State Level 

1. Civil Works 

Activity No. 

required 

as per 

the 

norms 

in the 

state 

No. 

already 

upgraded/ 

present in 

the state 

No. 

planned 

to be 

upgraded 

during 

next 

financial 

year 

Pl provide 

justification if an 

increase is 

planned in 

excess of norms 

(use separate 

sheet if required) 

Estimated 

Expenditure 

on the 

activity 

(a) (b) (c) (d) (e) (f) 

STDC/ 1 Justification 7, 

IRL 

Enclosed 05,000.00 

SDS 1 

DOTS 2 2 20, 

Plus Site 

00,000.00 

DTCs 16 13 3 12, 

58,500.00 

TUs 17 13 4 1, 

56,900.00, 

DMCs 35 34 1 

64,000.00 

TOTAL 41, 

84,400.00 

Quarter 

in which 

the 

planned 

activity 

expected 

to be 

completed 

340

2. Laboratory Materials 

3. Honorarium 

Activity Amount 

permissible as 

per the norms 

in the state 

Purchase of Lab 

Materials by Districts 

Lab materials for EQA 

activity at STDC (eg. 

Lab consumables for 

trainings, preparation 

of Panel slides etc) 

Lab materials & 

consumables for 

Culture/DST activity 

at IRL and other 

Accredited Culture & 

DST labs in Govt. 

sector including 

Medical Colleges IRL 

Equipment 

1.5lac/million 

district 

Amount 

actually 

spent in 

the last 4 

quarters 

Procurement 

planned 

during the 

current 

financial 

year (in 

Rupees) 

Estimated 

Expenditure for the 

next financial year 

for which plan is 

being submitted 

(Rs.) 

Justification/ 

Remarks for (d) 

669220.00 400000.00 12,00,000.00 Enclosed 

justification 

40,00,00.00 Enclosed 

justification 

10,00,000.00 

40,00,000.00 

Total 66, 00,000.00 

Enclosed 

justification 

For IRL cold 

room, incubator 

and silence 

generator, fund 

under 

additionalities 

from NRHM 

was sought but 

not given so far 

IRL has to be 

made 

operational 

with these 

equipment. 

341


permissible 

as per the 

norms in 

the state 

Honorarium for 

DOT providers (both 

tribal and non tribal 

districts) 

Honorarium for 

DOT providers of 

Cat IV patients 

Community 

volunteers in all the 

districts* 

Amount 

actually 

spent in the 

last 4 

quarters 

Expenditure 

(in Rs) 

planned for 

current 

financial 

year 

Estimated 

Expenditure for 

the next 


for which plan 

is being 

submitted (Rs.) 


Remarks for 

(d) 

(a) (b) (c) (d) (e) 

1. Rs. 250/- 

DOT 

Providers 

2. Rs. 250/- 

Treatment 

Completed 

Patients. 

No. presently involved in 

RNTCP 

459950.00 500000.00 10,00,000.00 

Total 10,00,0000.00 

Additional enrolment proposed for the next 

fin. Year 

2200 300 

* These community volunteers are other than salaried employees of Central/State government and 

are involved in provision of DOT e.g. Anganwadi workers, trained dais, village health guides, ASHA, 

other volunteers, etc. 

Annual Action Plan Format Advocacy, Communication and Social Mobilization (ACSM) for 

RNTCP 

1) Information on previous year’s Annual Action Plan 

a) Budget proposed in last Annual Action Plan: Rs. 30,90,000.00 

b) Amount released by the state: Rs. 10,55,000.00 

c) Amount Spent by the state- Rs. 7,28,434.00 

d) Permissible budget as per norm: Rs. 5,00,000.00 

e) Budget for next financial year for the district as per action plan detailed below: 15,50,000 + 

14,80,000 = 30,30,000.00 

342

Program 

Challenges to 

be tackled by 

ACSM during 

the Year 

20010-11 

Based on 

existing TB 

indicators and 

analysis of 

communication 

challenges 

(Maximum 3 

Challenges ) 

WHY 

ACSM 

Objective 

Desired 

behavior or 

action (make 

SMART: 

specific, 

measurable, 

achievable, 

realistic & 

time bound 

objectives) 

For WHOM 

Target 

Audience 

Challenge 1. To increase case detection rate 

Advocacy Activities 

To increase 

case detection 

rate 

To gain 

administrative 

support from 

district 

authorities for 

increased 

referral from 

OPD 

District 

magistrate/DHS 

Health and 

other deptt. 

Administrators 

Pvt. Health 

care providers 

WHAT 

ACSM Activities 

Activities Media/ 

One to one 

meeting 

Sensitization 

meeting 

Material 

Required 

Audio Visual 

Aids, 

Publications 

(PPT), 

Factsheets, 

posters, 

booklets/brochu 

res 

When 

Time Frame 

By WHOM 

Q1 Q2 Q3 Q4 Key 

implementer 

and RNTCP 

officer 

responsible 


supervision 

Monitoring and 

Evaluation 

Outputs; 

Evidence 

that the 

activities 

have been 

done 

Outcomes: 

Evidence 

that it has 

been 

effective 

Budget 

Total 

expenditure 

for the 

activity 

during the 

financial 

year 

• 1 State Meeting Increase 50,000.00 

programe minute, referral of 

• 1 

managers photographs 

, Reports, 

chest 

symptomat 20,000.00 

Review ic, 

1 1 

STO, MOTC 

( with 

support 

meeting by 

the 

authorities. 

program 

data 

1,50,000.00 

343

Communication Activities 

To increase 


rate 

To inform 

communities 

and care 

providres 

about the 

DOT services 

for early 

detection 

Awareness 

generation in 

general 

public 

General public 

Schools, 

Religious 

bodies, care 

providers, 

NGOs. 

Briefing 

meetings 

Observation of 

World TB Day 

day 

Use of 

regional/lcabl 

e channels 

Printing/reprinting 

of 

information 

booklets, 

brochures, 

posters 

Booklets, 

Flipcharts, 

posters, 

Banners, 

1 

1 

50 

00 

1 

1 

50 

00 

1 

1 1 

500 

0 

from WHO 

consultant) 

State 

program 

manager 

General public Wall paintings 1 1 1 1 STO, 

MOTC, IEC 

Offcr. 

Developed 

IPC 

materials, 

photographs 

, Stock 

register 

Visible wall 

paintings 

Hoardings 2 2 2 2 Do Visible 

hoardings 

Newspaper/ 

magazine 

advertisement 

Write-ups, 

Letters to 

Newspaper 

1 1 1 1 Do Newspaper 

clippings, 

copy of 

Increase 

self 

reporting/ 

referral 

Analysis 

of data 

KAP study 

after a 

year know 

the 

awareness 

level of 

general 

public 

2,00,000.00 

3,00,000.00 

20,000.00 

80,000.00 

60,000.00 

344

Social Mobilization activities 

To increase 


rate 

To generate 

awareness in 

general 

public 

Encourage 

early self 

reporting/refe 

rral 

To advocate 

community 

participation 

Community, 

Care providers 

Patients and 

their family, 

neighbours, 

suspected 

patients 

Challenge 2: To reduce high default rate 


To reduce high 

default rate 

To sensitize 

authorities 

about the 

urgency to 

reduce default 

PRI members, 

Religious 

groups, schools, 

NGOs, 

Health care 

providers(publi 

c and private) 

Community 

meetings 

Sensitization 

meetings 

Sensitization 

meetings 

Interaction 

meetings/semi 

nars 

Distribution of 

editors magazines 

Posters, 

banners, 


booklets 

Display 

materials, 


materials 

Display and 


materials 

Audio-visual 

Aids-posters, 

Factsheets, 


brochure 

1 1 STO, 

MOTC, IEC 

Offcr 

1 

1 

1 

1 

1 

1 1 

1 

1 

1 

STO, 

MOTC, IEC 

Offcr 

STO, 

MOTC, IEC 

Offcr 

STO,MOTC, 

IEC Offcr, 

Minutes of 

meetings, 

photographs 

Minutes of 

meetings, 

photographs 

Minutes of 

meetings, 

photographs 

Meeting 

records, 

Review of 

default 

cases 

Increase 

self 

reporting 

in chest 

symptomat 

ic 

Do 

Do 

Reduction 

of default 

rate by 

2%-data 

analysis 

1,50,000.00 

50,000.00 

50,000.00 

2,00,000.00 

345



default rate 

Social Mobilization 


default rate 

cases information 

materials 

To motivate 

patients and 

their families 


completion of 

treatment 

For 

mobilizing 

support from 

community 

and to ensure 

thei 

participants 

Patients, their 

families, DOT 

providers, 

NGOs 

Community 

support groups- 

NGOs, SHGS, 

Religious 

groups and 

other like 

minded groups 

Publication of 

program 

Factsheets/Ne 

wsleters 

Patient 

provider 

inreaction 

meetings 

Interaction 

meetings 

Patient provider 


booklets 

Posters, 


materials, 

30 

00 

1 

1 

30 

00 

1 

1 

STO, 

MOTC, IEC 

Offcr 

STO, 

MOTC, IEC 

Offcr, DOT 

provider 

1 1 STO, 

MOTC, IEC 

Offcr, NGO 

district wise 

Minutes of 

the meetings 

photographs 

Minutes of 

the meetings, 

photographs 

Reduction 

in time for 

retrieval 

of defaults 

Do 

Data of cure 

rate will 

increase 

20,000.00 

2,00,000.00 

346

Challenge 3:- 

Advocacy activities 

Communication activities 

Social Mobilization Activities 

4. Equipment Maintenance: 

m No. 

actually 

present 

in the 

state 

mputer (maintenance includes AMC, software and hardware upgrades, 

inter Cartridges and Internet expenses) 

Amount 

actually 

spent in the 

last 4 

quarters 

Amount Proposed 

for Maintenance 

during current 

financial yr. 

TOTAL BUDGET 15,50,000.00 

Estimated Expenditure for the next 

financial year for which plan is 

being submitted 

(Rs.) 

15 2,86,858.00 2,50,000.00 4,20,000.00 

nocular Microscopes (RNTCP) 48 72,000.00 

DC/ IRL Equipment 

y Other (pl. specify) 

5. Training: 

Activity No. in 

the 

state 

TOTAL 4, 92,000.00 

No. 

already 

trained 

No. planned to be trained in 

RNTCP during each quarter of 

next FY (c) 

Expenditure 

(in Rs) 


Estimated 

Expenditure 

for the next 


remarks 

Justification/ Remarks for 

(d) 

347

in 

current financial year 

RNTCP 

financial year (Rs.) 

(a) (b) Q1 Q2 Q3 Q4 (d) (e) (f) 

Training of DTOs (at National 

level) 

Training of MO-TCs 

13 13 

Training of MOs (Govt + Non- 

Expenditure 

Govt) 

Training of LTs of DMCs- Govt + 

Non Govt 

472 270 2 2 2 1, 00,000.00 4, 50,000.00 included TA/DA 

Training of MPWs 

Training of MPHS, pharmacists, 

nursing staff, BEO etc 

184 125 1 1 1 0 45,000.00 

Training of Community Volunteers 

Expenditure 

Training of Pvt Practitioners 

Other trainings # 

700 150 0 3 3 3 50,000.00 3, 00,000.00 included TA/DA 

Re- training of MOs 

270 2 2 2 2 70,000.00 4, 00,000.00 

Re- Training of LTs of DMCs 

Re- Training of MPWs 

Re- Training of MPHS, 

pharmacists, nursing staff, BEO 

Re- Training of CVs 

Re-training of Pvt Practitioners 

34 34 1 1 80,000.00 

Training at Dist. 

& State level 

348

Activity No. in 

the 

state 

No. 

already 

trained in 

RNTCP 

No. Planned to be 

trained in RNTCP 

during each quarter of 

next FY (c) 

Expenditure 

(in Rs) 


current 

financial 

year 

Estimated 

Expenditure 

for the next 

financial 

year 

(Rs.) 

Q1 Q2 Q3 Q4 

TB/HIV Training of MO-TCs and MOs 472 80 1 1 1 1, 50,000.00 

TB/HIV Training of STLS, LTs , MPWs, 

MPHS, Nursing Staff, Community 

Volunteers etc 

TB/HIV Training of STS 

800 150 1 1 1 1 2, 40,000.00 

Training of MOs and Para medicals in 

DOTS Plus for management of MDR TB 

Provision for Update Training at Various 

Levels # 

Review Meetings at State Level 

Any Other Training Activity 

1 

1 

1 

1 

2,00,000.00 

TOTAL 18, 

65,000.00 


remarks 

349

7. Vehicle Maintenance: 

Type of Vehicle Number 


per the norms 

in the state 

Number 

actually 

present 

Amount spent on 

POL and 

Maintenance in the 

previous 4 quarters 

Expenditure (in Rs) 

planned for current 


Estimated Expenditure for the 

next financial year for which 

plan is being submitted 

(a) (b) (c) (d) (e) (f) 

Four Wheelers 17 14 15,83,799.00 10,00,000.00 18, 25,000.00 

Two Wheelers 16 13 3,14,492.00 2,50,000.00 3, 90,000.00 

8. Vehicle Hiring*: 

Hiring of Four 

Wheeler 

Number 

permissible as per 

the norms in the 

state 

Number actually 

requiring hired 

vehicles 

Amount spent 

in the prev. 4 

qtrs 




(Rs.) 

TOTAL 22, 15,000.00 



plan is being submitted (Rs.) 

For STC/ STDC 1 1 0 50,000.00 1, 00,000.00 

For DTO 

For MO-TC 16 13 92, 82,200 

TOTAL 10, 28,200.00 

Justification/ remarks 


remarks 

* Vehicle Hiring permissible only where RNTCP vehicles have not been provided 

350

9. NGO/ PP Support: 

Activity No. of 

currently 

involved in 

RNTCP 

ACSM Scheme: TB advocacy, communication, and 

social mobilization 

Additional 

enrolment 

planned for this 

year 

Amount spent in 

the previous 4 

quarters 




Estimated Expenditure for 

the next financial year for 

which plan is being 


15 7 6, 30,000.00 9, 24,000.00 

SC Scheme: Sputum Collection Centre/s 6 5 3, 60,000.00 6, 60,000.00 

Transport Scheme: Sputum Pick-Up and Transport 

Service 

DMC Scheme: Designated Microscopy Cum 

Treatment Centre (A & B) 

LT Scheme: Strengthening RNTCP diagnostic 

services 

Culture and DST Scheme: Providing Quality 

Assured Culture and Drug Susceptibility Testing 

Services 

Adherence scheme: Promoting treatment 

adherence 

Slum Scheme: Improving TB control in Urban 

Slums 

3 20 72,000.00 5, 52,000.00 

1 3 1, 50,000.00 6, 00,000.00 

3 3 1, 20,000.00 2, 40,000.00 

6 6, 50,000.00 

351

Tuberculosis Unit Model 

TB-HIV Scheme: Delivering TB-HIV interventions 

to high HIV Risk groups (HRGs) 

NGO/ PP Support: (New schemes w.e.f. 01-10-2008) 

10. Miscellaneous: 

Activity* 

e.g. TA/DA, 

Stationary, etc 

TA/ DA for STCS 

,DTCS,IRL/STDC and 

other staff working for 

RNTCP. 

Office Stationary 

Telephone / fax bill 

Other office expn. Of 

DTCS & STCS 

11. Contractual Services: 

Amount 


per the norms 

in the state 

Amount spent in the 





Estimated Expenditure 

for the next financial 

year 

(Rs.) 

27, 23,743.00 15, 00,000.00 70, 00,000.00 

TOTAL 70, 00,000.00 

TOTAL 36, 26,000.00 


352

Category of Staff No. 

permissible 

as per the 

norms in the 

state 

TB/HIV Coord. 

Urban TB Coord. 

No. actually 

present in the 

state 

No. planned 

to be 

additionally 

hired during 

this year 

Amount spent in 

the previous 4 

quarters 



fin. year 

Estimated Expenditure 

for the next financial 

year 

MO-STCS 1 - 1 2, 12,580.00 1, 80,000.00 3, 69,000.00 

State Accountant 1 1 2, 07,000.00 1, 08,000.00 2, 26,800.00 

State IEC Officer 1 1 2, 02,500.00 1, 08,000.00 2, 26,800.00 

Pharmacist 1 - 1 - 1, 44,000.00 

Secretarial Asst 1 1 90,300.00 51,000.00 1, 07,100.00 

MO-DTC 3 3 10, 08,000.00 

STS 17 13 4 14, 85,750.00 10, 14,000.00 27, 45,600.00 

STLS 17 13 4 14, 85,750.00 10, 14,000.00 27, 45,600.00 

TBHV 

DEO (including DEO at 18 14 4 13, 37,700.00 7, 23,000.00 19, 44,300.00 

(Rs.) 


remarks 

353

IRL) 

Accountant – part time 16 13 3 3, 54,600.00 2, 34,000.00 5, 99,400.00 

Contractual LT 8 7 7 7, 11,900.00 3, 99,000.00 20, 99,975.00 

Driver 17 12 7, 45,200.00 5, 04,000.00 10, 58,400.00 

Asst Programme 

Officer/Epidemiologist 

DOTS Plus Site Sr. Medical 

Officer 

DOTS Plus site Statistical 

Assistant 

Sr. DOTS Plus& TB/HIV 

Supervisor (district level) 

12. Printing: 

1 1 4, 80,000.00 

2 2 7, 20,000.00 

2 2 3, 60,000.00 

Sr. LT at IRL 1 1 1, 92,000.00 

Store Assistant (State Drug 

Store) 

Any other contractual post 

approved under RNTCP 

1 1 96,000.00 

TOTAL 1, 51, 22,975.00 

354


permissible as per 

the norms in the 

state 

Printing-State level:* 

Printing- Distt. Level:* 

1.5lakh/ Million 

population 

Amount spent in the 


13. Research and Studies (excluding OR in Medical Colleges): 

14. Medical Colleges 

15. Procurement of Vehicles: 





next financial year for which plan 

is being submitted 

(Rs.) 


remarks 

(a) (b) (c) (d) (e) 

19,79,636.00 10,00,000.00 25,00,000.00 

Total 25, 00,000.00 

355

Equipment No. actually 

present in the state 

No. planned for 

procurement this year 

(only if permissible as 

per norms) 

Estimated Expenditure for the next 

financial year for which plan is being 



4-wheeler ** 14 5 21, 00,000.00 Replacement of 5 Nos Vehicles which 

is more than 8 years old. 

2-wheeler 13 17 8, 50,000.00 Replacement of 13 Nos Two Wheeler 

which is more than 7 years and 4 

Nos for Proposed TUs 

16. Procurement of Equipment: 

Equipment No. actually present 

in the state 

Office Equipment (Computer, 

modem, scanner, printer, UPS etc.) 

Photocopier 

Machine 

No. planned for 

this year (only 

as per norms) 

Total 29, 50,000.00 



plan is being submitted (Rs.) 


14 3 1, 80,000.00 For Proposed DTC 

15 6 6, 60,000.00 Replacement of 3 Nos. Photocopier 

Machine. Which has already covered 

more than 8 year, un-repairable due to 

non arability of parts in the local 

Market. And 3 nos for Proposed DTCs 

Total 8,40,000.00 

356

Section D: Summary of proposed budget for the state – 

Category of Expenditure Budget estimate for the coming FY 2010 

- 2011 

(To be based on the planned activities 

and expenditure in Section C) 

1. Civil works 41,84,400.00 

2. Laboratory materials 66,00,000.00 

3. Honorarium 10,00,000.00 

4. IEC/ Publicity 30,30,000.00 

5. Equipment maintenance 4,92,000.00 

6. Training 18,65,000.00 

7. Vehicle maintenance 22,15,000.00 

8. Vehicle hiring 10,28,200.00 

9. NGO/PP support 36,26,000.00 

10. Miscellaneous 70,00,000,00 

11. Contractual services 1,51,22,975.00 

12. Printing 25,00,000.00 

13. Research and studies 

14. Medical Colleges 

15. Procurement –vehicles 29,50,000.00 

16. Procurement – equipment 8,40,000.00 

Total 5,24,53,575.00 

Annual Action Plan Format Advocacy, Communication and Social Mobilization (ACSM) for 

RNTCP 

2) Information on previous year’s Annual Action Plan 

a) Budget proposed in last Annual Action Plan: Rs. 19,96,000.00 

b) Amount released by the state: Rs. 3,55,000.00 

c) Amount Spent by the district- Rs. 1,45,015.00 

3) Permissible budget as per norm : Rs. 75,000.00 per district 

4) Budget for next financial year for the district as per action plan detailed below: Rs. 14,80,000.00 

357

Program 

Challenges to 

be tackled by 

ACSM during 

the Year 

20010-11 

Based on 

existing TB 

indicators and 

analysis of 

communication 

challenges 

(Maximum 3 

Challenges ) 

WHY 

ACSM 

Objective 

Desired 

behavior or 

action (make 

SMART: 

specific, 

measurable, 

achievable, 

realistic & 

time bound 

objectives) 

For 

WHOM 

Target 

Audience 

Challenge 1. To increase case detection rate 


To increase 


rate 

To gain 

administrative 

support from 

district 

authorities for 

increase case 

District 

magistrate 

WHAT 

ACSM Activities 

Activities Media/ 

One to one 

meeting 

Material 

Required 

Publications- 

PPT, Audio 

visual aid, 

Booklets, 

brochures, 

When 

Time Frame 

By WHOM 

Q1 Q2 Q3 Q4 Key 

implementer 

and RNTCP 

officer 

responsible 


supervision 

13 13 DTO, MO- 

TC 

Monitoring and 

Evaluation 

Outputs; 

Evidence 

that the 

activities 

have been 

done 

Documenta 

tion of the 

meetings, 

photograph 

s 

Outcomes 

: 

Evidence 

that it 

has been 

effective 

Increase 

in chest 

symptoma 

tic cases 

Budget 

Total 

expenditure 

for the 

activity 

during the 

financial 

year 

Provided by 

state 

358

eferral from 

OPD. 


To increase 


rate 

To inform 

communities 

and care 

providers 

about DOT 

services 

Health and 

other deptt. 

administrat 

ors 

Private 

health care 

providers 

General 

public 

School, 

religious 

bodies 

Sensitization 

meetings 

Sensitization/bri 

efing meetings 

Wall painting 

Hoarding 

Newspaper 

advertisement 

Radio talk 

TV show 

Factsheets 13 13 260000.00 

13 13 150000.00 

13 

13 

13 

13 

13 

13 

13 

13 

13 

13 

13 

13 

13 

13 

DTO, MO 

TC, MOs of 

PHIs 

Visible 

wall 

painting 

, 

hoardin 

gs in 

PHCs, 

CHCs, 

and 

other 

promine 

nt 

places 

News 

paper 

clipping 

s 

130000.00 

160000.00 

130000.00 

0 

0 

359

Social Mobilization activities 

To increase 


rate 

To generate 

awareness in 

general public 

To encourage 

self reporting 

To ensure 

community 

participation 

Community 

, general 

public, 

DOT 

providers 

Challenge 2:To reduce high default rate 



default rate 

To sensitize 

district 

authorities 

about the 

importance of 

reducing 

default cases 

To gain 

necessary 

Community 

meetings 

World TB day 

celebration 

School /college 

activities(quiz/p 

ainting/essay 

competitions) 

Interaction 

meetings 

Sensitization 

meetings 

Posters, IEC 

materials 

Banners, 

posters, 


brochures, 

pamphlets, 

IEC 

materials 

IEC 

material, 

Data of the 

program 

13 13 DTO, MO 

TC, MOs of 

PHIs 

13 DTO, MO 

TC 

13 

13 13 DTO, 

MOTC, 

MOs of 

PHIs 

13 

DTO, MO 

TC 

Minutes of 

the meetings, 

photographs 

Documentati 

on of the 

event 

Provided by 

state 

650000.00 

photographs Provided by 

state 

Records of 

the meetings 

Provided by 

state 

360

support 



default rate 

Social Mobilization 

To motivate 

patients and 

their families 


completion of 

treatment 

Patients 

Their 

families 

DOT 

providers 

Patient provider 

meetings 

Radio talk 

TV show 

Re-printing of 


booklets 

Printing of 

posters 

IEC 

materials, 

posters, 

Cured TB 

patient 

13 

13 

13 13 DTO, MO 

TC, DOT 

providers 

30000 

13 

260 

00 

13 

DTO MO 

TC 

Record of the 

checklists of 

the meeting 

Reductio 

n in 

default 

rate by 

2%- 

Analysis 

of 

program 

data 

Provided by 

state 

Provided by 

state 

To reduce high For Community Community Posters, 13 13 Provided by 

361

default rate mobilizing 

support from 

community 

groups 

Challenge 3 

Advocacy activities 

Communication activities 

Social Mobilization Activities 

support 

groups- 

NGOs, 

SHGs, 

Religious 

bodies, 

local 

organisatio 

ns 

Cured 

patients 

meetings information 

materials 

state 

TOTAL BUDGET 1480000.00 

362

1. Civil Work, 

Justification 

i) Proposed 2 Nos of DOT plus Site (1) Arunachal State Hospital, Naharlagun 

(2) General Hospital Pasigahat 

ii) Up gradation of SDS and District Drugs Store for 2 nd line Drugs. 

i) Proposed DTC in newly created District (i) Anjaw, Kurung Kumey, Dibang Valley 

ii) Proposed TU in newly created district. (i) Anjaw, Kurung Kumey, Dibang Valley and 

Namsai under DTC Tezu. 

iv) Proposed DMC at Diyum under DTC Changlang 

2. Lab. Material 

Lab. Material for IRL/STDC will need to conduct training for LTs, STLS and DTOs of the 

state EQA on sputum microscopy as on when required in addition to the OSE (On Site Evaluation) at 

DTCs every month by IRL team. The IRL/STDC will therefore require to procure reagent for ZN 

staining and Panel slide preparation from supplier based outside the state leading to cost increase 

and increased transportation charges. 

3. Miscellaneous, 

Misc. expenditure involved the TA/DA of the officers and staff of includes staff of IRL, 

Telephone Bill, fax bill, office stationeries contingency expenditure like transportation of drugs from 

GMSD Guwahati to SDS and from SDS to Districts on amount of hiring transporter cost and contigen 

expenditure in this hilly state the Misc. Expenditure is much higher. 

4. Printing: Printing of modules for MO, STS, and STLS etc and forms, Treatment Card, I/ Card 

etc are required to be prints. 

5. Contractual services 

1. Appointment of 3 nos. of STS and STLS for 3 proposed TU. 

2. Appointment of 4 No. of LTs for IRL 

3. Appointment of 4. No. of lab Assit. for IRL 

4. Appointment of DEO for IRL 

6. Procurement of vehicle. 5 Nos. of 4- wheeler is to be replace as this vehicles are over 8 years 

old and maintenance cost is very high which create problems during supervision as such this vehicles 

may be replace. 13 Nos. of two wheelers is also to be replacing as this 2- wheeler is also more than 7 

year old and not in a condition to run in this hilly State. And 4 Nos of 2- Wheeler for Proposed TUs. 

7. Procurement of Equipment 

3 nos. of photocopier machine is to be replace as the machine are 8 year old and the spare 

part are not available in local the market.

3. NATIONAL LEPROSY ERADICATION PROGRAMME 

(A) Hansen’s Disease Sanatorium : 04 (Four)Nos. 

(a) Tawang : 19 Patient 

(b) Aalo : 14 Patient 

(c) Pasighat : 10 Patient 

(d) Khonsa : 06 Patient 

Total : 49 Patient 

(B) Ayurvedic Dispensary : 04 Nos. 

(C) Homeopathic Dispensary : 37 Nos. 

(D) Manpower Position : (GHC) 

E) Man Power Position (NLEP) : 

• State Leprosy Society : 

(i) Doctors : 464 Nos. 

(ii) Nurses : 158 Nos. 

(iii) Mid Wives : 418 Nos. 

(iv) No. of ASHA : 3,554 Nos. 

(v) PRI Members : 8,260 Nos. 

Sl. No. Designation Regular Staff Contractual Staff 

1. State Leprosy Officer 01 - 

2. AUO (Lep.) 01 - 

3. Sr. Para Medical Supervisor 01 - 

4. Statt. Asstt 01 - 

5. Sr. Para Medical Worker 01 - 

6. Sr. Health Educator 01 - 

7. UDC 01 - 

8. LDC 01 - 

9. Driver 01 01 

10. Data Entry Operator - 01 

364

• District Leprosy Society : 

Sl 

Designation Regular Staff Contractual Staff 

No. 

1. District Medical Officer 16 - 

2. District Leprosy Officer 02 

3. SMO 01 - 

4. Non - Medical Supervisor 10 - 

5. Para Medical Worker 40 - 

6. Statt. Asstt. 01 - 

7. Lab. Technician 02 - 

8. Smear Technician 01 - 

9. UDC 04 - 

10. LDC 04 - 

11. Gr. IV 09 - 

12. Computer Operator 01 - 

13. Driver 03 11 

(F) Situation Analysis: 

It may be mentioned that the NLEP programme was started in Arunachal Pradesh 

since 1982. Since the inception of the programme till 31 st March’ 2009 about 3,559 cases of PAL 

have been detected and brought under treatment and cured. But no contact tracing and follow up 

cases was carried out to evaluate persons with deformities requiring DPMR including Reconstructive 

Surgery and counseling of Family Members of the PAL was also not properly done in organized 

manner. 

At present in Arunachal Pradesh there is no high endemic District and presently prevalence 

rate is 0.48/10,000 Population. All the vertical staff has been integrated with the GHC under NRHM 

staff since 2005-06. 

The disease trend as such have been depicted in the following line graph. (March End 1982 – 

March End 2009) shown below: 

365

350 

300 

250 

200 

150 

100 

50 

TREND OF LEPROSY SHOWING ANNUAL NEW CASE DETECTION 

NEW CASE DETECTION 

The present trend of Leprosy shows declining after the integration of Leprosy activities with 

the general health services since 2005-06. This may be due to the low Case detection since general 

health care staff and Medical officer’s have not been trained on NLEP. 

Despite the low number of cases detected it is noticed that the MB proportion is 77.7% which 

is high with a very low coverage in females of a proportion of 27% (which should be ideally 50%). 

The child proportion in the high MB proportion is very low of 5% (which should be ideally 15%) and 

high deformity of 5.5% proportion, which have not been technically evaluated. 

Under the circumstances, the NLEP activities in Arunachal Pradesh needs to be focus on 

Capacity Building of District Nucleus, Medical Officer’s, Para Medical Workers of General Health 

Care Staff including proper monitoring & supervision under the same umbrella of NRHM. The State 

PIP as such have been prepared accordingly. 

(G) Physical Achievement: (2009-2010) 

From 1982 to 2009. 

0 

82 83 8485 86 87 8889 90 91 9293 94 95 9697 98 99 2k01 02 03 0405 06 07 0809 

7220912212815212511411511010913011 15818617015 15132218013012012610466 56 59 45 38 

YEAR (MARCH END) 

(i) New Cases Detected (April’ 09-Nov’09) = 19 

(ii) Cases released from treatment = 09 

(iii) Cases under treatment as on 30 th Sept’ 09 = 64 

(iv) Prevalence Rate = 0.48/10,000 Popl. 

(v) New MB Cases = 14 (77.77 %) 

366

(vi) New Female Cases = 05 (27.77 %) 

(vii) New Child Cases = 01 (5.55 %) 

(viii) ST = 08 (44.44 %) 

(ix) SC = 05 (27.77 %) 

(H) Financial Achievement: (2009-2010) 

(i) Fund received from GOI = 25,00,000.00 

(ii) Unspent Amount for 2008-09 = 2,90,419.00 

(iii) Fund Utilized during the year upto Dec’ 09 

(a) Contractual Services = 8,08,700.00 

(b) POL & Maint./ Hiring = 6,10,866.00 

(c) Training = 4,79,497.00 

(d) Review Meeting = 1,60,000.00 

(e) O.E. & Consumables = 3,37,413.00 

(f) Patient Welfare = 40,000.00 

(g) IEC = 15,000.00 

(iv) Fund Balance as on 31.12. 09 = 3,38,943.00 

(I) Objectives: A ‘paradigm-shift’ of NLEP in Arunachal Pradesh is required to be 

introduced and incorporated during the year 2010-2011. Keeping in view the ‘Global Strategies’ & 

GoI Guidelines in perspective, the state would shift it’s focus from stage of ‘Elimination’ to ‘ 

Provision of integrated, sustained quality leprosy services to all people effected by leprosy (PAL) 

utilizing all available resources from both government and non-governmental agencies under NRHM. 

The NLEP in Arunachal Pradesh plans now to develop a model to tackle the Leprosy situation as 

Arunachal Pradesh presents a very unique picture of diverse ethnic groups /tribes with different 

languages/dialects, traditions and customs and also other emerging problems of unrest/insurgencies. 

The major challenges being. 

• Special Needs: 

1) Reducing the ‘Stigma & Discrimination’ in the community. 

2) Functional integration of leprosy services with general health care 

services. 

3) Initiate surveillance for ‘relapses’ and ‘drug-resistance cases. 

4) Providing re-constructive surgeries (RCS) for back-log cases with 

grade-II deformities. 

5) Capacity Building of General Health Care Staff. 

1. Training of Surgical Specialist on RCS. 

2. Training of Physiotherapists on RCS from General Hospital, Naharlagun with ILEP 

support. 

3. Exchange Program to other states for the State Cell (SLO & staffs). 

4. Second Line Programme Officers, Dermatologist & Epidemiologist for State Cell. 

5. Appointment of M.O. District Nucleus for each District. 

367

A. 

1. 

Act. 

No. 

ACTIVITY SCHEDULE FOR April 2010 –March 2011. (Gantt Chart) 

TRAININGS 

Activities 

Training of MOs on DPMR & Lep. 

Management 

(4 days) 

2. Training of HS & HW on DPMR Lep. 

Management 

(4 days) 

3. Training of PRIs on Leprosy (1 day) 

4. Training of ASHAS on Leprosy (1 day) 

5. Training of Lab.Tech. & Smear Tech. at 

State Hq.(5 days ) 

6. CONFERENCE/WORKSHOP AT STATE 

HQ. 

7. Training of Surgeons on RCS 

8. Training o Physiotherapist 

B. WELFARE SCHEMES for INMATES of 

HDS COLONIES INCLUDING PALS 

1. Reconstruction/ Renovation of wards. 

April 

May 

June 

July 

Aug 

Sep 

Oct 

Nov 

Dec 

Jan 

Feb 

March 

368

2. Provision of basic amenities (i) Separate 

living room with kitchen (ii) water supply 

(iii) power supply (iv) Toilet (v) Approach 

Road (vi) Furniture (vii) Boundary Walls 

3. 

Provision for clothing (i) blankets (ii) 

Mosquito net (iii) pillow with covers (iv) 

Mattress. 

4. PRIMARY HEALTH CARE 

(i) OPD Service (ii) Free Medicines (iii) 

Lab. Services (iv) Immunization. 

5. DPMR SERVICES 

(i) Procurement of MCR Foot Wear (ii) Self 

Care Kit for Ulcer Cases. 

6. PROVISIONOF FOOD (i) Free diet (ii) 

Issue of AYYI Ration Card 

7. SOCIAL WELFARE 

(i) Children of PAL in colonies - 

identification & selections for higher/future 

education. (ii) Employment 

8. Financial Aids etc. 

(i) Pension/ Allowances. 

369

Sl 

No. 

A. 

B. 

Activities Responsibl 

e Staff 

1. TRAINING 

04 days training of 

324 M.O’s on DPMR 

& Leprosy 

Management 

04 days training of 

634 HS & HW on 

DPMR & Leprosy 

Management 

ILEP 

DHS 

(NLEP) 

SHS 

(NLEP) 

ILEP 

DHS 

(NLEP) 

SHS 

(NLEP) 

Duration & 

Date 

04 days July- 

Sept’ 2010 

04 days July- 

Dec’ 2010 

PROPOSAL UNDER CAPACITY BUILDING 

Expenditure Total Cost Fiscal 

Sources 

• DA : 324 x @ 400 x 4 

• TA/POL & Maint. : 324 x @ 1000 

• Honorarium to Facilitator : 4 x @ 500 x 4 

days x 7 batches 

• POL Maint. to Facilitator : 4 x @ 2000 

• Lunch : 335 x @ 150 x 4 

• Training material/ : 328 x 250 @ 200 

stationary 

• Tea & Snacks : 335 x @ 15 x 4 

• Banner : 2 nos. x @ 2000 x 7 

• Misc. Expenses : - 7 x @ 10,000 

• DA : 634 x @ 200 x 4 

• TA : 634 x @ 1000 

• Honorarium to Facilitator : 4 x @ 500 x 4 

days x 13 batches 

• POL Maint. to Facilitator : 4 x @ 2000 

• Lunch : 640 x @ 150 x 4 

• Training material/ : 640 x @ 100 

stationary 

5,18,400.00 

3,24,000.00 

56,000.00 

8,000.00 

2,01,000.00 

65,600.00 

20,100.00 

28,000.00 

70,000.00 

5,07,200.00 

6,34,000.00 

1,04,000.00 

8,000.00 

12,91,100. 

00 

18,83,600. 

00 

GOI 

GOI 

370

C. 

D. 

Training of PRI 8,260 

Members for 01 Day 

Training 

Training of ASHA 

3,387 for 01 day 

training 

E. Orientation Training 

M.O. (District 

ILEP 

DHS 

(NLEP) 

SHS 

(NLEP) 

ILEP 

DHS 

(NLEP) 

SHS 

(NLEP) 

01 day July’ 

2010 

01 day August’ 

2010 

• Tea & Snacks : 640 x @ 15 x 4 

• Banner : 2 nos. x @ 2000 x 

16 

• Misc. Expenses : - 16 x @ 5000 

• TA/ DA : 8,260 x @ 150 

• Stationary : 8,260 x @ 50 

• Lunch & Tea : 8,260 x @ 150 

• Facilitator for 16 Districts : 32 x @ 400 

• Banner : 2 x 16 x @ 2000 

• Misc. : 16 x @ 5000 

• TA/ DA : 3,554 x @ 150 

• Stationary : 3,554 x @ 50 

• Lunch & Tea : 3,554 x @ 150 

• Facilitator for 16 Districts : 32 x @ 400 

• Banner : 2 x 16 x @ 2000 

• Misc. Expenses : - 16 x @ 5000 

ILEP 04 days • DA : 300 x @ 400 x 1 

day 

3,84,000.00 

64,000.00 

38,400.00 

64,000.00 

80,000.00 

12,39,000.00 

4,13,000.00 

12,39,000.00 

12,800.00 

64,000.00 

80,000.00 

5,33,100.00 

1,77,700.00 

5,33,100.00 

12,800.00 

64,000.00 

80,000.00 

1,20,000.00 

30,47,800. 

00 

14,00,700. 

00 

5,15,000.0 

GOI 

GOI 

GOI 

371

F. 

2. 

Nucleus) for 04 days 

for 16 Districts 

05 days training of 32 

Lab. Tech. & Smear 

Technician at State 

H/ Qtr. 

Conference/ 

Workshop at 

State H/Qtr. 

DHS 

(NLEP) 

SHS 

(NLEP) 

ILEP 

DHS 

(NLEP) 

SHS 

(NLEP) 

ILEP 

DHS 

(NLEP) 

W.e.f May’ 

2010 

05 days 

W.e.f August’ 

2010 

As per 

scheduled 

• TA/ POL Maint. : 300 x @ 500 

• Facilitator : 2 x 16 Distt. @ 

500 

• Lunch & Tea : 350 x 150 

• Training Materials/ stationary : 332 x 100 

• Banner : 2 x 16 x @ 2000 

• Misc. Exp. For 16 Districts : 16 x 5000 

• DA : 32 x @ 150 x 5 

• TA : 32 x @ 1000 

• Facilitator : 3 x @ 500 x 5 

• Training Materials/ stationary : 35 x @ 100 

• Lunch : 40 x @ 150 x 5 

• Tea & Snacks : 40 x @ 15 x 5 

• Banner : 2 x @ 2000 

• Misc. Exp. : - @ 20,000 

1,50,000.00 

16,000.00 

52,500.00 

33,200.00 

64,000.00 

80,000.00 

24,000.00 

32,000.00 

7,500.00 

3,500.00 

30,000.00 

3,000.00 

4,000.00 

20,000.00 

0 

1,24,000.0 

0 

Total : 82,62,200. 

00 

2,00,000.00 

2,00,000.0 

0 

GOI 

GOI 

372

A. 

3. PATIENT WELFARE : 

Procurement of 

MCR 

B. Patient Welfare 

C. 

Supportive Drugs & 

Lab. Reagents 

SHS 

(NLEP) 

GOI 

DHS 

(NLEP) 

SHS 

(NLEP) 

GOI 

DHS 

(NLEP) 

SHS 

(NLEP) 

GOI 

DHS 

(NLEP) 

June’ 2010 

July’ 2010 

W.e.f May’ 10 

to July’ 2010 

122 x 2 x @ 250 

• 122 x @ 1000 

for Blanket, Mosquito net, Financial aids etc. 

• 10 Patients x @ 5000 

Welfare allowances for RCS patients from BPL 

families. 

• Printing of Forms, Register etc. 17 x @ 

10,000.00 

Total : 2,00,000.0 

0 

61,000.00 

1,22,000.00 

50,000.00 

1,70,000.00 

16 District x @ 15,000 2,40,000.00 

61,000.00 

3,42,000.0 

0 

2,40,000.0 

0 

GOI 

GOI 

GOI 

373

D. 

Incentive of ASHA 

for MB & PB Cases 

Treatment 

E. MDT Supply & 

Management Cost 

A. 

4. IEC ACTIVITIES (NRHM): 

IEC Activities for 16 

Districts & H/ Qtr. 

SHS 

(NLEP) 

GOI 

DHS 

(NLEP) 

SHS 

(NLEP) 

GOI 

DHS 

(NLEP) 

SHS 

(NLEP) 

GOI 

DHS 

(NLEP) 

SHS 

(NLEP) 

As Routine 

As needed 

W.e.f July – 

Dec’ 2010 

• MB Leprosy cases : 20,000.00 

• PB Leprosy cases : 4,000.00 

• On confirm diagnosis : 3,000.00 

• Transportation : 16 x @ 4000 

• Hoarding : 68 x @ 16,500 

• Wall painting : 2,550 x @ 400 

• Folk show : 400 x @ 5000 

• Health Mela : 36 x @ 5000 

• Press (Local new paper) : 50 x @ 5000 

• Poster (Multicolor) : 8000 x @ 15.50 

• Hanger (Silk cloth) : 150 nos. x @ 

300 

27,000.00 27,000.00 GOI 

64,000.00 64,000.00 GOI 

Total : 7,34,000.0 

0 

11,22,000.00 

10,20,000.00 

20,00,000.00 

1,80,000.00 

68,17,000. 

00 

GOI 

374

5. CONTRACTUAL SERVICES : 

• Envelope with slogan : 18,000 x @ 3 

• Meeting with Zilla Parishad : 32 x @ 3000 

• Orientation camp for NGO & : 32 x @ 3000 

Mahila Mandal 

• IPC Meeting for influences/ : 1,280 x @ 1000 

Opinion leaders 

• Observe Anti Leprosy day : 17 x @ 10,000 

• Observe Independence Day & : 32 x @ 10,000 

Republic Day 

• Radio Jingles : @ 60,000 

2,50,000.00 

1,24,000.00 

45,000.00 

54,000.00 

96,000.00 

96,000.00 

12,80,000.00 

1,70,000.00 

3,20,000.00 

60,000.00 

Total : 68,17,000. 

00 

375

A. 

(i) Salary of 12 nos. 

Contractual Driver 

(ii) Salary of 01 no. 

Contractual DEO for 

state cell & 

(iii) 17 nos. (01 for 

state cell) 

Honorarium to 

Accountant. 

B. (i) TA for SLO for 

attending 

Conferences/ 

Workshop for State 

cell supervisory staff 

(ii) TA for Regular 

Driver’s& Regular 

Staffs. (iii) T.A for 

Contractual Driver 

A. 

GOI 

DHS 

(NLEP) 

SHS 

(NLEP) 

GOI 

SHS 

(NLEP) 

DHS 

(NLEP) 

6. MAINTENANCE OF VEHICLES: 

POL Maint for 02 

(Two) nos. Vehicle of 

State Health Society 

GOI 

DHS 

April’ 2010 

As needed 

Routine 

• Driver salary : 12 x @ 4,500 x 

12 

• DEO salary : 1 x @ 8,000 x 12 

• Honorarium : 17 x @ 500 x 12 

• TA SLO & Staff : 2,00,000.00 

• TA Driver : @ 500 x 17 x 12 

• Regular Staffs : @ 40,000 x 16 

• SHS (NLEP) : 2 x @ 

1,00,000.00 

• Major Repairing SHS : 2 x @ 

6,48,000.00 

96,000.00 

1,02,000.00 

2,00,000.00 

1,02,000.00 

6,40,000.00 

8,46,000.0 

0 

9,42,000.0 

0 

Total : 17,88,000. 

00 

2,00,000.00 

2,00,000.00 

4,00,000.0 

0 

GOI 

GOI 

GOI 

376

B. 

C. 

D. 

A. 

(NLEP) (NLEP) 

POL Maint for 17 

nos. Vehicle for 16 

District Health 

Society (NLEP) 

HIRING OF VEHICLES: 

01 no. for SHS 

(NLEP) 

06 nos for DHS 

(NLEP) 

SHS 

(NLEP) 

GOI 

DHS 

(NLEP) 

SHS 

(NLEP) 

GOI 

SHS 

(NLEP) 

GOI 

DHS 

(NLEP) 

8. OFFICE EXPENSES AND CONSUMABLE : 

Office Maintenance 

for SHS (NLEP) 

SHS 

(NLEP) 

1,00,000.00 

• DHS : 17 x @ 75,000.00 

• Major Repairing DHS : 17 x @ 

25,000.00 

Hiring for DHS : 5 x @ 35,000 x 12 

12,75,000.00 

4,25,000.00 

21,00,000.00 

Routine 1,20,000.00 1,20,000.00 

Routine @ 1,20,000 x 6 7,20,000.00 

Regular 

• SHS : Telephone : 24,000.00 

: FAX Roll : 30,000.00 

: XEROX (AMCS Cartridge) : 50,000.00 

: Computer (Main & Cartridge) : 35,000.00 

2,39,000.00 

38,00,000. 

00 

1,20,000.0 

0 

7,20,000.0 

0 

2,39,000.0 

0 

GOI 

GOI 

GOI 

GOI 

377

B. 

Office Maintenance 

for DHS (NLEP) 

DHS 

(NLEP) 

Regular 

: O.E. & Consumable : 1,00,000.00 

• DHS : Maint. of Telephone 

: FAX, XEROX O.E. & Consumable 

= 16 x @ 40,000. 

6,40,000.00 

Total : 

Grand Total : 2,37,20,200.00 

(Rupees Two crores thirty seven lakhs twenty thousand & two hundred) only. 

6,40,000.0 

0 

8,79,000.0 

0 

GOI 

378

4. INTEGRATED DISEASE SURVEILLANCE PROJECT (IDSP) 

Preface: 

Integrated Disease Surveillance Project (IDSP) is intended to be the back-bone of all public 

health programs. The project aims to improve the information available to the government health 

services and private health care providers on a set of high-priority diseases and risk factors, with a 

view to improve the on-the-ground responses to such diseases and risk factors. 

IDSP will provide essential data to monitor progress of on going disease control program. It 

will help to identify areas of health priority where more inputs are necessary and tailor its 

implementation to levels desirable for the state. 

IDSP is to be implemented throughout the country electronically linking all 230 districts of 

the country in a phase manner. It was launched in the country in 2004-05. Arunachal Pradesh is 

included in the III rd phase of the project in 2006-07. 

The components of IDSP are: 

• Disease surveillance 

• Laboratory strengthening 

• Quality assurance 

• Information Technology 

• Human resource Development with training 

• IEC. 

17 diseases are included in the project for surveillance with a regular periodic report. Both 

Government health Institutes and Private Hospitals will be involved in surveillance activities. 

The State PIP has been prepared as per the guidelines of the project, in the backdrop of the 

infrastructure and resource availability and requirement in the state. 

1. INTRODUCTION 

Arunachal Pradesh has 16 districts but the National PIP has incorporated only 13 

districts in the state. Since these three districts are underdeveloped and require adequate 

effort, they have also been included in the project by a policy decision. The matter had the 

approval of Special Secretary, Ministry of Health & FW, Govt. of India during his visit to the 

state. 

IDSP was launched in Arunachal Pradesh in the year 2006-07 in conformity to 

National PIP as a Phase-III state where the project was budgeted by GOI for three years 

with a total budget of Rs.49,310,000.00 (Rupees four crores ninety three lakhs ten thousand) 

only excluding the cost of IT components. 

However, over the project period of three years (Phase-III state) an amount of Rs. 

1,92,76,000.00 only was released to the state (39%) as a result of which most of the 

perceived activities such as training etc couldnot be completed. Even the salaries of the 

contract staffs under IDP are due to be paid.

Accordingly, the State Plan of Action for 2010-2011 for Arunachal Pradesh is 

prepared on the basis of the needs to put in place the components which were envisaged 

under IDSP project as per the National PIP and are in conformity to the approved Project 

Plan. 

The proposal contains the component wise financial requirement for implementation 

of IDSP in the state for the year 2010-2011. 

2. IMLEMENTATION PLAN: 

The State PIP for the year 2010-11 emphasizes on the following Plan of Implementation, 

time line and budget requirement. 

2.1 CIVIL WORK for UPGRADATION OF STATE AND DISTRICT SURVEILLANCE 

UNITS and LABORATORIES: 

Civil works for SSUs, DSUs & District Hospitals were undertaken during 2007-08 but that of 

CHCs were proposed to be undertaken during 2008-09 & 2009-10 but due to non release of 

fund, these activities are yet to be completed and hence budgeted during this project year. 

1 Minor Civil works 

Civil works for Surveillance Units 

a 

& Computer room 

ANNEXURE-1 

PROPOSED COST ESTIMATE FOR CIVIL WORKS OF DSU/ DISTRICT AND 

PERIPHERALLABORATORY, ARUNACHAL PRADESH DURING 2010-11 

Sl Item 

b Civil works for laboratory 180,000 640,000 820,000 

Total 820,000 

4.2 FURNITURES AND FIXTURES 

380 

State 

(1 no) 

Furniture for SSU & DSU was provided during 2007-08. 

District 

CHC (32 

nos) @ 

20000 

TOTAL 

It is proposed to procure the furniture for the District Laboratories and Peripheral 

surveillance units/Laboratories (CHCs) as per requirements during 2010-11. 

The requirement of fund for furniture/fixtures is proposed at Annexure-2. 

0

381 

Annexure-2 

PROPOSED COST ESTIMATE FOR FURNITURES AND FIXTURES FOR 

SURVEILLANCE UNITS/LABORATORIES DURING 2010-11 

Sl Item 

State 

(1 no) 

District 

(16 nos) 

CHC (32 

nos) 

TOTAL 

2 Furnishing 

Furniture & fixtures for 

a 

Surveillance Units 

320,000 320,000 

Furnitures & Fixtures for 

b Laboratory 

60,000 960,000 320,000 1,340,000 

Total 1,660,000 

4.3 OFFICE EQUIPMENTS: 

Most of the office equipments required to equip the DSUs to undertake the activities 

envisaged under IDSP and as per guidelines was complete during 2007-08. 

During 2010-11 it is proposed to install AC in the DSUs and connect the CHCs wherever 

telephone connectivity is available. 

Until the computer network is established, the reporting will be done manually in 

conventional ways, but using the formats prescribed under IDSP. 

The budget requirement for office equipments is given in Annexure-3. 

Sl 

Item 

Annexure- 3 

Requirement of Office Equipments (2010-11) 

Unit 

Price 

Units Total Units Total 

5 Air conditioner 24,000 0 16 384,000 

6 Telephone 10,000 32 320,000 

Office 

equipment for 

DSU 

Total 320,000 384,000 

4.4 STRENGTHENING OF MANPOWER: 

Office 

equipment for 

PSU (CHC) 

(Amount in Rupees) 

Total cost 

of office 

equipment 

384,000 

320,000 

704,000 

The IDSP is so designed that it will require a dedicated team of experts for undertaking the 

scheduled activities of surveillance, data transfer and maintenance of records and accounts. 

Accordingly the manpower required in the State and District Surveillance Units to do their

specified jobs has already been appointed. The financial budget required for the salary of the 

contractual staffs for 2010-11 has been calculated below. 

The salary of the staffs engaged under IDSP and proposed to be paid by SSU is given as 

under: 

1 

2 

3 

4 

5 

6 

Sl Title Monthly Salary Paying agent 

Consultant (Finance) 

Epidemiologist 

Data Manager 

Data Entry Operator 

Accountant 

Administrative Assistant 

382 

14,000/- 

26500/- 

13500/- 

8500/- 

9500/- 

7000/- 

SSU 

SSU 

NIC 

SSU/DSU 

DSU 

SSU/DSU 

The budget requirement for salary of contractual staffs appointed under IDSP for the year 

2010-11 is given in Annexure-4. 

Annexure-4 

TOTAL BUDGET REQUIRED FOR SALARY OF CONTRACTUAL STAFFS 

Sl Title 

Monthly 

fees 

(2010-11) 

SSU DSU Total 

Total for 1 

month 

(Amount in Rupees) 

Total for 

(2010-11) 

1 Consultant (Finance) 14,000 1 0 1 14,000 168,000 

2 Data Manager 1 16 17 0 

3 Accountant 9,500 0 16 16 152,000 1,824,000 

4 Data Entry Operator 7,500 2 16 18 135,000 1,620,000 

5 Administrative 

Assistant 

7,000 1 16 17 119,000 1,428,000 

6 Epidemiologist 26,500 1 0 1 26,500 318,000 

Total 446,500 5,358,000

4.5. PRINTING OF MANUALS AND FORMATS: 

Until the IT network is in place, the reporting will be undertaken manually through 

conventional means as per the IDSP formats and protocol. Also reports from the peripheral 

units will be collected manually in prescribed formats. 

As such, Manuals and guidelines, registers and forms will be printed in limited numbers, as 

required. Separate budget for printing is proposed as follows: 

Annexure-5 

Budget requirement for PRINTING of formats and manuals 

during 2010-11 

Sl Printing materials 

No. of 

pages 

Quantity 

required 

Estimated 

cost 

1 Form L1 1 5000 9500 

2 Form L2 

3 Form S 

1 

1 

1000 

20000 

2200 

38000 

4 Form P 2 10000 21000 

5 Register for syndromic surveillance 50 200 19000 

6 Register for presumptive surveillance 50 200 19000 

7 HW manual 26 500 24700 

8 MO manual 57 200 21660 

9 Operation manual 165 200 62700 

10 Training manual 259 200 129500 

347,260.00 

4.6 TRAINING NEEDS IN IDSP 

Since the most important component of IDSP is reporting, it is required to train every 

individual involved in IDSP right from the ANM to HW to MO. Particularly in Sub-centres and 

Peripheral institutions which is mostly understaffed it will be necessary to train every staffs in the 

periphery whose services will be utilized for reporting. 

Though it was proposed to complete these trainings during 2007-08 after the 

completion of Masters Training i.e. TOT to be trained by expert faculty from GoI, but, it did not 

happen till date due to non availability of fund. 

383

384 

Table-1 

NUMBER OF TRAINEES IN THE STATE 

IN DIFFERENT CATEGORY AND LEVELS(REMAINING) 

Categ 

ory 

Level Trainees Numbers Total 

No. of 

batches 

I 

District Surv. 

Team 

District Surveillance officer, 2 District programme 

Managers, District Microbiologist / RRT members 

20 20 1 

II Medical Officers 

Medical Officers of the PHCs, CHCs and Urban Health 

sector. MOs of the SPM departments of local Medical 

16 per 

district 

237 11 

III 

Clinical Medical 

officers 

Medical Officers of the Hospitals, Subdistrict 

Hospitals, Medical College Hospitals, SPPs 

14 per 

district 

257 13 

IV Sub Block staff 

MPWs (Male / Female), Health Supervisors, ANM, 

NGO volunteers, traditional healers 

110 per 

district 

1783 89 

V 

VI 

State and District 

Lab. Technicians 

Sub District Level 

Lab. Technician 

State and District level microbiologists / LT. Also of 

the urban health sector. 

PHC / CHC / Urban dispensary LTs 

5 per 

district 

5 per 

district 

Total 2508 

The financial requirement for providing these trainings is given in Annexure-6. 

Annexure-6 

62 3 

149 7 

Total no Required 

Trainees Cost per of no. of Total fund 

Sl Trainees 

per Batch batch Trainees batches required 

1 

Health workers/ Para medical 

worker/ANM/ GNM 20 18,000 1783 89 

1602000 

2 

Laboratory Technicians/ 

Assistants (Peripheral) 20 21,000 149 7 

147000 

3 District Lab Technicians 20 62,000 62 3 186000 

4 Medical officers 20 42,000 494 25 1050000 

5 

State/District Surveiilance 

/Rapid Response team 

20 140000 20 1 140000 

Total 

3,125,000 

4.7 IEC ACTIVITIES 

IEC activities will be the major means of social mobilization used to create 

awareness about disease surveillance, its objectives and potential to improve health services. 

The budget requirement for IEC activities has been calculated for one year as per the 

guidelines of GOI, for the year 2010-11in the following annexure.

Sl 

Annexure-7 

Budget requirement for IEC Activities in 2010-11 

Amount Total Amount Total 

1 Press advertisement 20,000 320,000 150,000 150,000 470,000 

2 

Organisation of 

sensitization workshop 

30,000 480,000 100,000 100,000 580,000 

3 Review Meeting of DSU 10,000 160,000 50,000 50,000 210,000 

4 

IEC materials(Print 

media) 

20,000 320,000 150,000 150,000 470,000 

5 TV spot telecasting 0 400,000 400,000 400,000 

6 Radio broadcasting 0 150,000 150,000 150,000 

7 

Item 

Other including 

indigenous methods 

District Units (16 nos) State Unit (1 no) 

20,000 320,000 0 320,000 

Total 1,600,000 1,000,000 

2600000 

OPERATION COST 

385 

Grand 

Total 

The State & District units will be allotted specific fund under Operational cost to maintain 

the SSU/DSU. Requirement of operational cost for undertaking various activities under IDSP is 

given in Annexure-7. 

Annexure-7 

Requirement of operational cost in 2010-11 

Cost DSU (16 nos) CHCs (31 nos) 

Items 

per 

SSU 

Cost per 

DSU 

Cost per 

Total cost 

item 

Total 

cost 

Total cost 

POL, Travel cost, maint.& 

hiring of vehicle 

100000 40000 640,000 5000 160,000 800,000 

Office expense on telephone, 

fax, electricity 

60000 20000 320,000 4000 128,000 448,000 

Office Stationery & 

consumables 

60000 20000 320,000 2000 64,000 384,000 

DA to officers/staffs engaged 

under IDSP 

80000 30000 480,000 3000 96,000 576,000 

Miscellaneous including 

contingencies 

50000 20000 320,000 1000 32,000 352,000 

Total 350000 130000 2,080,000 15000 480,000 2,560,000 

4.9 LABORATORY SUPPORT FOR IDSP 

It was planned to give a comprehensive support to the laboratories at all levels, Peripheral, 

District Laboratory and the state level Public Health Laboratory in form of Infrastructure 

support, Laboratory Equipments and Laboratory supplies. 

Over the couple of years CSU has instructed SSU not to incur any expenditure against 

laboratory equipments for District Hospitals.

However, the fact remains that infrastructure development of the district hospitals are must 

and as such the requirement has been included in the State Plan as per the original National 

PIP. 

There are two types of requirement, one is equipments which are non recurring and the other 

is materials and supplies which will be required in a recurring basis. 

(a) LABORATORY EQUIPMENTS 

There will be requirement of major Laboratory equipments for peripheral, district 

and state laboratory which is given in following Annexures. 

(i) LABORATORY NEED AT PERIPHERAL LABORATORY: 

The CHCs in the state will be provided with equipments that will be necessary to 

carry out laboratory activity for diseased under IDSP. The supply will be as per guidelines 

for the 32 CHCs as given in the following annexure, district wise. 

BUDGET REQUIREMENT FOR PERIPHERAL LABORATORIES Annexure-8 

Name of District Total no 

of CHC 

Name of CHC per district Total cost @ 

40,000 per CHC 

1 TIRAP 2 Longding, Deomali 80,000 

2 CHANGLANG 2 Miao, Bordumsa 80,000 

3 LOHIT 2 Namsai, Chowkham 80,000 

4 ANJAW 1 Hayuliang 40,000 

5 LOWER DIBANG 

VALLEY 

2 Dambuk, Parbuk 80,000 

6 EAST SIANG 3 Ruksin, Boleng, Mebo 120,000 

7 UPPER SIANG 2 Mariang, Tuting 80,000 

8 WEST SIANG 

5 Basar, Likabali, Rumgong, 

Yomcha, Mechukha 

386 

200,000 

9 UPPER SUBANSIRI 1 Nacho 40,000 

10 Lower SUBANSIRI 1 Old Ziro 40,000 

11 KURUNG KUMEY 4 Koloriang, Palin, Nyapin, 

Sangram 

160,000 

12 PAPUM PARE 3 Sagalee, Doimukh, Kimin 120,000 

13 EAST KAMENG 1 Chayangtajo 40,000 

14 WEST KAMENG 3 Kalaktang,, Dirang, Rupa 120,000 

Total 32 1,280,000

(ii) NEEDS AT DISTRICT LABORATORIES 

There are 16 districts in the state and but some of the districts are very new and lacks 

infrastructure. Care would be taken to address these issues and these laboratories will be upgraded 

so that they can undertake the activities under IDSP properly. 

The budget requirement for laboratory equipments for the District Hospitals is given in the 

following annexure. 

Annexure-9 

BUDGET REQUIREMENT FOR LAB EQUIPMENTS OF DIST. LABORATORIES 

TOTAL DISTRICTS Unit cost for 

each Dist. lab 

Tirap,Changlang, Anjaw, Lohit, Dibang valley, Lower 

Dibang valley, East Siang, Upper Siang, West Siang, 

Upper Subansiri, Lower Subansiri, Kurung Kumey, 

Papumpare, East Kameng, West Kameng, Tawang. 

387 

850,000 

Total cost of 

equipments 

13,600,000 

Total 16 850,000 13,600,000 

(iii) NEED AT STATE LABORATORY 

Currently there is no State Public Health Laboratory in the state. However, the State Level 

Laboratory at General Hospital Naharlagun has the requisite personnel and it will be setup to 

function as a State Public Health laboratory which will undertake the following functions: 

1 Provide quality control of District laboratories 

2 Impart training of Laboratory Personnel at the district levels 

3 Participate in the epidemic investigation in response to surveillance challenges 

4 Link up with state and district surveillance units so that information transfer is 

optimized. 

5 Function as the Primary laboratory for NCD risk factor surveillance. 

The list of items to be procured is as per the guidelines of the GOI. 

The budget requirement for procurement of Laboratory equipments for State laboratory(L3) as per 

guidelines is given in the following annexure.

STATE 

Arunachal 

Pradesh 

Annexure-10 

BUDGET REQUIREMENT FOR STATE LABORATORY 

State 

Laboratory 

(General Hospital, 

Naharlagun) 

Unit cost Amount spent Amount required 

850,000 300,000 550000 

850,000 300,000 550,000 

Annexure-11 

SUMMARY OF FINANCIAL REQUIREMENT FOR 

LABORATORY EQUIPMENTS IN THE STATE during 2008-09 

Equipment for CHCs 

No. of 

Lab 

Total cost 

@ 40,000 

Equipments for DH 

No. of 

Lab 

Total cost 

@ 850,000 

388 

Equipments for State 

lab 

No. of 

Lab 

Total cost 

@ 550,000 

Total Cost on 

Equipments 

32 1,280,000 16 13,600,000 1 550,000 15,430,000 

(b) LABORATORY REAGENTS & SUPPLIES: 

It is required to provide materials and supplies for all level of laboratories, peripheral, 

district and state laboratory on recurring basis. The budget requirement for their procurement during 

2010-11 is given in the Annexure-12: 

STATE 

Arunachal 

Pradesh 

BUDGET REQUIREMENT FOR MATERIALS AND SUPPLIES 

Materials & Supplies 

for CHCs 

No. of 

Lab 

Total cost 

@ 10,000 


for DH 

No. of 

Lab 

Total cost 

@ 100,000 


for State lab 

No. of 

Lab 

Total cost 

@ 200,000 

Total Cost on 

Materials & 

Supplies 

32 320,000 16 1,600,000 1 200,000 2,120,000 

5.0 INFORMATION TECHNOLOGY IN IDSP 

IT based electronic transfer of data is proposed to be used for the computing and communication 

needs of the program. It is proposed to connect the state headquarter with the district and block level

units of IDSP with telephones which can be used for transfer of information on disease outbreaks 

quickly. The IT component will be provided by NIC. 

Until the IT network is in place, the reporting will be done in conventional ways with the help of 

communication materials supplied. On establishment of IT network the reporting along with 

surveillance will be switched over to electronic mode. 

However, as on date only 13 out of 16 DSUs have been provided with IT Hardware and it is 

proposed that CSU will provide adequate IT component to the remaining 3 districts including 

Computer hardware/ V-SAT & connectivity. 

4.10 Summary 

The State PIP for the year 2010-11for implementation of IDSP has been prepared as per the 

guidelines of Govt. of India and as per the State PIP already submitted to GOI with stress on the 

needs of the state government to achieve the goals set under IDSP. Special emphasis has been laid on 

infrastructure development and training, lack of which compromises the quality of services. 

Disease Surveillance in the state had been very poor and the department intends to utilize the 

resources being provided under IDSP to plug these gaps and provide necessary inputs in terms of 

disease surveillance and consequently, timely intervention to arrest the outbreaks or epidemics. 

It is intended to rigorously train as many functionaries whose involvement will manifest the 

results. Proper training will result in quality service and emphasis will be given to train and reorient 

the functionaries for proper surveillance and reporting. 

The summary total budget requirement for 2010-11 is given in the following table: 

ITEM TOTAL (2010-11) 

Minor Civil works 820,000.00 

Furnishing 1,660,000.00 

Laboratory equipments 15,430,000.00 

IEC activities 2,600,000.00 

Training 3,125,000.00 

Printing 347,260.00 

Office Equipments 704,000.00 

Salary of contract staffs 5,358,000.00 

Operational costs 2,560,000.00 

Laboratory reagents 2,120,000.00 

Grand Total 34,724,260.00 

.IDSP was launched in Arunachal Pradesh in the year 2006-07 in conformity to National PIP 

as a Phase-III state where the project was budgeted by GOI for three years with a total budget of 

Rs.49,310,000.00 only excluding the cost of IT components against which till date an amount of Rs. 

1,92,76,000.00 only has been released to the state (39%). 

It is hoped that the release of fund for the current year will be sufficient enough to 

undertake the activities as perceived. 

389

55. .. NATIIONAL IIODIINE DEFFIICIIENCY DIISSORDERSS CONTROL PPROGRAMME (NIIDDCPP) ( ) 

1. PREFACE 

Iodine Deficiency Disorders are one of the most severe form of micro-nutrient deficiency 

which superimposes it’s harmful effects on the productivity and vitality of our society. 

Some obvious clinical manifestation of Iodine Deficiency, such as Goitre, has been 

recognised in Arunachal Pradesh for of years, but with proper intervention over four decades has 

minimized the board spectrum of disability, morbidity and mortality affected by the iodine 

malnutrition. The State Government has initiated action oriented implementation of NIDDCP as per 

the recommendation of Govt. of India and the effort has borne visible dividends. The prevalence of 

IDD has diminished in the state remarkably. 

IDD affects people throughout the world. It causes brain disorders, cretinism, miscarriages 

and goiter. It is the world's single most important and preventable cause of mental retardation. And it 

is almost unknown. Equally unknown is the success in eradicating it. Calling it "one of our best kept 

secrets" the World Health Organization has rededicated itself to eliminating Iodine Deficiency 

Disorder, or IDD, through an intense programme of salt iodisation. 

Appreciating the ground reality, Govt. of Arunachal Pradesh submits this State Plan of 

Action for the year 2010-11 with the objective to control IDD in the state and bring about total 

awareness among the people about the ill effects of Iodine deficiency and the ways by which it can be 

controlled through a concerted Information, Education & communication mechanism and proper 

monitoring and evaluation. 

2. STATE PROFILE: Table-2.1:State Statistics 

1 Total area 83,743 sq. km. 

2 Population 10, 91,117 (Census 2001) 

3 Male 579941 

4 Female 578027 

5 Tribal Population 67.22 % 

6 Rural Population 79.59% 

7 Urban Population 20.41 %. 

8 Population Density 13 

9 Sex ratio (Total) 901 females per 1000 males. 

10 Sex ration (Tribal) 1003 females per 1000 males. 

11 population below poverty line in 1999- 

2000 

12 Decadal Growth Rate 26.21 % 

390 

33.47 (SRS Bulletin, April 2001)

SL. 

NO. 

13 Annual Exponential Growth Rate 2.33. 

14 decadal growth rate of urban population 101.29 %. 

15 Total literacy rate in the state is 54.74% 

16 Male literacy rate 64.07% 

17 Female literacy rate 44.24%. 

18 per capita income (97-98) Rs.13,424 [Source: Provisional 

Census of India 2001] 

Administrative Set up: ARUNACHAL PRADESH (Source: Census 2001) 

DISTRICT 

HEAD 

QUARTER 

Table-2.2 

391 

POPU 

L 

ATION 

SUB 

DVN 

BLO 

CK 

TO 

WN 

CIR 

CLE 

1 TAWANG TAWANG 34705 2 3 1 9 189 

2 WEST KAMENG BOMDILA 74595 3 4 1 10 215 

3 EAST KAMENG SEPPA 57065 2 4 1 11 288 

4 PAPUMPARE YUPIA 121750 2 2 2 9 274 

5 LOWER SUBANSIRI ZIRO 55332 1 3 1 6 216 

6 KURUNG KUMEY KOLORIANG 42282 1 6 0 12 471 

7 UPPER SUBANSIRI DAPORIJO 54995 1 8 1 13 398 

8 WEST SIANG ALONG 103575 6 11 2 20 399 

9 EAST SIANG PASIGHAT 87430 3 4 1 10 132 

10 UPPER SIANG YINGKIONG 33146 3 4 0 10 76 

11 

LOWER DIBANG 

VALLEY 

VILL 

AGE 

ROING 50391 2 3 1 6 127 

12 DIBANG VALLEY ANINI 7152 1 1 0 5 111 

13 LOHIT TEZU 125050 2 3 2 8 225 

14 ANJAW HAYULIANG 18428 1 2 0 7 281 

15 CHANGLANG CHANGLANG 124994 4 5 2 13 304 

16 TIRAP KHONSA 100227 3 6 2 8 156 

TOTAL 37 85 17 169 3863

2.3. Current Health Situation in Arunachal Pradesh: 

1. General Hospital : 2 Nos under Govt. 

2. District Hospital : 12 Nos. 

3. Community Health Centre 32 Nos. 

4. Primary Health Centre 83 Nos. 

5. Sub-Centre : 422 Nos. 

6. Homeopathy Dispensary : 37 Nos 

7. Ayurvedic Dispensary 2 Nos. 

8. Dental Units 39 Nos. 

9. Hansens Disease Sanatorium 4 Nos. 

10. Dispensaries 12 nos. 

11. Drug De-addiction centre 

392 

1 No. in NGO sector 

12. Nursing Schools :1 in Government 1in private sector. 

13. Autonomous/private hospitals 4 

14. Microscopy Centres 32 

15. Sentinel surveillance sites 12 

3. NIDDCP in ARUNACHAL PRADESH 

5.1. PREVALENCE IN ARUNACHAL PRADESH

1969 (ICMR) 

1980 (ICMR) 

1991(State 

Govt.) 

2001(State 

govt.) 

( %) , 2 0 0 1 ( S t a t e 

g o v t . ) , 8 

NIDDCP in 


( %) , 1 9 9 1 ( S t a t e 

G o v t . ) , 1 1 . 4 

Started in the state in 1987 

393 

( %) , 1 9 8 0 ( I C M R ) , 

2 6 . 8 

( %) , 1 9 6 9 ( I C M R ) , 

0 5 1 0 1 5 2 0 2 5 3 0 3 5 4 0 4 5 

The prevalence of Goitre in the state has reduced considerably to less than 6% from 38% 

during 1969(ICMR survey). 

5.2. BAN NOTIFICATION 

Basing on the ICMR report the Government of Arunachal Pradesh, then Union Territory of 

India under the signature of Secretary (Supply and Transport), Shillong issued a notification on 26th 

Oct, 1976 under Clause (IV) of section 7 of PFA, 1954 prohibiting the sale of non iodised salt for 

edible purposes with effect from 1st Dec,1976. 

5.3. FORMATION OF STATE IDD CELL 

NIDDCP erstwhile NGCP in Arunachal Pradesh was launched in the year 1986 in 

persuasion to the proposal of the ministry of health & Family Welfare, Govt. of India with creation of 

the following posts to establish the IDD Cell in the state headquarter with 100% Central assistance. 

1. Technical Officer : One Post. 

2. Technical Assistant (IDD) : One post 

3. Statistical Assistant : One Post. 

4. LDC cum Typist : One Post. 

5. Laboratory Technician : One Post. 

6. Laboratory Assistant : One Post. 

The team is led by State Programme Officer (IDD). 

3 8 . 2 

( %)

The State IDD laboratory is engaged in quantitative and qualitative analysis of iodine in 

edible salt. Measure of biochemical availability of Iodine in human body through Urinary Iodine 

Excretion method will be started after laboratory is established in general Hospital, Naharlagun. 

5.4. ORGANISATION CHART: 

DIRECTOR OF HEALTH SERVICES 

STATE PROGRAMME OFFICER 

TECHNICAL OFFICER 

TECHNICAL ASSISTANT 

Govt. Offices 

5.5 ACTIVITIES UNDERTAKEN 

5.5.1. BASELINE SURVEY: 

DISTRICT 

LEVEL 

ACTIVITIES 

STATISTICAL 

ASSISTANT 

LAB. 

TECHNICIAN 

LAB. 

ASSISTANT 

394 

Awareness 

STUDENTS 

PUBLIC 

Public, Citizen Group 

Endemic Goitre survey is conducted every year in some districts of Arunachal Pradesh in a 

phase manner to determine the following indices: 

a) To determine the prevalence of Goitre and IDD. 

b) To study the efficacy of consumption of Iodised salt and effect of compulsory 

iodisation of all edible salts. 

c) To intensify health awareness activities with proper IEC materials and motivate 

people’s participation in the programme. 

d) To determine the content of Iodine in edible salts in the state.

These surveys are primarily carried out in schools for children between the age group of 6 to 

12. The incidences of Nodular Goitre among these children are almost non existent now which 

reflects the efficacy of iodised salt in controlling IDD. 

5.5.2. IEC ACTIVITIES UNDERTAKEN : 

IEC is one of the major components of the programme. Conscious effort is being made to 

reach out to the people and informing them about IDD and its prevention. The Department 

undertakes the following activities every year as part of the IEC campaign: 

1. PRESS RELEASE BY HON’BLE CHIEF MINISTER AND HON’BLE HEALTH 

MINISTER. 

2. PANEL DISCUSSION ON DOORDARSAN. 

3. RADIO TALK IN ALL INDIA RADIO 

4. SCHOOL HEALTH AWARENESS PROGRAMME 

5. PUBLIC DISPLAY & SEMINARS 

6. ESSAY COMPETITION 

7. PAINTING COMPETITION. 

8. LECTURES IN COLLEGES AND SCHOOLS. 

DMO in their respective districts also carry out various activities as part of IEC campaign. 

DMOs in the district also conduct suitable programmes during Global IDD Prevention Day, being 

observed on 21 st October every year. 

5.5.3. IODINE PROPHYLEXIS IN ARUNACHAL PRADESH: 

Prevention of endemic goiter among the people in Arunachal Pradesh by Iodized salt 

prophylaxis is an important objective laid down by Govt. of India. 

The entire edible salt in Arunachal Pradesh is iodized. In order to determine the Iodine content 

in salt, salt samples are being analysed at State IDD laboratory. As per the analysis done, the 

content of Iodine in salt available both through PDS and in open market have satisfactory level 

of Iodine. 

The supply and distribution of Iodized salt in the state is monitored by the Director of Civil 

Supplies, Naharlagun. However, the open market is flooded with various brands of Iodized 

salts manufactured by different manufacturers. 

5.5.4 LABORATORY ACTIVITY: 

A State IDD monitoring laboratory is set up in the state headquarter which is engaged in 

analyzing salt samples collected from various parts of the state quantitatively estimate the 

amount of iodine present in salts. The staffs are engaged in collection of salt samples from the 

salt traders. 

The state IDD Monitoring laboratory is also strengthened to be able to estimate the iodine 

deficiency in the population through Urinary Iodine Excretion method. The laboratory staffs 

have been trained for the purpose at NICD, New Delhi and All India Institute of Hygiene & 

Public Health, Kolkata. 

6. STATE PLAN OF ACTION 2010-2011 

395

6.1 OBJECTIVES: 

The State Plan of Action has been prepared for the period 2010 11 where it is proposed that 

a complete functional monitoring system will be in place and the extent of Iodine deficiency in the 

state will be scientifically determined. 

The State Plan of Action is prepared with the following objective: 

6.1.1. The State Plan of Action proposes a comprehensive strategy for Universal Salt 

Iodisation Programme in the state. 

6.1.2. To establish a decentralized system of monitoring for the quality of Iodised salt 

consumed so that timely and effective public health action can be initiated in 

response to health challenges. 

6.1.3. To improve the awareness level of the people so that the demand for good quality 

iodised salt increases. 

6.1.4. To facilitate sharing of relevant information with the health administration, 

community and other stakeholders and evaluate strategies. 

6.1.5 To find out the incidence of Iodine deficiency. 

6.1.6 To establish a proper and effective monitoring system in the state. 

With the objectives set, the department proposes this Plan of Action to initiate measures to 

control iodine deficiency in the population. 

6.2. COMPONENTS : 

To achieve the above objectives, the following components have been included in the Plan of 

Action for three years: 

6.2.1 SURVEY 

6.2.2 IEC 

6.2.3 LABORATORY ACTIVITY 

6.2.4 MONITORING 

6.2.1 SURVEY: 

6.2.1.1 ACCESS TO IODISED SALT: 

The department of health in collaboration with the department of Civil Supplies plan to make 

available Iodised salt through out the state. For the purpose the Department will encourage Salt 

traders to install Re-iodisation Plants in the state with assistance from Department of Industries and 

Department of Civil Supplies. 

6.2.1.2 CONVERGENCE WITH ASHA 

396

A survey will be conducted in the state to know the percentage of people in the state who use 

Iodised salt. The specific objectives of the survey is to identify proportions of households effectively 

using iodised salt. 

The proposed activity is as follows: 

Survey of household at the village level will be conducted by the ASHAs to ascertain the 

percentage of population having adequate knowledge of Iodised salt and the percentage of the 

population who consume Iodised salt having adequate quantity of Iodine. 

Sl Activity Cost per 

district 

1 KAP on 

IDD by 

ASHAs 

Year wise Proposed No. of districts to be 

covered 

2010-11 Cost Toral 

50,000/- 16 50000/- 8,00,000/- 

The budget requirement for the above activity is proposed at Annexure-I 

6.2.1.3. ESTIMATION OF IODINE DEFICIENCY IN THE POPULATION: 

Scientific determination of the extent of iodine deficiency in the population is of paramount 

importance to initiate correct intervention for achieving the desired level of human resource 

development in the state. 

As such it is proposed to conduct survey of the school children between the age group of 6 to 

12 to know the percentage of children having Goitre and indicative IDD. 


Sl Activity Cost per 

district 

2 Survey of the school 

children for 

estimation of 

prevalence of Goitre 

& IDD 

50,000/- 

397 

Year wise Proposed No. of districts 

to be covered 

2010-11 district Total 

The budget requirement for the above activity is proposed at Annexure-II 

16 

16 

800000

6.2.1.4. MEASURE OF URINARY IODINE EXCRETION & TSH: 

The State Plan envisages qualitative estimation of iodine deficiency of the state population. 

The children between the age group of 6 to 12 will be screened for level of iodine in the body through 

Urinary Iodine excretion method. The urine samples will be collected from the districts and analyzed 

in the state IDD laboratory. The median value of urinary iodine of school children will give a clear 

idea of the iodine deficiency in the population. 

Simultaneously, another study will be conducted for estimating the level of Thyroid 

Stimulating Hormone (TSH) present in the cord blood samples of the new born. For the purpose, cord 

blood samples of new born will be collected from select hospitals and analyzed. 

Iodine deficiency is a risk factor for the growth & development of the people living in iodine 

deficient environment throughout the world and Arunachal Pradesh is no exception. Being in the sub- 

Himalayan region, the state is vulnerable to the malnutrition and needs the effort to determine the 

magnitude of the problem and to study the result of Iodine supplementation by Iodised salt. 

Sl 


Activity Project 

duration 

3 Urinary Iodine 

excretion of children 

between age group 

6-12 

4 Measure of Thyroid 

Stimulating 

Hormone (TSH) 

from New borns 

1 year 

1 years 

Methodology Project area 

Collection of urine samples 

from school children and 

analyzing them at State IDD 

Monitoring laboratory 

Cord Blood samples will be 

collected from new born 

babies and they will be tested 

for level of TSH in blood. 

The requirement for the project is given in Annexure-III. 

6.2.2 IEC ACTIVITIES: 

398 

Random survey of 

school children 

from all districts 

All districts of 

Arunachal 

Pradesh 

IEC activities will be the major means of social mobilization and will be used to create 

awareness about IDD Control programme, its objectives and role that the community can play in 

improving the preventing iodine deficiency. 

While the availability of iodised salt is being ensured in the state through various 

legislations, it is imperative to educate the people about the efficacy of iodised salt in controlling 

Iodine deficiency and the measures required to quality of salt at the consumer level. 

Adequate IEC activities would be undertaken throughout the state and more focused in the 

districts to highlight the benefits of Iodised salt. Suitable IEC components will be developed and 

media intervention sought to educate the mass about the iodine deficiency and the ways it can be

prevented. There will be an overall emphasis on monitoring system performance, evolution and on 

building capacity at all levels. 

The following activities are proposed: 

Sl Activity Year wise number of activity proposed 

1 State level Sensitization Meeting at 

Itanagar 

399 

2010-11 Total no 

1 1 

2 Sensitization meeting at District Level 1 x 16 16 

3 School Health Awareness Programme 

district wise 

16 x 10 160 

4 Press advertisement 5 5 

5 Radio Broadcasting 1 1 

6 Printing IEC materials 1 

7 Sensitization meeting for Traders 1 x 16 16 

8 Block level sensitization meeting 16 x 5 80 

The requirement for the activities are given in Annexure-IV. 

6.2.3. MONITORING AND EVALUATION 

It is proposed to strengthen the monitoring and evaluation procedure in the state so that a 

mechanism is evolved by which a system of monthly reporting is established in all the districts. 

Monitoring Mechanisms. 

a. Sharing of information about the prevalence of Goitre/IDD and the percentage of people 

consuming Iodised salt. 

b. Developing effective partnership with health and non health sectors in monitoring. 

Monitoring Activity: 

a. Collection of data 

b. Compilation of data 

c. Analysis and interpretation of data 

d. Feedbacks

f. Use standard formats developed by State IDD Cell. 

g. Ensure regularity of the reports 

h. Ensure actions taken as per the reports. 

Use of Information Technology 

To facilitate proper communication, data manning, feedback and for dissemination of reports 

and improving timeliness of responses at the state and district level, it is proposed to provide the 

following communication equipments like personal computer, fax machine and Overhead projectors 

in all the districts. At the state level, LCD Projector is proposed to be procured under IEC 

component. 

Sl Item Requirement for 

State Hq. 

400 

Requirement 

for districts 

Total 

1 Personal Computer 0 16 16 

2. Fax machine 0 16 16 

3. Over head projector 0 16 16 

4. LCD Projector 1 1 

Financial requirement for the above items is given in Annexure-V. 

6.2.4. STRENGTHENING OF MANPOWER: 

The Plan of Action under NIDDCP is so designed that it will require a dedicated team of 

people for undertaking the scheduled activities of survey, laboratory activity, monitoring and 

evaluation. Since there are no staffs under NIDDCP, it is proposed to appoint the following staffs on 

contractual basis on fixed pay for the project period i.e. for one year, 2010-2011. 

The proposed manpower to be appointed on contractual basis is as follows: 

Sl Title State 

Headquarter 

District Total 

1 Data Entry Operator 1 1 

2 Field Assistant 0 16 16 

The budget requirement for salary of contractual staffs proposed for three years from 2009- 

10 is given in Annexure-VI.

6.2.5. TRAINING 

For the programme to be successful, effective training of all categories of staff is vital. The 

Training strategy would aim at strengthening the capacities of both medical and paramedical staffs. 

Professional training is a pre-requisite for any research activity. Though the officers are sensitized 

on the programme it will be required to train the technical persons entrusted with the job. The 

Research Assistants to be appointed on contractual basis and the laboratory technicians will be 

adequately trained for collection of samples and their laboratory analysis. The emphasis of the 

training will therefore be on development of both skills and capacities. 

The staffs involved in survey and for research activity will be trained at State IDD laboratory 

along with Regional laboratory at All India Institute of Public Health & Hygiene, Kolkata where they 

will be trained on protocols for Iodine deficiency monitoring as well as Quality assurance. 

The budget requirement for salary of contractual staffs proposed for three years from 2010- 

11 is given in Annexure-VI. 

401

SUMMARY PLAN OF ACTION, Arunachal Pradesh 

Narrative summary Performance indicator Means of verification Important assumption 

Goal 

Sustainable IDD Elimination Adequate UIE among 5-15 yrold 

school children; 

Objective 

Outputs 

USI achieved Iodine levels are adequate in 

>90% of salt used in 

households 

1. State PLAN OF ACTION adopted State Plan of Action forms part 

of IDD Control programme 

and budget decisions 

Activities 

1.1. As per predefined roles and 

responsibilities of acting partners, 

timeline, financial needs, reporting 

requirements and funding sources 

1.2. Discuss the draft PIP with highlevel 

leaders in government, science, 

and consumer groups and establish 

Draft Plan of Action approved 

by the key acting partners: 

MOH, and State Government 

with Consumer representatives 

Consultations held with all 

groups mentioned 

402 

State level survey in 2010-11 Political will prevails 

among all key partners 

Salt supply data from 

monitoring to show that total 

edible salt supply is iodized 

Funds disbursed to implement 

Plan of Action is utilized 

State Plan of Action to be 

approved by GOI and funds 

released for it's execution 

Acceptance expressed by 

groups consulted 

Salt used in households is 

representative of total edible 

salt supply 

All partners play their part 

in executing the State Plan 

of Action 

Govt. of India approves the 

State Plan of Action and 

supports the project

Outputs 

a coalition 

1.3. Conduct a high-level policyadvocacy 

event to obtain broad PIP 

acceptance 

High degree of participation 

by all partner groups in the 

event 

2. State level Coalition established State level Coalition members 

known and accepted 

Activities 

2.1. Assure nomination of a high-level 

politician as Chair and establish 

adequate technical support 

2.2. Invite balanced and adequate level 

memberships from all acting and 

supportive partners 

2.3. Define oversight functions based 

on expressed demand for 

information, and planned use of 

monitoring data for decisions 

Chair has been nominated and 

has access to adequate 

technical support 

Members accept invitation for 

membership in the Coalition 

Monitoring reporting 

requirements have been 

defined by the state level 

Coalition and transmitted to 

partners 

403 

Political decision-makers 

agree to prioritize IDD 

elimination 

State level Coalition meeting 

schedule announced 

Chair sets meeting agenda of 

State level Coalition on 

secretariat recommendations 

Members participate in State 

level Coalition meetings and 

functions 

State Coalition obtains 

comprehensive monitoring 

information and uses it for 

programme decisions 

All partners accept their role 

in overseeing the IDD 

elimination programme 

Partners understand and 

accept IDD elimination 

through USI as a multisectoral 

responsibility

2.4. Ensure public reporting of the state 

progress toward IDD elimination 

Outputs 

3. USI legislation and/or regulation 

enacted 

Activities 

3.1. Formulate legislation (under PFA) 

to mandate the iodization of 

household salt, animal salt & food 

industry 

3.2. Define ways and procedures to 

enforce the draft legislation 

3.3. Ensure acceptance of draft sublaws 

by all parties involved or affected 

Outputs 

The State Coalition issues a 

annual progress report 

Laws formulated on mandatory 

iodization of edible salt 

Legislation drafted on each 

salt type (household, animal, 

food industries) 

Appropriate enforcement 

procedures formulated 

Organize review of draft 

proposals by broader society 

404 

Annual report obtained and 

used by the media to inform 

the public 

Laws enacted and published In place 

Publicity of the legislation 

through media. 

Draft legislation and 

enforcement procedures 

reviewed and accepted by all 

involved or affected 

In place

4. Supplies of iodized edible 

Activities 

salt ensured 

4.1. Obtain readiness by salt traders to 

import and sell only iodized salt for 

human and animal consumption 

4.2. Establish a system for effective 

quality assurance of all the edible 

salt supplies 

4.3. Support food inspection in 

developing an appropriate module 

for quality control 

4.4. Support salt industry in 

appropriate ethical promotion 

through their sales channels 

Outputs 

5. Advocacy and re-advocacy 

among leaderships takes 

place 

Appropriate systems developed 

for quality assurance, quality 

control and promotion of 

iodized salt for human and 

animal consumption 

Edible salt supply source(s) 

have been consulted 

System defined that assures 

adequate iodization of all the 

edible salt imported. 

Quality control module of all 

edible salt supplies proposed 

Iodized salt promotion plan 

developed by salt enterprises 

Milestone events are being 

used for advocacy and readvocacy 

among political 

leaders on the imperatives of 

IDD elimination and USI as 

405 

Quality assurance and quality 

control methods and 

procedures accepted by all 

parties involved or affected 

Supply source(s) have 

confirmed that sufficient 

amount of good quality iodized 

salt is available 

Quality assurance system is 

accepted by salt traders. 

Inspection module accepted by 

salt traders 

Plan to be submitted to GOI 

Advocacy and re-advocacy 

forms part of Plan of Action 

adoption , broad society 

consultation , USI law 

enactment and ceremony to 

Customers of salt import firms 

and consumers accept that 

only iodized salt is supplied for 

human and animal 

consumption 

No objection against nonavailability 

of non-iodized salt 

among consumers 

Political & community leaders 

participate and/or take note of 

milestone events.

Activities 

5.1. Conduct advocacy on USI and IDD 

elimination as part of milestone 

events 

Outputs 

6. Critical gatekeeper groups are being 

informed and educated 

Activities 

6.1. Conduct information and education 

for educational, media and public 

health professionals 

single, sufficient strategy mark goal attainment 

Plans developed for high-level 

advocacy as part of society 

consultation, law enactment 

and goal attainment events 

Information/education 

materials submitted to critical 

gatekeeper educational 

systems 

Critical gatekeeper groups 

receive informational and 

educational materials 

406 

State Coalition members 

coordinate the contributions to 

be made in advocacy among 

constituencies 

Education on USI/IDD 

inserted in ongoing 

curriculums of critical 

gatekeeper groups 

Critical gatekeeper groups use 

informational and educational 

materials 

No political objections raised 

among leaderships against USI 

as the single, sufficient 

strategy for IDD elimination 

Education leads to habitual 

practices supportive of USI 

No objection raised or created 

among gatekeeper groups 

against USI as single,

6.2. Conduct information on IDD and 

USI for dissemination through retail 

networks for household, animal and 

food industry salt 

Outcomes/Results 

7. Broad public acceptance for USI is 

being stimulated 

Activities 

7.1. Conduct educational activities 

through mass media 

7.2. Develop information and education 

for leading medical, educational, 

food industry, media and public 

health professionals 

7.3. Develop information on IDD and 

USI for dissemination through retail 

networks for household, animal and 

food industry salt 

Outputs 

8. Supply of edible salt is being 

monitored 

Retail networks receive 


materials 

Indormation/education 

materials submitted to key 

information dissemination 

systems 

Mass media experts 

collaborate in developing 

educational messages 

Communication experts 

collaborate with respective 

partners in material 

development 

Salt import firms collaborate 

with experts in material 

development for product 

promotion 

Salt Traders Association have 

developed their capacity for 

407 

Retail networks use 


materials 

Mass media, gatekeeper 

groups and edible salt retailers 

conduct coordinated consumer 

education 

Mass media disseminate 

educational messages 

Informational materials 

developed for critical 

gatekeeper groups 

Informational materials 

developed for retail networks 

of salt import firms 

Salt Traders Association issue 

periodic reports on supply of 

sufficient strategy for IDD 

elimination 

Regular provision of 

information leads to 

acceptance of USI among 

broad public 

No objection among mass 

media, gatekeeper groups and 

retail networks 

State supply data indicate that 

progress toward USI is

Activities 

8.1. Develop system for regular 

reporting of edible salt supplies to 

retail shops 

6a.2. Set up system for annual 

reporting on results of quality 

control inspections by health 

functionaries 

Outputs (Products) 

9. Population iodine nutrition status 

is being monitored 

Activities 

9.1. Develop and strengthen capacity 

on salt iodine and urine iodine 

assessment and reporting 

reporting supply of edible salt edible salt continuous 

Quarterly reporting system on 

edible salt supplies has been 

devised 

Deptt. of health has developed 

annual reporting system on QC 

of edible salt supplies in retail 

markets 

System in place to measure 

and report on the use of 

iodized edible salt and its 

impact on population iodine 

nutrition status 

Districtwise capacity and 

support needs for salt and 

urine assessments considered 

and established 

408 

Salt Traders Association 

reports quarterly on the 

amount and quality of the 

edible salt supplies in the state 

Deptt. of health reports 

annually on QC results of 

edible salt supplies in retail 

markets 

Regular monitoring reports 

are received and reviewed in 

State Coalition, and used for 

decisions on how to proceed 

Assessment and management 

capacity for salt and urine 

iodine measurement 

established in each district 

No objection by Salt Traders 

Association against public 

reporting 

Review and decision capacity 

by GOI 

Functional salt and urine 

sampling, measurement and 

reporting systems in place to 

document the use of iodized

9.2. Design regular data collection and 

reporting on edible salt use and 

iodine nutrition status in population 

9.3. Conduct State level survey to 

affirm optimal population iodine 

nutrition and sustainable attainment 

of the goal 

Salt and urine sample 

collection, measurement and 

reporting system designed, 

tasks assigned and costs 

budgeted 

Timing and draft design of a 

verification survey to be 

agreed upon by the 

Government 

409 

Sampling of salt and urine for 

iodine determinations and 

reporting is ongoing 

Plan for survey execution, 

connection with Govt. of India, 

and funding have been made 

edible salt in the population 

and demonstrate its impact on 

iodine status

7. 

410

BUDGETING 

The Annual budget for the State Plan of Action for implementation of NIDDCP in the state 

for 2010-11 has been proposed as per the state requirement and anticipated allocation by the Govt. 

of India. 

7.1 STATE LEVEL 

State IDD Cell in the state headquarters will implement the approved Plan of Action. Under 

the umbrella of the Arunachal Pradesh Rural Health Mission, and through Integrated Disease 

Surveillance Project, a separate bank account in the name of “State Health Society (IDD)” would be 

opened in the State Bank of India. The books of accounts at the state level would be maintained using 

double entry book keeping principles. 

7.2 DISTRICT LEVEL 

The District Surveillance Units of the districts will receive funds by cheque/demand draft 

from the State IDD Cell for undertaking the activities at the state level. The account will be 

maintained in a separate bank account which would be operated under the umbrella of the District 

Surveillance Society. 

7.3 BOOKS OF ACCOUNT AND PROCEDURE: 

The account of NIDDCP would be maintained in accordance with procedures and policies 

prescribed by the GOI and conforming to General Financial Rules (GFR) as issued from time to time. 

Standard books of accounts on a double entry basis (cash and bank books, journals, fixed 

assets register, ledgers, work registers, contractor registers etc.) will be maintained. 

8. SUMMARY 

The National IDD Control Programme in the state is functioning as per the guidelines of 

Govt. of India since last 20 years. 

This State Plan of Action has been proposed for three years in which period it is planned to 

undertake two research work to determine the extent of iodine deficiency prevalent in the population. 

The major components which are part of the normal programme implementation are: 

1. Survey 

2. IEC activity 

3. Monitoring quality of iodised salt. 

4. To determine the level of iodine present in iodised salt. 

Special emphasis has been laid on IEC since the impact of Iodine deficiency almost always 

goes unnoticed and very few people are aware of the different consequences of Iodine deficiency. 

411

Laboratory activity is vital to track the quality of various brands/makes of iodised salts 

available in the state. 

It is intended to strengthen the reporting system. Many districts do not report and even f they 

do, not always timely. It is proposed to provide one PC to all the districts so that they can send the 

report in time, efficiently. 

The spot test kit supplied by UNICEF since last decade had been an excellent medium for 

awareness generation both at the community level and for the students. This year also, UNICEF will 

be requested to supply atleast 5000 Spot test Kits which will be distributed to the districts. 

Total budget requirement proposed for 2010-2011 is Rs. 1,28,07,000/- 

Annexure in the following pages gives the budget requirement to transform this Plan of 

Action into result. 

Sl Activity 

1 KAP on IDD by ASHAs at the 

district level to ascertain the 

percentage of population having 

adequate knowledge of Iodised salt 

and the percentage of the population 

who consume Iodised salt having 

adequate quantity of Iodine. 

Total 

ANNEXURE-I 

BUDGET REQUIREMENT FOR 

KAP by ASHAs for SCHOOL CHILDREN 

Cost per district 

survey 

412 

Total no. of 

districts 

50,000/- 16 

Total Budget requirement for 

2010-11 

(In Rupees) 

8,00,000/- 

8,00,000/-

Sl Activity 

ANNEXURE-II 

BUDGET REQUIREMENT FOR SURVEY 

TO ACCESS THE PERCENTAGE OF HOUSEHOLD CONSUMING IODISED SALT 

1 Survey to estimate the 

percentage of household 

having access to Iodised salt 

Sl 

1 

Cost per 

district 

Total no. of districts 

413 

Total Budget requirement for 2010-11 

(In Rupees) 

50,000/- 16 8,00,000/- 

Total 8,00,000/- 

Activity Project 

duration 

Analysis of 

Urinary 

Iodine 

excretion of 

children 

between age 

group 6-12 

2 Measure of 

Thyroid 

Stimulating 

Hormone 

(TSH) from 

New born 

ANNEXURE-III 

BUDGET REQUIREMENT FOR SCIENTIFIC ANALYSIS OF 

1 year 

1 years 

URINARY IODINE EXCRETION AND 

TSH IN CORD BLOOD SAMPLES OF NEW BORNS 

Methodology Cost per district (in 

Rupees) 

Collection of urine 

samples from 

school children and 

analyzing them at 

State IDD 

Monitoring 

laboratory 

Cord Blood 

samples will be 

collected from new 

born babies and 

they will be tested 

for level of TSH in 

blood. 

1,00,000/- 

Total no. 

of 

districts 

16 

Total Budget 

requirement for 

2010-11 

16,00,000/-

ANNEXURE-IV 

BUDGET REQUIREMENT FOR IEC ACTIVITIES 

IN THE STATE DURING THE PROJECT PERIOD, 2009-10 

Sl Activity Cost estimate 

1 

2 

3 

State level Sensitization 

Meeting at Itanagar 

Sensitization meeting at 

District Level 

School Health 

Awareness Programme 

414 

Number of 

activity per 

year 

Total no 

Grand Total 

1,80,000/- 1 1 1,80,000/- 

80,000/- 16 16 8,00,000/- 

5,000/- 

10 schools per 

dist 

160 8,00,000/- 

4 Press advertisement 15,000/- 5 5 75,000/- 

5 Radio Broadcasting 30,000/- 1 1 30,000/- 

6 Printing IEC materials 1,00,000/- 1 per district 16 16,00,000/- 

7 

8 

Sensitization meeting for 

Traders 

Block level Sensitization 

meeting 

40,000/- 1 per district 16 6,40,000/- 

10,000/- 

5 blocks per 

dist 

80 8,00,000/- 

Total 49,25,000/- 

ANNEXURE-V 


PROCUREMENT OF OFFICE EQUIPMENTS FOR THE PROJECT PERIOD, 2010-2011 

Sl ITEMS Cost 

1 Personal Computer with 

UPS & Printer 

No of activity & cost for 2010-11 

Total required Total 

Justification 

50,000/- 16 8,00,000/- Required for 

Monitoring & 

reporting 

2 Fax machine 10,000/- 16 1,60,000/- 

3 Over-head Projector 10,000/- 16 1,60,000/- Required for IEC. 

4 LCD Projector 80,000/- 1 80,000/- 

Total 12,00,000/-

ANNEXURE-VI 


SALARY OF STAFFS PROPOSED TO BE APPOINTED ON CONTRACTUAL BASIS FOR 

THE PROJECT PERIOD, 2010-11 

Sl ITEMS Cost Total requirement of fund 

1 Salary of Field 

Assistant. 

2 Data Entry 

Operator 

5,000/- 

per month 

6,000/- 

per month 

Total 

required 

16 districts 

x 12 

months 

1 for State 

Hq 

415 

2010-11 Total 

80,000/- x 

12 

6,000/- x 

12 

Total 10,32,000/- 

ANNEXURE-VII 

Justification 

9,60,000/- The personnel will 

be appointed on 

Contract basis for 

one year to 

72,000/- undertake the 

laboratory activity. 

ADDITIONALITIES UNDER MAINTENANCE OF STATE IDD CELL 

FOR THE PROJECT PERIOD, 2010-11 

Sl Activity Estimated cost 

1 Salary of Officers & Staffs under NIDDCP 

12,00,000/- 

2 TA/DA 1,00,000/- 

3 Medical Treatment 

50,000/- 

4 Maintenance of Office 

5 Maintenance of State IDD Laboratory 

6 Maintenance of Vehicle 

5,00,000/- 

5,00,000/- 

1,00,000/- 

Total 24,50,000/-

ANNEXURE-VIII 

TOTAL BUDGET REQUIREMENT FOR THE PROJECT PERIOD, 2010-2011 

FOR PLAN OF ACTION ON NIDDCP 

SUMMARY OF TOTAL BUDGET REQUIREMENT,2010-11 

Sl Activity State IDD Cell Districts (16) Total 

1 KAP on IDD by ASHAs 

8,00,000/- 8,00,000/- 

2 IDD SURVEY OF DISTRICTS 

3 Scientific analysis on UIE & TSH 

4 HEALTH EDUCATION & PUBLICITY 

5 Office equipments/ Maintenance of State 

IDD Cell 

6 Salary of contractual staffs 

416 

8,00,000/- 8,00,000/- 

16,00,000/- 16,00,000/- 

49,25,000/- 

80000/- 11,20,000/- 12,00,000/- 

10,32,000/- 

7 Maintenance of State IDD Cell 24,50,000/- 

Total 1,28,07,000/- 

CONCLUSION: 

The NIDDCP is the state is functioning with its limited resources. Over the years Goitre and 

survey has been done in almost all districts. What is encouraging is that Goitre has almost 

disappeared in the state with only a few sporadic reports. The incidence of Goitre was very high 

during 1960s with a prevalence rate of 38%, as per ICMR survey. Subsequent survey by ICMR in 

1970s showed a reduction in the prevalence rate to about 28%. State IDD cell has since 1990 started 

conducting survey of selected districts and the prevalence rate has since been reduced to less than 

6%. The dramatic reduction in the prevalence rate of Goitre is definitely due to consumption of 

Iodised salt in the state. Use of non-Iodised salt was banned in the state since 1974 and it’s impact 

has been transformed into results. 

However, there is a need to study the actual prevalence of iodine deficiency in the population 

for which Goitre survey is not enough. Also the availability of Iodised salt in the households as per 

the Universal Salt Iodization programme needs to be ascertained. 

As such the State Plan of Action for 2010-2011 has reflected the need of the state as regards 

to research work along with routine duties as per the National IDD Control programme. 

Total budget estimated for the perceived activities for the budget year 2010-2011 is Rs. 

1,28,07,000/-

NPCB : PIP FORMAT TO BE FILLED IN BY THE STATE 

NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS GRANT – 

IN – AID TO STATES / UTs FOR VARIOUS COMPONENT DURING 

2009-10 

Recurring 

Grant-inaid(*) 

Nonrecurring 

Grant-in-aid 

Contractual 

Manpower 

For free Cataract operations @ Rs 750/- per case 

and other Approved schemes as per financial 

norms(*) 

417 

Physical 

Target 

(Figure in Rupees) 

Funds 

Required 

1,84,83,000 

For RIO (new) @ Rs.60 Lakhs 

For Medical Colleges @ Rs.40 lakhs/- 

For Vision Centres @ Rs.50000/- 6 Nos 3,00,000 

For Eye Bank @ Rs.15 Lakhs 1 No 15,00,000 

For Eye Donation Centre @ Rs.1 Lakhs 

For NGOs @ Rs.30 Lakhs 

1 (continue 

2nd 

Installment) 

17,50,000 

For Eye Wards & Eye OTs @ Rs.75 Lakhs 2 Nos 1,50,00,000 

For Mobile Ophthalmic Units with tele-network @ 

1 No 60,00,000 

Rs.60 Lakhs 

Ophthalmic Surgeon (Salary of Rs.25000/- p. m.) 4 No 12,00,000 

Ophthalmic Assistant (Salary of Rs.8000/- p.m.) 18 No 17,28,000 

Eye Donation Counsellor (Salary of Rs.10000/- p.m.) 4 Nos 4,80,000 

Total Grant-in-aid 4,64,41,000 

(*) = Recurring Grant-in-Aid for Free Cataract Operations and various other schemes which 

include: Other Eye Diseases @ Rs 1000/-, School Eye Screening Programme @ Rs 200/- per pair of 

spectacles, Private Practitioners @ as per NGO norms , Management of State Health Society and 

District Health Society @ Rs 14 lakhs/ 7 lakhs, Recurring GIA to Eye Donation Centres @ Rs 1000/- 

pair of Eye Ball collection and Eye Banks @ Rs 1500/- per pair of Eye Ball collection Rs 1500, 

Training, IEC, Procurement of Ophthalmic Equipment, Maintenance of Ophthalmic Equipments, 

Remuneration, Other Activities & Contingency. 

PIP OF NPCB 2010-11 

Physical Target & other activities under NPCB for the year 2010-11 

1. CATARACT OPERATION GOI TARGET Achiev. Upto Dec’09 

for 2009-10 

2000 984 

Special drive for Cataract operation camp will be organized in all the districts for 

attaining the target over & above fixed facility surgeries. 

2. School Eye Screening Target 

a) No. of Students to be screened 30,000 15356 

b) Children to be detected with 

refractive errors 1800 1286

c) Free Spectacles to be provided 540 370 

Free spectacles will be provided to poor children detected with refractive errors. 

3. Eye Collection 20 Nil 

4. Infrastructure Development New proposal for 2010-11 

a) Strengthening of District Hospital 2 No. 

b) Vision Centre 6 Nos. 

c) Eye-OT cum Eye-Wings 2 Nos. 

d) Mobile Ophthalmic Unit 1 No. 

with tele-Ophthalmology 

e) Eye bank 1 No. 

f) Contractual Ophthalmic manpower 18 Nos. (continuation of 12 

Nos. + 6 Nos) PMOA & 4 

Nos. OS. (Continuation of 2 

Nos. + 2 Nos) 

5. Participation of NGO 

RKM Hospital, a NGO Hospital has been nominated to provide a fund from GOI for 

development of eye-care facilities service. For this purpose Rs. 12.50 lakhs has been sanctioned 

in 2008-09 as a first installment and released during 2009-10. Provision for second installment 

was kept in PIP of 2009-10, but was not approved. Hence provision is kept in present PIP for 

second installment of Rs. 17.5 lakhs being committed liability. 

6. Training 

In-service refresher training will be given to the following categories 

1) Eye-Surgeon, 

2) I/C M.O., PHC 

3) Ophthalmic Asstt. 

4) Staff Nurse 

5) O.T. Technician 6) ASHA & other para-medical staffs. 

7. Commodity Assistance 

Sophisticated eye-equipments is proposed to be provided to two nos District 

Hospitals of the state, to make them Eye Micro-Surgery Centre as per standard list of GOI, 

alongwith procurement of consumable items like 10/0 sutures & IOL for the whole state. 

418

8. IEC 

Public awareness about prevention & timely treatment of eye diseases are done 

through news-paper advertisements, installation of hoarding, wall-writing, posters, 

pamphlets, Radio Jingles over AIR, FM, spots over cable T.V. network etc. 

9. Human Resource Development 

We propose to continue Contractual appointment of 12 Nos of PMOA & 2 Nos of 

Ophthalmic Surgeon and new recruitment of 6 Nos of PMOA & 2 Nos of Ophth. Surgeon 

against new Vision Centres & new strengthened District Hospital proposed. 

10. Associate Activities 

1) Members of Gaon Panchayat will be approached for their co-operation towards eye-care 

activities to the village-level. 

2) ASHA’s are to be trained for NPCB activities by DBCS & will be utilized for identifying 

motivating & bringing cataract patients to cataract surgical facilities. 

11. Monitoring Indicators under NPCB 

a) No. of Cataract operation 

b) School Eye Screening performance 

c) No. of Eye collection. 

12. Special Attention to 3 (three) backward high focus districts :- 

i) Upper Subansiri ii) East Kameng iii) Kurung Kumey District 

Provision is kept & proposed as follows:- 

a) One Eye ward cum OT building at District Hospital DAPORIJO, provided Eye Surgeon 

is posted in the District Hospital ( As per GOI norm) 

b) Two vision centre each in the three districts proposed. 

c) Strengthening of Dist. Hospital K/Kumey Dist(Dist.Hospital Daporijo & Seppa already 

strengthened) 

d) Minimum three Nos Cataract Operation Camp in each district during 2010-11 proposed 

to be organized by DMO concerned for which special extra- grant of Rs. 1.00 lakh(One 

lakh) each proposed. 

419

FINANCIAL IMPLICATION OF PIP-2010-11 

420 

Rs, in lakh 

Head Physical 

Salary & Honorarium 

Adm. Asstt. - 1 No 

Financial 

0.84 

Accounts officer - 1 No 1.68 

a) Salary---------------------- 

Data Entry Operator - 1 No 0.84 

S.A - 1 No 0.96 

Peon - 1 No 0.60 

4.92 

b) Honorarium ------------- M.S. SBCS - 1No 0.24 

2. Stationery ----------------- Cost of Stationery articles- 0.80 

3. Office expenses---------- ----------------------------------- 0.80 

4. Miscellaneous expenses - - - - - 0.75 

POL Expenses 

1No Vehicle-AR-01’C’-3280 

1.00 

6. Hire charges of Vehicle 

0.50 

7. Maint of office Equipments & 2 Nos.Computer,1No Fax,1No 2.40 

Vehicle & AMC of computer & Xerox Xerox,2Nos Telephone & 1No 

machine 

Vehicle & 1 No. Laptop. 

8. Traveling expenses - - - - - - - - - - - 1.00 

9. Training - - - - - - - - - - - 2.70 

10. Contigencies 

a) Telephone Postage & 

Fax 

- - - - - - - - - - - 0.80 

b) Refreshment - - - - - - - - - - - 0.20 

c) Bank charges - - - - - - - - - - - 0.02 

d)Consumable - - - - - - - - - - - 0.10 

e) Others - - - - - - - - - - - 0.50 

HEAD 

11. Special drive for cataract 

operation of backward high 

focus district & School Eye 

Screening 

PHYSICAL FINANCIAL 

9 Eye camps in three District @ Rs. 

1.00 lakhs each 

School Eye Screening for 16 Dist. @ 

Rs. 0.50 lakhs each 

12. Eye Bank - - - Establishment of 1No Eye Bank 

9.00 

8.00 

17.00

13. Strengthening of Eye-care 

facilities in NGO Sector (On 

going) 

2 nd installment yet to release to 

RKMission, Itanagar 

421 

15.00 

17.50 

14. I. E. C. 8.00 

15. Vision Centre Construction of new 6 Nos Vision 

centres @ 0.5 lakhs each. 

16. Fund for DBCS Installment of funds for 16Nos Eye 

Socities @ 5.0lakhs for each DBCS. 

3.00 

80.00 

17. Eye ward and Eye O.T. New construction of Eye – ward and 

Eye O.T.-= 2Nos @ Rs,75.00 lakhs 

each 

150.00 

18. Recurring Expenses on Eye 20 pairs of Eye 0.10 

Donation centre 

19. Ophthalmic Assistants on 

Contract basis (on going) 

20. Ophthalmic Surgeon on 

Contract (on going) 

18 Nos contractual basis Ophthalmic 

Assistant @Rs,8000/-PM 

4 Nos Contractual basis Eye 

Surgeons @25,000/- 

17.28 

12.00 

21.Commodity Assistances For purchase of Sophisticated Eye 

equipments for 2 Nos Districts & 

other consumable etc. 

60.00 

22. GIA for other Eye diseases 1.00 

23.Mobile Ophthalmic Unit 

With Tele Network 1 No 

60.00 

24. Maint. of Ophthmic equipments 2.00 

25. Eye Donation counselor 4 Nos 4.80 

Total 464.41

Name of State /UTArunachal Pradesh No. of District 16 

Sl. 

No 

Name of 

the 

Training 

Programme 

Category 

of Trainees 

Total 

Training 

Load 

Comprehensive Training Plan for the Year (2010-11) 

Trained 

Till Date 

B NPCB Oph Asstt 34 22 

National Programme for Control of Blindness 

Venue 

Sri 

Sankardev 

Nethralaya, 

Ghty 

Duration 

of 

training 

422 

No. of 

Participants 

per batch 

Training 

laod as 

projected for 

Coverage 

2010-11 

Funds 

requirement 

for training 

during 2010- 

11 

2 weeks 10 12 50,000 

Staff Nurse 32 15 - Do - 2 weeks 5 17 75,000 

Budget 

Estimate(Rs.) 

OTT 2 - Do - 2 weeks 2 2 25,000 2,70,000 

ASHA All District Dist HQ 1 day 16 District 

As per Dist 

figure 

1,20,000 

Remark

A. Executive summary: 

1.Goals : 

2. Activities: 

NATIONAL CANCER CONTROL PROGRAMME 

I. To increase early detection and diagnosis of cancer. 

II. To establish baseline cancer care facilities for surgery and chemotherapy. 

III. To provide palliative and rehabilitative care in advanced stages of the cancer. 

I. To identify PHC/CHC for financial incentive schemes. 

II. To identify CHC for upgradation: Early Detection and Referral (level 0) 

III. To identify a District for Basic Cancer Care Facilities without Radiotherapy (level I). 

3. Financial support: 

The financial support is being provided by the GoI, Ministry of Health & Family Welfare, New Delhi 

under Revised National Cancer Control Programme for the year 2009-2010. 

B. Introduction: 

Cancer care facilities both for diagnosis and treatment are very much limited in the state of 

Arunachal Pradesh. Most of the patients are diagnosed in very advanced stages of the disease due to 

lack of diagnostic tools, trained manpower and lack of awareness etc. Moreover, facilities for cancer 

surgeries, chemotherapy, and palliative care are limited to General Hospital, Naharlagun only which 

is the apex Referral Hospital of the state. A separate plan is being prepared for Development of 

Oncology Wing at General Hospital, Naharlagun and the action plan is ready for final submission to 

the GOI for financial grant under NCCP. A supplementary PIP is made to avail the Physical & 

Financial targets for the State of Arunachal Pradesh under NCCP, Ministry of Health & Family 

Welfare, Government of India for the year 2009-2010. 

C. Brief on Arunachal Pradesh: 

423


Arunachal Pradesh erstwhile known as North Eastern Frontier Agency (NEFA) is 

known as “The land of rising sun”. The state is situated as a sentinel in the northeastern 

part of India, bounded by international boundaries with China in the north, Myanmar in 

the southeast and Bhutan in the west. The state is situated at latitude of 90.36 0 E to 97.3 0 

E and longitude of 26.42 0 N to 29.30 0 N covering a total land area of 83,743 sq. km. The 

population of Arunachal Pradesh is 10, 91,117 (Census 2001).Density of population is 

13 persons per square kilometer. Sex ratio of the state is 901 females per 1000 males 

as per census 2001. The total literacy rate of the state is 54.74% with a male literacy 

rate of 64.07% and female literacy rate of 44.24%. The per capita income (97-98) of the 

state is Rs. 13424. [Source: Provisional Census of India 2001]. 

Due to its peculiar topography and difficult terrain, there is widely dispersed 

settlement pattern of the population that applies to both rural and urban areas. The rural 

population constitutes 79.59% and the urban only 20.41 %. 0-6 yrs population is 18.33% 

in which male constitute 17.77% and female 18.96%. 

The state has a total population of10, 91,117 (Census 2001) with male 

constituting 573951 and 517166 females. The percentage of population below poverty 

line in 1999-2000 is 33.47 (SRS Bulletin, April 2001) with a percentage decadal growth 

of 26.21 and Average Annual Exponential Growth Rate of 2.33. The decadal growth rate 

of urban population is a staggering 101.29 %. 

Sl.No. Background 

Characteristics 

1 Geographic Area (in 

Sq. Kms) 


3 Size of Villages (2001 

Census) 

1-500 

501-2000 

2001-5000 

5000+ 

4 Number of towns 

5 Total Population 

(2001) 

424 

Number 

83743 

3862 

3442 (Census-2001) 

392 (Census-2001) 

26 (Census-2001) 

3 (Census-2001) 

17 

1097968 (Census- 

2001) 

Urban 

227881 (Census-2001) 

Rural 

870087 (Census-2001) 

6 Sex Ratio (F/M*1000) 

• Population Sex Ratio 

901 

Population Sex Ratio 893

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 MMR 

19 


Decadal growth rate 26.21 

Density- per sq. km 13 

Literacy Rate (6+ Pop) 54.74 

Male 64.07 

Female 44.24 

%SC population 0.507 

%ST population 67.77 (2001 Census) 

No. of schools 538 

No. of Anganwadi 

Centres 

Length of road per 100 

sq. km. 

% of villages having 

access to safe drinking 

water facility 

% of households having 

sanitation facility 

(Specify Type –sewer, 

septic tank) 

% of population below 

poverty line 

Health Status Morbidity 

Male Female Child 

IMR 

Health Resources- 

Facilities (Specify level 

of Facility like Subcentre) 

Personnel(Sanctioned 

Vacancy) 

425 

3862 

15356 

70.4 

66.4 

61 

33.47 (SRS Bulletin April 

2001) 

Will be given separately

1 

20 

21 

22 

23 

24 

Finances(Requirement 

and Releases) 

1. Birth rate and death 

rate 2. Fertility rate. 

3. Disease maximum 

Disability. 


B.To link with the 

nutritional 

determinants-1. % of 

Infants with low birth 

weight. 2.Weight for Age 

no. above 90%, 3. No 

between 60%-80%, 4. 

No. below 60% weight 

for age 

No of Primary school 

teachers 

No of children enrolled 

(Age wise) (All relevant 

data needed to Start 

School Health 

Programme) 

426 

DNA 

3.03 

1280 

D. Census indicators: Health Indicators – Arunachal Pradesh 

Reproductive & Child Health Outcomes NFHS –III 

Infant Mortality Rate ( per 1000 live births) 

2 Total Fertility Rate(the average number of children that would be born to 

a woman over her lifetime) 

61 

37 (SRS 2006) 

3 % of pregnant women receiving 3 ANC check ups 36.4 

4 % of pregnant women age 15-49 who are anemic 49.2 

5 % of births assisted by a doctor/nurse/LHV/ANM/other health personnel 33.4 

6 % of institutional births 30.8 

7 % of mothers who received post partum care from a doctor/ nurse/ LHV/ 23.3 

3

ANM/ other health personnel within 2 days of delivery for their last birth 

8 % of neonates who were breastfed within one hour of life 55.0 

9 % of infants exclusively breastfed till 6 months of age 60.0 

10 % of infants receiving complementary feeds apart from breast feeding at 

9 months 

11 % of children 12-23 months of age fully immunized 28.4 (45 – CES07) 

12 % of children 6-35 months of age who are anemic 66.3 

13 % of children under 3 years age with diarrhea in the last 2 weeks who 

received ORS 

14 % of children under 3 years age who are underweight 36.9 

15 Contraceptive prevalence rate (any modern method) 37.3 

16 Contraceptive prevalence rate (limiting methods) 

17 Male Sterilization 0.1 

18 Female Sterilization 22.5 

19 Contraceptive prevalence rate (spacing methods) 

20 Oral Pills 8.3 

21 IUDs 3.6 

22 Condoms 2.9 

23 Unmet need for spacing methods among eligible couples 8.6 

24 Unmet need for terminal methods among eligible couples 10.7 

25 Birth Rate 5.0 (SRS 2006) 

26 Death Rate 23.3 (SRS 2006) 

E. Health Care Facilities: 

No. Facility 

427 

In Position 


2 Primary Health Centres 116 


4. District Hospital 12 

5. General Hospital 2 

77.6 

33.5

F. Cancer control status facility: 

Arunachal Pradesh is in its infancy regarding cancer control activities. General Hospital, 

Naharlagun is the only institute which caters for the need of cancer patients. Although General 

Hospital, Naharlagun is not equipped with Radiotherapy Facilities, majority of the cancer patients of 

the State turn up here for treatment purposes. Surgery and chemotherapy are provided in this 

hospital. 

It is in the process of upgradation to Oncology Wing with Radiotherapy Facilities under 

NCCP. 

G. Statistics on Cancer: 

Arunachal Pradesh does not have PBCR/HBCR. A PBCR is being planned to be started very 

soon. It has Cancer Atlas which was started in May, 2005. 

1. Data of General Hospital, Naharlagun : 

a). OPD patients registered (last 3 years): 

Sl no. Year No. of new patients 

registered 

428 

Male : 

1. 2006-2007 127 1.3:1 

2. 2007-2008 225 1.4:1 

3. 2008-2009 303 1.4:1 

b). Number of Cancer surgeries performed (last 3 years): 

Sl. No. Year No. of cancer surgeries 

1. 2006-2007 45 

2. 2007-2008 52 

3. 2008-2009 54 

c). Number of cancer chemotherapy patients : 

Female Ratio 

Sl. No. Year No. of patients registered for cancer 

chemotherapy 

1. 2006-2007 75 

2. 2007-2008 159

3. 2008-2009 171 

H. Status on setting up of institutional arrangements: 

1. State Nodal Officer for State NCD cell is also the in charge of State Cancer Control Cell. 

State Nodal Officer for State NCD cell/ State Cancer Control Cell was appointed via order 

no. No. MDEV – 2005/3, dated Itanagar, the 25 th Jan’07 

Name: Dr. M. Basar MS 

Postal address: State Cancer Control Cell,Directorate of Health Services, 

Govt. of Arunachal Pradesh, Naharlagun, 

District: Papumpare,Arunachal PradeshPIN – 791110 

E-mail id – mbasar@rediffmail.com Phone – 09436041755 (m) 

Fax: 0360-2244182 

2. Cluster of districts through which the District Cancer Control Programme will be operated. 

No. of Districts in Arunachal Pradesh = 16 

The Districts are divided into 4 (four) clusters of 4 (four) congruent Districts each. 

Cluster A : 1. Tawang 

2.West Kameng 

3. Kurung Kumey 

4. East Kameng 

Cluster B : 1. Papumpare 

2.Upper Subansiri 

3.Lower Subansiri 

4. West Siang 

Cluster C : 1. East Siang 

2. Upper Siang 

Cluster D : 1. Lohit 

3. Dibang Valley 

4. Lower Dibang Valley 

2. Anjaw 

3. Changlang 

429

4. Tirap 

Districts which are proposed to have Basic Cancer Care facilities with radiotherapy 

Facilities: 

1. West Kameng for Cluster A 

2. Papumpare District for Cluster B 

3. East Siang District for Cluster C 

4. Lohit District for Cluster D 

3. District NCD Nodal Officers identification and notification under consideration and process 

by the State Government. 

4. Appointment of Cytotechnician, Nurses in the District Cancer cell under consideration and 

process by the State Government. 

5. Medical Physicist, Radiotherapy Technicians posts already created by the State Government 

and appointment under process. 

6. Development of New Oncology Wing under active process for General Hospital, Naharlagun, 

Papumpare District. Separate proposal is being prepared and will be submitted very soon. 

I. Proposed intervention: 

As per GoI norms vide letter no. D. O. No. T.2013/11/2006-CR Part III dated September 1, 

2009 a survey / assessment was conducted. Need based activities facility wise as below: 

1. Financial incentives to PHCs: 

To fulfill the basic cancer services in Arunachal Pradesh, the following PHCs have been 

selected for early detection at PHC level under the Revised National Cancer Control Programme: 

Justification: 

I. PHC, Jung, Tawang District 

II. PHC, Yajali, Lower Subansiri District 

III. PHC, Tirbin, West Siang 

PHC, Jung, Tawang District is in western part of Arunachal Pradesh with adequate man 

power and it has a high incidence of cancer patients according to hospital data. 

PHC, Yajali, Lower Subansiri Disrict also has adequate man power with high incidence of 

cancer in that area. 

Activities: 

PHC, Tirbin, West Siang District – this area also has high incidence of cancer in that area. 

As per GoI guidelines Rs. 300 per confirmed case would be given to Health functionaries 

(Doctors, Health Worker (M), Health Worker (F), Health Assistant (M), Health Assistant (F), and 

430

ASHA or an equivalent worker) at the level of PHC. For each confirmed case the ground level worker 

who referred the case would be given Rs. 100 and the doctor would be given Rs. 200. 

Total cost involved: 

Sl no. PHC Amount 

1. PHC, Jung, Tawang Rs. 4800.00 

2. PHC, Yajali, Lower Subansiri Rs. 4800.00 

3. PHC, Tirbin, West Siang Rs. 4800.00 

Total Rs. 14400.00 

2. Financial incentives to CHC(s): 

For detection of cancers in the early stage and diagnosis of cancer where treatment is effective 

could have a major impact on the disease outcome. The following CHC has been selected for 

financial incentive. 


I.CHC, Kimin, Papumpare District 

CHC, Kimin is approached by most of the patients before being referred to any other higher 

centre. It will definitely work as a centre for early diagnosis of cancer. Also, it is having adequate 

manpower for the said purpose. 

Activities: 

Doctors at CHC will be given an incentive of Rs. 300 per confirmed case. 


Sl. No. CHC Amount 

1. CHC, Kimin, Papumpare District Rs. 18000.00 

Total Rs. 18000.00 

3. Up-gradation of CHC : 

The following CHC has been selected under this category. 


I. CHC, Kimin, Papumpare District 

CHC, Kimin, Papumpare District area has a high concentration of population in compared 

to others and it is having concerned doctors for the said purpose. It is well connected to the State 

Capital for regular visits by specialist doctors and other diagnostic workup. 

Activities: 

431

As per the guidelines of GoI, the following activities will be taken up at the CHC: 

1. Cervical Cancer screening will be done by Visual Inspection with Acetic Acid. 

2. Clinical Breast Examination (CBE) by physician/surgeon. Breast Self Examination (BSE) will 

be taught to women. 

3. Oral Cancer Screening will be done by visual inspection. Community will also be taught 

about Oral Self Examination. 

4. Investigations like X Ray Chest, USG, and Haemogram etc would be done at CHC. 

5. Regular visits by cancer surgeon/physician twice a week will be organized. 

6. Nurses dedicated for the purpose will be positioned to organize the activities. 


Non- recurring: 

Non recurring Rs. (in lakhs) 

Magna visualiser equipment (for VIA), indirect Laryngoscope 

& punch biopsy forceps 

Total 0.1 

Recurring: 

Recurring (per year) Rs. (in lakhs) 

Manpower* 4.8 

Public Private Partnership for laboratory investigation 1.2 

Consumables 1.91 

Total 7.91 

*Manpower for CHC: 

Manpower Monthly Yearly 

Part time Cancer surgeon/physician @ Rs. 

2500 per visit twice a week 

432 

0.1 

Rs. 20000.00 Rs. 240000.00 

Nurse Rs. 20000.00 Rs. 240000.00 

Total Rs. 480000.00 

4. Districts with Basic Cancer Care Services without Radiotherapy (level –I centre) : 

General Hospital, Naharlagun of Papumpare District is providing surgery, chemotherapy, 

palliative care facilities etc. to majority of cancer patients of the state. But it lacks in Radiotherapy 

facilities. State Government is planning to set up its lone Radiotherapy Centre at General Hospital, 

Naharlagun with the help of NCCP. In the mean time the following district may be taken up for

providing Basic Cancer Care services without Radiotherapy as a Level-I centre as far EFC 

memorandum recommendation. 

I. Papumpare District 


General Hospital, Naharlagun, Papumpare District is already performing cancer surgeries, 

administering cancer chemotherapy, and providing pain and palliative care services. It will further 

strengthen the Baseline Cancer Care services at this level. 

Activities: 

a. To provide Baseline Cancer Care facilities like surgery, chemotherapy and pain and 

palliative care services. 

b. To procure equipments/medicines etc. for early detection and diagnosis and treatment of 

cancer. 

c. IEC activities to be taken up. 

d. Establishment of District Cancer Cell. 

e. To recruit manpower for effective implementation of activities. 


Non recurring expenditure for one level I centre: 

Non-recurring (for 1 st year only) 

District Cancer Cell (Renovation/office/ equipments/ fax/ phone/ 

computer/ photocopier/ internet etc. 

Equipments- Mammography machine (Rs. 25 lakhs), Cryoprobe (Rs. 

25000), Surgical disposables (GI – staplers, etc) ( Rs. 2.51 lakhs) 

Recurring expenditure for one level I centre: 

433 

Rs. in Lakhs 

5 

27.76 

Total 32.76 

Recurring (per year) Rs. in lakhs 

Manpower * 7.2 

Chemotherapy drugs @ Rs. 50000 p.m. 6 

Laboratory expenses @ Rs. 10000 p.m. 1.2 

Palliative care @ Rs. 10000 p.m. 1.2 

IEC activities including camps for health education & screening of 

common cancers & involving NGOs, PRI, Community Volunteers 

Misc. incl. office/admn. Expenses @ Rs. 5000 p.m. 0.6 

Public Private Partnership for laboratory investigations 1 

1

Total 18.2 

Total = non-recurring + recurring = 32.76+18.20 = Rs. 50.96 lakhs 

*Manpower: 

Manpower Monthly Yearly 

District Programme Officer* Nil Nil 

Cytotechnician 20000 240000 

Programme Assistant 20000 240000 

Nurse 20000 240000 

Total 720000 

*NOTE : District Programme Officer will be appointed from the existing State Govt. employee and 

hence separate funds not requested and funds adjusted for other more priority areas and to avoid 

exceeding the limit. 

5. Work plan: 

Activity 3 rd qtr 4 th qtr 

I. Financial incentives to PHCs 

a. Incentives to – Doctors 

b. Incentives to – Health Worker (M), Health Worker (F), 

Health Assistant (M), Health Assistant (F), ASHA or an 

equivalent worker 

II. Financial incentives to CHC 

a. Incentive to doctors 

III. Upgradation of CHC 

a. Purchase of equipments eg. Magna Visualiser Equipment, 

Indirect Laryngoscope Mirror, punch biopsy forceps 

b. Manpower, PPP for laboratory investigations, consumables 

IV. Basic Cancer Care Services without Radiotherapy facilities 

a. District Cancer Cell (Renovation/office/ equipments/ fax/ 

phone/ computer/ photocopier/ internet etc. ) 

b. Purchase of equipments – Mamography machine (Rs. 25 

lakhs), Cryoprobe (Rs. 25000), Surgical disposables (GIstaplers, 

etc.) (Rs. 2.51 lakhs) 

c. Manpower 

d. Chemotherapy × × 

434

e. Laboratory expenses × × 

f. Palliative care × × 

g. IEC activities × 

h. Misc. incl. office/admn. expenses × × 

i. PPP for laboratory investigations × × 

6. Funding mechanism 

- The central fund under NCCP may be released to State Health Society. 

- State Health Society will then release to Sub Group Account – DHS account. 

- Financial management through State Health Society. 

- Financial monitoring by Financial Management Group (FMG) of NRHM. 

- Audit – through NRHM mechanism. 

8. Budget for 2010-11: 

Activity 1 st Half 2 nd Half Total 

requirement 

I. Financial incentives to PHCs 

a. Incentives to – Doctors 200×24=4800 200×24=4800 Rs. 9600 

b. Incentives to – Health Worker 

(M), Health Worker (F), Health 

Assistant (M), Health Assistant (F), 

ASHA or an equivalent worker 

II. Financial incentives to CHC 

100×24=2400 

435 

100×24=2400 

Rs. 4800 

a. Incentive to doctors 300×30=9000 300×30=9000 Rs. 18000 

III. Upgradation of CHC 

a. Purchase of equipments eg. 

Magna Visualiser Equipment, 

Indirect Laryngoscope Mirror, 

punch biopsy forceps 

b. Manpower, PPP for laboratory 

investigations, consumables 

Rs. 10000 

IV. Basic Cancer Care Services without Radiotherapy facilities 

a. District Cancer Cell 

(Renovation/office/ equipments/ fax/ 

Rs. 10000 

Rs. 791000 Rs. 791000

phone/ computer/ photocopier/ 

internet etc. ) 

b. Purchase of equipments – 

Mamography machine (Rs. 25 

lakhs), Cryoprobe (Rs. 25000), 

Surgical disposables (GI-staplers, 

etc.) (Rs. 2.51 lakhs) 

Rs. 500000 Rs. 500000 

Rs.2776000 

436 

Rs.2776000 

c. Manpower Rs. 720000 Rs. 720000 

d. Chemotherapy Rs. 300000 Rs. 300000 Rs. 600000 

e. Laboratory expenses Rs. 60000 Rs. 60000 Rs. 120000 

f. Palliative care Rs. 60000 Rs. 60000 Rs. 120000 

g. IEC activities Rs. 100000 Rs. 100000 

h. Misc. incl. office/admn. Expenses Rs. 30000 Rs. 30000 Rs. 600000 

i. PPP for laboratory investigations Rs. 50000 Rs. 50000 Rs. 100000 

Total Rs. 5413200 Rs. 516200 Rs. 5929400 

Total amount required for 3 rd quarter = Rs. 54,13,200.00 

Total amount required for 4 th quarter = Rs. 5,16,200.00 

Grand total = Rs. 59,29,400.00 

(Rupees Fifty-nine lakhs twenty nine thousand four hundred) only. 

Annexure 

(Oncology Wing Development Scheme) 

ONCOLOGY WING DEVELOPMENT SCHEME AT GENERAL HOSPITAL, 

NAHARLAGUN, ARUNACHAL PRADESH 

1. INTRODUCTION : 

Cancer care facilities both for diagnosis and treatment are very much limited in the State of 

Arunachal Pradesh. Most of the patients are diagnosed in very advanced stages of the disease due to 

lack of diagnostic tools, trained manpower and lack of awareness etc. Moreover, facilities for cancer 

surgeries, chemotherapy, and palliative care are limited to General Hospital, Naharlagun only which 

is the apex Referral Hospital of the state. General Hospital, Naharlagun lacks in Radiotherapy 

facilities which is the need of the hour, especially for the poor patients who can’t afford to travel and 

stay outside the state for same.


Arunachal Pradesh erstwhile known as North Eastern Frontier Agency (NEFA) is 

known as “The land of rising sun”. The state is situated as a sentinel in the northeastern 

part of India, bounded by international boundaries with China in the north, Myanmar in 

the southeast and Bhutan in the west. The state is situated at latitude of 90.36 0 E to 97.3 0 

E and longitude of 26.42 0 N to 29.30 0 N covering a total land area of 83,743 sq. km. The 

population of Arunachal Pradesh is 10, 91,117 (Census 2001).Density of population is 

13 persons per square kilometer. Sex ratio of the state is 901 females per 1000 males 

as per census 2001. The total literacy rate of the state is 54.74% with a male literacy 

rate of 64.07% and female literacy rate of 44.24%. The per capita income (97-98) of the 

state is Rs. 13424. [Source: Provisional Census of India 2001]. 

Due to its peculiar topography and difficult terrain, there is widely dispersed 

settlement pattern of the population that applies to both rural and urban areas. The rural 

population constitutes 79.59% and the urban only 20.41 %. 0-6 yrs population is 18.33% 

in which male constitute 17.77% and female 18.96%. 

The state has a total population of10, 91,117 (Census 2001) with male 

constituting 573951 and 517166 females. The percentage of population below poverty 

line in 1999-2000 is 33.47 (SRS Bulletin, April 2001) with a percentage decadal growth 

of 26.21 and Average Annual Exponential Growth Rate of 2.33. The decadal growth rate 

of urban population is a staggering 101.29 %. 

Sl.No. Background 

Characteristics 

1 Geographic Area (in 

Sq. Kms) 


3 Size of Villages (2001 

Census) 

1-500 

501-2000 

2001-5000 

5000+ 

4 Number of towns 

5 Total Population 

(2001) 

437 

Number 

83743 

3862 

3442 (Census-2001) 

392 (Census-2001) 

26 (Census-2001) 

3 (Census-2001) 

17 

1097968 (Census- 

2001) 

Urban 

227881 (Census-2001) 

Rural 

870087 (Census-2001) 

6 Sex Ratio (F/M*1000) 

• Population Sex Ratio 

901 

Population Sex Ratio 893

7 

8 

9 

10 

11 

12 


Decadal growth rate 26.21 

Density- per sq. Km 13 

Literacy Rate (6+ Pop) 54.74 

Male 64.07 

Female 44.24 

%SC population 0.507 

%ST population 67.77 

(2001 

Census) 

No. of schools 538 

No. of Anganwadi Centres 3862 

13 Length of road per 100 sq. km. 

14 

15 

16 

17 

18 MMR 

% of villages having access to safe 

drinking water facility 

% of households having sanitation 

facility (Specify Type –sewer, septic 

tank) 

% of population below poverty line 

Health Status Morbidity Male Female 

Child 

IMR 

19 Health Resources-Facilities (Specify 

level of Facility like Subcentre) 

Personnel(Sanctioned Vacancy) 

438 

15356 

70.4 

66.4 

33.47 

(SRS 

Bulletin 

April 

2001) 

61 

Will be 

given 

separately

20 

21 

Finances(Requirement and Releases) 

1. Birth rate and death rate 2. Fertility 

rate. 

3. Disease maximum Disability. 


B.To link with the nutritional 

determinants-1. % of Infants with low 

birth weight. 2.Weight for Age no. above 

90%, 3. No between 60%-80%, 4. 

22 No. below 60% weight for age 

23 No of Primary school teachers 

24 

No of children enrolled 

(Age wise) (All relevant data needed to 

Start School Health Programme) 

439 

DNA 

3.03 

1280

2. HEALTH CARE FACILITIES IN ARUNACHAL PRADESH : 

No. Facility 

440 

In Position 


2 Primary Health Centres 116 


4. District Hospital 12 

5. General Hospital 2 (Government) 

3. AIMS & OBJECTS : 

1 (Semi Government 

RK Mission Hospital) 

a. Establishment of an Oncology Wing for basic cancer care facilities including 

Radiotherapy in the State’s Apex Referral Hospital. 

b. Creation of well equipped cancer surgery facilities. 

c. Providing chemotherapy facility. 

d. Providing palliative and rehabilitative care in patients with advance stage of 

cancer. 

e. Training of medical and paramedical personnel for cancer care. 

f. Providing health education and promotion of healthy lifestyle for prevention of 

cancers. 

PROFORMA FOR REVISED ONCOLOGY WING SCHEME 

PART-I 

1. Name and address of Institute : General Hospital, Naharlagun 

Govt. of Arunachal Pradesh P.O. – Naharlagun District– Papumpare Arunachal Pradesh 

2. Details of infrastructure : Own building 

2.1 Total number of indoor beds : 148 (Being upgraded to 350 bedded (In the entire hospital) 

Arunachal State Hospital) 

2.2 Beds for cancer patients 

2.2.1 Already available : 07 

2.2.2 Proposed full strength : 24 

2.2.3 Day Care facilities : 

Chemotherapy : 7 bedded day care Chemotherapy Centre is

available for cancer patients. 

Palliative care : Oncology Clinic also provides Pain and 

Palliative Care services to the cancer 

patients. There is plan to open a separate 

Pain & Palliative Care Clinic very soon. 

Procurement of Morphine tablets is under 

the process. Presently inj. Morphine is 

being used for the purpose. Regular home 

visits are paid to bedridden terminal cancer 

patients. 

3. Facilities for management of Cancer patients 

Service Existing Proposed Head of Service 

Name/Qualification/ 

Experience 

Pathology 

- Histopathology 

- Cytology 

- Haematology 

- Blood Bank 

Microbiology 

Biochemistry 

Radiodiagnosis 

X Ray 

Ultrasound 

CT Scan 

MRI 

3 nos. 

Yes 

Yes 

Yes 

Yes 

441 

Nil 

Nil 

Nil 

Nil 

Nil 

Dr. S. Tausik 

MD (Pathology) 

15 years 

2 nos. Nil Dr. B. Apum 

MD (Microbiology) 

5 years 

1 no. Nil Dr. K. Ete 

MD (Biochemistry) 

8 years 

1 Radiologist 

1 Sonologist 

Stable- 1 no. 

Portable – 2 nos. 

1 no. 

(CT Scan & MRI 

available in nearby 

RK Mission Hospital) 

1 no. 

3 nos. 

1 no. 

1 no. 

Dr. N. Lampung 

MD (Radiodiagosis) 

8 years

Surgical Oncology 

Head & Neck 

General 

Gynaecology 

Specialized 

Medical Oncology 

Paediatric Oncology 

Pain & Palliative 

& Rehabilitative Care 

Services 

Radiotherapy 

Radiation Physics 

Anaesthesiology 

Cancer Registry 

Medical Records 

Any other 

1. Patient population data 

Nil 

4 nos. 

Nil 

Nil 

442 

Nil 

Nil 

1 no. 

Nil 

Dr. M. Basar 

MS (Gen. Surgery) 

Trained in Surgical 

Oncology at TMH, 

Mumbai. 

7years 

2 nos. Nil Trained doctor 

available 

Nil Nil 

Day Care services 

available 

Nil 

2 nos. Nil 2 nos. of 

radiotherapists 

Nil 2 nos. of post 

for Medical 

Physicist 

created by 

State Govt. 

available 

Recruitment of Medical 

Physicists under 

process 

4 nos. Nil Dr. D. Raina, MD 

15 years 

Nil 

(Cancer Atlas since 

May, 2005) 

1 no. of 

PBCR to be 

proposed 

Dr. S. Tausik 

MD (Pathology) 

3 Nil Shri Tomar Basar 

I/C Medical Records 

Nil Nil 

1.1 Districts and region covered by Hospital: Entire State of Arunachal Pradesh and Sonitpur, 

North Lakhimpur and Dhemaji Districts of Assam. 

1.2 Population in the above districts and region : 1312023 (Projected population of Arunachal 

Pradesh for 2008-09, Census-2001) 

1.3 Expected number of new cases of cancer per year : 1300 

1.4 Registered new cases/year in last years :

Year Total cancer cases 

2007 261 

2008 231 

2009 215 (till 20 th October, 2009) 

Source – Cancer Atlas, General Hospital, Naharlagun 

1.5 Payment for treatment by patients : self 

1.6 User charges levied or not : No, At present user’s charges are not taken for any patients, all 

operations and chemotherapy administration are done free of cost. However, to provide 

quality service reasonable user’s charges will have to be taken in future. 

2. Radiotherapy facilities 

Equipments 

Cobalt 

Linear Accelerator 

Manual Brachytherapy 

Remote A/L Brachytherapy 

Simulator 

Treatment Planning System 

Radiation Physics 

Survey meter (Ion chamber based) 

Secondary Standard Dosimeter 

Gamma Zone Monitor 

Radiation Frequency Analyzer 

Mould room accessories 

Existing (Number) Proposed (Number) 

Nil 1 (One) 

Nil Nil 

Nil Nil 

Nil Nil 

Nil 1 (One) 

Nil 1 (One) 

Nil 

Nil 

Nil 

Nil 

Nil 

443 

1 (One) 

2 (Two) 

1 (One) 

1 (One) 

1 (One) set

3. Surgical Oncology 

No. of Operation Theatres – 2 (Two) 

- General Surgery – 1 

- Cancer Surgery – 1 

Details of major equipments: 

1. Datex Ohmeda 904E Anaesthesia machine with monitor – dedicated to cancer 

surgery – 1 no. 

2. Operating Table – Automatic electrical button operated – dedicated to cancer 

surgery – 1 no. 

3. Laparoscopic set – 1 no. 

4. Standard surgical electrocautery set – 1 no. 

5. All basic surgical instruments. 

Sl. No. Year No. of cancer surgeries 

1. 2006-2007 45 

2. 2007-2008 52 

3. 2008-2009 54 

No. of beds in Surgical Oncology : 10 

No. of Cancer Surgery done in last three years: 

4. Medical Oncology 

No. of beds in Medical Oncology: 7 (Day Care Chemotherapy Centre) 

No. of new patients treated with Chemotherapy: 

Sl. No. Year No. of patients registered for 

cancer chemotherapy 

1. 2006-2007 75 

2. 2007-2008 159 

3. 2008-2009 171 

444

Details of cases in Medical Oncology (Year March 2008 – March 2009): 

Sl. No. Diagnosis No. of cases 

1. Ca Stomach 45 

2. Hepatocellular Carcinoma 25 

3. Ca. Breast 17 

4. Non Hodgkin’s Lymphoma 13 

5. Ca Lung 08 

6. Ca Ovary 07 

7. Ca Oesophagus 07 

8. Ca. Gall Bladder 05 

9. Ca. Rectum 05 

10. Ca. Colon 05 

11. Sec. Neck with Unknown Primary 04 

12. Choriocarcinoma 04 

13. Ca. Oropharynx 03 

14. CML 03 

15. Ca. Vulva 03 

16. Multiple Myeloma 02 

17. ALL 02 

18. Renal Cell Carcinoma 02 

19. Ca. Nasopharynx 02 

20. Ca. Pancreas 02 

21. Neuroblastoma 01 

22. AML 01 

23. Ca. Cervix 01 

24. Ca. Supraglottis with sec. lungs 01 

25. Wilm’s Tumour 01 

26. Seminoma 01 

445

27. Retinoblastoma 01 

5. Teaching Programme – Nil 

SpecialityCourse DurationSeats/YearAffiliationExisting/ 

Proposed 

- Radiotherapy 

- Surgical Oncology 

- Medical Oncology 

- Palliative Care 

- Cancer Epidemiology 

- Radiation Physics 

- Technologist 

(specify) 

- Nursing 

- Others 

6. Research and Training Activities 

Total 171 

9.1. Mention in Brief Continuing/proposed research works in cancer epidemiology, basic 

sciences, clinical sciences etc. 

- Cancer Atlas Project, General Hospital, Naharlagun, under ICMR is going on 

since May, 2005. 

- Other research activities will be possible after development of Oncology Wing. 

9.2. Mention in brief training activities and community oriented programmes (within and 

outside the RCC). 

– Awareness programmes on cancer, tobacco etc. is being conducted on regular basis 

for doctors, school children and public. 

– CME on cancer on regular basis. 

– 5 th Annual Conference of Association of Radiation Oncologists of India – North East 

Chapter was held at Itanagar from 30 th to 31 st October, 2009. 

9.3. Research Publications already carried out - Nil 

446

PART-II 

PROPOSAL FOR OBTAINING GRANT-in-aid (Action Plan) 

Equipments can be procured for Radiotherapy/Surgical Oncology/Medical 

Oncology/Pathology/Radio-diagnosis/Nuclear Medicine etc. (refer annexed indicative list) 

10. Radiotherapy (Teletherapy/Brachytherapy) Equipment 

10.1. Estimated cost of equipment : Rs. 3.5 crores 

10.2. Building for Equipment :Not available, will be constructed on 

receipt of fund from GOI. 

10.3. Approval by AERB/BARC :Obtained 

10.4. Building Plan of RCC :Not Applicable 

10.5. Building Plan for Proposed Equipment :Attached 

11. Medical Oncology/Palliative care 

11.1. Medical Oncology/dedicated physician or surgeon : Available 

(2 nos.) 

11.2. Palliative Care Physician/Surgeon or PMR specialist : 

Available 

11.3. Dedicated day care ward/facility for chemotherapy : 7 bedded 

Day Care Chemotherapy Centre available 

11.4. Dedicated palliative care ward or Rehabilitation ward : Not 

available 

11.5. Chemotherapy drugs/consumables : Purchased by patients and 

free chemotherapy drugs provided to poor cancer patients 

from time to time. 

12. Surgical Oncology 

12.1. Surgical Oncology/Trained Surgeon : available 

12.2. Dedicated Operation Theatre/OT table : available 

12.3. Special Surgical equipments like endoscopy/knife etc. : not 

available 

13. Diagnostic/pathology/other equipments 

13.1. Estimated cost 

13.1.1 Equipments – 

1. Valley Lap Cautery Machine – 1 no. – Rs 9,00,000.00 

447

2. Ultrasonic Scalpel – 1 no. – Rs 15,00,000.00 

3. Laparoscopy Set – 1 no. – Rs 15,00,000.00 

Total: Rs. 39,00,000.00 

13.1.2 Civil - Rs 1,50,00,000.00 

14. Timelines (Gantt Chart) for different stages of completion of action plan 

WORK PLAN 

Activity 4 th quarter 1 st quarter 2 nd quarter 3 rd 1. Construction of 

quarter 

building to house the 

Unit and other ancillary 

facilities. 

2. Tendering and 

* 

* 

purchase of equipments 

3. Installation and 

* 

commissioning 

* 

15. Funding mechanism: 

a. The central fund under NCCP may be released to State Health Society. 

b. State Health Society will then release to Sub Group Account – DHS account. 

c. Financial management through State Health Society. 

d. Financial monitoring by Financial Management Group (FMG) of NRHM. 

e. Audit – through NRHM mechanism. 

16. Monitoring and evaluation: 

State Health Society Mechanism will be used. 

448 

ANNEXURE - I 

Details of available trained personnel (for Radiotherapy Unit) 

Name Designation Qualification Years of 

experience 

1. Dr. S. Tsering Medical Officer MBBS, MD 

(Radiotherapy) 

3 years 

2. Dr. A. Kri Sr. Medical MBBS, MD 1 year 

Officer (Radiotherapy) 

3. Sri Iba Lombi RTT Undergoing 

training of 

Diploma in RTT 

Nil 

4. Sri P. Pakam RTT Undergoing 

training of 

Diploma in RTT 

Nil 

Remarks 

NOTE: 2 (two) posts of Medical Physicist and 2 (two) posts of RTT has been sanctioned by Govt. 

of Arunachal Pradesh and recruitment is under process.

ANNEXURE II 

Details of previous grant: 

Sanction Order no. and 

Date 

T-20015/33/2001-R 

Dated 21-02-2002 

Amount Component of Utilization 

(in lakhs) of Fund (in lakhs) 

45 1) IEC - 9.00 

2) Equipment and 

Reagent - 15.00 

3) Drugs for palliative 

treatment - 15.00 

4) Training - 6.00 

5) Miscellaneous - 3.00 

Total = 45.00 

449 

Remarks 

Utilization Certifica- te 

have been submitted to 

GoI vide our letter no. 

MDEV/120 dtd. 11-12- 

2007 

CERTIFICATE AND RECOMMENDATIONS OF THE STATE GOVERNMENT 

NoMDEV-56/07………Station and date 16.12.09……………Government of Arunachal Pradesh, 

Department of Health & Family Welfare 

1. The Institution is a Govt. Hospital/ Institution, funded and controlled/supervised autonomous 

body/institution and is involved in cancer treatment activities. 

2. The State Government/ UT has examined the audited accounts of the institution and is satisfied 

that their financial position is sound (applicable for autonomous institution). 

3. The Sate Government is satisfied themselves about the soundness of the project and that the 

organization is of proven capability for undertaking the project. 

4. The information furnished by the Institution is correct. 

5. The State-Government recommends the proposal for grant of Rs. 5 crore to be utilized in General 

Hospital, Naharlagun for the purpose of Development of Oncology Wing. 

Sd/ 

Dated 16.12.09____________________ 

(Shri AB Shukla) 

Secretary 

Health & Family Welfare 

Govt. of Arunachal Pradesh 

Itanagar 

CHECK LIST FOR REVISED ONCOLOGY WING DEVELOPMENT SCHEME 

1. Specified application Performa along with enclosures – enclosed 

2. State Government’s Recommendation letter on specified format – enclosed 

3. Details of available/existing infrastructure in terms of equipment – details given 

4. Details of available trained personnel (Radiotherapists & Physicist in case of 

radiotherapy equipments) – enclosed (Annexure I) 

5. Whether building is ready to house the radiotherapy unit – AERB/BARC approved 

layout map ready 

6. AERB/BARC approval letter and approved lay out map in case of radiotherapy 

machines – a copy is enclosed herewith 

7. Details of previous grant (if any) – as enclosed (Annexure II)

AIM 

MENTAL HEALTH PROGRAMME 

To provide sustainable basic mental health services to the community and to integrate these 

services with other health services. 

� Early detection and treatment within the community. 

� Take pressure off Mental Hospitals 

� Reduce stigma. 

� Follow up and rehabilitation of discharge patients from Mental Hospital within the 

community. 

Schemes: 

1. District Mental Health Programme (DMHP) 

2. Up-gradation of Psychiatric Wing of General Hospitals. 

3. Man Power Development (Since there is no Medical College and Nursing College in the 

State we are not able to implement this Scheme.) 

Status of implementation: 

1. DMHP Papum Pare (1997-2005) 

� Total fund received = Rs.1,02,24,250 

(Rupees One crore two lakh twenty four thousand two hundred and fifty) 

Achievements: 

Training: 

Fully utilized and U/C submitted. 

1st ever Psychiatric Department established in Arunachal Pradesh with: 

1. Daily OPD & emergency service at General Hospital, Naharlagun. 

2. 10 bedded Psychiatric Ward built and functioning. 

3. Counseling Services. 

4. Recruitment of Psychiatrist and other Staff to run the Psychiatry Ward. 

1. First Batch of DMHP Staff trained at NIMHANS, Bangalore. 

2. 3 Batch of in-service training of nurses on Mental Health. 

3. 2 Staff nurses completed Diploma in Psychiatric Nursing (DPN) at LGBRIMH at 4. Tezpur & 

NIMHANS, Bangalore. 

5. Two medical officers undergoing one year training course at NIMHANS, Bangalore. 

IEC Hoarding 

Wall writing 

Pamphlets 

450

TV Programme 

2. DMHP East Siang District: 

Achievements: 

Rs.26.2 lakh received from GOI during 2007-08. 

Rs.17.50 lakh allotted to Nodal Officer, DMHP, East Siang. 

Rs. 8.7 lakh Salary component yet to be utilised due to delay in creation of posts. 

1. Renovation of 10 bedded Psychiatric Ward 

2. Procurement of 8 seater Maruti Van 

3. Procurement of Equipments like ECT and other as per Guidelines 

4. Training +IEC: Medical Officers from various PHC/CHC of the District & GH, Pasighat 

trained on Mental Health. 

Upgradation of Psychiatric Wing of General Hospitals 

1. General Hospital, Naharlagun-Rs.18 lakh received from GOI during 2007-2008 

Rs.10.5 lakh for Civil work 

Achievements: 

Rs. 7.5 lakh for Psychiatric Instruments 

a) Civil work completed and being used as Psychiatry OPD. 

b) Computerised ECT Machine procured. 

c) Behaviour Therapy instrument procured and functioning. 

d) Patients Beds, lockers, plastic chairs procured 

3. Performance 

Number of Patients (old and new) 

YEAR INDOOR OUTDOOR TOTAL 

2001 26 1672 1698 

2002 29 1542 1571 

2003 23 1511 1534 

2004 26 1864 1890 

2005 34 1600 1634 

2006 15 1943 1958 

2007 37 2119 2156 

2008 61 1908 1969 

2009 55 1978 2033 

Referred cases from other wards not included. 

General Hospital, Pasighat: 

451

Rs.50 lakh sanctioned to the State Health Society and is transfer to concerned institution. 

Proposal 2010-11 

Proposal submitted to GOI:vide our letter No.MDEV 2004/16 Dated 10/06/08 

1) Separate State Mental Health Cell & regular staff. 

2) New DMHPs- West Kameng 

Upper Subansiri Lower SubansiriWest Sianig LohitChanglang Districts. 

A. The new proposal for 6 DMHP as mentioned above are resubmitted herewith. 

The fund required will be as follows. 

1. Staff Salary -Rs.7.00 X 6 districts = 42.00 lakhs. 

2. Medicines/Stationary -Rs.5.05 X 6 districts = 30.30 lakhs. 

3. Training -Rs.2.00 X 6 districts = 30.00 lakhs. 

4. IEC -Rs.2.00 X 6 districts = 12.00 lakhs. 

Old districts East Siang District. 

452 

114.30 lakhs 

B. The 2 nd installment for DMHP Pasighat yet to release by the GOI. As per GOI guideline the 

following amount will be required for implementing the DMHP Pasighat. 

1. Salary 8.00 lakhs. 

2. Medicines/Stationary 6.50 lakhs 

3. Contingency 5.00 lakhs 

4. Training 5.00 lakhs 

5. IEC 2.00 lakhs 

Total 21.50 lakhs 

C. For smooth functioning of the State Mental Health Cell in directorate of Health Services the 

following fund will be required which may include in State PIP during the year 2010-11. 

1. O.E -2.50 lakhs 

2. O.C -1.50 lakhs 

3. Machinary and equipment -3.00 lakhs 

4. Training -4.00 lakhs 

5. Medinice -5.00 lakhs 

6. DTE -1.00 lakh 

7. Miscellaneous -1.00 lakhs 

8. IEC -1.00 lakh 

9. Procurement of new vehicle -9.00 lakhs 

Total -29.00 lakhs 

The proposal for State Mental Health Cell already been submitted to the GOI vide our letter 

No.MDEV-84/08 Dated 16/06/08. 

Budget 

Total A+B+C = 164.80 lakhs.

1 

PIP APPRAISAL SHEET FOR F.Y.2010-2011 

Name of the State: Arunachal Pradesh 

Name of the State Health Society & Place 

453 

No. of Districts 

No. of 

Blocks 

Arunachal Pradesh State Health Society 16 84 

2 Status of Maintenance of Accounts 

a Specify the frequency of writing the Cash Book: 

b 

c 

At State Level Daily 

At District Level Daily 

At Block Level BPMSU yet to be constituted 

Specify the system followed for checking of cash book by the incharge of 

the unit While signing the cheque 

Whether Bank Reconciliation Statement of all the National Disease 

Control Program Funds under NRHM along with RCH is being prepared 

on regular basis by the State ? (Yes / No) No 

d If Yes , then specify the date upto which reconciliation has been done.? NA 

e 

f 

g 

h 

Whether the District has maintained Bank Reconciliation Statement 

(BRS) seperately for all the National Disease Control Programs under 

NRHM along with RCH on regular basis ? (Yes / No) No 

No.of districts,which are regular in submitting in BRS Statements along 

with monthly Financial Reports 14 

No.of districts, which do not submit regular BRS Statements along with 

monthly Financial Reports 2 

Is there any system of Reconciliation of Physical & Financial datas , 

(Yes/ No) No 

i Specify the System of Reconciliation and types of data analysed. 

j 

Chapter –VII 

Financial Managment 

Frequency of Such Type of Reconciliation done 

(Weekly/Monthly/Quarterly ) NA 

NA

k 

l 

No. of Districts who are regular in submitting Monthly SOEs for all 

NRHM Funds along with separate Financial Report on JSY, Routine 

Immunisation (Sub Head Wise), Hospital Management Societies, Untied 

Fund for VHCs, HSCs, PHCs, CHCs for different functional entities . 14 

No. of Districts Who Do Not submit the above mentioned Monthly 

Financial Reports to State and Action taken by the State for follow-up 

3 Status of Management of Advances 

I) Procurement 

Amount of Total Advances with nature of such advances 

Nature of Advances given Amount 

ii) Construction Work 

iii) Staff Advances 

iv) Any Others (Pl.Specify) 

1,63,82,283/- 

454 

Age of 

Advances 

More than 24 

months 

4 Status of Refund of Unspent balance Under RCH-I 

a 

b 

2, the show cause notice have 

been issued. 

Action Taken for early 

settlement of old advances 

The Deputy Commissioner, 

DMO & DRCHO of the 4 

Districts where these advances 

lying have been instructed to 

settle the same within this 

financial year. 

[Applicable for only those States which are having the Unspent Balances] 

Do you still have any unspent balance Under RCH Phase-I 

(Yes/No) Yes 

If Yes then specify the amount of Unspent Balance and Status of Refund 

of the same. Rs. 14,00,286/- 

5 FMR Uploading Status under HMIS 

i) 

ii) 

iii) 

State Level 

District Level 

No. of Districts who are regular in 

uploading the FMR. 

Month up to Which it has been 

uploaded Yet tp be uploaded 

Month up to Which it has been 

uploaded Upto II nd Quarter of 2009-10 

Specify the Nos. 

iv) What are the Intiatives taken by DPMUs for regular uploaoding of FMR 

6 Manpower Status 

3

Particulars 

No. Of 

Sanctioned 

Posts 

455 

No. of Staffs 

in Position 

No. of 

Vacancy 

a State (SPMU) 11 10 1 

b District (DPMU) 64 56 8 

c Blocks (BPMU) 84 Nil 84 

7 Status of Concurrent Audit 

Since 

When 

Vacant 

Since 

2006 

Since 

2006 

Since 

2009 

i) No. of Districts Covered . 16 

ii) 

iii) 

iv) 

v) 

vi) 

Specify the Action taken for districts who have not yet started Concurrent 

Audit NA 

Whether the Contribution of Concurrent Audit in Statutory Audit is 

satisfactory(Yes /No) ? Yes 

No. of Districts where Concurrent Audit has been conducted and found 

satisfactory . 16 

Action 

Plan and 

Time 

Frame 


Filling 

ups 

Latest by 

Ist 

quarter 

2010-11 

Under 

process 

Under 

process 

Whether monthly reports on observations of Concurrent Audit has been 

forwarded by the Districts to State ? (Yes / No) Yes, on quarterly basis 

Have you started sending the Summary Report of Concurrent Audit 

Reports of all districts to GOI . (Yes / No) No 

vii) Are you able to get C.A. Firm in all the district in your State for 

Concurrent Audit ? 

viii) 

Do you have any suggestion in the improvement of Concurrent Audit 

System, please specify. 

8 (a) Status of Audit Report & Utilisation Certificate for the year 2008-2009. 

a 

No, all the CA firms were 

engaged from the neighbouring 

State Assam 

Whether Statutory Audit Report Under NRHM for the Year 2008-2009 

has been submitted. ? (Yes / No) Yes

c 

d 

e 

If audit has not yet completed, then, please specify the reasons for the 

same and the date by which the Audit Report will be submitted? NA 

Whether any Adverse remarks given by Stautory Auditor in Audit 

Opinion while conducting the Audit of SHS Under NRHM have been 

addressed by you, then please forward a copy of Action Taken Report. No 

Whether Utilisation Certificate have been submitted along with Audit 

Reports ? (Yes / NO). Yes 

If not submitted then latest by when UCs would be submitted . 

(Pl. Specify the date) NA 

8 (b) Appointment of Statutory Auditor for the Year 2009-10 

i) 

ii) 

Particulars Comment 

Whether Statutory Auditor for the Year 2009-2010 has 

been appointed through the open tender system ? (Yes 

/ No) 

Suggestions for Improvement in the Quality of 

Statutory Audit . 

456 

Under process for appointment through Open 

Tender System 

Preference should be given to firms located in the 

State or the nearest neighbouring States having 

proficiency in local language 

8© Action Taken Report of Auditors Observations for the Year 2008-2009 

i) 

ii) 

iii) 

Whether the State has responded on Auditor's Observation in Audit 

Report and Ministry's observation on the same? (Yes /No) Yes 

What Action Taken by the State on FMRs where thare has been major 

variations between Expenditures as per FMR and as per Audit Report ? No 

Whether Copy of ATR (Action Taken Report ) has been forwared by the 

State to GoI and if not ,forward the same. No 

iv) If not then please give the Status of ATR ? 

The ATR is under preparation 

at the State level 

v) Whether any Improvements has observed after such ATR ? NA 

9 Any other Issues/ Problems Pertaining to Finance which the State may like to address. 

In the light of implementation of Sixth Pay Commission Report by the State Government and the high cost of 

living in the State, particularly in the rural areas, there is an urgent need to revise the pay rates of 

contractual staff working under NRHM which is long overdue. The proposal in this regard has been

incorporated in the State PIP for the year 2010-11, which may be considered and approved by the MoHFW, 

GOI. Due to very low rates of salary, it has become very difficult to get technical manpower and managerial 

staff for NRHM in the State. Moreover, due to the same problem, the turnover rate of contractual staff has 

increased by manifold during the last two years. 

NAME OF THE STATE: 

CHECK LIST FOR E-BANKING UNDER NRHM 

Sl.No. PARTICULARS COMMENT 

1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

Whether On line Disbursement of Funds (E- Banking Fund 

Transfer ) from State to Districts takes place? (Yes / No ) Yes 

Whether On Line Disbursement of Fund from State Health 

Society takes place for Payment to Own Vendors/Suppliers ? 

(Yes /No ) No 

Whether On Line Disbursement of Fund from District Health 

Societies takes place for Payment to Own Vendors/Suppliers ? 

(Yes /No ) No 

Whether On Line Disbursements takes place from Districts to 

PHCs / CHCs (Yes / No) No 

Whether On Line Disbursement of Salaries to all employees in 

the State / Disritct /PHCs/ CHCs takes place (Yes / No) Yes, Only at the State HQ 

Whether E-Payment application for Utilisation Report 

generation for the State takes place? (Yes/ No) No 

Whether E-Payment application for Utilisation Report 

generation for the Distritcts take place? (Yes/ No) No 

Whether Integration of Online Application with Financial 

Application has taken Place (Like Tally Etc) (Yes /NO) No 

Whether Payment made to ASHA Workers through Bank 

Account, Card or Mobile Banking as may be appropriate and 

cost effective. (Yes /No) No 

If any of the above item not yet implemented then give the road 

map for each implementation in PIP for the Fin. Year 2010-11 

457 

The matter is under 

discussion with AXIS 

Bank Ltd., Itanagar

Questionnaire for State PIPs with regard to implementation of customised version of Tally 

Name of State: Arunachal Pradesh 

Name of the State Health Society 

No. of 

Districts 

458 

No. of 

Blocks 

Arunachal Pradesh State Health 

Society 16 84 

S.No. Particulars Yes/No Number 

A Tally Licenses 

1) Is the state using Tally at the SHS 

level? If yes, then which version? Yes 1 

2) Number of Districts using Tally Yes 16 

3) Are any of the Blocks using Tally? If 

yes, then the number of blocks using the 

same? No NA 

4) Has the steps have been taken by the 

State to purchase the customized 

version of Tally as per the letter from 

the MoHFW dated 12th August, 2009 Yes 17 

5) Does it propose to implement the Tally 

customized version at the state and 

district level only or at the block level 

also Yes 

6) Current number of licences at the 

a. SHS Yes 1 

b. DHS Yes 16 

c. Block NA NA 

7) Procured / In the Process of 

Procurement 

a. SHS Yes 

b. DHS Yes 

c. Block No 

Other 

Comments Rate Budget 

Already 

procured 

Implemented 

upto district 

level

8 Infrastructue for Tally Implementation 

1 Districts 

Current availability 

a) Computers Yes 16 

b) Internet Yes 10 

c) UPS Yes 16 

Additional propsed to be purchased in 

next year 

a) Computers No Nil 

b) Internet Yes 6 4,000/- 24,000/- 

c) UPS No NA 

2 Blocks 

Current availability 

a) Computers No NA 

b) Internet No NA 

c) UPS No NA 

3 Additional proposed to be purchased in 

next year for Tally implementation 

a) Computers Yes 84 55,000/- 46,20,000/- 

b) Internet Yes 84 4000/- 3,36,000/- 

c) UPS Yes 84 

C Human Resource 

1 State Finance Manager Yes 1 

2 State Accounts Manager Yes 1 

3 District Accounts Manager 

a) Number of DAMs in place Yes 16 

b) Number of DAMs with prior experience 

of working with Tally Yes 16 

c) 

Number of posts currently vacant but 

No Nil 

459

proposed to be filled up in the next year 

d) Total Number of DAMs to be budgeted 

for in the next year Yes 16 

4 Block Accountants 

a) Number of block accountants in place No Nil 

b) Number of block accountants with prior 

experience of working with Tally No 

c) Number of posts currently vacant but 

proposed to be filled up in the next year Yes 84 

d) Total Number of block accountants to 

be budgeted for in the next year Yes 84 

D Training for Tally 

1 Number of workshops / training 

conducted for DAM/SFM/SAM during 

the last year Yes 2 

2 Provide the number of DAMs who 

attended each of the above mentioned 

trainings Yes 2 


proposed to be conducted for DAM 

during this year Yes 3 


conducted for block accountants during 

the last year No NA 

5 Provide the number of block 

accountants who attended each of the 

above mentioned trainings No NA 


proposed to be conducted for Block 

Accountants during this year Yes 1 

7 The above mentioned trainings were 

conducted by which agency / person? No NA 

8 Whether the adequate training support, 

free of cost was provided by Tally 

Solutions (India) Pvt. Ltd. ? Yes 1 

460 

BPMSU yet to 

be constituted 

Yet to be 

conducted

9 Has the state engaged any Other Tally 

Agency / external consultant / training 

institute to provide training or to 

develop training material? Yes 1 

10 Does the state has any tie up with Tally 

Agencies/ external consultants / 

training institutes to impart further 

training to the FM staff? Yes 1 

11) A. Has the state developed any training 

calendar for the next year to train the 

FM staff on Tally? If yes, please share 

details: 

- No. of trainings Yes 4 

- No. of days for each training - 3 

- No. of participants for each training - 100 

-Costs per training - 

- Total training budget - 

11) B. Number of accountants at the following 

level proposed to be trained 

461 

Rs. 

5,81,137 

Rs. 

23,24,548 

a) State Finance Staff (SFM & SAM) Yes 1 

b) District Accounts Manager Yes 16 

c) Block Accountant Yes 84 

12 

13 

If no training calendar is developed / 

proposed, how does the state propose 

to carry forward the customized Tally 

implementation 

Whether any help needed from FMG- 

MOHFW for Tally Training ? Yes 

In the month of 

February, 2010 

another training 

will be imparted 

In the month of 

February, 2010 

another training 

will be imparted 

The training 

will be 

conducted at the 

middle of the 

each quarter of 

the financial 

year 

If reqiured, it 

would be 

intimated to the 

FMG

Chapter-VIII Monitoring & Evaluation 

HMIS / M&E 

To facilitate better monitoring and evaluation of progress of NRHM in the State, State 

Programme Officer for monitoring and Supervision is entrusted and hence carried out regular 

monitoring, timely review of the RCH/NRHM and other vertical program activities. Infrastructure 

facilities like computers, software, telecommunication connectivity etc being provided almost to all 

districts headquarters (HQ). The quality of MIES in State HQ and in districts is now towards 

inclination. Real hurdle faced by the HMIS Cell is reporting and recording of NRHM/RCH formats 

which are still carried out manually in most of the districts and is inconsistent. Formats are also not 

filled up completely. The information provided needs to be properly reviewed at the PHC level so to 

get quality reports. Feedback system has been introduced from State to the district and will be fully 

implemented from the beginning of the coming financial year. 

Notification of 1 (one) Nodal Information Officer at the State and 16 Nodal Information Officer 

from the existing staff in all the districts had been completed. They are entrusted with, to provide 

information on all the health statistics at the District level, to upload data on the HMIS Portal and for 

sending feedback to the lower information. 

Now almost all the Districts are reporting in the revised MIS format developed by GoI. For 

overall management of the Health Information System, a HMIS Cell has already been established 

under the Mission Directorate in the state. The HMIS/M&E Cell headed by Programme Officer is 

responsible for overall monitoring and supervision of the programme in the state and the districts. 

At the district level, the District Health Society with the District Program Management Support 

Unit in place is responsible for the all data dissemination from the sub-district level to the district 

level for management of HMIS. 

As such, there is Monitoring Team constituted each at state and district level to monitor the 

implementation of the NRHM/RCH activities. The Hospital Management Committee/ Rogi Kalyan 

Samity at all PHCs and CHCs is already in place. 

Strengthening of M&E Cell 

Data on Health received from the districts are compiled and maintained at State M&E Cell. In 

fact, the reports that are being received from the districts are found to be incomplete. Hence, a clear 

analysis can’t be drawn. For proper strengthening of HMIS in the state, integration of activities 

across other programs shall be ensured with utilization of IT infrastructure. Developing an electronic 

system of monitoring & reporting is in partial implementation in the state. The Web based HMIS 

Portal launched by the GoI is used only by two districts (Lower Dibang Valley and Anjaw) The state 

shall ensure same for other 14 districts. Uploading of the facility wise reports will be ensured. In this 

connection District Commissioner would be requested to provide their internet facilities at the 

Department of NIC/CIC at district levels where internet communication is not well integrated/poor so 

to upload data on the HMIS Portal timely. 

Since, there have been no monitoring plans so far, it had been difficult to review the progress 

of the program in an actual sense. During this financial year 2010-11, it is planned to set up a 

Monitoring & Evaluation Cell at the State level. The Cell shall be responsible for taking up all 

monitoring activities in the State. The M&E Cell shall focus on the monitoring of all the health 

facilities. The cell shall also evaluate the progress of the program annually. Efforts shall be initiated 

to introduce a routine self evaluation of the programme at least once a year. It is also planned to 

have an annual evaluated publication in respect of the program, incorporating all other National 

462

Disease Control Programs. This would be a step forward in documentation of the achievements made 

so far. 

Manpower Status 

State HMIS/M&E Cell: 

One State Programme Officer from the state level along with the following official on 

contract basis is available: 

place. 



3. State Data manager 1 



At the district level District RCH officer along with the following contractual staffs are in 

1. District Program Manager 8 




Review Meetings at every level will be carried out to ensure quality and regular reporting. 

Details are as follows: 

� Block PHC Level Review Meeting on every 2 nd to 4 th day of the every quarter. 

� District Level Review Meeting on 6 th to 7 th day of the each quarter. 

� Half Yearly State Level Review Meeting. 

All the PHC, CHCs and DHs will organize a review meeting on 2 nd to 4 th Day of the quarter and 

send the minutes of the review meeting to the Mission Director (NRHM). MO i/c of the PHC will be 

the chairperson of the review meeting. The meeting shall review the following along with other 

matters: 

� Review of implementation of all NRHM Activities and vertical programme. 

� Review and analysis of reports submitted by the ANMs from the SCs. 

� Examine the registers maintained by the ANMs to assure quality of services and data. 




At the Districts will organize a District level review meeting on 6 th to 7 th day of the Quarter. Districts 

will compile the status of the review meeting of all the DHs, CHCs, PHC and SCs and send a 

quarterly report to the Mission Director, NRHM, along with the minutes of District level review 

meeting. The District medical Officer of the concern District will be the chairperson and District 

463

Programme Manager will be the convener of the review meeting. The meeting must included the 

review of the following along with other matters: 

� Review of implementation of all Programmes. 

� Review and analysis of reports submitted by health facilities. 

� Analyze the performance and quality of service & data. 



� Review of the minutes of the Block PHC level review meeting. 


Half yearly State Level review meeting is proposed to be organized at State HQ to review 

performance of all the Programmes. Review of reports submitted by the Districts will be the main 

objective of the meeting. Reports submitted by monitoring team will also be reviewed in the meeting. 

Monitoring and Evaluation 

Schematic diagram for monitoring and evaluation 

District Programme Management 

Support Unit (DPMSU) 

Hospital Management 

Committee/RKS 

State Health Society (SHS) 

State Programme Management 

Support Unit (SPMSU) 

STATE MONITORING TEAM 

District Health Society (SHS) 

DISTRICT MONITORING TEAM 

464 

Village Health Committee

Monitoring from State Level: 

A monitoring plan has been introduced in the state which shall come into effect from the first 

quarter of this financial year. It is planned that the state Monitoring team of the State officials shall 

monitor every district twice a year with mobility support from mobility support head. The State 

Monitoring and Evaluation Team (SMET) shall comprise officials from the State. 

Sl.N 

o. 

1 

2 

4 

5 

• The team will carry prescribed checklist for monitoring which shall be provided by the state 

HMIS/M&E Cell. 

• A team of at least 2-3 members shall monitor all 16 Districts twice during the year. 

Monitoring of all Health Facilities up to the SC level will be ensured. 

• This will include monitoring of activities like maternal health, Child Health, JSY, 

Immunization, IEC/BCC activities, PPP, VHND, outreach activities, monitoring of post 

training activities and other NRHM activities. 

• A detail report shall be submitted to the Mission Director, NRHM, Arunachal Pradesh and 

the Director Health Services. 

• Feedback and suggestion on the observations shall be sent to all the Districts for 

improvement. 

Monitoring Quarter Proposed 

month 

1 st (April – June 2010) April Tawang, W/Kameng & E/ 

Kameng 

2 nd (July – September 

2010) 

3 rd (October – December 

2010) 

4 th (January – March 

2010) 

465 

Districts Duration 

15 days 

June Lohit, Anjaw & East Siang, 10 days 

July Upper Siang & West Siang 10 days 

July Dibang Valley & Lower 

Dibangvalley 

August Tirap & Changlang& Papum 

Pare, 

September Kurung Kumey & Lower 

Subansiri & U/Subansiri 

October Tawang & West Kameng & 

East Kameng 

10 days 

15 days 

15 days 

15 days 

November Upper Siang & West Siang 10 days 

December Lohit, Anjaw & East Siang, 10 days 

January Dibang Valley & Lower 

Dibangvalley 

February Tirap & Changlang& Papum 

Pare, 

March Kurung Kumey & Lower 

Subansiri & Upper Subansiri 

10 days 

15 days

Monitoring Plan 

The State Monitoring and Evaluation Team (SMET) constituted with the officials from the 

State Health Society. A team of at least 3 members shall monitor all 16 Districts twice during the 

year. Monitoring of all Health Facilities at least up to the PHC level will be ensured. The team will 

carry prescribed checklist for monitoring and submit the detail report to the Mission Director, 

NRHM and the Director Health Services This will include monitoring of activities like maternal 

health, Child Health, JSY, Immunization, IEC/BCC activities, PPP, VHND, outreach activities, etc. A 

feedback and suggestion on the observations shall be sent to all the Districts for improvement. 

Monitoring at District Level: 

A District Monitoring Team is constituted to monitor various programmes under NRHM in 

each district. The team will carry prescribed checklist for monitoring and submit the detail report to 

the District Health Society with a copy to the Mission Director and Director of Health Services. 

Feedback of the monitoring report will be sent the concern Health Facility with suggestion for 

improvement. 

Monitoring Indicators 

Indicators for HMIS 

1. List of registered maintained 2. No. of reporting month 

3. Time of reporting 4. Accuracy Level ( Good/Average/Poor) 

Sl.No Indicator Remarks 

1. % ANC registered 

2. 3 ANC 

3. Pregnant women with Anaemia 

4. Institutional Delivery 

5. Pregnancy outcome 

6. Newborns breastfeed

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