1

OPERATIONAL GUIDELINES


for



State Programme Implementation Plan


(2012-13)















Jammu and Kashmir
NATIONAL RURAL HEALTH MISSION


2

ABBREVIATIONS

AYUSH Ayurveda, Yoga & Naturopathy, Unani, Siddha and
Homeopathy
AD Allopathic Dispensary/ New Type PHC
ASHA Accredited Social Health Activist
ANC Antenatal Checkup
ANM Auxiliary Nurse Midwife
AFHC Adolescent Friendly Health Centre
AWC Anganwadi Centre
AWW Anganwadi Worker
ADMO Assistant District Medical officer (AYUSH)
BMO Block Medical Officer
BPL Below Poverty Line
BAM Block Accounts Manager
BB Blood Bank
BM&EO Block Monitoring & Evaluation Officer
BSU Blood Storage Unit
CHC Community Health Centre
CMO Chief Medical Officer
DHS District Health Society
DIO District Immunization Officer
DMEIO District Mass Education and Information Officer
DPMU District Programme Management Unit
DPM District Programme Manager
DAM District Accounts Manager
D M& EO District Monitoring & Evaluation Officer
FBNC Facility Based Newborn Care.
FRU First Referral Unit
FMPHW Female Multi Purpose Health Worker
HBNC Home Based Newborn Care
HMIS Health Management Information System
ICDS Integrated Child Development Services
IMR Infant Mortality Rate
IUCD Intra Uterine Contraceptive Device
J SY J anani Suraksha Yojana
3

J SSK J anani Shishu Suraksha Karyakaram
MCTS Mother and Child Tracking System
MMA Medical Methods of Abortion
MMR Maternal Mortality Rate
MAC Medical AID Centre/ Sub Centre
MVA Manual Vacuum Aspiration
NBCC Newborn Care Corner
NBSU Newborn Stabilization Unit
NMR Neonatal Mortality Rate
NRC Nutrition Rehabilitation Centre
NRHM National Rural Health Mission
NPCC National Programme Co-ordination Committee
PHC Primary Health Centre
PRIs Panchayati Raj Institutions
PIP Programme Implementation Plan
PNC Postnatal Checkups
RCH Reproductive & Child Health Programme
RKS Rogi Kalyan Samiti
ROP Record of Proceedings
SHS State Health Society
SDH Sub District Hospital
SC Sub Centre
SNCU Sick Newborn Care unit
TFR Total Fertility Rate
VHND Village Health & Nutrition Day
VHSNC Village Health Sanitation & Nutrition Committee
WIFS Weekly Iron Folic Acid Supplementation










4


NATIONAL RURAL HEALTH MISSION
National Rural Health Mission (NRHM) was launched at the National Level in April 2005.
However, in J &K State it was started in December 2005. The Goal of the Mission is to improve
the availability of and access to quality health care by people especially for those living in rural
areas. NRHM aims to undertake architectural corrections in the health system enabling it to
promote policies that strengthen public health management and service delivery throughout the
country with special focus on those States which have weak public health indicators and/ or
weak infrastructure. Jammu and Kashmir State is one of the focused States. NRHM is a platform
to provide affordable, equitable and accessible health services, especially people residing in
rural areas.
In the first phase of NRHM (2005-12), the focus was on bridging infrastructure gaps and
augmentation of manpower to improve the delivery of health care services. NRHM is now
poised to enter the second phase and the focus in this phase would be more on health system
reforms for sustainable turnaround of health systemin the State. The State would focus on
strategies/ interventions which are aligned with key goals of NRHM viz reduction of MMR, IMR
and stabilization of TFR.
OBJECTIVES OF NATIONAL RURAL HEALTH MISSION
i. To reduce Maternal Mortality Rate (MMR)
ii. To reduce Infant Mortality Rate (IMR)
iii. To reduce Total Fertility Rate (TFR)

STRATEGIES
i) Strengthening of the Health Institutions providing Primary Health Care (CHCs, PHCs
and Sub Centres) so as to provide all the basic and emergency obstetric care.
ii) Strengthening of the Routine Immunization for the vaccine preventable diseases.
iii) Improving the health services and the services determining the health of the society viz
sanitation and potable drinking water.
iv) Decentralizing the health planning and management of the health institutions by way of:
Constitution of District Health Missions and District Health Societies for planning
and implementing the health related initiatives in the respective districts.
Formation of Rogi Kalyan Samitis (RKS) and Village Health Sanitation and
Nutrition Committees (VHSNC).
v) Bringing all the centrally sponsored Health schemes under the umbrella of NRHM.

Programme Action Plan (PIP) for 2012-13
The Ministry of Health and Family Welfare, Govt. of India conveyed administrative approval to
the implementation of State PIP for the year 2012-13 for an amount of Rs. 312.54 crores
5

including Supplementary PIP of Rs.41.78 crores. The State PIP has been approved for the
components and activities detailed in forthcoming paragraphs subject to compliance of following
key conditionalities.
Key Conditionalities
A) Rational and equitable deployment of HR with the highest priority accorded to high
focus districts and delivery points.
Rational and equitable deployment would include posting of staff
on the basis of case load, posting of specialists in teams (e.g.
Gynecologist and Anesthetist together), posting of EmOC/ LSAS
trained doctors in FRUs, optimal utilization of specialists in FRUs
and above and filling up vacancies in high focus/ remote areas.

B) Facility wise performance audit and corrective action based thereon.
Performance parameters must include OPD/ IPD/ normal
deliveries/ C. Sections (wherever applicable).

Non-compliance with either of the above conditionalities given at A and B may
translate into a reduction in outlay upto 7 % and non-compliance with both
translating into a reduction of upto 15%.
C) Gaps in implementation of J SSK may lead to a reduction in outlay upto 10%.
D) Continued support under NRHM for 2nd ANM would be contingent on improvement
in ANC coverage and immunization as reflected in MCTS.
E) Vaccines, logistics and other operational costs would also be calculable on the basis of
MCTS data.
F) All buildings/vehicles supported under NRHM should prominently carry NRHM logo
in English, Hindi and Regional language.
G) The State has been directed to ensure mandatory disclosure of the following
information on the State website of NRHM:
Facility wise deployment of all contractual staff engaged under NRHM with name
and designation.
MMUs- total number of MMUs, registration numbers, operating agency, monthly
schedule and service delivery data on a monthly basis.
6

Patient Transport ambulances and emergency response ambulances- total number
of vehicles, types of vehicle, registration number of vehicles, service delivery data
including clients served and kilometers logged on a monthly basis.
All procurements- including details of equipments procured (as per the directions
of CIC which have been communicated to the States by this Ministry vide letter
'No.Z.28015/162/2011-H' dated 28th November 2011).
Buildings under construction/renovation total number, name of the
facility/hospital along with costs, executing agency and execution charges (if any),
date of start & expected date of completion.

The major heads of operation are:
1. RCH Flexible Pool
2. NRHM Flexible Pool
3. Immunization

The detailed district wise/ activity wise budget for the year 2012-13 has already been
circulated to the District Health Societies for implementation of the approved activities
during the current year. The approval, however, is subject to the compliance of Key
Conditionalities given above. The District Health Societies shall furnish the monthly
progress report in the format given in Annexure A.

Components under the National Rural Health Mission

MATERNAL HEALTH

Janani Suraksha Yojana (JSY)
In order to promote safe Institutional deliveries, the GOI has implemented J SY
throughout the country including J &K. Under this scheme, the incentives are being paid
to mother beneficiaries at the following norms:
S.No Area Incentive for mother
beneficiary
1 Rural areas Rs. 1400.00
2 Urban areas Rs. 1000.00
3 BPL mothers (aged 19 years and above)
delivering at home upto two living children
only
Rs. 500.00

7

ASHAs will facilitate Antenatal checkups and accompany the mothers to the health
institutions for delivery and will get the following incentives:
S.No Districts Incentive for ASHA
1 High Focus Districts Rs.600.00
2 Other Districts Rs.350.00*
*Excluding Rs 250.00 for referral transport which will be borne by J SSK.
J SY cards, MCP cards and broader guidelines of J SY have already been made available
to the District Health Societies.

NOTE:
J SY guidelines to be strictly followed and payments made as per the eligibility criteria.
J SY benefit to the mother should be paid at the Health facility immediately after the
delivery and before discharge.
All payments to be made through crossed cheques / e-banking.
The DDO should ensure that the J SY, MCP Card and Discharge slip have been
prepared before making payment to the beneficiary as well as ASHA.
JSY card and MCP card to be filled at the time of registration of pregnant women
and not at the time of disbursement of cheque to the beneficiary and should be
followed till the completion of pregnancy.
Regular monitoring by Deputy Chief Medical Officers (District Nodal officers) for
J SY.
Physical verification of J SY beneficiaries to be done by the State and district level
health authorities as per the following norms:
i) State level officers 2%.
ii) Chief Medical Officer 5%.
iii) District Nodal Officer (Deputy CMO) 5%
iv) Block Medical Officer 10%
Accuracy of J SY data reported at the HMIS portal of MOH&FW to be ensured besides
furnishing quarterly progress reports to the State Health Society as per the prescribed
format for onward transmission to Ministry within the given timeframe.
The list of J SY beneficiaries to be displayed at prominent places in the Health facility.
Grievance redressal mechanisms as stipulated under J SY guidelines to be activated at
the district and State levels. Quarterly reports of complaints received and action taken
thereon by the Grievance Redressal Cell to be submitted to the State Health Society.

8

Mother and Child Health Card (MCP)
The State has already initiated J oint MCP card developed by the Ministry of Health &
Family Welfare and Social Welfare for monitoring the services of MCH and Nutrition
interventions. This card will be filled at the time of first ANC. ASHA incentives and J SY
benefits to the mother will be given upon verification and checking the entries in the J oint
MCP card prepared by the ANM.

Janani Shishu Suraksha Karyakram (JSSK)
The J anani Shishu Suraksha Karyakram (J SSK) has been implemented in the State with a
view to encourage all pregnant women to deliver in Public Health Facilities and full fill
the commitment of achieving cent percent institutional deliveries.

All Pregnant women and sick neonates till 30 days after birth who access government
Health Institutions including SMGS Hospital, J ammu, Lal Ded Srinagar, G.B. Pant
Hospital Srinagar and SKIMS Srinagar shall be entitled for availing following benefits:-
S. No Entitlements for Pregnant Women: Entitlements for Sick Newborn till 30 days
after birth
1 Free delivery Free and zero expense treatment.
2 Free caesarian section
3 Free drugs and consumables Free drugs &consumables.
4 Free diagnostics (Blood, Urine tests and
Ultrasonography etc.)
Free diagnostics.

5 Free diet during stay (upto 3days for
normal delivery and 7days for caesarian
section)
Diet for mother during the stay of sick children
in hospital for 5 days.
6 Free provision of blood (Relatives and
attendants should be encouraged to donate
blood for replacement)
Free provision of blood. (Relatives and
attendants should be encouraged to donate
blood for replacement)
7 Free transport fromhome to health
institution, between health institutions in
case of referrals and drop back home
Free transport fromhome to health institution,
between health institutions in case of referrals
and drop back home.
8 Exemption fromall kinds of user charges Exemption fromall kinds of user charges.

NOTE:
J SSK entitlements to be ensured to all pregnant women and sick newborns accessing
Govt. health institutions.
Drop back to be ensured to at least 70% of pregnant women delivering in the public
health facilities.
Effective IEC to be ensured.
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Grievance Redressal Cells constituted for J SY shall also look into the Grievances for
J SSK. Submission of Quarterly Reports to be ensured.

Accredited Social Health Activist (ASHA)
ASHA is the first port of call for any health related demands of deprived sections of the
population, especially women and children, who find it difficult to access health services.
She is a trained female health activist in the community who creates awareness on health
and its social determinants and mobilizes the community towards local health planning
and increased utilization and accountability of the existing health services. She is a good
promoter of health practices.

Criteria for selection of ASHA
One ASHA has to be in place for a population of 1000.
ASHA must be a woman resident of the village--- Married/Widow/Divorced and
preferably in the age group of 25 to 45 yrs.
She should be a literate woman with formal education up to Eighth Std.
In case the special circumstances require relaxation of the educational qualification of
ASHA, the District Health Society needs to send the proposal to the State Health
Society with full justification for seeking approval from Ministry of Health and
Family Welfare, Government of India.
She should have effective communication skills, leadership qualities and be able to
reach out to every section of the community.
Adequate representation from disadvantaged population groups should be ensured to
serve such groups better.

10000 ASHAs have been engaged in the State so far. However during the year 2012-13,
engagement of 2000 additional ASHAs has been approved in the Programme
Implementation Plan (PIP). ASHAs are in place in majority of the villages and have been
trained in module I to V. In the year 2012-13, the ASHAs will be trained in Module VI-
VII.

Uniforms to ASHA in High Focus Districts @ Rs. 1000.00 and in other districts @ Rs.
750.00. The amount has to be e-transferred to the account of ASHA.

All payments to ASHAs be made through payees account Cheque/ electronic transfer on
10th of every month.
10

ASHAs are not paid any fixed monthly remuneration. However, they are paid
performance based incentives.

Incentives for ASHAs:
S.No Activity Amount of Incentive
1 Incentive for full ANC Rs 250/- per case
Approved with the condition of registration of PW
within 12 wks, completion of 4 ANC, testing for
Hemoglobin, Routine urine, 100 IFA and TT
injection. The payment would be made after entry in
joint MCP card and verified by the ANM/SN/MO.
2 Incentive under J SY Rs.350/- per delivery
Rs.600/-per delivery in HFDs (with conditions of
J SY)
3 Incentive for HBNC Rs 250/- on completion of six visits (3rd, 7
th
, 14
th
,
21
st
, 28
th
and 42
nd
day) in case of institutional
deliveries and seven visits ((1
st
,3rd,7
th
,14
th
,21
st
,28
th

and 42
nd
day) in case of home deliveries subject to
certification by ANMs.
4 Incentive for full immunization per
child(upto 1 year age)
Rs 100 per child for full immunization in 1
st
year of
age
4 Incentive for full immunization per child
upto 2 years age(all vaccination received
between 1st and 2nd year age after
completing full immunization at 1 year
age)
Rs 50 per child for ensuring complete immunization
upto 2nd year of age of Child.

6 Mobilizing Drop out Children for
Immunization Sessions on VHND
Rs 150 /- subject to the condition that no drop out
child is left without immunization in her area.
7 Incentive for facilitating the monthly
meeting of VHSNC followed by the
meeting of the Women and Adolescent
Girls
Rs. 150/-
8 Incentive for birth registration Rs 50/-
9 Incentive for death registration Rs 50/-
10 Incentive for events reporting (diarrhea,
epidemic, accidents, etc )
Rs 100/-
11 Maternal Death Reporting Rs 100/-
12 Infant Death Reporting Rs 100/-
13 Incentive to ASHA for Roster duty at
ASHA help desk in selected Delivery
points. (Annexure B)
Rs. 100 for 8 hours duty on rotation basis.
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S.No Activity Amount of Incentive
14 Reimbursement for Mobile user charges
for ASHA
Rs. 100 per month
15 ASHA incentive for sale of 50 sanitary
napkins packs.
Rs. 50/-
16 ASHA incentives for testing 50 salt
samples per month in endemic districts
Rs. 25/- per month
17 Early case detection of Leprosy
MB
PB

500/-
300/-
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Motivation of any beneficiary for
tubectomy/laproligations
Rs 150 /- per operation
19 Motivation of any beneficiary for
vasectomy
Rs 200 /- per operation
20 Providing DOTS to the TB. Patients
Rs 250 /- on completion of treatment
21 Pulse Polio Day Rs 75 /- x 3 days =Rs 225

Job functions of ASHA
Activities as mentioned in the table above and mobilizing the Pregnant Ladies for
Antenatal checkups/dropouts for immunization.
Accompanying the pregnant ladies to the institution for delivery.
Tracking of Pregnant women from early registration in the first trimester upto post
natal care after delivery in her respective areas.
Tracking of Children upto full immunization stage
Maintenance of ASHA Diary
Record of house hold visits, under one year children, pregnant ladies and the eligible
couple register.
Assisting the FMPHWs and AWWs in organizing Village Health & Nutrition Days.
Facilitating the monthly meeting of VHSNC followed by the meeting of women and
adolescent girls.
Maintenance of register in which all the services provided viz registration of pregnant
women, ANC, immunization, Oral pills, IUCD, sterilization- Male female, referral of
sick newborns/children/ infants, spacing methods etc. are recorded with signature of
the concerned health person.
Monthly reports generated by ASHA as per her diary is to be consolidated at SC level.
ASHA is a main service provider for Home Based Neonatal Care. She has to provide
newborn care through a series of home visits which include the skills for weighing the
newborn, measuring newborn temperature, ensuring warmth, promoting hand
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washing, providing skin, cord & eye care, supporting exclusive breast feeding,
accessing low birth weight babies through the use of protocols and managing such
babies through various means like monitoring weight supporting / counseling etc.,
detect signs and symptoms of sepsis, recognize post partum complications in the
mother and refer appropriately etc.

ASHA Diary
ASHA has to record and track the pregnant women upto 42 days postnatal period and has
also to follow the children till they are fully immunized. Besides, she has to attend
Village Health and Nutrition Days for mobilizing women and children to avail health
services being provided on VHN Day. She has also to facilitate holding of meeting of the
Village Health Sanitation and Nutrition Committees (VHSNCs) and maintain records of
untied funds of VHSNCs. All these activities need to be recorded for tracking them later
on. The State Health Society is providing the diary to the District Health Society for
distribution among ASHA for this purpose.

Drug kit for ASHA
ASHA have been provided drug kit in the previous year which will be replenished by the
Block Medical Officer out of the available stock of medicines.
Home Based Newborn Care (HBNC) Kit will be provided to ASHAs for Home Based
Newborn Care. The contents of the kits will be as under:
S.No. Equipment No.
1 Baby weighing scale with sling 1
2 Digital thermometer 1
3 Digital watch/Timer device 1
Consumables
4 Cotton
5 Gauze
6 Soap & Soap Case
7 Baby Blankets, Locally made and Locally Procured 2
8 Spoon-stainless steel 1


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ASHA Help Desk/ASHA Greh (New Activity)
Escorting pregnant women to the hospital for institutional delivery is one of the important
activities that an ASHA performs. The ASHA has to escort the pregnant women even
during the odd hours which necessitates for keeping a provision of Help desk-cum-rest
room at the hospitals which would provide space to the ASHAs for freshening up and
taking rest for some time. Besides, it will also act as a help desk to provide required
information to ASHAs. To begin with, this has to be initiated and operationalized in 30
health institutions including District Hospitals and few CHCs on the basis of delivery
load given in Annexure C

ASHA GREH will be having one room with attached toilet and bathroom facility, having
proper electrical fittings like light, fan or heater etc. The room should have a provision of
at least two beds with all other accessories like bed sheets, bed covers, pillows, drinking
water facility etc. Relevant informative documents on health issues shall remain available
in ASHA GREH for reference. The room should be exclusively used by ASHAs and
accessible for use on 24x7 basis.

The management of ASHA GREH shall be assigned to ASHAs selected on the basis of
performance and belonging to the nearby locality. Each selected ASHA shall be assigned
the task of managing ASHA GREH on daily rotation basis. A roster duty register shall be
maintained to record the use of the facility and performance of the duty by ASHAs.
ASHAs will receive incentives for performing duty on roster basis. The overall
management of ASHA GREH will be under the control of Rogi Kalyan Samiti (RKS) of
the concerned health institution.

ASHA shall be given incentive of Rs. 100 / day for performing roster duty for 8 hours.
ASHAs from the adjoining areas will be called for roaster duty to be prepared by the
concerned Block Medical Officer and submitted to the Medical Superintendent of the
concerned Hospital. The incentives to ASHA for performing roaster duty shall be paid by
the concerned Block Medical Officer.
Cost of Operationalization of ASHA HELP DESK/ASHA GREH will be
Rs. 10, 000/facility as per the breakup given below:

S.No. Items Upto a maximum of
1 Two wooden Beds @ Rs. 1500/- Rs. 3000/-
2 Bedding and Linen @ Rs. 1500/ Rs 3000/-
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3 Fan and Heater Rs 2000/-
4 Table and Chair Rs. 2000/-
Total Rs.10,000/-

Delivery points
At present there are 133 functional delivery points (Annexure D) in the State as per the
benchmark set by GoI i.e.
i. SCs conducting >3 deliveries/ month.
ii. PHCs/Non-FRUs conducting >10 deliveries/month.
iii. FRUs conducting >20 deliveries/ month.
iv. District Hospitals conducting >50 deliveries/ month.

Services to be provided in these Delivery Points:
A) All District Hospitals and other similar district level facilities to provide the following
services:
24x7 service delivery for CS and other Emergency Obstetric Care.
1st and 2nd trimester abortion services.
Facility based MDR.
Essential newborn care and facility based care for sick newborns.
Family planning and adolescent friendly health services
RTI/STI services.
Functional Blood Storage Unit / Blood Bank.

B) CHCs and other health facilities at sub district level (above block and below district
level) functioning as FRUs to provide the same comprehensive RMNCH Services as
the district hospitals.
C) 24x7 PHCs and Non FRUs to provide the following services:
24x7 BeMOC services including conducting normal delivery and handling
common obstetric complications.
1st trimester safe abortion services. (MVA upto 8 weeks and MMA upto 7 weeks)
RTI/STI services.
Essential newborn care and facility based care for sick newborns.
Family planning

D) All identified SCs/ facilities will:
Conduct Delivery by SBAs.
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Provide IUD Services
Provide Essential New born care services.
Provide ANC, PNC and Immunization services.
Provide Nutritional and Family planning counseling.
Conduct designated VHND and other outreach services.

Maternal Death Review (MDR)
Under NRHM, various attempts are being made to reduce Maternal Mortality by
improving quality of maternal health care delivery and stepping up monitoring.
Government of India has decided to take up Community based maternal death review
(CBMDR) and the Facility based maternal death review (FBMDR) which would help in
identifying the gaps in the existing health care delivery systems, prioritizing and planning
for intervention strategies and to reconfigure health services.

The Maternal Death Review will be taken up both at Facility level and Community level
in all Districts of the State.

Community-Based MDR
Community based MDR using a verbal autopsy format is a method of finding out the
medical causes of death and ascertaining the personal, family or community factors that
may have contributed to the death. The verbal autopsy consists of interviewing people
who are knowledgeable about the events leading to the death such as family members,
neighbors and traditional birth attendants.
Community based reviews must be taken up for all deaths that occurred in the specified
geographical area, irrespective of the place of death, be it at home, facility or in transit.
Procedure for Community-Based Verbal Autopsy
i) The ASHA/AWW/ANM will inform/intimate all women deaths in the age group of
15 to 49 years from her area by telephone to the BMO within 24 hour. The local
panchayats and other relevant persons/ groups may also be encouraged to inform the
BMO about women s death in their area.
ii) The ASHA/AWW/ANM will fill up the format for primary informant (Annexure E)
for all women deaths (age 15-49) and send the format to the BMO within 24 hours.
Format for primary informer gives information whether the death is a suspected
maternal death or a non maternal death.
16

iii) Line listing of maternal deaths should be submitted to the BMO by the ASHA, by 5th
of every month. In case no death has occurred during the month, the ASHA has to
submit a Nil report.
iv) The ASHA/AWW/ANM should also ensure the presence of the respondents during
the visit of the investigation team

Facility-Based MDR
Facility Based Maternal Death Review will be taken up for all Government hospitals viz.
Medical College/DHs/SDHs/CHCs where more than 500 deliveries are conducted in a
year.
Procedure for Facility-Based Autopsy
i) All Maternal deaths occurring in the hospital, including abortions and ectopic
gestation related deaths, in pregnant women or within 42 days after termination of
pregnancy irrespective of duration or site of pregnancy should be informed
immediately by the Medical officer who has treated the mother and was on duty at the
time of occurrence of death to the Facility Nodal officer (FNO)
ii) The FNO of the hospital should inform the maternal death to the District Nodal
Officer (DNO) and State Nodal Officer on telephone within 24 hours of the
occurrence of death.
iii) The Nodal Officer of the hospital should complete the format for Primary informant
Annexure E and send it to the District Nodal Officers within 24hrs of the
occurrence of maternal death

At the District level the Maternal Death Review is envisaged at two levels.
Maternal Death Review under chairmanship of CMO.
Maternal Death Review by District Level Committee under chairmanship of
District Magistrate.

Composition of District Level Committee
District Magistrate Chairperson
Chief Medical Officer Member Secy/ Convener
Dy. Chief Medical Officer Member
District Nodal Officer (MDR) Member
Facility Based Nodal Officer (MDR) Member
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Representative of Federation of Obstetric and
Gynaecological Society of India (FOGSI)
Member

Committee should meet at least once in a month to review the maternal death cases and
should submit the minutes of the meeting and corrective actions taken to reduce the
maternal deaths to the State Health Society. The meeting of the District Committee shall
be held irrespective of the fact whether any maternal death has occurred in that particular
month or not.

o Maternal Death Reporting:- A provision of Rs. 100.00 has been kept for reporting
maternal death by a community volunteer/ ASHA. The report of such deaths will be
submitted to the District Health Society who will take appropriate action.

o Maternal Death Investigation (Verbal Autopsy):- An amount of Rs. 250 per
investigation shall be provided to Deputy CMO/BMO/MO for Maternal Death
Investigation (Verbal Autopsy). Investigation reports are to be furnished to GOI
through State Health Society on monthly basis/Quarterly basis.

Road Map for Priority Action on Maternal Health is enclosed as Annexure
B
CHILD HEALTH

Before launch of NRHM in the State, the Infant Mortality Rate was 52 as per Sample
Registration Survey (SRS) 2006. Different strategies have been adopted under NRHM
which are directed towards reduction of IMR in the State. As per the targets fixed by
MoH&FW, GoI the State has to achieve the following targets by end of March 2013.
Indicator Current Status
(SRS 2010)
Target
2012-13
Early Neonatal Mortality 30 24
Neonatal Mortality Rate
(NMR)
35 27
Infant Mortality Rate (IMR) 43 34
Under 5 Mortality 48 37

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With these targets in consideration, the following specific interventions are being taken
up in the Districts during the current year:
A) Facility Based New born Care:-
During the current year, emphasis will be laid upon strengthening of existing Facility
Based Newborn Care Units viz. SNCUs/NBSUs/NBCCs at different levels, as most of
these units have been established but need to be operationalized so as to achieve the
desired outputs.
Sick Newborn Care Units: - Sick Newborn Care unit (SNCU) is a neonatal unit in the
vicinity of labour room at District hospital which would provide level-II care for Sick
New Borns. Seven SNCUs have been established till date & eight more are to be
established during this year. Please refer Annexure G for list of Hospitals where
SNCUs are to be set up.
Operational cost has been approved for 5 functional SNCUs @ Rs 10 lakhs and @ Rs. 5
lakhs for the SNCUs which have been established but are yet to be operationalized.
Please refer Annexure H for list of Hospitals in this regard. The component wise
detail of Operational Cost is given below:


Consumables for SNCU includes meconium aspirator adaptors, infusion pumps,
Cuvettes, Vacuum tubes, lancets, capillary tubes, sealing compound, masks & caps,
surgical gloves, suction tubes, feeding tubes, syringes & needles, cotton wool, compress
gauze, connectors, disinfectants & antiseptics, adhesive tapes, scalpels, umbilical venous
catheters, blood transfusion sets, endotracheal tubes, electrodes for ECG recorder,
microscopic slides, paper sheets crepe for sterilization pack, etc.

Human Resources approved for this financial year for each SNCU at District Hospitals:-
1. One Child Specialist.
2. Four Medical Officers (MBBS) to be engaged on contract basis.
3. Five Staff Nurses.
4. One Lab Technician.
5. One Data Entry Operator for ARSH/ SNCU/HMIS at DH.

Recurring or running
cost per year
Operational cost of Rs. 10.00
Lakhs (for One Year)
Operational cost of Rs.
5.00 lakhs (for six months)
Consumables Rs. 3,50,000 1,75,000
Maintenance cost Rs. 6,50,000 3,25,000
Sub Total Rs. 10,00,000 5,00,000
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Newborn Stabilization Units:- Stabilization unit is facility within or in close proximity
of the Maternity ward where sick and low birth weight new born can be cared for short
period. 69 NBSUs have been established till date in the State whereas work is in progress
in 14 NBSUs. Strengthening of existing NBSUs will be carried out this financial year for
which an amount @ Rs 1.75 lakh /unit has been approved as operational cost for 45
functional NBSUs. List annexed as Annexure I.

Recurring or running cost per year Amount in Rupees
Consumables Rs.25,000
Maintenance cost Rs. 1,50,000
Sub Total Rs. 1,75,000

Consumables for NBSU includes I/V cannula 24/26 G, mucous extractors, feeding tubes,
oxygen cylinder 8 F, suction tubes, Sterile gloves, Cotton wool, Disinfectants etc.

Newborn Care Corners: Baby care corners are to be established in the PHCs (Delivery
point) in phased manner by way of addition/alternation of the existing space within/
nearer to the labour room for paying special attention to the sick newborn. 269 Newborn
Care Corners have been established in the State till date. In the previous years the grant
for setting up of NBCC was only Rs. 25000/- & in most of the facilities the equipment
purchased includes Oxygen cylinders, Suction apparatus, Laryngoscope etc whereas in
many of the Institutions radiant warmers were not purchased. An amount of Rs. 42.50
lakhs @ Rs 85,000 per unit has been approved for procurement of equipments for
NBCCs including radiant warmer for 50 delivery points/facilities. List of institutions
annexed as Annexure J.

List of Equipments for NBCC
S No. Item Description Essential/Desirable Quantity
1
Open care system: radiant warmer,
fixed height, with trolley, drawers,
O2-bottles
E 1
2
Resuscitator hand-operated for
neonate, neonate,500ml
E 1
3
Weighing Scale, spring E 1
4
Pump suction, foot operated D 1
5
Room Thermometer E 1
6
Light examination, mobile, 220-12 V D 1
20

Consumables required for NBCC
7
I/V Cannula 24 G, 26 G E

8
Extractor, mucus, 20ml E

9
Towels for drying and
wrapping the baby
E

10

Sterile equipment for cutting and
tying the cord
E

11
Tube, feeding, CH07, L40cm, E

12
Oxygen cylinder 8 F D

13
Sterile Gloves E

Moreover, for strengthening of existing NBCCs Operational cost for 200 units @ Rs
20,000/unit has been approved this financial year. List annexed as Annexure K.
Recurring or running cost per year Amount in Rupees
Consumables Rs.5,000
Maintenance cost Rs. 15000
Sub Total Rs. 20,000

Note: Detailed Guidelines/Toolkit for setting up of SNCUs/ NBSUs/ NBCCs has
already been circulated to the districts. These guidelines are also available on
website of National Rural Health Mission, J&K www.jknrhm.com.

Strengthening of SMGS Hospital Jammu / GB Pant Hospital Srinagar:

For tertiary care hospitals Rs 2 Crore each have been approved for Strengthening of the
paediatrics department of SMGS Hospital Jammu & GB Pant Hospital Srinagar this
financial year.

Note:
All procurement/purchases should be made as per the rates approved by the
Central Purchase Committee.
All codal formalities should be observed while making purchases.

B. Home Based Newborn Care:-
Home Based New Born Care is an effective approach for achieving the desired reduction
in infant mortality in rural and poor population. 10000 ASHAs are working in the State.
21

Training of Module 6 & 7 is being rolled out shortly. By the end of this financial year it is
expected that most of the ASHAs will get trained in Module 6 & 7 to implement
effectively Home Based New Born Care. Training on MCP cards for HBNC will be
imparted to the ASHAs during monthly meetings. HBNC visits will be monitored by the
ASHA facilitators, MCP cards will be filled by the ANM in order to ascertain their Home
visit & ASHA will be entitled for Rs. 250 on completion of her six visits (Day 3, 7, 14,
21, 28, 42) in case of institutional deliveries and seven visits (Day 1, 3, 7, 14, 21, 28, 42)
in case of Home deliveries.

C. Janani Shishu Suraksha Karyakram (JSSK)
J SSK has been implemented in the State vide Govt. Order No. 516-HME of 2011 free
entitlements for sick newborn for 30 days after birth are given at under Maternal
Health.

D. Nutrition Rehabilitation Centre NRC (New Activity)
NRC is a unit in a health facility where children with Severe Acute Malnutrition (SAM)
are admitted and managed. Children are admitted as per the defined admission criteria
and provided with medical and nutritional therapeutic care. Once discharged from the
NRC, the child continues to be in the nutrition rehabilitation program till he/she attains
the defined discharge criteria as per the guidelines.

Location and size of NRC
NRC is a special unit, located in a health facility and dedicated to the initial management
and nutrition rehabilitation of children with severe acute malnutrition. The unit should be
a distinct area within the health facility and should be in proximity to the pediatric
ward/inpatient facility.

The NRC should have the following Facilities:
Patient area to house 10 beds; in NRC adult beds are kept so that the mother can
be with the child.
Play and counseling area with toys; audiovisual equipment like TV, DVD player
and IEC material.
Nursing station
Kitchen and food storage area attached to ward, or partitioned in the ward, with
enough space for cooking, feeding and demonstration.
Attached toilet and bathroom for mothers and children, along with two separate
hand washing areas.
22

The approximate covered area of the NRC should be about 150 square feet per
bed, plus 30% for ancillary area. A 10 bedded NRC should have a covered area of
about 1950 square feet; this will include the patient area, play and counseling area,
nursing station, kitchen, storage space, two bathrooms and two toilets.
NRC should have a cheerful, stimulating environment; it should be child friendly.
Walls can be brightly painted and decorated. Ward should have sufficient space
for all mothers/caregivers staying with the children to sit together and be given
cooking and feeding demonstration.
To begin with, the State will establish two Nutrition Rehabilitation Centres (NRCs). In
this financial year one in G.B Pant Hospital, Srinagar and one in SMGS Hospital, J ammu.
Rs. 19.6 lakhs have been approved for this activity during this financial year @ Rs. 2
Lakh as establishment cost & Rs. 7.8 lakh as operational cost per unit.

Approved Budget for 10 bedded NRC
S. no. Items Unit cost Total cost
A. One-time expenditure
A1 Civil Work (renovation)
1.1 Ward 25,000 25,000
1.2 Kitchen 20,000 20,000
1.3 Bathroom and toilets 15,000 15,000
A2 Cots and Mattresses
(10 Cots & mattresses @ Rs 2500 each)
2,500 25,000
A3 Essential Ward equipments 50,000 50,000
A4 Other Ward equipments 35,000 35,000
A5 Kitchen equipments 30,000 30,000
One-time expenditure 2,00,000
B. Recurrent expenditure
B1 Kitchen Supplies 15,000 (per month) 1,80,000
B2 Pharmacy Supplies and Consumables 15,000(per month) 1,80,000
B3 Other Costs
Wage Compensation and food for mother/care
giver* (Rs 100 X 10 beds X 30days X 12 months)
Rs.100/day 3,60,000
Maintenance of equipments, linen, Cleaning
supplies
3,500(per month) 42,000
Contingency 1,500(per month) 18,000
Subtotal 64,500 7,80,000
TOTAL COST (A+B) 9,80,000

23

* The Mother/ Care taker of Child shall prepare special diet for the child as prescribed by
the Medical officer under the supervision of Staff Nurse, for this purpose mother of child
shall be provided wage compensation/ food @ Rs 100 per day.
Medical Superintendent of Hospital shall utilize the services of one Medical Officer
(MBBS) and One Staff Nurse from existing hospital staff for providing services in the
Nutrition Rehabilitation Centre. The Staff will be trained in facility based management of
SAM.
Medical Officer shall be the overall in-charge of the unit and will be responsible for
clinical management of children admitted in the NRC. The MO will examine each patient
every day and will attend to emergency calls as per the need.
The nurse posted in the unit will be responsible for the nursing care including weight
record; measure, mix and dispense feed; give oral drugs; supervise intra venous fluids;
assess clinical signs and fill the multi chart with all the routine information. The nurse
will also counsel mothers/caregivers on the emotional needs of their children and
encourage them to give sensory stimulation. She will be also in charge of the structured
play therapy.

Details of equipments and supplies for NRC
i. Essential Ward equipments
Glucometer (1)
Thermometers (preferably low-reading) (2)
Weighing scales (Digital) (3: one each to be kept in Ward, OPD and Emergency area)
Infantometer (1 each for OPD & NRC)
Stadiometer (to measure standing height) (1)
Resuscitation equipments
Suction equipment (low pressure)

ii. Other Ward equipments
IV stands
Almiras, Shoe racks, Dust bins, Room Heaters
IEC Audio/visual materials (TV; DVD player)
Toys for structural play
Calculator & Clock
Reference height and weight charts

24

iii. Kitchen equipments
Cooking Gas
Dietary scales (to weigh to 5 gm.)
Measuring jars
Electric Blender (or manual whisks)
Water Filter
Refrigerator
Utensils (large containers, cooking utensils, feeding cups, saucers, spoons and jugs, etc.)

iv. Drugs and Consumables
Antibiotics: (Ampicillin/Amoxicillin/Benzyl penicillin
Chloamphenicol Cotrimoxazole Gentamycin Metronidazole
Tetracycline or Chloramphenicol eye drops
Atropine eye drops
ORS
Electrolyte and minerals Potassium chloride Magnesium chloride/ Sulphate iron syrup
Multivitamin Folic acid vitamin A syrup
Zinc Sulfate or dispersible Zinc tablets
Glucose (or sucrose)
IV fluids (ringer s lactate solution with 5% glucose; 0.45% (half normal) saline with 5%
glucose; 0.9% saline (for soaking eye pads)
Cannulas, IV sets,
Pediatric Nasogastric tubes

v. Kitchen Supplies
Supply for making Starter and Catch up Diet
Dried Skimmed Milk
Whole dried milk
Fresh whole milk
Puffed rice vegetable oil
Foods similar to those used in home

D. Infant and young Child Feeding (IYCF):
Beast feeding is to be initiated within one hour after birth of the child. During the current
financial year, breast feeding week (1 7 August 2012) will be organized at all delivery
points, block and district headquarters for promoting breast feeding. An amount of Rs.
25

5000/- has been approved to be kept at the disposal of the heads of the institutions for
carrying out activities like IEC and organizing camps.

E. Infant Death Review (IDR)
One of the prime objectives of NRHM is to reduce the Infant Mortality Rate (IMR).
Various attempts are being made to reduce Infant Mortality by improving quality of child
health care delivery through strengthening of Facility Based Newborn Care Units,
introduction of Home Based Newborn Care Programme and stepping up monitoring.
However, it has been felt that prompt reporting and review of infant Deaths can provide
insight into the cause of death and the possible solutions to check the problem.

The Infant Death Review will be taken up both at Community level and Facility level in
all Districts of the State.

Community-Based IDR
Community based IDR using a verbal autopsy format is a method of finding out the
medical causes of death and ascertaining the personal, family or community factors that
may have contributed to the deaths. The verbal autopsy consists of interviewing people
who are knowledgeable about the events leading to the death such as family members,
neighbors and traditional birth attendants.

Community based reviews must be taken up for all deaths that occurred in the specified
geographical area, irrespective of the place of death, be it at home, facility or in transit.

Procedure for Community-Based Verbal Autopsy
i) The ASHA/AWW/ANM will inform/intimate all infant deaths in the age group of 0
to 1 year from her area by telephone to the BMO within 24 hour. The local
panchayats and other relevant persons/ groups may also be encouraged to inform the
BMO about women deaths in their respective areas.
ii) The ASHA/AWW/ANM will fill up the format for primary informer for all infant
deaths and send the format to the BMO within 24 hours.
iii) Line listing of the infant deaths should be submitted to the BMO by the ASHA, by
5th of every month. In case no death has occurred during the month, the ASHA has
to submit a nil report.
iv) The ASHA/AWW/ANM should also ensure the availability of the respondents
during the visit of the investigation team.

26

Facility-Based IDR
Facility Based Infant Death Review will be taken up for all Government hospitals
including Medical Colleges (District, Sub district, CHCs) where more than 500 deliveries
are conducted in a year.

Procedure for Facility-Based Autopsy
i) All Infant deaths occurring in the hospital, should be reported immediately by the
Medical officer who has treated the child and was on duty at the time of occurrence of
death to the Facility Nodal officer (FNO)
ii) The FNO of the hospital should report the infant death to the District Nodal Officer
(DNO) and State Nodal Officer by telephone within 24 hours of the occurrence of
death.
iii) The Nodal officer of the hospital should complete the primary informant format and
send it to the DNO within 24hrs of the occurrence of infant death.

At the District level the Infant Death Review is envisaged at two levels.
Infant Death Review under chairmanship of CMO.
Infant Death Review by District Level Committee under chairmanship of District
Magistrate.

The District Level MDR Committees shall also review the infant deaths in the District.
However, one Pediatrician will be included in the aforesaid committee for review of
Infant Deaths.

Committee should meet at least once in a month to review the infant death cases and
should submit the minutes of the meetings and corrective actions taken to reduce the
infant deaths to the State Health Society irrespective of the fact whether any infant death
occurred in that particular month or not.

Infant Death Reporting: - A provision of Rs.100 has been kept for reporting infant
death by a community volunteer/ ASHA. The report of such deaths is to be submitted to
the District Health Society who will take appropriate action. Formats for infant death
reporting are annexed at Annexure L

Infant Death Investigation (Verbal Autopsy):- An amount of Rs. 250 per investigation
shall be provided to Deputy CMO/BMO for Infant Death Investigation (Verbal Autopsy).
27

Investigation reports are to be furnished to GOI through State Health Society on monthly
and quarterly basis

Emphasis needs to be given to:
Initiation of Breast feeding within one hour after Birth.
A minimum stay of 48 hours of the mother & the child after delivery at the Health
facility followed by post natal visits by ASHAs/ANMs upto 42 days to monitor the
well being of mother & Child.
Full immunization of the children as per the Universal Immunization schedule.
Proper Facility Based Newborn Care.

Road Map for Priority Action on Child Health is enclosed as Annexure
F
URBAN RCH

Urban RCH is being implemented in Capital cities of Srinagar & J ammu under NRHM;
Urban Health Posts and Urban Health Centres have been established in cities of Srinagar
& J ammu.

Urban Health Centres
Manpower One Medical Officer, Three ANMs and One Helper

Urban Health Posts
Two ANMs and One Part Time Cleaner

Note: Funds under Urban RCH have been approved for six months only. Further approval
shall be given subject to the sharing of work done performance of UHCs / UHPs with the
Ministry of Health and Family Welfare, GoI. The Chief Medical Officers J ammu /
Srinagar shall furnish the progress report of Urban Health Centres / Posts to the State
Health Society by 30
th
September 2012 for its onward transmission and taking up the
matter with GoI for sanction of funds for next six months.

ROAD MAP FOR PRIORITY ACTION UNDER URBAN RCH
Carry out a comprehensive third party evaluation of UHCs/ NGO performance
including an assessment of reasons for low expenditure (9.6 % in the first 9
28

months of 2011-12). State to apprise MoH&FW of action taken on the basis of the
findings of the evaluation by September 2012.
Monitor performance of UHCs/NGOs against targets.
Staffing at UHCs to be linked to case load.


TRIBAL RCH

Under Tribal RCH, AMCHI units have been setup under NRHM in District Hospitals,
CHCs, PHCs of Leh and Kargil. AMCHI healers are to be engaged in these AMCHI units
on contractual basis upto 31st March 2013.

Manpower for AMCHI Units
Two AMCHI Healers per District Hospital
One AMCHI Healer per CHC; and
One AMCHI Healer per PHC

The medicines have been approved for these AMCHI units at the following rates:
S.No Activity Unit Cost
1 Procurement of medicines for AMCHI at District
Hospital
1,00,000/-
2 Procurement of medicines for AMCHI at CHC 75,000/-
3 Procurement of medicines for AMCHI at PHC 25,000/-

ROAD MAP FOR PRIORITY ACTION UNDER TRIBAL HEALTH During the
year 2012-13
Monitoring progress (physical and financial) on all health activities in notified
tribal areas.
On a quarterly basis, a progress report, including constraints faced and action
proposed to be sent to the State Health Society for onward transmission to
MoHFW.
The State shall focus on health entitlements of vulnerable social groups like SCs,
STs, OBCs, minorities, women, disabled, migrants etc

Establishing Control Room for Ambulances (Toll Free No. 102)
The control rooms are being established in each of the District Hospital to regulate and
use all ambulances optimally. A toll free number 102 will be obtained for these control
29

rooms. These control rooms shall be manned round the clock by operators who shall
control and direct the flow of ambulances as per requirement. These are being established
to ensure optimal delivery care to the patients/clients calling for help, i.e. stabilization
before transport, emergency admission, preparation of the institution to receive a critical
patient, etc.

Detailed guidelines for operationalizing these control room have been circulated to the
Chief Medical Officers.

Blood Storage Centre (BSC)
26 Blood Storage Centres, the details of which mentioned in Annexure M, have
been approved for the financial year 2012-2013 in the State. Some of these are already in
the process of getting licensed and these BSCs need to be strengthened. List of
equipments to be procured for such Blood Storage Centres is as follows:
S.No Name of Equipment Quantity required
1 Blood Bank Refrigerator having capacity of 50 blood units 01
2 Air Conditioner 01
3 Autoclave 01
4 Binocular Microscope 01
5 Deep Freezer for freezing ice packs 01
6 Dry Incubator 01
7 Insulated Blood Bags Containers 01
8 Table Top Centrifuge 01
9 Micropippets of different capacities One each
10 Consumables, reagents, disinfectants As per workload

Special incentives to doctors
With a view to ensure the availability of Doctors in remote areas of the State, the
Government has approved special incentive of Rs.20,000.00, Rs 15,000 and Rs.
10,000.00 for Allopathic / ISM doctors hired under NRHM and serving in Category A ,
(inaccessible areas), Category B (very difficult areas) and Category C (difficult
areas) respectively. List of health institutions falling in such areas is enclosed as
Annexure N. The incentive is an additional lump sump allowance payable over and
above the existing pay/salary structure to the Allopathic / ISM doctors working on
contractual basis under NRHM.

In addition to this, the incentives shall also continued to be paid @ Rs.8000.00 and Rs.
4000.00 per month for MBBS / AYUSH Doctors serving in the areas notified under SRO
30

201 of 2006 in respect of Category A (Very difficult) and Category B (Difficult)
respectively. The incentive is an additional lump sump allowance payable over and above
the existing pay/salary structure to all categories of doctors irrespective of the fact
whether they are appointed on regular basis or on adhoc basis or under SRO 255 on
contractual basis or under NRHM on contractual basis. The incentive is payable after
production of a certificate from CMO/ADMO concerned that his/her performance during
the period of report has remained good and has done adequate work in terms of OPD,
IPD, immunization antenatal, postnatal checkups and conduct of deliveries (wherever
applicable).

The incentives should be linked to the place of work and no transfer/shifting should
be allowed from the place where the person is getting incentive.

Permissible Manpower

Sub-Centres
During 2011-12, districts were allowed to hire one additional ANM on contractual basis
in all the Sub-Centres which shall be continued in the year 2012-13 as well. The local
residency of the ANM needs to be given priority while making recruitment.

MACs renamed as Sub Centres
During 2011-12, districts were allowed to hire one Male Multipurpose Health Worker on
contractual basis in all the MACs (renamed as Sub-Centres) which shall be continued in
the year 2012-13 as well. The local residency of the MPHW needs to be given priority
while making recruitment.
24X7 PHCs
In addition to the required Manpower positioned in PHCs as per sanctioned strength, the
additional manpower under NRHM is also being provided on contractual basis with the
purpose to provide basic obstetric care round the clock in the PHCs designated as 24x7.
The category wise maximum permissible limit under NRHM (including already
engaged) is as follows:
One Medical Officer (MBBS)
Two Staff Nurses.
One Laboratory Technician.



31

At PHC level under NRHM
Each PHC has been provided with 1 AYUSH Doctor and 1 AYUSH Pharmacist
(Dawasaaz) during the year 2011-12 which shall be continued in the year 2012-13 as
well.
One Additional MBBS doctor and one additional AYUSH doctor has been provided
in PHCs notified as falling in remote areas as per SRO 201 of 2006 from the year
2009-10 which shall be continued in the year 2012-13 as well.

FRUs under NRHM
In addition to the required Manpower positioned in FRUs as per sanctioned strength, the
additional manpower under NRHM is being engaged in CHCs designated as FRUs with
the objective to provide Basic and Emergency Obstetric Care round the clock.

The Category wise maximum permissible limit under NRHM (including already
engaged) is as follows:
i. Two Medical Officers (MBBS)
ii. Two Staff Nurses
iii. Two O.T. Technicians
iv. Two X-ray Technicians
v. Two Laboratory Technicians
vi. Additional 8 Staff Nurses for CHC Kupwara, Magam, Bijbhera, Akhnoor, R S Pura
and Ramgarh

Newly created District Hospitals
The objective of providing manpower in newly created District Hospitals remains to
provide the basic and emergency obstetric care round the clock. The Category wise
maximum permissible limit in each of the District Hospital of newly created districts
under NRHM (including already engaged) is as follows:
i. Two MBBS doctors
ii. Ten Staff Nurses.
iii. Two O.T. Technicians
iv. Two X-ray Technicians
v. Two Lab. Technicians.

Old District Hospitals
The objective of providing additional manpower in old District Hospitals remains to
provide basic and emergency obstetric care round the clock.
32

i. Ten Staff Nurses in Old District Hospitals on contractual basis.
ii. However, Govt Hospital, Sarwal, J ammu and G.B.Pant Hospital, Srinagar have also
been provided Ten Staff Nurses each on contractual basis on the pattern of District
Hospitals.

Strengthening of Institutional Mechanism
District Health Societies: 22 District Health Societies have been constituted for planning
and implementing the health related initiatives in the respective districts.
Rogi Kalyan Samitis. 571 RKS have been constituted and registered at the level of
District hospital/ CHC/PHC for community management of public hospitals. RKS at the
level of new type PHCs are to be constituted on the pattern of PHCs. The District
Health Societies shall initiate immediate action on constitution of the RKS for new
type PHCs.
Sufficient budget is provided to the District Hospitals, CHCs, PHCs and Sub Centres as
Corpus fund, Untied fund & Annual Maintenance Grant for improvement and
maintenance of physical infrastructure and meeting the day-to-day needs of these
institutions. This budget should be utilized after identifying the needs and approval of the
RKS/VHSC.
The institution wise details of the budget are as under:-
S.No. Name of the Institution Corpus Fund
( Rs. in Lacs)
Untied fund
(Rs. in Lacs)
Annual *
Maintenance Grant
( Rs. in Lacs)
1 District Hospital 5.00 Nil Nil
2 Community Health Centres (CHCs) 1.00 0.50 1.00
3 Primary Health Centre (PHC) 1.00 0.25 0.50
4 New Type PHCs 1.00 0.25 0.50
5 Sub Centres (SC) including MACs
which have been renamed as Sub
Centres
Nil 0.10 0.10

*Annual Maintenance Grant is provided to the institutions located in Govt. building(s) only.
NOTE
The funds for New Type PHCs shall be utilized only after constitution of RKS.
Meetings of RKS should be held as per schedule envisaged in the guidelines. However, incase
due to some exigency, the Honble MLA is not in a position to attend the meetings (s), the same
may be held under the Chairmanship of any of the members present (preferably CMO/BMO as
the case may be) on the schedule date.
33

It has further to be ensured that the requisite quorum for the meeting is present and that the
minutes of the meeting are properly recorded and circulated among all members including
concerned Honble MLA.
The guidelines with regard to spending of these grants are annexed as Annexure O
VILLAGE HEALTH SANITATION AND NUTRITION COMMITTEES (VHSNCS)
The Ministry of Health and Family Welfare, GoI vide their No. Z.18015/15/2011-NRHM-II
dated 25-07-2011 has conveyed instructions to rename Village Health and Sanitation
Committees as Village Health Sanitation and Nutrition Committees (VHSNCs). With a view
to sensitize the PRIs about various schemes of NRHM, the State Health Society is providing
diaries to Sarpanches. The diary also contains guidelines regarding constitution of Village
Health Sanitation and Nutrition Committees and the norms for utilization of untied grants
eligible for the committees.

1. During the current financial year, ASHAs shall be involved for facilitating meeting of
Village Health Sanitation and Nutrition Committee in terms of GoI guidelines, as per the
following conditions:
i) Making payment of an incentive @ Rs 150/- to each ASHA for facilitating the
monthly meeting of VHSNC followed by the meeting of women and adolescent
girls.
ii) Payment of the incentive should be made out of the untied grants given to each
VHSNC under NRHM.
iii) ASHAs should coordinate for both VHSNC and monthly meeting of women and
adolescent girls.
iv) The concerned ANM at Sub-Centre / PHC will certify the conduction of the
meeting.
2. Further, the under mentioned guidelines should be followed for convening the meetings
of VHSNC:-
i) The meeting of VHSNC should be followed by the meeting of Women and
Adolescent girls where the issues pertaining to Nutrition, Reproduction & Child
Health, Sanitation & Hygiene, Breast Feeding, Menstrual Hygiene, Age at Marriage,
Contraception, Pre-School Education and Female Literacy etc. should be discussed.
ii) The meeting of VHSNCs should be convened every month in consultation with the
members of VHSNC and President of Gram Panchayat.
iii) ASHAs should make all possible efforts for the sufficient publicity of the meeting
so as to ensure wider participation of women and adolescent girls of the village.
34

iv) The meeting should be fixed on the date other than that of Village Health &
Nutrition Day (VHND).

FAMILY PLANNING
The State has achieved the target of reduction of Total Fertility Rate (TFR) to 2.0
(SRS 2010) against the target of TFR to 2.1by 2012. The State has to achieve the target
of 1.8 by the end of 12
th
Five year Plan.
Family Planning Programme is being strengthened by distribution of Condoms/
contraceptives through ASHAs at Village level at the door steps of needy clients. It
will not only help in avoiding unwanted pregnancies but also protection against HIV/
AIDS and other Sexually transmitted diseases. The scheme is being implemented as pilot
project in 4 districts of J ammu Division viz. Rajouri, Poonch, Udhampur & Doda.

The approved activities and the permissible amount are mentioned in the table:-

The permissible budget for Male and Female Sterilization camps is given:
S.No. Heads Camp Management for
Male Sterilization
Camp Management for
Female Sterilization
1 Transport for service providers team as
per actual/entitlement
8000.00 8000.00
2 POL / Transport for acceptors 5000.00 5000.00
3 Contingency 2000.00 2000.00
4 IEC (Newspaper, Handbill, Cable T.V. 20000.00 Nil
S No. Activity Target Permissible Amount
1 World Population Day Celebration: (Such
as mobility, IEC activities etc.): funds
earmarked for District and block level
activities
One per District Rs 2,00,000 lakh/ district
2 Sterilization Camps
a) Male One Per District Rs. 35000 per camp
b) Female One Per District Rs. 15000 per camp
3 Package for Sterilization
a) Male Targets being given
separately in
District PIP
Rs.1500 per case
b) Female Rs. 1000 per case
4 Compensation for IUCD service Targets being given
separately in
District PIP
Rs. 20 per case
35

Banners etc)
Total 35000.00 15000.00
However, while organizing such camps all efforts should be made to conduct around 100
cases in each of the camp.
The guidelines issued by Govt. of India for this component have already been
provided to all the Districts.

Quality Assurance Committees (QAC)
QACs for monitoring family planning activities have been constituted at the District
Level. The quarterly meetings of these committees need to be organized for which Rs
5000.00 per quarter are being provided to each of the district. The Districts are required
to submit the Minutes of these Meetings to the State Health Society on regular basis.

Block Level NRHM Sammelans
During the current financial year, the block level NRHM Sammelans shall be organized
in each of the block. These Sammelans aim at creating awareness among the PRIs,
prominent citizens, NGOs, health functionaries viz CMOs, BMOs/MOs (Block PHCs)
and mainly for the field functionaries like Field NGOs, FMPHWs, ASHAs and AWWs
who are directly associated with the implementation of various schemes/ programmes
under NRHM at the ground level. Rs. 20000/- has been approved for each Sammelan at
Block Level.
Guidelines for organizing BLOCK Level NRHM Sammelans have been circulated to
the districts.
Road Map for Priority Action on Family Planning during the year 2012-13 is
enclosed as Annexure P

ADOLESCENT HEALTH
Adolescent Reproductive and Sexual Health (ARSH): - Ministry of Health and Family
Welfare, Government of India has included Adolescent Reproductive and Sexual Health
(ARSH) as a key technical strategy under the National RCH II programme. Mainly
strategy focuses on reorganizing adolescent population that will yield dividends in terms
of delaying age at marriage, reducing incidence of teenage pregnancy, prevention and
management of obstetric complications including access to early and safe abortion
services.
36

A core package of services that includes preventive, promotive, curative and counselling
services will be delivered during routine clinics at District level and further shall extend
to sub-centre, PHCs and CHCs, and dedicated adolescent clinics on fixed days and time
as well as through outreach activities.
Adolescent Clinics: Adolescent Friendly Health Clinics (AFHCs) have been
established across all the 22 districts of the state in addition to one clinic each in Govt.
Medical College J ammu/ Kashmir at divisional level. In addition, 3 new Adolescent
Clinics have been approved to be established one each in Govt. Hospital Sarwal,
CHC Akhnoor and CHC Kupwara for which an amount of Rs.100000/- has been
approved
Manpower: In order to consolidate the role of AFHCs in providing youth friendly
services to this high focused group, trained Lady Counselors and Data Entry
Operators have been appointed in each Adolescent Clinic except 3 new clinics to be
set up in the current financial year.
Operating expenses: The existing 24 clinics and the 3 new CHCs approved during
2012-13 will continue to get a recurring amount of Rs. 20,000 per annum for each
Adolescent Clinic as operating expenses for printing of the stationery/IEC
material/Formats for the clinic @Rs 15000/- and Rs 5000/- as mobility support on
account of holding outreach camps/meeting by the counselor in a year.
Menstrual Hygiene Programme: A new scheme for promotion of menstrual hygiene
among adolescent girls (10-19) in rural areas has been launched under which the sanitary
napkins shall be distributed among the school going and out of school adolescent girls.
Target districts:- The scheme has been launched on pilot basis in 10 Districts of
J &K State where in total 7 districts, namely Rajouri, Poonch, Doda, Kishtwar,
Ramban, Udhampur and Kathua are selected in J ammu Division and three districts
namely Baramulla, Bandipora & Kupwara in Kashmir Division. Under the
scheme, sanitary napkins are being procured by the Ministry of Health & Family
Welfare, Govt. of India and supplied under the NRHM brand name Free days .
Operationalization:- In the State, the scheme shall be operationalized at two tier
level through the wide network of the health care providers at Block/sub health centre
level and ASHA as link worker between the service provider and the community at
village level. The sanitary napkins shall be supplied directly to the block headquarters
from the central supply and further be purchased by the ANM/LHV at Sub- Centre
Level from the Block office and shall further be sold to the ASHA for future sale at
village level to the adolescent girls falling under both APL/BPL categories.
37

The cost of the sanitary napkins has been fixed at Rs.5/- per pack containing six napkins
(each pack) and shall be made available to the adolescent girls at the price of Rs. 6/- per
pack. Initially, the ASHA will be given Imprest money of Rs. 300/- from the sub centre
(untied fund) for purchase of sanitary napkin packs from the ANM at Rs. 5/- per pack and
the ASHA will sell the pack to adolescent girl at Rs. 6/- regardless of APL/BPL status.
The ASHA will be entitled to retain Re. 1/- as an incentive for sale of each pack of
sanitary napkins and rest of Rs. 5/- will be used to purchase sanitary napkin packs for
future sale. ASHA will receive one additional sanitary napkin free of cost from ANM
each month for her personal usage apart from Re. 1/- as incentive.

Further, the storage of the sanitary napkins shall be made at PHC/SC level and in case if
additional room for storage is required, it can be taken on rent out of untied funds. Also
the revenue generated out of sale of the sanitary napkins shall be deposited by the ANM
with the Block Medical Officer who shall further deposit the same into the District Health
Society .The District Health Societies shall deposit these to the State Health Society for
procurement of the napkins for further supply.

SABLA Programme: - SABLA is a new centrally sponsored, comprehensive scheme,
called Rajiv Gandhi Scheme for Empowerment of Adolescent Girls or SABLA, merging
the erstwhile Kishori Shakti Yojna (KSY) and Nutrition Programme for Adolescent Girls
(NPAG) schemes to address the multidimensional problems of Adolescent Girls (AGs).

Implementation: - In J ammu & Kashmir, Sabla is being implemented in 5 districts
namely - Anantnag, Kupwara, Kathua, Jammu, Leh using the platform of ICDS.

Under the scheme, the following services are being provided in convergence with the
Departments of Health and Family welfare, Social Welfare Department and State AIDS
Control Society:
IFA supplementation, including supply of IFA tablets.
General health check-up, including recording of height, weight, BMI for all
adolescent girls, by the Medical Officer/ANM.
Referral to specialized healthcare facilities, as required for conditions like
malnutrition, menstrual problems, frequent headaches, prolonged acne, worm
infestation, etc.
Nutrition and Health Education.
Family welfare and ARSH services.

38

School Health Programme: - The School Health Programme shall focus on the health
needs of the school going children so as to promote the preventive and rehabilitative
health in the state of J &K.
Target Districts: - The School Health Programme shall be started initially on pilot
basis in five SABLA districts in the State viz. Jammu, Kathua in J ammu Division
and Anantnag, Kupwara and Leh in Kashmir Division.
Operationalization: - Under the programme, the School Health Committees shall be
formed which shall be responsible for implementation and monitoring of the
programme in all the Govt. and Govt.-Aided schools in the selected districts. The
teams shall also conduct check-ups for children below 6 years at AWCs. The
programme shall focus on three Ds- Deficiency, Disease and Disability. The referral
of children shall be tied up and complete treatment at higher facilities shall be
ensured. The nodal teachers from all the Govt. and Govt. aided schools shall be
involved. School Health Cards shall be issued and height, weight measurement and
BMI calculation shall be part of the School Health Card. In addition, under the school
health programme apart from health needs of the school going children, the school
health talks on prevention of diseases and promotion of health shall be given by the
existing dedicated teams.
The School Health Programme shall be carried out by the Directorate of Health services
J ammu/Kashmir and the Chief Medical officers of the respective Districts shall send a
copy of the monthly compiled report to the Programme Manager in charge School Health
Programme.

Weekly Iron and Folic Acid Supplementation for adolescents (WIFS)
As adolescent anemia is a critical public health problem in the country, the Ministry of
Health and Family Welfare, Government of India, based on the empirical evidence
generated by these scientific studies, has developed programmatic guidelines for Weekly
Iron and Folic Acid Supplementation (WIFS) of adolescent. This scheme is to reduce the
prevalence and severity of anemia in adolescent population (10-19 years) and programme
to be implemented for the following two target groups in both rural and urban areas:
A. Adolescent girls/boys who are school going and are in government/government aided
schools from 6
th
-12
th
classes.
B. Adolescent Girls who are not in school or out of school.

The WIFS programme will also cover married non-pregnant adolescent girls in order to
increase their pre-pregnancy iron stores and decrease prevalence of anemia among
pregnant adolescent girls.
39

Target Districts: - The WIFS programme shall be started in the five Districts on pilot
basis which are already selected under SABLA scheme namely Jammu, Kathua in
J ammu Division and Anantnag, Kupwara and Leh in Kashmir Division.
Operationalization: - The implementation strategy of WIFS programme involves a
fixed day approach i.e. Monday for WIFS distribution to ensure high compliance. The
programme shall be implemented in both urban and rural areas. Under the programme,
the school adolescent population, enrolled in 6
th
to 12
th
standard, in rural and urban
regions will be reached. The programme shall encourage consumption of weekly IFA
tablets and six monthly de-worming tablets through school and ICDS platform.
At district level, a monitoring committee comprising Health and Education departments
will be formed to monitor the progress of the project and resolve programmatic issues.
The meeting could be organized every six months with the participation of health and
education block officials. Yearly meeting with nodal teachers could be organized to
further streamline the project.

Road Map for Priority Action on Adolescent Centric Programmes is enclosed as
Annexure Q
PC & PNDT AND GENDER MAINSTREAMING
MISSION:
The mission of PNDT programme is to improve the sex ratio at birth by regulating the
pre-conception and prenatal diagnostic techniques misused for sex selection.

Regulatory Mechanism under PC&PNDT Act

STATE LEVEL
v State Supervisory Board under the Chairmanship of the Hon ble Health
Minister, J &K and Co-Chairmanship of Hon ble Minister of State for Health
v Mission Director NRHM appointed as State Nodal Officer PC&PNDT for
coordination with the Ministry of Health and Family Welfare, GoI.

DIVISIONAL LEVEL
v Divisional Advisory Committee under the Chairmanship of respective Divisional
Commissioner.
v Divisional Appropriate Authority ----- Director Health Services, J ammu/
Kashmir.

DISTRICT LEVEL
40

v District Advisory Committee under the Chairmanship of concerned Deputy
Commissioner.
v District Appropriate Authority ---- Concerned Chief Medical Officer.

DISTRICT ADVISORY COMMITTEE
Reconstituted vide Government order No. 502-HME of 2011 dated: 20.09.2011

DISTRICT APPROPRIATE AUTHORITY
CMOs have been designated as District Appropriate Authority vide Govt. Order No 609-
HME of 2011 Dated: 22-11-2011

Composition of District Advisory Committee
District Development Commissioner / Dy. Commissioner Chairman
Chief Medical Officer Member Secretary
Medical Supdtt. District Hospital Member
District Information Officer Member
District Social Officer Member
Senior Most Gynecologist of the District Hospital Member
Senior Most Pediatrician of the District Hospital Member
Leading advocate of the District to be
nominated by Deputy Commissioner Member
NGO to be nominated by Deputy Commissioner Member
Deputy Commissioners concerned will co opt at least one peoples representative as
a special invitee in the District Advisory Committee
FUNCTIONS OF THE DIVISIONAL/DISTRICT ADVISORY COMMITTEES
To pay surprise visits or periodic visits to centres, Laboratories and clinics with a
view to check compliance of the provision of Act and Rules.
To recommend to the appropriate authority cancellation or otherwise of
registration of or prosecution against a centre laboratory or clinic.
To check and prevent contravention of provision of the Act or Rules in the area of
its purview.
To advise appropriate authority about implementation of the Act and creation of
public awareness on the issue of the sex selection;
To seize machine as may be found appropriate.

FUNCTIONS OF DIVISIONAL/DISTRICT APPROPRIATE AUTHORITY
To grant, suspend or cancel registration of a Genetic counseling Centre, Genetic
Laboratory or Genetic Clinics.
To enforce standards prescribed for the Genetic Counseling Centre, Genetic
Laboratory or Genetic Clinics.
41

To investigate complaints of breach of the provisions of this Act or the rules made
there under and take immediate action.
To seek and consider the advice of the Advisory Committee, constituted under
sub section (5) on application for registration and on complaints for suspension or
cancellation of registration
To take appropriate legal action against the use of preconception sex selection
techniques by any person at any place, brought to its attention or suo motto and
also to initiate independent investigation in such matters.
To create public awareness against the practice of preconception sex selection or
prenatal determination of sex.
To supervise the implementation of the provision of the Act and Rules; and
To recommend to the State Supervisory Board modifications required in the Act
or Rules in accordance with changes in technology or social conditions
To recommended to the State Supervisory Board modifications required in the
Act or Rules in accordance with changes in technology or social conditions.
Composition and functions of State/Divisional level committees are available on website
of pcpndt www.pcpndtjk.in

REWARD UNDER PC&PNDT
A reward scheme has been introduced where under a reward of Rs. 50,000/- is being
given to any person who gives information regarding the occurrence of sex-determination
/ female foeticide and Rs. 25,000/- is being given to any person who gives information
about un-registered Ultrasound machine.
Online filling of Form F on website of PC-PNDT www.pcpndtjk.

STRENGTHENING OF MONITORING MECHANISMS
Monitoring of sex ratio at birth through civil registration of birth data
Formulation of Inspection and Monitoring committees
Increasing the monitoring visits
Review and evaluation of registration records
Online availability of PNDT registration records
Online filling and medical audit of form Fs
Ensure regular reporting of sales of ultrasound machines from manufacturers
Enumeration of all Ultrasound machines and identification of un-registered ultrasound
machine
Ensure compliance for maintenance of records mandatory under the Act
Ensure regular quarterly progress reports at state and district level

Road Map for Priority Action on PC & PNDT is enclosed as Annexure R

42

TRAININGS
The term training refers to the acquisition of knowledge, skills and competence as a result
of the teaching of vocational or practical skills and knowledge that relate to specific
useful competencies. The State of J ammu and Kashmir has resolved to go into the PIP for
trainings in 2012-13 adhering to the dictum of the right person for the right training at the
right place, so that trainings are effective and result-oriented.
Trainings /Workshops are an essential activity for updating the knowledge and skills of
the workers of any organization. Upgradation of the skills of the health personnel has
been taken up on priority basis under NRHM.
Aim of Trainings:
i) Development of human resource potential in health care for optimum output.
ii) Operationalization of health care institutions developed and strengthened as per the
requirements of the State, with particular emphasis on maternal and child care units.
iii) Up-gradation of current medical knowledge with evidence based inputs in alignment
with current health care policies and requirements.
iv) Creation of awareness among different stake-holders regarding issues of health and
social well-being.
The Mission has planned training/workshops during 2012-13 at the
National/State/Divisional & District level in:-
Maternal Health.
Child Health.
Family Planning.
Immunization.
Adolescent Health.
Urban and Tribal RCH.
PC&PNDT
Quality Assurance.
Gender / Equity.
Intersectoral Convergence.

Trainings under the Maternal Health
Skilled Birth Attendance (SBA) Training: Any pregnancy can develop complications
at any stage, so timely provision of obstetric care services is extremely important for
management of such cases and as such, every pregnancy needs to be cared for by a
43

Skilled Birth Attendant (SBA) during pregnancy, childbirth and the post-partum period.
GoI considers an SBA to be a person who can handle common obstetric and neonatal
emergencies and is able to timely detect and recognize when a situation reaches a point
beyond his/her capability, and refers the woman/newborn to an appropriate facility
without delay. In order to strengthen the delivery points the Government of India has
approved the budget for SBA trainings for ISM Doctors, Staff Nurses, ANMs//LHVs in
SBA with the condition that State must ensure SBA training at delivery points first and
then other facilities.
To ensure safe deliveries, SBA training is being imparted at district headquarters.
Following categories of staff will be trained in each district:-
4 ISM Doctors
8 Staff Nurses
8 ANMs/LHVs
Trainings under Child Health
IMNCI Training: Training in Integrated Management of Neonatal and Childhood
Illnesses (IMNCI) includes both preventive and curative interventions that aim to
improve practices in health facilities, the health system and at home. At the core of the
strategy is integrated case management of the most common childhood problems with a
focus on common causes of neonatal and child mortality.
The following categories of staff will be trained in each district during the current
financial year from the designated delivery points and their retention at the facility must
be ensured:-
ANMs/ MPWs/ LHVs -24 per batch (ten districts).
Trainings under Adolescent Health
1. ARSH Training for Medical Officers, ANMs/LHVs and AWWs.
2. Capacity building of school teachers (2 teachers from each school) from districts
selected under SABLA Programme for School Health Programme.
Other Trainings
Trainings under Immunization
1. Training of vaccine handlers in cold chain system.
2. Cold chain handlers training for block level cold chain handlers by state and district
cold chain officers.

44

Trainings under Family Planning
1. NSV Training.
2. IUD Insertion Training.
3. Post-partum IUCD (PPIUCD) Training.
4. Interval IUCD Training.
General Guidelines:
All trainings are aimed at making health care facilities operational. Certain guidelines
must be followed while nominating candidates, conducting trainings and following up on
their performance:
1. For all technical trainings such as EmOC, LSAS, Blood transfusion, nomination of
medical officers should be sought from centres where facilities are available i.e.
FRUs/CHCs but specialists are not present.
2. Medical officers from all 24x7 PHCs must be trained in BEmOC, MTP, Safe abortion
and IUCD insertion and facilities for the same be provided to them. Paramedical staff
at PHCs and SCs must be trained in IUCD insertion.
3. A participant should be nominated for one technical training only.
4. For non interventional trainings like ARSH, IMNCI, Gender equity, infection
control, all categories of health care staff- Medical Officers at the divisional level, and
paramedical staff (LHVs, ANMs/MPWs) at the district level should be trained.
5. All trainings must begin with a questionnaire for pre-evaluation survey of the
existing knowledge of the participants followed by a post-evaluation survey to assess
the efficiency of the training.
6. Only trained staff may be used as resource persons for the training.
7. For all trainings, the utilization of funds must be strictly in accordance with the
budget guidelines approved by GoI.
8. All DDOs must ask for the attendance of the candidates for the period of training after
the candidate rejoins his place of posting.
9. TA/ DA to all nominees is to be paid by the organizers of the training and should not
be drawn from the place of posting unless specifically mentioned.
10. Feedback of each training should be sent to the headquarters within a fortnight of the
completion of the training.
11. The trained manpower must be posted at suitable institutions in consonance with their
expertise, and the necessary facilities be provided to them for the utilization of their
services.
12. The performance of all medical and paramedical staff who have undergone technical
trainings (SBA, EmOC, BEmOC, LSAS, MTP, MVA, IUD insertion, training in
Blood transfusion) must be monitored on monthly basis.
45

PROGRAM MANAGEMENT UNITS
The management structure in the form of Programme Management Support Units at
State, Division, District and Block Levels have been established as shown below:

At the State level, State Programme Management Support Unit has been established
headed by the Mission Director and comprising of officers from Finance, Planning, State
Programme Manager, Programme Officers of various programmes etc. The State
Programme Unit provides technical support to the State Health Society/State Health
Mission in formulation and implementation of the planned activities.

At the Divisional Level, the Divisional Programme Management Unit is headed by
Divisional Nodal Officer and supported by Divisional Accounts Manager, Divisional
Monitoring and Evaluation Officer and one J unior Assistant. One Law Officer has also
been engaged on contractual basis in the Divisional Nodal office to assist the State Health
Society on legal issues. The Divisional Programme Management Unit has to perform all
activities in their respective Division pertaining to planning, monitoring and coordinating
with Divisional level Directorates / Offices in achievement of the financial and Physical
targets set up under NRHM.

At the District Level all the 22 Districts are manned with one District Programme
Manager, One District Accounts Manager and One District Monitoring and Evaluation
Officer. One Data Entry Operator has been placed in all the 22 District Hospitals and one
Data Entry Operator for every Deputy CMO office of the district.

At the Block Level all the 116 Blocks are manned with one Block Monitoring &
Evaluation Officer and one Block Accounts Manager at every Block.

Reporting system of Programme Management Units
The following monitoring system needs to be ensured:-
Block Programme Management unit shall report to the BMO as well as to the District
Programme Management Unit.
District Programme Management Unit shall report to the CMO as well as to the
Divisional Programme Management Unit.
Divisional Programme Management Unit shall report to the Divisional Nodal Officer
as well as to the State Programme Management Unit.
46

The State Programme Management Unit headed by the Mission Director NRHM shall
provide feedback to the higher authorities both in the State / GoI.
Road Map for Programme Management during the year 2012-13
A full time Mission Director is a prerequisite. Stable tenure of the Mission
Director should also be ensured.
A regular full time Director/ J oint Director/ Deputy Director (Finance) (depending
on resource envelope of State), from the State Finance Services not holding any
additional charge outside the Health Department must be put in place, if not
already done, considering the quantum of funds under NRHM and the need for
financial discipline and diligence.
Regular meetings of state and district health missions/ societies must take place.
Key technical areas of RCH to have a dedicated / nodal person at state/ district
levels; staff performance to be monitored against targets and staff sensitised across
all areas of NRHM such that during field visits they do not limit themselves only
to their area of functional expertise.
Performance of staff to be monitored against benchmarks; qualifications,
recruitment process and training requirements to be reviewed.
Delegation of financial powers to district/ sub-district levels in line with guidelines
should be implemented.
Funds for implementation of programmes both at the State level and the district
level must be released expeditiously and no delays should take place.
Evidence based district plans prepared, appraised against pre determined criteria;
district plans to be a live document. Variance analysis (physical and financial)
reports prepared and discussed/action taken to correct variances.
Supportive supervision system to be established with identification of nodal
persons for districts; frequency of visits; checklists and action taken reports.
Remote/ hard to reach/ high focus areas to be intensively monitored and
supervised.
An integrated plan and budget for providing mobility support to be prepared and
submitted for review/approval; this should include allocation to State/ District and
Block Levels.

HMIS / MCTS
HMIS and MCTS are two important online monitoring tools of NRHM.
47

HMIS portal provides all the information uploaded at the facility level thus providing
information about the workload of different institutions and the delivery of services
provided there.
MCTS is useful in tracking the mother and child for their due services. The basic aim of
this system is to track and monitor delivery of services given to the mother and child,
thus giving a clear picture of the gaps in the service delivery of Health system.

In order to provide guidance and monitor implementation of the MCTS at the District
level District-e-Mission Team has been constituted vide Govt. order no. 640-HME of
2011 dated 12-12-2011. The Composition and role of District Project e-Mission team is
given as under:
Composition of District Project e Mission Team
District Magistrate/Deputy Commissioner Chairman
Chief Medical Officer Member Secretary
District Informatics Officer-NIC Member
District Programme Manager (NRHM) Member
District Monitoring and Evaluation Officer (NRHM) Member

Role of District Project e Mission Team
a. Overall Responsibility of Project Implementation in the District.
b. Close Monitoring of the project.
c. Coordination with the concerned agencies.
d. Communication and training.

Monitoring and Evaluation for HMIS and MCTS
State has envisaged following monitoring protocols for Programme Management Units at
different levels to ensure proper implementation of HMIS and MCTS data from different
level:
Block Monitoring and Evaluation Officer shall visit every PHC / CHC and 1/3
rd
of the
Sub Centres once a month. He will submit his tour report to the Block Medical
Officer and District Health Society.
District Monitoring and Evaluation Officer shall visit every Block Head Quarter, 50%
of the PHCs and 25% of the Sub Centres once a month. He will submit his tour report
to the Chief Medical Officer and respective Divisional Nodal Officers.

Plan for Use and Feedback of HMIS/MCTS Data by the Districts and Blocks
CMOs and BMOs shall hold regular monthly meetings to review the progress with regard
to uploading of data, registration, updation and authentication of data on HMIS/MCTS
portals. The BMOs should share the findings of the observations with the ASHAs /
ANMs and take corrective steps for rectifying the errors in the filling of formats by the
ANMs. The BMOs shall also ensure that the work plans are generated on monthly basis
and provided to ANMs for tracking the pregnant women / children for their due services.
48

The progress with regard to follow up by the ANMs as per the work plans shall be
reviewed by the BMOs in every meeting.

At the District level, the Chief Medical Officers shall also review the progress of the
uploading and updation of the MCTS data. This will help in improving the quality of
HMIS / MCTS data.

Monitoring Mechanisms
The State has put in place a proper mechanism to monitor and evaluate physical and
financial progress of NRHM periodically. At the State level, the Programme is being
reviewed on quarterly basis through meetings under the Chairpersonship of the Hon ble
Chief Minister of J &K. Monthly review meetings are conducted in both the Divisions
under the Chairpersonship of the Hon ble Health Minister. Regular meetings of
Governing Body are being held to assess and review the performance of NRHM
programmes. Regular meetings of Executive Committee are conducted by Commissioner
Secretary Health and Medical Education. The progress is also being reviewed on monthly
basis by the Mission Director NRHM. Similarly at the District level Deputy
Commissioner (Chairman District Health Society) also reviews the functioning of
NRHM.
MONITORING PROTOCOLS FOR FIELD LEVEL OFFICERS
The following protocols for regular monitoring of field activities are being followed.

Monitoring by field level officers
Each PHC MO shall visit all Sub Centres in his/her jurisdiction at least once every
month to review the functioning of SCs and guide ASHA and ANM on critical
aspects of outreach etc. including filling up formats for HMIS / MCTS.
Each Block Medical Officer shall visit all PHCs and at least 50% SCs in his/her
jurisdiction at least once every quarter to review the functioning and guide the
officials.
Each District CMO shall visit all CHCs, at least 50% of PHCs and at least 25% of
SCs in his/her jurisdiction at least once every quarter.
All the visits should be documented in the inspection register to be maintained at
level of the facility concerned. As per the above protocol, every SC would receive
at least one visit of PHC MO every month, one visit of BMO once every six
months and one visit of the CMO once every year. Similarly each PHC would
receive at least one visit of the BMO every month and CMO once every six
months. Similarly each CHC would receive at least one visit of the CMO every
quarter. The members of RKS, civil society, VHSNCs may also accompany on
these supervision visits. These visits should be followed up with a tour report
which should be compiled at the District Health Society and discussed in the
quarterly reviews at the state level by the Mission Director.

49

Monitoring by Programme Management Units
Block Monitoring and Evaluation Officer shall visit every PHC /CHC and 1/3
rd
of
the Sub centres once a month. He will submit his tour report to the Block Medical
Officer and District Health Society.
District Monitoring and Evaluation Officer shall visit every Block Head Quarter
once a month and of the PHC and 1/4
th
of the Sub centres once a month. He
will submit his tour report to the Chief Medical Officer and respective Divisional
Nodal Officer.
Monitoring by District Monitors engaged under NRHM
State has hired 8 Monitors (4for each division) who monitor and evaluate the progress
of NRHM programmes in the districts assigned to them. Each monitor has to visit the
districts allotted to him on regular basis and has to monitor all the activities and evaluate
the performance of each District and has to submit a report of their findings on prescribed
format to the Mission Director NRHM, J &K. The findings of reports of Monitors are
being shared with CMOs, Director Health Services and Administrative Department.

MONITORING PROTOCOLS for State Level Officers.
At the State level, the Programme Mangers are also monitoring the programme related
activities.

At the Divisional level, the Divisional Nodal Officers are monitoring and supervising all
the programmes of NRHM in the Division with the assistance of Divisional Level
Monitoring and Evaluation Officer.

ROAD MAP FOR PRIORITY ACTION:
Data is uploaded, validated and committed; data for the month available by the
15th of the following month.
Uploading of facility wise data by the first quarter of 2012-13.
Facility based HMIS to be implemented. HMIS data to be analysed, discussed
with concerned staff at state and district levels and necessary corrective action
taken.
Programme managers at all levels use HMIS for monthly reviews.
MCTS to be made fully operational for regular and effective monitoring of service
delivery including tracking and monitoring of severely anemic women, low birth
weight babies and sick neonates.
Pace of registration under MCTS to be speeded up to capture 100% pregnant
women and children
Service delivery data to be uploaded regularly work plans for service delivery be
generated on regular basis and should be distributed to ANMs.
50

Progress to be monitored rigorously at all levels
MCTS call centre to be set up at the State level to check the veracity of data and
service delivery.

IMMUNIZATION
Government of India has declared 2012-13 as Year of Intensification of Routine
Immunization. The immunization coverage needs to be strengthened all over the State
with a special focus on poor performing Districts. The level of fully immunized children
by age of one year (CES 2009) is 66.60 %.
Full immunization gives a child one of the best chances for healthy and disease free
life. In this connection we need to address the following issues on priority basis:-.
The birth dose of immunization should be ensured for all newborns delivered in the
institutions, before discharge. Daily Immunisation services should be available in PHCs,
CHCs/ DHs.
To reach the inaccessible areas by holding special immunization camps, and tracing
the dropouts and bringing them to the immunization session by utilizing services of
ASHAs.
Generating demand through IEC Activities.
Holding of VHNDs regularly & supervisory monitoring by BMO/CMO.
Focusing upon Name based tracking of Children for immunization.

Following activities have been approved in the current year for immunization
strengthening.

i. Mobility Support for Supervision and Monitoring at district and State level:-
An amount of Rs. 2,50,000/- has been allotted to each district. The said amount should be
allotted for incurring expenditure on POL for the Supervision and Monitoring of
immunization programme by the Dy. CMO and DIO. Districts need to provide a
minimum of Rs 20,000 to each block for supervision of Immunization activity from
Block and PHC. Detailed monthly tour diary should be sent.

ii. Focus on Slums & underserved areas in urban areas:-
The funds under this sub head are meant for hiring of an ANM for providing
immunization in the identified slum areas of J ammu (city), Anantnag, Srinagar (city),
Baramulla, Leh & Budgam Districts. The ANM has to conduct four sessions of
51

immunization every month for twelve months. The hired ANM is to be paid Rs. 450.00
per session for four sessions per month per slum of ten thousand population and Rs
300.00 per month has been kept as contingency for hiring of room and furniture etc for
the sessions.

iii. ASHA Incentives under Immunization:-
ASHA incentive for full immunization per child upto 1 year age=Rs 100.
ASHA incentive for full immunization per child upto 2 yrs age =Rs 50.
(Provided all vaccines received between 1
st
& 2
nd
year of age after completing full
immunization at 1 year of age).

iv. Support for Computer Assistant.
Services of the Computer Assistant engaged under immunization strengthening
programme at the State/district level shall be continued based on performance of previous
year.

v. Quarterly Review meetings:-
A review meeting has to be held at the district HQs on quarterly basis where in steps to
improve the immunization Programme can be discussed. The BMOs, the Dy CMO, DIOs
and DMEIOs should attend such meetings. The CDPOs and one medical officer of the
PHC on rotation basis have also to be called to attend these meetings. The amount has to
be utilized for meeting expenses like light refreshment to the participants and other
organizational expenses. It is advised to call 3-4 ANMs from each block by rotation to
attend such meetings. Participation of ANMs of Sub Centre should also be made
mandatory. The Refrigerator Mechanic should also be invited for attending such
meetings. The dates for review meetings be intimated to the State Health Society well in
advance so that some officer from this office shall be in a position to attend the meetings.
Moreover minutes of the meetings should reach office of State Health Society, J &K on
regular basis.

vi. Preparation of Microplan:-
Microplan for immunization has to be prepared right form Sub Centre level. The
microplan, besides institutional immunization services should include the outreach and
underserved areas where immunization services have to be provided. It should be ensured
that neither any outreach area nor any underserved area is left in the microplan. The
expenditure to be incurred in preparing Block/PHC levels microplan is Rs.1000.00 each
52

and for sub-center Rs. 100 each. All ANMs, ASHAs and AWWs are to be involved in
this activity.

vii. POL for vaccine delivery from State to District and from District to PHC/CHC
level:-
This amount is to be utilized for POL charges required for carriage of vaccine under
proper cold chain system from State to District and from District to Block Head Quarters.

viii. Alternate vaccine Delivery to Session Site:-
This amount is to be incurred at the rate of Rs. 150.00 per session for delivery of vaccine
at session site falling in most difficult and hilly terrains and Rs 75.00 per session for other
than difficult areas. Preparation of microplan is mandatory for this activity as stated
above. District Health Societies shall identify the sub centres on this basis in their
respective district

ix. Consumables for computer including provision for internet access for RIMs
Rs. 400 per month per district has been approved for this activity.
x. Procurement of Plastic bags for Biomedical Waste Disposal:-
Two bags per session of immunization for every sub-centre functioning in each district
have to be procured and issued to the Sub Centres at the earliest.

xi. Procurement of Bleach / Hypochlorite Solution for safe disposal of waste
(syringes & needles)/Twin buckets:-
Bleach/hydrochloride solutions are to be procured for every PHC and CHC functioning in
each district. Two buckets preferably are to be procured for use of immunization waste
for each PHC and CHC (excluding CHCs functioning as District hospitals in newly
created districts).

The procurement/purchases should be made after fulfilling all codal formalities and
as per the rates approved by the Rate Contract Committee.

Road Map for Priority Action on Immunization is enclosed as Annexure S

FINANCIAL MANAGEMENT
1. Cash and Bank Books:- All entries must be completed in the Cash Book and Bank
Book on daily basis duly signed by the concerned DDO s.
53

2. Ledger:- According to the entries of cash & bank books, all entries must be posted in
the Ledger.
3. Journal:- J ournal Ledger should be complete in all respect. All opening entries must
be made in the journal along with adjustment entries as per audit report and Accounts
for all the advance adjustment vouchers submitted by the concerned parties.
4. Vouchers:- All vouchers should be serially numbered and filed and kept under safe
custody.
5. Bank Reconciliation Statement:- Bank Reconciliation Statement must be prepared
to reconcile the Bank Book figures with the Bank statement and all un-reconciled
bank entries must be identified and proper entries passed in the books of accounts.
Stale cheques should also be identified and reverse entries made in the books of
accounts.
6. Preparation of Trial Balance:- It is very important that trial balance to reconcile the
ledger balances prepared at State/ District / Block levels. All the opening balances as
per Audit Report may also be accounted for in the current financial year s Trial
Balance. It must be ensured that Trial Balance of the current year is prepared at these
levels.
7. Preparation of Receipts and Payment Account, Income and Expenditure
Account at each level:- On the basis of final Trial Balance, it is necessary to prepare
the final accounts at each level (State/Districts/Blocks) at the close of financial year.
8. Preparation of Action Taken Report (ATR):- Action taken points of Audit Report
for the previous years should be discussed in the SHS/DHS meetings and the
concerned State/District/ Blocks should prepare the Action Taken Report as per
Auditor's and MoH&FW observations. A copy of the Compliance Report must be sent
to State Health Society for onwards transmission to Ministry at the earliest.
9. Records Keeping:- All accounts records of NRHM must be kept under lock and key
with specific responsibility assigned to concerned official/officers for their proper
maintenance at all the levels. All vouchers relating to accounts transactions must be
kept year wise in box files or duly bound files after audit. Records, mainly cash book,
petty cash book, ledgers and paid vouchers, deposit receipts etc at district/Block level
may be kept properly and safely under the custody of the District Chief Medical
Officer/Block Medical Officer or by an authorized officer.
10. Reminders for Advance Adjustment:- Age wise analysis of advance must be
conducted at all levels and reminders for settlement of advance and refund of unspent
balance must be sent to all concerned on a quarterly basis and pursued vigorously.
11. Audit Reports: Audit reports of all previous years must be kept at State and District
levels, preferably with soft copies as per retention schedule of the State Govt. The
54

previous audit reports must be scanned and also kept in computers. Action taken
points of audit of previous years should be finalized. District Health Societies shall
also ensure to undertake monthly District Audit and periodic assessment of the
financial system in the subordinate offices.
12. Upkeep of Cheque Books and Cheque Registers:- All cheque books issued by the
bank must be entered in a register and kept under safe custody of the concerned
officer alongwith unused / cancelled cheques.
13. Cash verification certificate:- Cash verification certificate must be obtained from the
concurrent auditor at the end of each month and verified in the presence of
Programme officer of the concerned program.
14. Physical verification of Fixed Assets:- All the fixed assets must be physically
verified by the designated committee and a physical verification certificate must be
kept safely for verification.
15. Stock Registers:- Store keeper of concerned program should maintain/complete the
stock registers upto date.
16. Important Agreements/MOUs:- All the important agreements such as EMRI
agreement, Rent Agreement, Contractor Agreement, Security Agreement and MOUs
duly registered must be kept in safe custody.
17. Income Tax Return:- All the TDS deducted by the District Health Societies must be
deposited in time in the bank and quarterly Income tax Return must be filed through
NSDL agencies.
18. Concurrent Audit:- The District Health Societies should complete and finalize their
concurrent Audit with reports on monthly basis and action taken thereon.
19. Transfer of Funds/ Monitoring of Bank Balance: Regular monitoring of Bank
Balances may be ensured for timely and adequate transfer of funds through e-transfer/
Demand Drafts from State to District and District to Block levels in time to ensure the
achievement of stipulated targets. Closing bank balance certificate/ bank statement at
the end of financial year must be obtained from the Branch Manager of concerned
banks.
20. FMR/Statement of Funds Position:- FMR must include all the expenditure of the
SHS/DHS and statement of funds position should also show same expenditure as
mentioned in the FMR. These statements should be sent in a complete form to the
State Health Society by the 5th of every month.
21. Uploading of FMR on HMIS web portal: Every District must ensure that quarterly
FMRs are uploaded on HMIS web portal on a regular basis.
55

22. Committed and Uncommitted Unspent Balance:- District should also calculate the
Committed and Uncommitted Unspent Balance at the end of every financial year
under each component.
23. The District Health Societies shall not make any change in allocation among different
components/ activities without approval of State Health Society.
24. The accounts of the State Health Societies/District Health Societies/ Implementing
agencies grantee institution/ organization shall be open to inspection by the
sanctioning authority and Audit by the Comptroller and Auditor General of India
under the provisions of CAG(DPC) Act 1971, Internal Audit by Financial
Management Group of State Health Society/Principal Accounts Office of the Ministry
of Health & Family Welfare.

Road Map for Priority Action on Financial Management is enclosed as Annexure
T























56














ANNEXURES






















57

Annexure A
MONTHLY PROGRESS REPORT FOR THE Month _______ OF THE FINANCIAL YEAR
2012-13

District _________
S.No. (A) Cummulative Achievements on Key Startegies As on Date
1
No. of District Health Societies
Constituted

2
No. of Rogi Kalyan Samities (RKS)
Registered for

I District Hospital
ii CHCs
iii PHCs
iv ADs
v Any other Hospital(Mention name)
3
No. of Village Health Sanitation &
Nutrition Committees Constituted

4
No. of VHSNCs for which accounts
opened

5
No. of CHCs upgraded as FRUs (Give
names on separate sheet)

6
No. of PHCs made Operationalized as
24x7 PHCs(Give names on separate
sheet)

7 No. of ASHAs engaged
8 No. of ASHAs trained in Module I
9 No. of ASHAs trained in Module II-IV
10 No. of ASHAs trained in Module V
11 SNCUs established
12
No. of Stablization Units established
(Give names on separate sheet)

13
No. of Baby Care Corners
Established(Give names on separate
sheet)

58

14
No. of
Specialists/Doctors/Paramedics
engaged

15 No. of Ambulances provided from
i Regular side
ii NRHM
16 No. of ARSH Clinics Setup
(B)Activity-wise Achievements during the year 2012-13

S.NO NAME OF THE ACTIVITY
Ach.
During
2011-12
Target
2012-
13
Cummulative
Ach. Ending
previous
month
Ach.
During
the
reporting
month
Total
JSY
1 Total Deliveries (Home+ Institutional)
2 Total Institutional deliveries
3
Institutional deliveries escorted by
ASHAs

4
Mother beneficiaries given
incentive under JSY

a Home Deleveries
i Rural
ii Urban
Total (a)
b Institutional Deleveries
i Rural
ii Urban
Total (b)
Total (a+b)
No. of ASHAs given incentive under JSY
i High focus Districts
ii Non High focus Districts
Maternal Health

1
No. of Maternal Deaths reported in
the District

2 No. of Maternal Deaths occurred in
i Govt. Health Institution
59

ii At community level
3
No .of Maternal Death Autopsy
conducted by Dy.CMO/ BMO

4
No. of Maternal Death Reviewed by
District MDR committee

5
No. of Community based Voluntary
Workers/ASHAs given incentive for
reporting Maternal Death

6
No. of pregnant women given Iron
Sucrose intervention Dose

7
No. of deliveries conducted at home
by SBA trained persons

8
No. of SBA trained persons given
Incentive for conducting home
deliveries in inaccessiable/ Snow
bound area of high focus districts

VHSNCs

1 No. of VHSNCs meetings held
2 No. of meetings facilitated by ASHA
3
No. of ASHAs given incentives for
facilitating meeting of VHSNCs

4
No. of meetings of Women and
Adolescent girls held

VHNDs

1 VHNDs conducted (Nos.)
2 No. of VHNDs supervised by
i CMOs
ii BMOs
iii Any other Officer (DHO, DMEIO etc.)
3
No. of ASHAs who have attended the
monthly meeting at Block level (PHC)

JSSK

1
No. of Preganent Women given
Drugs and consumables for

i Normal Deliveries
ii C-Section
2
No. of Preganent Women provided
free

i Diagnostics
ii Blood transfusion
60

3
No.of Preganent Women provided
diet for during

i Normal Deliveries
ii C-Section
iii During stay of sick childen
4
No. of Preganent Women given free
referral transport from

i Home to facility
ii Drop back facility
iii Referral to higher facility
5
No. of Sick Neonates provided Drugs
and consumable

7
No. of Sick Neonates given free
referral transport from

i Home to facility
ii Drop back facility
iii Referral to higher facility
Child Health

1 No. of Infant deaths reported
i From Govt. Health Institution
ii At community level
2
Infant Death verbal autopsy
conducted by Dy . CMO / BMO

3
No. of Infants deaths reviewd at
District Level

4
No. of Community based Voluntary
Workers/ASHAs given incentive for
reporting Maternal Death

5
No. of ASHA given incentive under
Child Health (HBNC)

6
Total number of Sick Neonates
admitted in SNCUs

7
Total number of Admissions in
Stabilization Units

FAMILY PLANNING

1
No. of meeting held on Quality
Assurance (QA) of
sterilisation/Family Planning services

61

2
Compensation for Female
sterilisation(No. of cases)

3
Compensation for Male sterilisation
(No. of cases)

4 Male Sterlization Camp (Nos.)
5 Female Sterlization Camp (Nos.)
6
IUD insertion at Health facilities (No.
of cases)

7
No. of monitoring visits conducted by
Dy. CMO/BMO/Any other
officer/official

Menstrual Hygiene Programme
1
No. of adolescent girls reached by
ASHA

2
No. of Free days sanitary napkins
received by ASHA

3
No of Free days sanitary napkins
sold/ distributed by ASHA

4
No. of free Sanitary Napkins given to
ASHA as incentive for sale of Free
days sanitary napkins

5
No. of group meeting conducted by
ASHA/ANM with Adolescent girls

School Health Programme

1
No. of Govt./Govt. aided schools
visited

2 No. of school children examined
a Boys
b Girls
3
No. of screening camps held at PHC
level falling under Sabla district

4
No. of tablets distributed at school
level

a IFA
b Deworming
5
No. of Peer educator identified during
VHNDs in SABLA Districts

PNDT

62

1
No. of Orientations held for
programme Manager and series
provider on PC and PNDT act

2
No. of Informer given reward for
informing about Unregistered
Ultrasound machines/Ultrasound
Clinics/illegal practice of sex/Female
foeticide

ASHAs Incentives

1
No. of Pregnant women facilitated full
ANC by ASHA

2 No. of Birth got registered by ASHA
3 No. of Deaths got registered by ASHA
4 No .of ASHAs given incentives for
i Full ANC
ii Registration of births
iii Registration of deaths
5
No .of ASHAs given incentives for
event reporting

6 No. of events reported by ASHAs
7
No. of ASHAs given Incentives for
performing roaster duty at ASHA help
desk

IEC/BCC

1
No. of symposium held for female
adolescents in high/higher secondary
schools and colleges

2
No. of Rallies / Debates /Seminar
held in school /colleges

3 No. of Block Sammelans organised
Immunization

1
No. of drop out children Mobilised
through ASHA on
VHNDs/Immunization sessions

63

2
No. of ASHA given incentive for
mobilizing drop out children

3
No. of quality review meeting held
exclusively for RI at district level with
Block MO, CDPO and other stake
holders

3
No. of Quarterly Review meeting held
exclusive for R.I. at Block level.

4
No. of ASHAs given incentive for full
immunization.

i
No. of children fully immunized (upto
1st year) through ASHA

ii
No. of children fully immunized
through ASHA (2nd year)

5 No. of children administered BCG
6
No. of children administered DPT
III/POLIO III

7
No. of children administered Measles
I

8
No. of children administered Measles
II

Trainings

1 Nos. trained in SBA
i MO(ISM)
ii SNs
iii LHVs/ANMs
2
No. of ANMs/MPWs/LHVs trained in
NSSK & IMNCI

3
No. of LHVs/ANMs/SNs/MPWs
trained in RTI/STI

4
No. of Mos/LHVs/ANMs trained in
IUD Insertion

5 No. of Medical Officers trained in NSV
6
No. of ANMs/ trained in ARSH
programme

7
Training of vaccine handlers in cold
chain system (No. of persons trained)

8
Orientation training of
ANMs/LHVs/Health worker in
Immunization(No. of persons trained)

64

9
Orientation of Medical Officers in
Immunization (No. of MOs trained)

No. of Meetings held

1
District Health Mission
(No. of meetings)

2
District Health Society
(No. of Meetings)

3
District Level Vigilance & Monitoring
committees (DLVMC)(Nos.)

4
Rogi Kalyan Samities
(No. of meetings)




























65

Annexure B

ROAD MAP FOR PRIORITY ACTION: MATERNAL HEALTH

Commitment No. 1- Operationalizing Delivery Points
Gaps in the identified delivery points to be assessed and filled through prioritized
allocation of the necessary resources in order to ensure quality of services and provision
of comprehensive RMNCH (Reproductive Maternal Neonatal and Child Health) services
at these facilities. These must be branded and positioned as quality RMNCH 24x7
Service Centres within the current year.
The targets for different categories of facilities are:
A) All District Hospitals and other similar district level facilities to provide the
following services:
24*7 service delivery for CS and other Emergency Obstetric Care.
1st and 2nd trimester abortion services.
Facility based MDR.
Essential newborn care and facility based care for sick newborns.
Family planning and adolescent friendly health services
RTI/STI services.
Functional BSU/BB.
B) 33 CHCs and other health facilities at sub district level (above block and below
district level) functioning as FRUs to provide the same comprehensive RMNCH
Services as the district hospitals.
C) 33 24*7 PHCs and Non FRUs to provide the following services:
24*7 BeMOC services including conducting normal delivery and handling
common obstetric complications.
1st trimester safe abortion services. (MVA upto 8 weeks and MMA upto 7
weeks)
RTI/STI services.
66

Essential newborn care and facility based care for sick newborns.
Family planning
D) All identified SCs/ facilities will:
Conduct Delivery by SBAs.
Provide IUD Services
Provide Essential New born care services.
Provide ANC, PNC and Immunization services.
Provide Nutritional and Family planning counseling.
Conduct designated VHND and other outreach services.
Commitment No.2- Implementing free entitlements under JSSK
A) J SSK entitlements to be ensured to all pregnant women and sick newborns
accessing Public health facilities.
B) Drop back to be ensured to at least 70% of pregnant women delivering in the
public health facilities.
C) Effective IEC and grievance redressal to be ensured.

Commitment No. 3- Centralized Call Centre and Assured Referral
A) To ensure availability of a centralized call centre for referral transport at State or
district level as per requirements along with GPS fitted ambulances.
B) Response time for the ambulance to reach the beneficiary not to exceed 30
minutes.

Commitment No. 4- Essential Drug List
A) To formulate an Essential Drug List (EDL) for each level of facility viz. SC,
PHCs, CHCs, DHs, and Medical colleges
B) Ensure timely procurement and supply linked to case load.
C) The EDL should include drugs for maternal and child health, safe abortion
services, RTI/STI.

67

Commitment No. 5- Capacity Building
A) Delivery points to be first saturated with trained HR. High focus/ remote areas to
be covered first.
B) Shortfall in trained human resource at delivery points particularly sub centres and
those in HFDs/ tribal/ remote areas to be addressed on priority.
C) Training load for skill based trainings to be estimated after gap analysis.
D) Certification /accreditation of the training sites is mandatory.
E) Training plan to factor in reorientation training of HR particularly for those posted
at non functional facilities and being redeployed at delivery points. Orientation
training of field functionaries on newer interventions e.g. MDR.
F) Performance Monitoring during training/post-deployment need to be ensured
G) Specific steps to strengthen SIHFW/ any other nodal institution involved in
planning, implementation, monitoring and post training follow up of all skill
based trainings under NRHM

Commitment No. 6 Tracking severe anaemia
A) All severely anaemic pregnant woman (2% of the anaemic pregnant woman) to
be tracked and line listed for providing timely treatment of anaemia followed by
micro birth planning.

Commitment No. 7 For High Focus Districts
A) The State to make use of the MCH sub plans made for these districts in the recent
past and develop and operationalise the identified facilities as delivery points.
B) At least 25% of all sub centres under each PHC to be made functional as delivery
points in the HFDs.

Commitment No. 8Demarcation /Division of population and job clarity between the
two ANMs working at the Sub-centre. Ensuring availability of one ANM at the SC, while
the other visits the assigned population/villages.

Commitment No. 9-For 12 High Focus States: Pre service Nursing Training
A) At least one state Master Nodal centre shall be created and made functional.
B) State nursing cell will be created and made functional.

Commitment No.10-- Proper implementation of J SY:
68

A) J SY guidelines to be strictly followed and payments made as per the eligibility
criteria.
B) No delays in J SY payments to the beneficiaries and full amount of financial
assistance to be given to the beneficiary before being discharged from the health
facility after delivery.
C) All payments to be made through cheques and preferably into bank/ post office
accounts.
D) Strict monitoring and physical (at least 5%) verification of beneficiaries to be
done by state and district level health authorities to check malpractices.
E) Grievance redressal mechanisms as stipulated under J SY guidelines to be
activated at the district and state levels.
F) Accuracy of J SY data reported at the HMIS portal of MOHFW to be ensured
besides furnishing quarterly progress reports to the Ministry within the prescribed
timeframe.

Commitment No. 11: Strengthening Mother & Child Tracking System
A) State level MCTS call centre to be set up to monitor service delivery to pregnant
women and children .

MCTS to be made fully operational for regular and effective monitoring of
service delivery including tracking and monitoring of severely anaemic women,
low birth weight babies and sick neonates.













69

Annexure C
Line Listing of ASHA GREH
S.No Name of District Name of Delivery point
1 Doda DH Doda
2 J ammu Gandhi Nagar Hospital
3 J ammu Sarwal Hospital
4 Kathua DH Kathua
5 Kishtwar DH Kishtwar
6 Poonch DH Poonch
7 Rajouri DH Rajouri
8 Reasi DH Reasi
9 Samba DH Samba
10 Udhampur DH Udhampur
11 Ramnan DH Ramnan
12 Anantnag MCCH Ang
13 Bandipora DH Bandipora
14 Baramulla D.H. BARAMULLA
15 Budgam Distt.Hospital
16 Ganderbal SDH Ganderbal
17 Kargil DH Kargil
18 Kulgam District Hospital
19 Kupwara DH Handwara
20 Leh SNM Hospital Leh
21 Pulwama District Hospital PuL
22 Shopian District Hospital Shopian
23 Srinagar J LNM
24 J ammu CHC Akhnoor
25 Poonch CHC Mendhar
26 Rajouri CHC Sunderbani
27 Anantnag CHC Bijbehara
28 Baramulla MCH sopore
29 Kupwara CHC Kupwara
30 Leh CHC Disket/Nubra



70

Annexure D
S.No Indicator Number S.No.
Name of
District
Name of Delivery
Points

SC Conducting >3
deliveries/month
26
1 Kishtwar SC Sigdi
A
2 Rajouri SC Tatapani
3 Udhampur SC Loudra
4 Udhampur SC Kudwah
5 Ramban SC Jatgali
6 Anantnag S/C Dehwatoo
7 Bandipora S/C Aragam
8 Bandipora S/C Ahamsharief
9 Bandipora S/C Watapora
10 Bandipora S/C Malangam
11 Bandipora S/C Aloosa
12 Bandipora S/C Pazalpora
13 Bandipora S/C Mukdamyari
14 Bandipora S/C Panzinara
15 Baramulla SC's Watergam
16 Kupwara S/C Khurhama
17 Kupwara S/C Moori
18 Kupwara S/C Thayan
19 Kupwara S/C Pathroo
20 Kupwara S/C Keran bala
21 Kupwara S/C Zonereshi
22 Kupwara S/C Farkin
23 Kupwara S/C Budnambal
24 Kupwara MAC Putushai
25 Kupwara MAC Nagsari
26 Kupwara MAC Machil

No. of 24X7 PHCs
conducting > 10 deliveries
/month
28
1
Jammu PHC Pallanwala
B
2
Kishtwar PHC Chatroo
3 Kishtwar PHC Atholi
4
Rajouri PHC Manjakote
5
Udhampur PHC Majalta
6 Ramban PHC Ukerhal
7 Ramban PHC Khari
8 Ramban PHC Ramsoo
9
Anantnag PHC Achabal
10 Anantnag PHC Larnoo
11
Anantnag PHC Aishmuqam
12
Anantnag PHC Saller
71

S.No Indicator Number S.No.
Name of
District
Name of Delivery
Points
13
Anantnag PHC Verinag
14
Bandipora PHC Hajin
15 Baramulla PHC BONIYAR
16
Baramulla PHC DANGIWACHA
17
Budgam PHC Khag
18
Budgam PHC Soibug
19 Ganderbal PHC Gund
20
Ganderbal PHC Lar
21
Kulgam PHC Qazigund
22 Kupwara PHC Kalaroose
23
Kupwara PHC Chowgal
24
Kupwara PHC Tarthpora
25
Kupwara PHC Vilgam
26 Kupwara PHC Trehgam
27
Kupwara PHC Drugmulla
28
Kupwara PHC Panzgam
C
No. of any other PHCs
conducting > 10 deliveries/
month
2
1 Bandipora PHC Chantimulla
2 Kupwara PHC Awoora
D
No. of CHCs ( Non- FRU)
conducting > 10 deliveries
/month
2
1 Budgam CHC Chattergam
2 Budgam CHC Nagam
E
No. of CHCs (FRU)
conducting > 20 deliveries
/month
47

1 Doda CHC Bhaderwah
2 Doda CHC Gandoh
3 Jammu CHC Akhnoor
4 Jammu CHC Bishnah
5 Jammu CHC RS Pura
6 Kathua CHC Hiranagar
7 Kathua CHC Billawar
8 Poonch CHC Surankote
9 Poonch CHC Mandi
10 Poonch CHC Mendhar
11 Rajouri CHC Sunderbani
12 Rajouri CHC Kalakote
13 Rajouri CHC Nowshera
14 Rajouri CHC Kandi
72

S.No Indicator Number S.No.
Name of
District
Name of Delivery
Points
15 Rajouri CHC Darhal
16 Reasi CHC Katra
17 Reasi CHC Mahore
18 Samba
CHC Ramgarh
19 Samba A/H Vijaypur
20 Udhampur CHC CHENANI
21 Udhampur CHC RAMNAGAR
22 Ramban CHC Banihal
23 Ramban CHC Batote
24 Anantnag CHC Bijbehara
25 Anantnag CHC Kokernag
26 Anantnag CHC Seer
27 Anantnag CHC Shangus
28 Bandipora CHC Sumbal
29 Baramulla CHC URI
30 Baramulla MCH SOPORE
31 Baramulla CHC KREERI
32 Baramulla CHC PATTAN
33 Baramulla CHC TANGMARG
34 Budgam CHC Beerwah
35 Budgam CHC Chadora
36 Budgam CHC Ch.Sharif
37 Budgam CHC Magam
38 Ganderbal CHC Kangan
39 Kulgam CHC D H Pora
40 Kupwara CHC Kupwara
41 Kupwara CHC Kralpora
42 Kupwara CHC Sogam
43 Kupwara CHC Tangdar
44 Pulwama SDH Pampore
45 Pulwama SDH Tral
46 Shopian CHC Keller
47 Srinagar
CHC-Gousia Hosital
Khanyar
F
No. of DH conducting > 50
deliveries /month
23
1 Doda DH Doda
2
Jammu
Gandhi Nagar Hospital
3 Jammu Sarwal Hospital
4 Kathua DH Kathua
5 Kishtwar DH Kishtwar
73

S.No Indicator Number S.No.
Name of
District
Name of Delivery
Points
6 Poonch DH Poonch
7 Rajouri DH Rajouri
8 Reasi DH Reasi
9 Samba DH Samba
10 Udhampur DH Udhampur
11 Ramnan DH Ramban
12 Anantnag MCCH Ang
13 Bandipora DH Bandipora
14 Baramulla D.H. BARAMULLA
15 Budgam DH Budgam
16 Ganderbal SDH Ganderbal
17 Kargil DH Kargil
18 Kulgam DH Kugam
19 Kupwara DH Handwara
20 Leh SNM Hospital Leh
21 Pulwama District Hospital PuL
22 Shopian
District Hospital
Shopian
23 Srinagar JLNM
G
Total No. of District
Women And Children hospital
2

H
No. of Medical colleges
conducting > 50 deliveries per
month
3
















74

Annexure E

FORMAT FOR PRIMARY INFORMANT





75

Annexure F

ROAD MAP FOR PRIORITY ACTION: CHILD HEALTH.

Priority Actions to be carried out for Child Health
1. All the delivery points must have a functional Newborn Care Corner consisting of
essential equipment and staff trained in NSSK. All staff must be trained in a 2 days
NSSK training package for skills development in providing Essential Newborn
Care.
2. Special Newborn care Units (SNCU) for care of the sick newborn should be
established in all Medical Colleges and District Hospitals. All resources meant for
establishment of SNCUs should be aligned in terms of equipment, manpower,
drugs etc. to make SNCUs fully operational.(Refer to facility based new born care
guidelines )
3. SNCUs are referral centres with provision of care to sick new born in the entire
district and relevant information must be given to all peripheral health facilities
including ANM and ASHA for optimum utilisation of the facility. Referral and
admission of outborn sick neonates should be encouraged and monitored along
with inborn admissions.
4. NBSUs being set up at FRUs should be utilised for stabilization of sick newborns
referred from peripheral units. Dedicated staff posted to NBSU must be adequately
trained and should have the skills to provide care to sick newborns.
5. All ASHA workers are to be trained in Module 6 & 7 (IMNCI Plus) for
implementing Home Based Newborn Care Scheme. The ASHA kit and incentives
for home visits should be made available on a regular basis to ASHAs who have
completed the Round 1 of training in Module 6 .
6. All ANMs are to be trained in IMNCI. All Medical Officers and Staff Nurses,
positioned in FRUs/DH and 24x7 PHCs should be prioritised for F-IMNCI training
so that they can provide care to sick children with diarrhoea, pneumonia and
malnutrition.
7. Infant and Under fives Death Review must be initiated for deaths occurring both at
community and facility level.
8. In order to promote early and exclusive breastfeeding, the counselling of all
pregnant and expectant mothers should be ensured at all delivery points and
breastfeeding initiated soon after birth. At least two health care providers should be
76

trained in Lactation Management at District Hospitals and FRUs; other MCH
staff should be provided 2 days training in IYCF and growth monitoring.
9. Nutrition Rehabilitation Centres are to be established in District Hospitals (and/or
FRUs), prioritizing tribal and high focus districts with high prevalence of child
malnutrition. The optimum utilization of NRCs must be ensured through
identification and referral of Severe Acute Malnutrition cases in the community
through convergence with Anganwadi workers under ICDS scheme (refer to
guidelines on NRCs).
10. Line listing of newly detected cases of SAM and Low birth weight babies must be
maintained by the ANM and their follow-up must be ensured through ASHA.
11. In order to reduce the prevalence of anaemia among children, all children between
the ages of 6 months to 5 years must receive Iron and Folic Acid tablets/ syrup (as
appropriate) as a preventive measure for 100 days in a year. School health teams
can, in addition assess children below 6 years of age at AWCs. Accordingly
appropriate formulation and logistics must be ensured and proper implementation
and monitoring should be emphasised through tracking of stocks using HMIS.
12. Use of Zinc should be actively promoted along with use of ORS in cases of
diarrhoea in children. Availability of ORS and Zinc should be ensured at all sub-
centres and with ASHAs.
13. Data from SNCU, NBSU and NRC utilization and child health trainings (progress
against committed training load) must be transmitted on a regular basis to the Child
Health Division, MoHFW.













77

Annexure G

SNCUs in Old District Hospitals

S. no. District District Hospitals Remarks
1 2 3 4
Jammu
Division

1 J ammu Gandhi Nagar Hospital Established
2 Kathua District Hospital, Kathua Established
3 Udhampur District Hospital,
Udhampur
Established
4 Doda District Hospital, Doda To be
Established
5 Rajouri District Hospital, Rajouri To be
Established
6 Poonch District Hospital, Poonch To be
Established
Kashmir
Division

7 Leh SNM Hospital, Leh Established
8 Anantnag District Hospital,
Anantnag
Established
9 Baramulla District Hospital,
Baramulla
Established
10 Budgam District Hospital,
Budgam
To be
Established
11 Pulwama District Hospital,
Pulwama
To be
Established
12 Srinagar District Hospital,
Srinagar
To be
Established
13 Kupwara District Hospital,
Kupwara
To be
Established
14 Kargil District Hospital, Kargil Established

78

Annexure H
List of SNCUs where Operational Cost has to provided

S. no. District District Hospitals
1 2 3
1 J ammu Gandhi Nagar Hospital
2 Kathua District Hospital, Kathua
3 Udhampur District Hospital,
Udhampur
4 Leh SNM Hospital, Leh
5 Anantnag District Hospital,
Anantnag























79

Annexure I
Line of Health Institutions having Stabilization Units for whom
Operational Cost approved

S
No. District
Name of Health Institution
1 Kishtwar DH Kishtwar
2 Poonch FRU Mendhar
3 Poonch FRU Surankote
4 Udhampur CHC Chenani
5 Udhampur CHC Ramnagar
6 Ramban CHC Banihal
7 Ramban CH Batote
8 Kathua CHC Billawar
9 Kathua CHC Hiranagar
10 Doda CHC Bhaderwah
11 Doda CHC Gandoh
12 Jammu CHC Akhnoor
13 Jammu CHC RS Pura
14 Jammu CHC Bishnah
15 Rajouri FRU Sunderbani
16 Rajouri FRU Nowshera
17 Rajouri FRU Darhal
18 Rajouri FRU Kalakote
19 Samba CHC Ramgarh
20 Samba DH Samba
21 Anantnag FRU Brijbehra
22 Anantnag FRU Shangus
23 Anantnag FRU Kokernag
24 Bandipora DH Bandipora
25 Bandipora CHC Sumbal
26 Baramulla FRU Tangmarg
27 Baramulla CHC Pattan
28 Baramulla CHC Keeri
29 Baramulla CHC Sopore
30 Baramulla CHC Uri
31 Budgam FRU Beerwa
32 Budgam FRU Chadoora
80

S
No. District
Name of Health Institution
33 Budgam FRU Ch. Sharief
34 Budgam FRU Magam
35 Ganderbal FRU Kangan
36 Kulgam CHC DH Pora
37 Kupwara FRU Kupwara
38 Kupwara FRU Sogam
39 Kupwara FRU Tangdar
40 Kupwara FRU Kralpora
41 Leh SDH Disket
42 Pulwama FRU Pampore
43 Pulwama FRU Tral
44 Shopian DH Shopian
45 Srinagar FRU Khanyar























81

Annexure J

Operational cost approved for procurement of equipments in following NBCCs
S No. District Health Facility
1 Anantnag PHC Akingam
2 Anantnag PHC Ashmuqam
3 Anantnag PHC Hapatnar
4 Anantnag PHC Wandevalgam
5 Anantnag PHC Hakoora
6 Bandipora PHC Naidkhai
7 Baramulla PHC Mohra
8 Budgam PHC Hardpanzoo
9 Budgam PHC Soibugh
10 J ammu PHC Pargwal
11 J ammu PHC Mera Mandrian
12 Kargil PHC Panikhar
13 Kathua PHC Budhi
14 Kathua PHC Dinga amb
15 Kishtwar PHC Chatroo
16 Kishtwar PHC Atholi
17 Kishtwar PHC Keeru
18 Kishtwar PHC Dachhan
19 Kishtwar PHC Nali
20 Kulgam PHC Qazigund
21 Kulgam PHC Devsar
22 Kulgam PHC Mpora
23 Kulgam PHC K B Pora
24 Kulgam PHC Killam
25 Kulgam PHC Qaimoh
26 Kupwara PHC Tarthpora
27 Kupwara PHC Trehgam
28 Kupwara PHC Drugmulla
29 Kupwara PHC Kalaroose
30 Kupwara PHC Villagam
31 Kupwara PHC Awoora
32 Kupwara PHC Magam
33 Kupwara PHC Kalamabad
34 Kupwara PHC Machil
35 Kupwara PHC Harrie
36 Leh PHC Chushul
82

37 Poonch PHC Dhargloon
38 Poonch PHC Hari Marhote
39 Poonch PHC Mankote
40 Poonch PHC Harni
41 Poonch PHC Loran
42 Poonch PHC Sawjian
43 Poonch PHC Bandichachian
44 Rajouri PHC Manjakote
45 Rajouri PHC Dalhori
46 Rajouri PHC Gambir Mughlan
47 Samba PHC Mansar
48 Srinagar PHC zadibal
49 Udhampur PHC Latti
50 Udhampur PHC Basantgarh
Red Colour indicates Delivery Point

























83

Annexure K
List of Health Institutions having NBCC for whom Operational Cost
Sanctioned
S
No.
District Name of Health Institution
1 Kishtwar PHC Chatroo
2 Kishtwar PHC Dachan
3 Kishtwar PHC Atholi
4 Kishtwar PHC Nali
5 Kishtwar PHC Keeru
6 Kishtwar PHC Afti
7 Poonch PHC Chandak
8 Poonch PHC Fazalabad
9 Poonch PHC Dhargloon
10 Poonch PHC Loran
11 Poonch PHC Mankote
12 Poonch PHC Sawajian
13 Poonch PHC Bandichachian
14 Poonch PHC Harimarote
15 Poonch PHC Harni
16 Poonch PHC Lassana
17 Poonch PHC Batadhurian
18 Reasi PHC Laiter
19 Reasi PHC Dharmari
20 Reasi PHC Arnas
21 Reasi PHC Pouni
22 Udhampur PHC Sudhmahadev
23 Udhampur PHC Bharnara
24 Udhampur PHC Ghordi
25 Udhampur PHC Bhugtrain
26 Udhampur PHC Majalta
27 Udhampur PHC Tikri
28 Udhampur PHC Basantgarh
29 Udhampur PHC Hartryan
30 Udhampur PHC Pancheri
31 Udhampur PHC Latti
32 Ramban PHC Ukheral
33 Ramban PHC Ramsoo
84

34 Ramban PHC Kheeri
35 Ramban PHC Mangit
36 Kathua PHC Parole
37 Kathua PHC Budhi
38 Kathua PHC Dingaamb
39 Kathua PHC Hutt
40 Kathua PHC Ramkote
41 Kathua PHC Sandhar
42 Kathua PHC Koti Chadyar
43 Kathua PHC Macheedi
44 Kathua PHC Bhoond
45 Kathua PHC Lakhanpur
46 Kathua PHC Kough
47 Kathua PHC Marheen
48 Kathua PHC Sanonghat
49 Kathua PHC Lohai
50 Kathua PHC Dhani
51 Doda PHC Assar
52 Doda PHC Bhagwah
53 Doda PHC Chinta
54 Jammu PHC Sungal
55 Jammu PHC Mera Mandrian
56 Jammu PHC Kanachak
57 Jammu PHC Sai
58 Jammu PHC Chowki Choura
59 Jammu PHC Arnia
60 Jammu PHC Dhanger
61 Jammu PHC Rehal
62 Jammu PHC Pargwal
63 Jammu PHC Dansal
64 Jammu PHC Kotbhalwal
65 Jammu PHC Pallanwala
66 Jammu PHC Ambgarota
67 Jammu Gol Gujral
68 Rajouri PHC Manjakote
69 Rajouri PHC Budhal
70 Rajouri PHC Moughla
71 Rajouri PHC Gambhir Mughlan
85

72 Rajouri PHC Tralla
73 Rajouri PHC Upper Hathal
74 Rajouri PHC Balshama
75 Rajouri PHC Shadra Sharief
76 Rajouri PHC Seeri
77 Rajouri PHC Dalhori
78 Rajouri PHC Peeri
79 Rajouri PHC Lamberi
80 Rajouri PHC Bagla Nadyal
81 Rajouri PHC Kallar Chattyar
82 Rajouri PHC Laroka
83 Samba EH Vijaypur
84 Samba PHC Purmandal
85 Samba PHC Sanoora
86 Samba PHC Mansar
87 Anantnag PHC Sallar
88 Anantnag PHC D.K.Pora
89 Anantnag PHC Mattan
90 Anantnag PHC Srigufwara
91 Anantnag PHC Larnoo
92 Anantnag PHC Achabal
93 Anantnag PHC Verinag
94 Anantnag PHC Sirhama
95 Anantnag PHC Nowgam
96 Anantnag PHC Ashmugam
97 Anantnag PHC Hakroo
98 Anantnag PHC Brakpora
99 Anantnag PHC Sirhama
100 Anantnag PHC Akingam
101 Anantnag PHC B. Kalan
102 Anantnag PHC Sagam
103 Anantnag PHC Khiram
104 Anantnag PHC Haptnar
105 Bandipora PHC Astangoo
106 Bandipora PHC Badugam
107 Bandipora PHC Hajin
108 Bandipora PHC Naidkahi
109 Baramulla PHC Mora
86

110 Baramulla PHC Bijhama
111 Baramulla PHC Shrakwara
112 Baramulla PHC GK Kasim
113 Baramulla PHC Hardbora
114 Baramulla PHC Kahitangan
115 Baramulla PHC Fategarh
116 Baramulla PHC Tujar Shrief
117 Baramulla PHC Seriwarpora
118 Baramulla PHC Dangiwacha
119 Baramulla PHC Boniyar
120 Baramulla PHC Sheeri
121 Baramulla PHC Kalantra
122 Budgam PHC Kralnewa
123 Budgam PHC Khag
124 Budgam PHC Soibugh
125 Budgam PHC Hardapanzoo
126 Budgam PHC OM Pora
127 Budgam PHC Poshker
128 Budgam PHC Surasyar
129 Budgam PHC Lasjan
130 Budgam PHC Narbal
131 Budgam PHC Hafroo
132 Budgam PHC Wadwan
133 Ganderbal PHC Kullan
134 Ganderbal PHC Gund
135 Ganderbal PHC Lar
136 Ganderbal PHC Wussan
137 Ganderbal PHC Babanagri
138 Ganderbal PHC Kachen
139 Ganderbal PHC Wakura
140 Ganderbal PHC Sonamarg
141 Kargil PHC Panikhar
142 Kargil PHC Sargole
143 Kulgam PHC Qaimoh
144 Kulgam PHC Katrasoo
145 Kulgam PHC Bugam
146 Kulgam PHC Manzgam
147 Kulgam PHC Kilam
87

148 Kulgam PHC Frisal
149 Kulgam PHC Behibagh
150 Kulgam PHC Tarigam
151 Kulgam PHC Qazigund
152 Kulgam PHC Mahnpora
153 Kulgam PHC Nehma
154 Kulgam PHC Razloo
155 Kulgam PHC Devsar
156 Kulgam PHC Pahloo
157 Kupwara PHC Drugmulla
158 Kupwara PHC Trathpora
159 Kupwara PHC Maidanpora
160 Kupwara PHC Awoora
161 Kupwara PHC Keran
162 Kupwara PHC Cherakote
163 Kupwara PHC Harie
164 Kupwara PHC Machil
165 Kupwara PHC Kalamchakla
166 Kupwara PHC Kalaroose
167 Kupwara PHC Chogal
168 Kupwara PHC Villagam
169 Kupwara PHC Trehgam
170 Kupwara PHC Magam
171 Kupwara PHC Panzgam
172 Leh PHC Nyoma
173 Leh PHC Tangtse
174 Leh PHC Turtuk
175 Leh PHC Bogdang
176 Leh PHC Turtuk
177 Leh PHC Panamik
178 Leh PHC Timisgum
179 Leh PHC Chushul
180 Pulwama PHC Wuyan
181 Pulwama PHC Khrew
182 Pulwama PHC Parigam
183 Pulwama PHC Kakapora
184 Pulwama PHC Awantipora
185 Pulwama PHC Dadsara
88

186 Pulwama PHC Aripal
187 Pulwama PHC Newa
188 Pulwama PHC Tahab
189 Pulwama PHC Ladhoo
190 Shopian PHC Sedow
191 Shopian PHC Rahmoo
192 Shopian PHC Singerwani
193 Shopian PHC D. K. Pora
194 Srinagar PHC Khanmoh
195 Srinagar PHC Brane
196 Srinagar PHC Zadibal
197 Srinagar PHC Narwara
198 Srinagar PHC SR Gunj
199 Srinagar PHC Harwan
200 Srinagar PHC Hazratbal























89

Annexure L

Monthly Infant Death Review Reporting Format
Name of the District:- Month & Year: April-2012
Sr.no ACTIVITY NUMBERS REMARKS
1. Number of Infant Deaths Reported during the
month

2. Number of Infant Deaths Reported w e f
April-2012up to the reporting month

3. Number of Infant Deaths Reviewed by CMO
at District Level during the reporting month

4. Number of Infant Deaths Reviewed by CMO
at District Level w e f April-2012up to the
Reporting Month

5. Total no of Infant Deaths not Reviewed by CMO
6. Causes of Infant Death during the reporting
month

a. Sepsis
b. Birth pneumonia
c. Pre-mature birth
d. Low birth weight baby
e. Asphyxia at Birth
f. Birth injury
g. Death during referral
h. Any other cause
7. Number of Infant Deaths Reviewed by District
Magistrate at District Level during the reporting
month

8. Number of Infant Deaths Reviewed by District
Magistrate at District Level w e f April-
2012up to the Reporting Month

9. Steps taken by the district to improve the
reporting of Infant Deaths


90

Annexure M

Line listing of Blood Storage Centres
S.No Division Name Of FRU
1
Jammu
FRU Bishnah
2 FRU R.S Pura
3 FRU Chennani
4 FRU Ramgarh
5 FRU Hiranagar
6 FRU Basohli
7 FRU Billawar
8 FRU Gandoh
9 FRU Thathri
10 FRU Kalakot
11 FRU Thannamandi
12 FRU Banihal
13 FRU Katra
14
Kashmir
FRU Bijbehra
15 FRU Kokernag
16 FRU Magam
17 FRU Ch. Sharief
18 FRU Sogam
19 FRU Tangdhar
20 FRU Kralpora
21 FRU Pampore
22 FRU Khalsti
23 FRU Uri
24 FRU Sopore
25 FRU Kreeri
26 FRU Tangmarg






91


Annexure-N

Jammu Division

District wise list of CHCs/PHCs falling in Category A, B and C Areas of
Jammu Division
S.No District
Name of Health
Institution
(CHC/PHC)
Category

1
Doda
CHC Gandoh B

2 PHC Tipri B
3 PHC Bharath B
4
PHC Malanoo B
5 PHC Changa B
6 PHC Bhagwa C
7
PHC Goha C
8 PHC Gundana B
9 PHC Chinta C
10
PHC Bhalla C
11 PHC Bhella C
12 PHC Prem Nagar C
13
Jammu
PHC Aghar Majoor C
14 PHC Dori Dager C
15 PHC Kathar C
16
PHC Gangal C

Kathua
CHC Bani B
17 PHC Dhaggar B
18 PHC Koti Chandiar B
19 PHC Sandroon B
20 PHC Malhar B
21 PHC Lohai B
22 PHC Gudu Phalal B
23 PHC Machedi C
25
Kishtwar
CHC Marwah A
26 PHC Wardwan A
27 PHC Dachhan A
28 PHC Nali A
29 PHC Keeru A
92

S.No District
Name of Health
Institution
(CHC/PHC)
Category

30 PHC Afti A
31 PHC Chingaon A
32 PHC Chattroo C
33 PHC Massu A
34 PHC Padder A
35
Ramban
CHC Gool B
36 PHC Rajgarh C
37 PHC Battani B
38 PHC Trigam B
39 PHC Ukhral C
40 PHC Khari C
41
Poonch
PHC Swajian C
42 PHC Loran C
43 PHC Bruti B
44 PHC Hari Marote B
45 PHC Chandimarh C
46
Rajouri
PHC Jamola C
47 PHC Peeri B
48 PHC Androoth B
49 PHC Gambir Mogla C
50 PHC Budhal C
51 PHC Shahdra Sharief C
52 PHC Dalouri C
53 PHC Upper Hathal C
54 PHC Bagla Nadiala B
55 PHC Gharan C
56
Reasi
CHC Mahore C
57 PHC Lar A
58 PHC Bhagodas A
59 PHC Tote A
60 PHC Dharmari C
61 PHC Arnas C
62 PHC Panasa B
63 PHC Bana A
64
Samba
PHC Sumbh C
65 PHC Rattanpur C
66
Udhampur
PHC Landhar C
93

S.No District
Name of Health
Institution
(CHC/PHC)
Category

67 PHC Rang B
68 PHC Basantgarh C
69 PHC Latti C
70 PHC Mongari C
71 PHC Panchari C
72 PHC Joffer B
Sd/-
Director Health Services
Jammu
























94

Annexure-N

KASHMIR DIVISION

District wise list of CHCs/PHCs falling in Category A, B and C Areas of
Kashmir Division
S.No District
Name of Health
Institution
(CHC/PHC)
Category
1
Bandipora
CHC Gureez
A
2
PHC Chantimulla
A
3
PHC Sheikhpora
A
4
PHC Budgam
A
5
Kulgam
PHC K.B.Pora B
6 PHC Waltangoo B
7
Baramulla
PHC Sultan Daki A
8 PHC Danisyedan A
9 PHC Warikha B
10 PHC Bijhama B
11 PHC Panzala B
12
Shopian
PHC Sangarwani A
13
Ganderbal
PHC Sonamarg B
14
Kupwara
CHC Tangdar A
15 CHC Zachaldara B
16 CHC Kralpora B
17 PHC Monbal B
18 PHC Ashpora B
19 PHC Nowgam B
20 PHC Gabra A
21 PHC Teetwal A
22 PHC Chiterkote A
23 PHC Tikkipora B
24 PHC Kalaroose B
25
PHC Dudi Machil
A
26 PHC Awoora B
95

S.No District
Name of Health
Institution
(CHC/PHC)
Category
27 PHC Behnipora B
28 PHC Villgam B
29 PHC Trathpora B
30 PHC Kukroosa B
31 PHC Gonipora B
32 PHC Drugmulla B
33 PHC Nagri B
34 PHC Gushi B
35 PHC Kandi B
36 PHC Panzgam B
37 PHC Hari B
38 PHC Keran A
39 PHC Batpora B
40 PHC Magam B
41
Budgam
PHC Churmunjroo B
42 PHC Kichwarai B
43 PHC Poshkar B
44
Kargil
CHC Drass A
45
CHC Chiktan
A
46 CHC Sankoo A
47 CHC Padoom A
48 PHC Shargoole A
49 PHC Panikhar A
50
Leh
CHC Disket A
51 CHC Sukerbachan A
52 CHC Khalsti A
53 PHC Turtuook A
54 PHC Bogdang A
55 PHC Panimak A
56 PHC Diggar A
57 PHC Tamisgam A
58 PHC Saspool A
96

S.No District
Name of Health
Institution
(CHC/PHC)
Category
59 PHC Noyama A
60 PHC Basgo A
61 PHC Shakti A
62 PHC Cheushal A
63 PHC Thiksay A
64 PHC Tangtse A
65 PHC Chahool A






Sd/-
Director Health Services
Kashmir
























97

Annexure-O

GUIDELINES FOR FUNDS OPERATED BY RKS
Corpus funds for District Hospitals
Objectives of the RKS / HMS
The following could be the broad objectives of the HMS
i. Ensure compliance to minimal standard for facility and hospital care and protocols of
treatment as issued by the Government.
ii. Ensure accountability of the public health providers to the community;
iii. Introduce transparency with regard to management of funds;
iv. Upgrade and modernize the health services provided by the hospital and any
associated outreach services;
v. Supervise the implementation of National Health Programmes at the hospital and other
health institutions that may be placed under its administrative jurisdiction;
vi. Organize outreach services / health camps at facilities under the jurisdiction of the
hospital;
vii. Display a Citizens Charter in the Health facility and ensure its compliance through
operationalisation of a Grievance Redressal Mechanism;
viii. Generate resources locally through donations, user fees and other means;
ix. Establish affiliations with private institutions to upgrade services;
x. Undertake construction and expansion in the hospital building;
xi. Ensure optimal use of hospital land as per govt. guidelines;
xii. Improve participation of the Society in the running of the hospital;
xiii. Ensure scientific disposal of hospital waste;
xiv. Ensure proper training for doctors and staff;
xv. Ensure subsidized food, medicines and drinking water and cleanliness to the patients
and their attendants;
xvi. Ensure proper use, timely maintenance and repair of hospital building equipment and
machinery.

FUNCTIONS AND ACTIVITIES
To achieve the above objectives, the Society shall direct its resources for undertaking the
following activities / initiatives
i. Identifying the problems faced by the patients in District Hospital;
ii. Acquiring equipment, furniture for the hospital;
iii. Expanding the hospital building, in consultation with and subject to any Guidelines that
may be laid down by the State Government;
98

iv. Making arrangements for the maintenance of hospital building (including residential
buildings), vehicles and equipment available with the hospital;
v. Improving boarding / lodging arrangements for the patients and their attendants;
vi. Entering into partnership arrangement with the private sector (including individuals) for
the improvement of support services such as cleaning services, laundry services,
diagnostic facilities and ambulatory services etc.;
vii. Developing / leasing out vacant land in the premises of the hospital for commercial
purposes with a view to improve financial position of the Society;
viii. Encouraging community participation in the maintenance and upkeep of the hospital;
ix. Promoting measures for resource conservation through adoption of wards by
institutions or individuals; and,
x. Adopting sustainable and environmental friendly measures for the day-to-day
management of the hospital, e.g. scientific hospital waste disposal system, solar lighting
systems, solar refrigeration systems, water harvesting and water recharging systems etc.

ACCOUNTS AND AUDIT
i. The Society shall cause regular accounts to be kept of all its monies and properties in
respect of the affairs of the Society.
ii. The accounts of the Society shall be audited annually by a Chartered Accountant firm
included in the panel of Chartered Accountants drawn by the designated authority of
the State Government.
iii. The report of such audit shall be communicated by the auditor to the Society, which
shall submit a copy of the Audit Report along with its observation to the District
Collector.
iv. Any expenditure incurred in connection with such audit shall be payable by the
Society to the Auditors.
v. The Chartered Accountant or any qualified person appointed by the Govt. of
India/State Government in connection with the audit of the accounts of the Society
shall have the same rights, privileges and authority in connection with such audit as
the Auditor General of the State has in connection with the audit of Government
accounts and in particular shall have the right to demand the production of books,
accounts, connected vouchers and other necessary documents and papers.

BANK ACCOUNT
The account of the Society shall be opened in a bank approved by the Governing Body. All
funds shall be paid into the Society s account with the appointed bank and shall not be
withdrawn except by a cheque, bill note or other negotiable instruments signed by the
99

Member-Secretary of the Society and such one more person from amongst the Executive
Committee members as may be decided by the Governing Body.

Suggested areas where Corpus funds for District Hospitals may be used include:
i. Minor modifications to the DH- curtains to ensure privacy, repair of taps,
installation of bulbs, other minor repairs, which can be done at the local level.
ii. Patient examination table, delivery table, BP apparatus, Hemoglobin meter,
Copper-T insertion Kit, instruments tray, baby tray, weighing scales for mothers
and for newborn babies, plastic/rubber sheets, dressing scissors, stethoscopes,
buckets, attendance stools, mackintosh sheet.
iii. Provision of running water supply.
iv. Provision of electricity.
v. Adhoc payments for cleaning up the centre, especially after childbirth.
vi. Transport of emergencies to appropriate referral centres.
vii. Transport of samples during epidemics.
viii. Purchase of consumables such as bandages and drugs in the center to be used only
to tie over temporary gaps due to logistic failures but not as a regular supply.
ix. Purchase of bleaching powder and disinfectants for use in common areas under the
jurisdiction of center.
x. Labour and supplies for environmental sanitation, such as clearing of larvicidal
measures for stagnant water.
xi. Payment/reward to ASHA for certain identified activities.
xii. Repair/ Operationalizing soak pits.

The following nature of expenditure should not be incurred out of the Corpus funds
for District Hospitals funds.
i. Purchase of Office Stationary & Equipment, training related equipment, vehicles
etc.
ii. Engagement of full time or part time staff and payment of
honorarium/incentives/wages of any kind.
iii. Purchase of drugs and consumables in bulk and furniture
iv. Payments towards inserting advertisements in any Newspaper/ J ournal/Magazine
and IEC related expenditure.
v. Organising Swasthya Mela or giving stalls in any Mela for ostensible purpose of
awareness generation of health schemes/programmes.
vi. Payment of incentives to individual/groups in cash/kind.

100

Meeting any recurring non-plan expenditure.
i. Taking up any individual based activity except in the case of referral and transport
in emergency situations.

Funds operated by RKS at CHC
Untied funds CHC:
ii. CHC untied funds shall be kept in the bank account of the concerned Rogi Kalyan
Samiti (RKSs)/ Hospital Management Committee (HMC). CHC level RKS will
have the mandate to undertake and supervise the work to be undertaken from
Untied funds. These funds will be spent and monitored by RKS.
iii. Since there would be substantial fund flow to be utilized for the CHCs under
NRHM/RCH-II and other Programmes, the untied funds should not duplicate what
is/can be taken up under other programmes. Each activity planned by the CHC
should have clear rationale and separate register be maintained in the CHC giving
sources of funds clearly for various activities.

Suggested areas where untied funds may be used include:
i. Minor modifications to the CHC- curtains to ensure privacy, repair of taps,
installation of bulbs, other minor repairs, which can be done at the local level.
ii. Patient examination table, delivery table, BP apparatus, Hemoglobin meter,
Copper-T insertion Kit, instruments tray, baby tray, weighing scales for
mothers and for newborn babies, plastic/rubber sheets, dressing scissors,
stethoscopes, buckets, attendance stools, mackintosh sheet.
iii. Provision of running water supply.
iv. Provision of electricity.
v. Adhoc payments for cleaning up the centre, especially after childbirth.
vi. Transport of emergencies to appropriate referral centres.
vii. Transport of samples during epidemics.
viii. Purchase of consumables such as bandages and drugs in the center to be used
only to tie over temporary gaps due to logistic failures but not as a regular
supply.
ix. Purchase of bleaching powder and disinfectants for use in common areas under
the jurisdiction of center.
x. Labour and supplies for environmental sanitation, such as clearing of larvicidal
measures for stagnant water.
xi. Payment/reward to ASHA for certain identified activities.
xii. Repair/ Operationalizing soak pits.
101


The following nature of expenditure should not be incurred out of the untied funds.
i. Purchase of Office Stationary & Equipment, training related equipment, vehicles
etc.
ii. Engagement of full time or part time staff and payment of
honorarium/incentives/wages of any kind.
iii. Purchase of drugs and consumables in bulk and furniture
iv. Payments towards inserting advertisements in any Newspaper/ J ournal/Magazine
and IEC related expenditure.
v. Organising Swasthya Mela or giving stalls in any Mela for ostensible purpose of
awareness generation of health schemes/programmes.
vi. Payment of incentives to individual/groups in cash/kind.

Meeting any recurring non-plan expenditure.
i. Taking up any individual based activity except in the case of referral and transport
in emergency situations.

B. Annual Maintenance Grant CHC:
i. CHC AMG shall be kept in the bank account of the concerned Rogi Kalyan
Samiti(RKS)/Hospital Management Committee (HMC). CHC level RKS will
have the mandate to undertake and supervise the work to be undertaken from
Annual Maintenance Grant . These funds will be spent and monitored by RKS.
ii. Since there would be substantial fund flow to be utilized for the CHCs under
NRHM/RCH-II and other Programmes, the AMG funds should not duplicate
what is/can be taken up under other programmes. Each activity planned by the
CHC should have clear rationale and separate register be maintained in the
CHC giving sources of funds clearly for various activities.
The Annual Maintenance Grant for CHCs may be utilized for the purpose subject
to the following conditions.
i. That there is no duplication of funds already permissible for repair/renovation
under RCH.
ii. The repairs and renovations are carried out on the basis of facility Survey.
iii. There should be proper scrutiny of estimates/accounts by the competent authority.
iv. The progress of work should be monitored by the Rogi Kalyan Samities.

The following nature of expenditure should not be incurred out of the AMG funds.
102

i. Purchase of Office Stationary & Equipment, training related equipment, vehicles
etc.
ii. Engagement of full time or part time staff and payment of
honorarium/incentives/wages of any kind.
iii. Purchase of drugs and consumables in bulk and furniture
iv. Payments towards inserting advertisements in any Newspaper/ J ournal/Magazine
and IEC related expenditure.
v. Organising Swasthya Mela or giving stalls in any Mela for ostensible purpose of
awareness generation of health schemes/programmes.
vi. Payment of incentives to individual/groups in cash/kind.

C. Corpus Fund CHC:

Objectives of the RKS/HMS
The following could be the broad objectives of the HMS.
i. Ensure compliance to minimal standard for facility and hospital care and protocols
of treatment as issued by the Government.
ii. Ensure accountability of the public health providers to the community.
iii. Introduce transparency with regard to management of funds.
iv. Upgrade and modernize the health services provided by the hospital and any
associated out of services.
v. Supervise the implementation of National Health Programmes at the hospital and
other health institutions that may be placed under its administrative jurisdiction.
vi. Organize outreach services/health camps at facilities under the jurisdiction of the
hospital.
vii. Display a Citizens Charter in the Health facility and ensure its compliance though
operationalisation of a Grievance Redressal Mechanism.
viii. Generate resources locally through donations, user fees and other means.
ix. Establish affiliations with private institutions to upgrade services.
x. Undertake construction and expansion in the hospital building.
xi. Ensure optimal use of hospital land as per government guidelines.
xii. Improve participation of the Society in the running of the hospital.
xiii. Ensure scientific disposal of hospital waste.
xiv. Ensure proper training for doctors and staff.
xv. Ensure subsidized food, medicines and drinking water and cleanliness to the
patients and their attendants.
103

xvi. Ensure proper use, timely maintenance and repair of hospital building equipment
and machinery.

FUNCTIONS AND ACTIVITIES
To achieve the above objectives, the Society shall direct its resources for undertaking the
following activities Initiatives.
i. Identifying the problems faced by the patients in CHC.
ii. Acquiring equipment, furniture for the hospital.
iii. Expanding the hospital building, in consultation with and subject to any
Guidelines that may be laid down by the State Government.
iv. Making arrangements for the maintenance of hospital building (including
residential buildings), vehicles and equipment available with the hospital.
v. Improving boarding/lodging arrangements for the patients and their attendants
vi. Entering into partnership arrangement with the private sector (including
individuals) for the improvement of support services such as cleaning services,
laundry services, diagnostic facilities and ambulatory services etc.
vii. Developing/leasing out vacant land in the premises of the hospital for commercial
purposes with a view to improve financial position of the Society.
viii. Encouraging community participation in the maintenance and upkeep of the
hospital.
ix. Promoting measures for resource conservation through adoption of wards by
institutions or individuals.
x. Adopting sustainable and environmental friendly measures for the day-to-day
management of the hospital, e.g. scientific hospital waste disposal system, solar
lighting systems, solar refrigeration systems, water harvesting and water
recharging systems etc.











104

Annexure P

ROAD MAP FOR PRIORITY ACTION: FAMILY PLANNING
MISSION: The mission of the national Family Planning Programme is that all women
and men (in reproductive age group) in India will have knowledge of and access to
comprehensive range of family planning services, therefore enabling families to plan and
space their children to improve the health of women and children .
GUIDING PRINCIPLES: Target-free approach based on unmet needs for
contraception; equal emphasis on spacing and limiting methods; promoting children by
choice in the context of reproductive health.

STRATEGIES:
1. Strengthening spacing methods:
a. Increasing number of providers trained in IUCD 380A
b. Strengthening Fixed Day IUCD services at facilities. Increased focus on IUCD
services at subcentres for at least 2 fixed days a week
c. Introduction of Cu IUCD 375
d. Delivering contraceptives at homes of beneficiaries (in pilot states/ districts)
2. Emphasis on post-partum family planning services:
a. Strengthening Post-Partum IUCD (PPIUCD) services at least at DH level
b. Promoting Post-partum sterilization (PPS)
c. Establishing Post-Partum Centers at women & child hospitals at district levels
d. Appointing counsellors at high case load facilities
3. Strengthening sterilization service delivery
a. Increasing pool of trained service providers (minilap, lap & NSV)
b. Operationalising FDS centers for sterilisation
c. Holding camps to clear back log
4. Strengthening quality of service delivery:
a. Strengthening QACs for monitoring
b. Disseminating/ following existing protocols/ guidelines/ manuals
c. Monitoring of FP Insurance
5. Development of BCC/ IEC tools highlighting benefits of Family Planning specially on
spacing methods
105

6.Focus on using private sector capacity for service delivery (exploring PPP availability):
7. Strengthening programme management structures:
a. Establishing new structures for monitoring and supporting the programme
b. Strengthening programme management support to state and district levels

KEY PERFORMANCE INDICATORS:
a. % IUD inserted against ELA
b. % PPIUCD inserted against total IUCD
c. % PPIUCD inserted against institutional deliveries
d. % of sterilisations conducted against ELA
e. % post-partum sterilisation against total female sterilisations
f. % of male sterilisation out of total sterilisations conducted
g. % facilities delivering FDS services against planned
h. % of personnel trained against planned
i. % point decline in unmet need
j. point decline in TFR
k. % utilisation of funds against approved


















106

Annexure Q
ROAD MAP FOR PRIORITY ACTION: ADOLESCENT HEALTH

SETTING UP OF AH CELL
A unit for adolescent health at state level with a nodal officer supported by four
consultants one each for ARSH, SHP, Menstrual hygiene and WIFS; one nodal officer
(rank of ACMHO) for all the components of Adolescent Health at district level to take
care of Adolescent health programme including the SHP.

PROGRAMME SPECIFIC ESSENTIAL STEPS FOR IMPLEMENTATION:
I. Adolescent Reproductive Sexual Health (ARSH) Programme
Clinics
- Number of functional clinics at the DH, CHC, PHC and Medical
Colleges(dedicated days, fixed time, trained manpower).
- Number of clinics integrated with ICTCs
- Quarterly Reporting from the ARSH clinics to be initiated to GoI.
- Establish a Supportive supervision and Monitoring mechanism

Outreach
- Utilisation of the VHND platform for improving the clinic attendance.
- Demand generation in convergence with SABLA and also through Teen Clubs
of MOYAS

Capacity Building/Training:
- Calculation of the training load and development of training plans/ refresher
trainings.
- Deployment of trained manpower at the functional clinics.

II. School Health Programme:
GoI Guidelines including terms of reference of stakeholders adapted by States and
operational plan in place..
School health committee with diverse stakeholders beyond the health department;
this committee with representation of academia will be responsible for
implementation and monitoring of the programme.
Involvement of nodal teachers from schools in the programme (Screening and
communication - preventive and promotive) is to be ensured.
107

Height / weight measurement and BMI calculation should be part of School Health
Card.
All children in government and government aided schools should be covered.
The programme should focus on three Ds- Deficiency, Disease and Disability.
Referral of children must be tied up and complete treatment at higher facilities to
be ensured.
An effort should be made to have dedicated teams for school health. The teams
should also conduct health check- ups for children below 6 years at AWCs.

III. Menstrual Hygiene Scheme (MHS):
Formation of State and district level steering committees.
Training / re-orientation of service providers(MOs, ANMs, ASHAs)
Monthly meeting with BMO.
Regular feedback on quality of sanitary napkins to be sent to GoI
Identification of appropriate storage place for sanitary napkins.
Mechanism of distribution of SN right upto the user level.
Reporting and accounting system in place at various levels.
Utilizing MCTS for service delivery by checking with ASHAs and ANMs about
supply chain management of IFA tabs and Sanitary napkins.
Distribution of Sanitary Napkins to school going adolescent girls to be encouraged
in schools and preferably combined with Weekly Iron Folic Acid Supplementation
(WIFS).

IV. Weekly Iron and Folic Acid Supplementation programme (WIFS):
Procurement policy in place for procurement of EDL including IFA and
deworming tablets.
Establish Monday as a fixed day for WIFS.
Plan for training and capacity building of field level functionaries of concerned
Departments (i.e. Department of Women and Child Development and Department
of Education) and plan for sensitization of Programme Planners on WIFS.
Ensure that monitoring mechanism as outlined in the operational framework
(Shared with the States during the National Adolescent Health Workshop) is put in
place across levels and departments.
108

Annexure R
ROAD MAP FOR PRIORITY ACTION: PNDT
MISSION:
The mission of PNDT programme is to improve the sex ratio at birth by regulating the
pre-conception and prenatal diagnostic techniques misused for sex selection.
Guiding Principle:
Deterrence for unethical practice sex selection to ensure improvement in the child sex
ratio
STRATEGIES:
Strengthening programme management structures:
Appointment of Nodal officer
Strengthening of Human resource
Formation of PNDT Cell at state and district level

Establishment of statutory bodies under the PC&PNDT Act
Constitution of 20 member State Supervisory Board
- Reconstitution every three years (other than ex-officio members)
- Four meetings in a year
Notification of three members Sate Appropriate Authority,
Constitution of 8 member State Advisory Committee
- Reconstitution in every 3 years
- At least 6 meetings in a year
Notification of District Appropriate Authorities
Constitution of 8 member district Advisory Committees
- Reconstitution in every 3 years
- At least 6 meetings in a year
Strengthening of monitoring mechanisms
Monitoring of sex ratio at birth through civil registration of birth data
Formulation of Inspection and Monitoring committees
Increasing the monitoring visits
Review and evaluation of registration records
Online availability of PNDT registration records
109

Online filling and medical audit of form Fs
Ensure regular reporting of sales of ultrasound machines from manufactures
Enumeration of all Ultrasound machines and identification of un-registered
ultrasound machine
Ensure compliance for maintenance of records mandatory under the Act
Ensure regular quarterly progress reports at state and district level

Capacity building and sensitisation of programme managers
Appropriate Authorities
Advisory committee members
Nodal officers both State and District
Sensitisation and Alliance building with
J udiciary
Medical Council / associations
Civil society

Development of BCC/ IEC/ IPC Campaigns highlighting provisions of PC&
PNDT Act and promotion of Girl Child
Convergence for Monitoring of Child sex Ratio at birth

KEY PERFORMANCE INDICATORS:
Improvement in child sex ratio at birth
% of civil registration of births
Statutory bodies in place
% registrations renewed
Increase in inspections and action taken
No. of unregistered machines identified
% of court cases filed
% of convictions secured
No. of medical licences of the convicted doctor cancelled or suspended





110

Annexure S

Priority Actions to be carried out by state for Immunization
1. The year 2012 has been declared as the Year of Intensification of Routine
Immunisation. Therefore, state must prepare a detailed district plan for Intensification
of Routine Immunization with special focus on districts with low coverage.
2. The birth dose of immunisation should be ensured for all newborns delivered in the
institutions, before discharge. Daily Immunisation services should be available in
PHCs, CHCs, SDHs/DHs.
3. A dedicated State Immunisation Officer should be in place. District Immunisation
Officer should be in place in all the districts. The placement of ANMs at all session
sites must be ensured. For sub centres without ANMs, special strategy should be
formulated.
4. Due list of beneficiaries must be available with ANM and ASHA and village wise list
of beneficiaries should be available with ASHA after each session. MCTS should be
made full use of for generating due lists for ANMs, sending SMS alerts to
beneficiaries and maintaining actual service delivery.
5. The immunisation session must be carried out on a daily basis in District Hospitals and
FRUs/ 24x7 PHCs with considerable case load in the OPD.
6. Cold chain mechanics must be placed in every district with a definite travel plan so as
to ensure that at least 3 facilities are visited every month as a preventive maintenance
of cold chain equipment.
7. The paramedic person instead of a clerical staff should be identified as the Cold Chain
Handler in all cold chain points and their training must be ensured along with one
more person as a backup.
8. It has been observed that the coverage of DPT 1st booster and Measles 2nd dose to be
given at the age of 18 months is less than 50% across the country. Therefore coverage
of DPT 1st booster and measles 2nd dose must be emphasized and monitored.
9. District AEFI Committees must be in place and investigation report of every serious
AEFI case must be submitted within 15 days of occurrence.
10. Rapid response team should be in place in priority districts of the states to identify
pockets of low immunization coverage and to respond to any threat of polio.
111

11. Special micro plans are to be developed for inaccessible, remote areas and urban
slums. The micro plans developed under polio programme must be utilized and
special focus should be given to the migrant population (Refer to guidelines).


































112

Annexure T

Priority Actions to be carried out by state for Financial Management

1. Quality FMRs must be submitted on time with both physical and financial
progress fully reflected.
2. State is to ensure that states outstanding share is deposited. Further, with effect
from 2012-13, States share would be 10%.
3. Release of 100% of funds for the year 2012-13 would be contingent on the state
providing Utilisation certificates upto 2010-11.
4. The appointment of Concurrent Auditor for the year 2012-13 is a prerequisite for
release of 2
nd
tranche of funds.
5. Timely submission of Statutory Audit Report for the year 2011-12 is a must for
release of 2
nd
tranche of funds.
6. State is required to comply with the instructions and/or guidelines issued for
maintenance of bank account vide D. O. No. G-27017/21/2010-NRHM-F dated
J anuary 23, 2012.
7. State should provide a confirmation of submission of Action Taken Report/
Compliance Report on the FMR Analysis (2011-12) and Audit Report Analysis
for FY 2010-11.
8. State needs to prioritise the internal control procedures for all transactions.
9. State should ensure proper maintenance of books of accounts at all districts and
blocks within the State.
10. Appointment of Auditor for the year 2011-12 is pending and must be completed
in the first quarter of 2012-13.
11. The state must ensure due diligence in expenditure and observe, in letter and
spirit, all rules, regulations, and procedures to maintain financial discipline and
integrity particularly with regard to procurement; competitive bidding must be
ensured and only need-based procurement should take place.








113

Format of Financial Management Report to be submitted by the District to the State Health Society
("Name of the District") District Health/RCH Society____________________________________________
FINANCIAL REPORT FOR THE QUARTER/MONTH/ENDING _____________________________of the Financial Year 2012-13
FMR
Code
Activities
Physical Progress Financial Progress
T
a
r
g
e
t


(
f
o
r

t
h
e

y
e
a
r
)

*
*

P
r
e
v
i
o
u
s

C
u
m
u
l
a
t
i
v
e


Achievements
P
e
r
m
i
s
i
b
l
e

a
s

p
e
r

B
u
d
g
e
t

S
h
e
e
t
s


(
2
0
1
2
-
1
3
)



{
c
o
l

(
1
>
=
2
+
3
)
}

B
a
l
a
n
c
e

a
s

o
n



0
1
-
0
4
-
2
0
1
1

Funds Received
2012-13
Expenditure
T
o
t
a
l

E
x
p
e
n
d
i
t
u
r
e

(
C
o
l
.

5
+
6
+
7
+
8
)

R
e
f
u
n
d


(
i
f

a
n
y
)

C
l
o
s
i
n
g

B
a
l
a
n
c
e










{
C
o
l
.
(

2
+
3
+
4
)
-
(
9
+
1
0
)
}

Reporting Qtr.
*
*

P
r
e
v
i
o
u
s

C
u
m
u
l
a
t
i
v
e

E
x
p
e
n
d
i
t
u
r
e

Reporting Qtr.
M1 M2 M3
From
SHS
From
Dir.HS/Oth
er Agencies
Month
1
Month
2
Month
3
1 2 3 4 5 1 2 3 4 5 6 7 8 9 10 11
A. RCH Flexipool

-
-

Maternal Health


-

-

Janani Suraksha Yojana / JSY


-
-
A.1.4.1
Incentives to Mothers (Home
Delivery) Rs.500/- per delivery


-

-
A.1.4.2.
a
Incentives to Mothers (Institutional
Delivery) Rural (Rs. 1400/- per
delivery


-

-
A.1.4.2.
b
Incentives to Mothers (Institutional
Delivery) Urban(Rs. 1000/- per
delivery)


-

-
A.1.4.4
Performance Related incentive to
ASHAs under JSY (Rs 350/-)


-

-
A.1.4.4
Performance Related incentive to
ASHAs under JSY(High Focus) (Rs
600/-)


-

-

Sub Total (JSY)
-

- - - - -

-

- - - -

-

-

-

- -

Maternal Death Audit


-
-
114

A.1.5
Maternal Death Autopsy by
Dy.CMO/BMO@ 250/- for autopsy


-

-
A.1.5
Incentive to community Based
Volunteers for reporting maternal
Death@ 100/- per report


-

-

Sub Total (Maternal Death Audit)
-

- - - - -

-

- - - -

-

-

-

- -
A.1.6
Other Activities


-
-
i)
Ironsucrose Intervention(3 doses
Approved)


-

-
ii)
Mobility Support for District Nodal
Officers for monitoring JSSK


-

-
iii)
Mobility Support for District Nodal
Officers for monitoring JSSK in
high focus

-

-
iv)
Mobility support for Block level
officers for monitoring JSSK


-

-
v)
Mobility support for Block level
officers for monitoring JSSK in
high foucs

-

-
vi)
Incentive to SBAs for conducting
home deliveries in
inaccessible/snow bound areas of
high focus districts as a pilot project


-

-
vii)
Printing of MCP cards


-
-
viii)
Printing of Safe motherhood booklet


-
-
ix)
Mobility support for State level
officers for monitoring JSSK
(Lumpsum)

-

-

Sub Total (Other Activities)
-

- - - - -

-

- - - -

-

-

-

- -
A.1.7
Janani Shishu Suraksha
Karyakram(JSSK)


-

-
115

A.1.7.1.
1
Drugs and Consumables for
Normal Deliveries


-

-
A.1.7.1.
2
Drugs and Consumables for
Caesarean Deliveries


-

-
A.1.7.2
Diagnostic


-
-
A.1.7.3
Blood Transfusion


-
-
A.1.7.4
Diet (3 days for Normal Delivery)


-
-
A.1.7.4
Diet (7 days for Caesarean)


-
-
A.1.7.4
Diet for mother during the stay of
sick children in hospital for five
days

-

-
A.1.7.5
Referral Transport


-
-

For pregnant women


-
-
i)
Home to facility


-
-
ii)
Drop Back faciliity


-
-
iii)
Facility to Higher Facility


-
-

Sub Total (JSSK)
-

- - - - -

-

- - - -

-

-

-

- -

G.Total Maternal Health
(Including JSY)
-

- - - - -

-

- - - -

-

-

-

- -
A.2
CHILD HEALTH


-
-
A.2.3
Home Based Newborn
Care/HBNC

-

-
i)
Printing of Guidelines for HBNC


-
-
ii)
Printing of Guidelines for FBNC @
Rs. 100/-


-

-
A.2.4
Infant and Young Child
Feeding/IYCF

-

-
i)
Prepare and disseminate guidelines
for IYCF.(Breast Feeding


-

-
116

Awareness Week)
A.2.5.1
Prepare detailed operational plan
for care of sick children and
severe malnutrition at FRUs,
across districts ( cost of plan
meeting should be kept).

-

-
i)
One time cost for establishing new
NRC

-

-
ii)
Operational cost for existing +new
NRCs per year


-

-
A.2.8
Infant Death Audit


-
-
i)
Infant Death verbal Autopsy by
Dy.CMO/BMO@ 250/-


-

-
ii)
Incentive to community Based
Volunteers for reporting infant
Death@ 100/- per report


-

-
A.2.9
Incentive to ASHA under child
health (HBNC)


-

-
A.2.10
JSSK(For Sick Neonates upto 30
days)


-

-
A.2.10.
1
Drugs & Consumables(Other than
reflected in Procurement)@ Rs
200/=

-

-
A.2.10.
2
Diagnostics


-

-
A.2.10.
3
Free Referral Transport for Sick
Neonates @ Rs. 250


-

-

Second Referral


-
-
i)
Level 3 MCH centres located within
a distance of 50 to 100 Kms


-

-
ii)
Level 3 MCH centres located within
a distance of 100 to 200 Kms


-

-
117

iii)
Level 3 MCH centres located within
a distance of more than 200 kms


-

-
iv)
Drop Back Facility for Sick Neo
nates @ Rs. 250


-

-

Sub Total (Child Health)
-

- - - - -

-

- - - -

-

-

-

- -

FAMILY PLANNING


-
-
A.3.1.1
Orientation workshop and
dissemination of manuals on FP
standards & quality assurance of
sterilisation services @ Rs.
2000/meeting


-

-

Compensation


-
-
A.3.1.4
Compensation for female
sterilization @ Rs. 1000/- per case


-

-
A..3.1.4
Compensation for NSV Acceptance
@ Rs. 1500/- per case


-

-
A.3.1.3
Organising Sterilization (Male)
NSV camps (1/per district) @ Rs.
35000.00 per camp


-

-
A.3.1.2
Organising Sterilization (Female)
(1/per district) camps @ Rs.
15000.00 per camp.

-

-
A.3.2.2.
1
Provide IUD services at health
facilities / compensation


-

-
A.3.5.1
Monitor progress, quality and
utilisation of services (both terminal
and spacing methods) including
complications / deaths / failure
cases.


-

-
A.3.5.2
Performance reward Rs. 50000/-
per district , one in each of the
Division

-

-
118

A.3.5.2
Performance reward Rs. 25000/-
per Block , Two Block in each of
the Division

-

-
A.3.5.3
World Population fortnight
celebration (such as mobility, IEC
activities etc.): funds earmarked for
district and block level activities

-

-
Sub Total (Family Planning) -

- - - - -

-

- - - -

-

-

-

- -
A.4
ADOLESCENT
REPRODUCTIVE AND
SEXUAL HEALTH (ARSH)

-

-
A.4.1.3
Establishment of new clinics at
CHC/PHC level @100000/=
i) Govt Hospital Sarwal, Jammu
ii) CHC Akhnoor, Jammu
iii) SDH Kupwara


-

-
A.4.1.3.
1
Operating expenses for existing
clinics@20000/=


-

-
A.4.3
Other strategies/activities (please
specify)@50000/=
Details of the Menstrual Hygiene
project to be provided and budgeted
under this head


-

-

Sub Total (ARSH)
-

- - - - -

-

- - - -

-

-

-

- -

School Health Programme


-
-
A.4.2
One Day Workshop for orientation
for capacity building of School
teachers

-

-
A.4.2
Financial Assistance for treatment
of complicated diseases among
childrens and adolescent under
School Health Programme


-

-
119

A.4.2.1
Prepare and disseminate guidelines
for School Health Programme.


-

-
A.4.2.3
Implementation of School Health
Programme by districts. Screening
Camps at PHC Level twice a year
falling under Sabla Districts


-

-
A.4.2.4
Monitor progress and quality of
services. (Mobility support) for
Deputy CMO's as District Nodal
Officers/per annum

-

-
A.4.2.4
Printing of cards etc. under school
health programme activities falling
under Sabla Districts


-

-

Sub Total (School Health)
-

- - - - -

-

- - - -

-

-

-

- -

G.Total ARSH
-

- - - - -

-

- - - -

-

-

-

- -

PNDT & Sex Ratio


-
-
A.7.1.2
Orientation of programme managers
and service providers on PC &
PNDT Act at District Level


-

-
A.7.1.2
Orientation of programme managers
and service providers on PC &
PNDT Act at Divisional Level
@20000/=for Batch of 125 persons


-

-
A.7.2
Reward to informer for giving
information regarding unregistered
ultrasound machine

-

-
A.7.2
Reward to informers for intimating
the illegal practice of sex selection
and selective female foeticide


-

-

Sub Total (PNDT & Sex Ratio)
-

- - - - -

-

- - - -

-

-

-

- -
A.5
URBAN RCH


-
-
120

i)
Urban RCH Services


-
-
ii)
Rent for urban health post @
Rs.2000/month per UHP


-

-
iii)
Hiring part time cleaner @
Rs.1000/per month per UHP


-

-
iv)
Rent for urban health center @
Rs.12000 / month per UHC .


-

-
v)
ANM Urban Health Centre@ Rs.
10800.00/Month ( 3 per UHC) and
Urban Health Posts ( 2 per UHP)


-

-
vi)
Helper Urban Health Centre@ Rs.
6000/ month per UHC


-

-
vii)
Link Worker Urban Health Centre
Hon. Rs. 2000/ month per UHC


-

-
viii)
Medical Officers Urban Health
Centre( 1 per Urban Center)


-

-

Sub Total (Urban RCH)
-

- - - - -

-

- - - -

-

-

-

- -
A.6
TRIBAL HEALTH


-
-
A.6.1.3
Engagement of AMCHI Healers
@9000/=PM
(26 AMCHI Healers) District
Hospital 2, CHC -7, PHCs- 15


-

-

Sub Total of Tribal Health
-

- - - - -

-

- - - -

-

-

-

- -

Human Resource


-
-
A.8.1.1
Additional ANM at S/C


-
-
A.8.1.1
Staff Nurse at FRU Level


-
-
A.8.1.1
Staff Nurse at PHC/CHC Level


-
-
A.8.1.1
Staff Nurse at District Level


-
-
121

A.8.1.2
OT Technicians at FRU Level


-
-
A.8.1.2
OT Technicians at DH Level


-
-
A.8.1.2
X- Ray Technicians at FRU Level


-
-
A.8.1.2
X- Ray Technicians at CHC Level


-
-
A.8.1.2
X- Ray Technicians at PHC Level


-
-
A.8.1.2
X- Ray Technicians at DH Level


-
-
A.8.1.2
Lab Technicians at PHC Level


-
-
A.8.1.2
Lab Technicians at FRU Level


-
-
A.8.1.2
Lab Technicians at CHC Level


-
-
A.8.1.2
Lab Technicians at DH Level


-
-
A.8.1.2
MMPHW


-
-
A.8.1.3
Specialists


-
-
A.8.1.5
MBBS Doctors at PHC level


-
-
A.8.1.5
MBBS Doctors at CHC level


-
-
A.8.1.5
MBBS Doctors at FRU level


-
-
A.8.1.5
MBBS Doctors DH


-
-
A.8.1.6
Incentive to Doctors Serving in
Difficult Areas


-

-
A.8.1.9
Sister Tutor


-
-
A.8.1.9
Lady Councellor


-
-
A.8.1.9
PHN AMT Schools


-
-
A.8.1.9
Lady Councellor


-
-
A.8.1.9
Staff for SNCU


-
-
122

A.8.1.9
Data Entry Operator for
SNCU/HMIS/ARSH for all the22
DH +2 SMGS, Lal Ded (1 each) +
3 New ARSH Clinics


-

-

Sub Total (HR)
-

- - - - -

-

- - - -

-

-

-

- -
A.10
PROGRAMME
MANAGEMENT

-

-
A.10.2
District Programme Manager @
Rs. 19800/-Month


-

-
A.10.2
District Accounts Manager @ Rs.
15840/- Month


-

-
A.10.2
District Monitoring & Evaluation
Officer @ Rs. 13200


-

-
A.10.2
O.E. for District Health Socities


-
-
A.10.2
Mobility of District Health Socities
( including DPMU)


-

-

Sub Total (DPMU)
-

- - - - -

-

- - - -

-

-

-

- -
A.10.3
Block Accounts Managers


-
-
A.10.3
Block M&E Officer


-
-
A.10.3
O.E. For BPMU


-
-
A.10.3
Mobility of Blocks ( including
BPMU)

-

-

Grand Total (BPMU)
-

- - - - -

-

- - - -

-

-

-

- -
A.10.6
Concurrent Audit Fee


-
-
A.10.6
Tally ERP 9


-
-
Trainings

-
-
A.9.3
Maternal Health Trainings


-
-
A.9.3.1
Training of ISM doctors in SBA


-
-
123

A.9.3.1.
3
Training of Staff Nurses in SBA


-

-
A.9.3.1.
4
Training of ANM/LHVs in SBA


-

-
A.9.3.2
Training of Medical Officers in
EmOC

-

-
A.9.3.3
Training of Medical Officers in life
saving Anaesthesia skills


-

-
A.9.3.4
Safe abortion services training
(including MVA/ EVA and Medical
abortion)

-

-
A.9.3.5.
2
Training of laboratory technicians in
RTI/STI


-

-
A.9.3.5.
3
Training of Medical Officers in
RTI/STI

-

-
A.9.3.5.
5
Training of ANMs / LHVs in
RTI/STI/SHP


-

-
A.9.3.6
BEmOC training


-
-
A.9.3.7
Other Maternal Health Trainings


-
-
A.9.3.7
Orientation of CMOs/BMOs/Mos
for implentation guidelines under
MDR/IDR

-

-
A.9.3.7
Training on Blood Transfusion MO
and Lab Technicians


-

-

Sub Total (Maternal Health
Trainings) -

- - - - -

-

- - - -

-

-

-

- -
A.9.5
Child Health Trainings


-
-
A.9.5.1.
2
IMNCI Training for ANMs / LHVs
(District level)


-

-
A.9.5.2.
2
F-IMNCI Training for Medical
Officers, staff nurse and Nursing
tutors

-

-
A.9.5.2.
3
F-IMNCI Training for Staff nurse


-

-
124


Other Child Health training


-
-
A.9.5.5.
2
Training of staff of Nutritional
Rehabilitatio Centre


-

-

Sub Total (Child Health
Trainings) -

- - - - -

-

- - - -

-

-

-

- -

Family Planning Trainings


-
-
A.9.6.1.
2
Laparoscopic sterilisation training
for doctors


-

-
A.9.6.2.
1
TOT on Minilap


-

-
A.9.6.2
Minilap training for medical officers


-
-
A.9.6.2.
1
TOT on NSV


-

-
A.9.6.3
NSV Training of medical officers in
NSV camps


-

-
A.9.6.4.
1
TOT for IUD insertion


-

-
A.9.6.4.
2
Training of Medical officers in IUD
insertion


-

-
A.9.6.6
IUD insertion Kits


-
-
A.9.6.6 Other Family Planning Trainings

-
-

Sub Total (Family Planning
Trainings) -

- - - - -

-

- - - -

-

-

-

- -

ARSH


-
-
A.9.7.2
Orientation training of State and
District Programme
Managers@61500/=

-

-
A.9.7.3
ARSH training for Medical Officers
@69400/=


-

-
A.9.7.4
ARSH training for ANMs / LHVs
@83475/=


-

-
A.9.7.5
ARSH training for AWWs



-
125

@150000/= -

Sub Total (ARSH)
-

- - - - -

-

- - - -

-

-

-

- -

Programme Management
Trainings

-

-
A.9.8.1
Refresher training of State,
Divisional , District and Block
Accounts Manager under NRHM
(Divisional level)

-

-
A.9.8.1
Quarterly review meetings of
Programme management unit
(divisional/district/block)

-

-

Training of DPMSU staff


-
-
A.9.8.2
Training in Planning process fro
DHAPs 2013-14


-

-

Other Trainings


-
-
A.9.9
Training of vaccine handler in cold
chain system


-

-
i)
Orientation training of
ANM/LHV/Health Assistant/BEE
in Immunization

-

-
ii)
Orientation training of MO's in
Immunization


-

-
iii)
Workshop on Disaster Management


-
-
iv)
Workshop on Quality Assurance


-
-
v)
Workshop on BioMedical Waste


-
-
vi)
One day workshop for orientation of
CMOs/BMOs/MO's regarding
MDR/IDR guidelines
implementation

-

-
vii)
Workshop on Medicolegal Issue


-
-

Sub Total (Programme
Management Trainings)
-

- - - - -

-

- - - -

-

-

-

- -
126

A.9.10.
2
New Training Institutions/School


-

-
i)
PG Diploma in Health Management


-
-
ii)
Training in Quality Assurance
through AHA (Distant learning
mode with 2 content programmes of
one week each) @ Rs. 70000 per
candidate inclusive of TA DA


-

-
iii)
Orientation and Induction of MOs
for Financial Management (Institute
of Management and Public
Adminstration Jammu/Srinagar)


-

-
iv)
Training of Mos in Infection
Control Programme


-

-
v)
Training of Staff Nurses in Infection
Control Programme(New training)


-

-
vi)
Capacity building of Supervisory
Staff (CHO, health educator, LHV)
for different programmes under
NRHM

-

-

Sub Total (New Training
Institutions/School)
-

- - - - -

-

- - - -

-

-

-

- -
Grand Total (Trainings) -

- - - - -

-

- - - -

-

-

-

- -

Activities which are not
mentioned above (Plz specify the
activity)

-

-


-
-


-
-


-
-
Grand Total (Flexipool) -

- - - - -

-

- - - -

-

-

-

- -
Mission Flexipool

-
-
127

B.1
ASHA


-
-
B.1.1.1
Selection & Training of ASHA


-
-
i)
Training on HBNC for State
Trainers (round 3rd) (7
participants)

-

-
ii)
Training on HBNC for ASHA DRP
(round 2nd ) (9 batches 25
participants per batch)


-

-
iii)
Training of ASHA Facilitator
Round 2nd (16 batches 30
participants per batch)

-

-
iv)
Training of ASHA on HBNCRound
1 (part 1 & 2) (97 Batches 25 per
batch)

-

-
v)
Training of ASHA on HBNC
Round 2 (400 Batches 25 per
batch)

-

-
vi)
Procurement of ASHA Drug Kit


-
-
vii)
Procurement of HBNC Kit for
ASHA

-

-
B.1.1.3
Incentive to ASHA for full ANC


-
-
i)
Incentive for registration of Births


-
-
ii)
Incentive for registration of Deaths


-
-
iii)
Incentive to ASHA for event
reporting

-

-
iv)
Incentive to ASHA for Roster duty
at ASHA help desk @ Rs. 100 for 8
hours duty for 365 days
(365X100X3)

-

-
v)
ASHA help desk cumrest roomin
30 level 3 MCH facilities


-

-
128

vi)
Uniforms to ASHA (2 sets of
uniform, I-card, 1 sweater, 1 shawl
in high focus districts @ Rs.1000.00


-

-
vii)
Uniforms to ASHA ( 2 sets of
uniforms, 1 sweater and I-card in
other districts @ Rs. 750.00)


-

-
viii)
ASHA Diary


-
-

Sub total ASHA
-

- - - - -

-

- - - -

-

-

-

- -

Untied Funds


-
-
B.2.1
CHCs


-
-
B.2.1
Untied Fund for 3 Hospitals
(Rajiv Gandhi Jammu, MGM
Kathua and MCH Anantnag)


-

-
B.2.2
PHCs


-
-
B.2.2
ADs/New type PHCs


-
-
B.2.3
Sub Centers


-
-
B.2.3
MACs/ SCs


-
-
B.2.4
VHSC


-
-

Sub Total (Untied funds)
-

- - - - -

-

- - - -

-

-

-

- -
B.3
Annual Maintenance Grants


-
-
B.3.1
CHCs


-
-
B.3.1
AMG for 3 Hospitals (Rajiv Gandhi
Jammu, MGM Kathua and MCH
Anantnag)


-

-
B.3.2
PHCs


-
-
B.3.2
ADs/New type PHCs


-
-
B.3.3
Sub Centers



-
129

-
B.3.3
MACs/ SCs


-
-

Sub Total (Annual Maintenance
Grants)
-

- - - - -

-

- - - -

-

-

-

- -

Hospital Strengthening


-
-
B.4.2
Blood Storage Centre(BSC)


-
-
B.4.2
SNCUs


-
-
B.4.2
Operational cost of SNCU


-
-
B.4.2
Operational cost of Stabilazation


-
-
B.4.2
Operational cost of NBCC


-
-

Sub Total (Hospital
Strengthening) -

- - - - -

-

- - - -

-

-

-

- -
B.6
Corpus grant to HMS/RKS


-
-
B.6.1
District Hospitals


-
-
B.6.1
RKS for Govt. Hospitals
(Sarwal Hospital Jammu )


-

-
B.6.2
CHCs


-
-
B.6.2
RKS for 3 Hospitals (Rajiv Gandhi
Jammu, and MGM Kathua )


-

-
B.6.3
PHCs


-
-
B.6.3
ADs/New type PHCs


-
-

Sub Total (Corpus grant)
-

- - - - -

-

- - - -

-

-

-

- -
B.9
Mainstreaming of AYUSH


-
-
B.9.1
AYUSH Doctors at PHC level


-
-
B.9.2
AYUSH Dawasaaz at PHC level


-
-
B.9.3
AYUSH Doctors at difficult area


-
-
130


Sub Total (AYUSH)
-

- - - - -

-

- - - -

-

-

-

- -

IEC-BCC NRHM


-
-
B.10.2.1
Display of four video spots on
different NRHM components from
4 local cable networks 2 each cable
@ Rs. 10000/- per month per cable
per channel ( State Level)


-

-
B.10.2.1
Display of 2 video spots on all
components of NRHM on rotational
basis fromdistrict cable networks in
20 districts @ Rs. 5000/- per district
per month (excluding Leh and
Kargil).


-

-
B.10.2.1
Broadcast of video spots on NRHM
components fromRadio Kashmir
Jammu and Srinagar in Hindi and
Kashmiri @ Rs. 578043.00 per
month for both stations ( State
Level)


-

-
B.10.2.1
Procurement and display of two
hoardings per district @ Rs. 13000/-
each (one each for Maternal and
Child Health activity)

-

-
B.10.2.1
Procurement and display of
Hoardings on National Highway
fromLakhanpur to Leh ten each
division @ Rs.13000 ( StateLevel)


-

-
B.10.2.2
Production and procurement of
video spots on NRHM components
for display on local cable networks


-

-
B.10.2.2
Organizing of symposiumfor
female adolescents in high / higher
secondary schools and colleges for
110 institutions @ Rs. 8000/- each 5
each districts


-

-
131

B.10.2.2
Organisation of Rallies, debates and
seminars for schools / colleges @ 5
per district costing Rs. 10,000/-
each

-

-
B.10.2.2
Issue of press advertisement in print
media through Information
Department (Lumpsum) ( State
Level)

-

-
B.10.5
Display of scroll with nine slogans
from4 cable networks of Jammu &
Srinagar cities with atleast 30
displays per day @ Rs.8000/- per
scroll per month. ( State Level)


-

-
B.10.5
Organisation of District / Block
Sammelans


-

-
B.10.5
Printing of modules / brouchers in
regional languages as per GoI
guidelines (lumpsum) ( State Level)


-

-
B.10.5
Display and procurement of
documentary films for DD Kendra /
Cable network (lumpsum) ( State
Level)

-

-
B.10.5
Miscellaneous IEC / BCC activities
(State Level)


-

-

Sub Total (IEC-BCC)
-

- - - - -

-

- - - -

-

-

-

- -
B.11
Mobile Medical Units (Including
recurring expenditures)


-

-
B.11
Recurring cost for 11 MMUs
procured in the current year


-

-

Sub Total (Mobile Medical Units)
-

- - - - -

-

- - - -

-

-

-

- -

Planning, Implementation and
Monitoring


-

-

Quality Assurance


-
-
132

B.15.2
For completion of accrediation of
ongoing hospital projects


-

-

Sub Total (Qualilty Assurance)
-

- - - - -

-

- - - -

-

-

-

- -
B.15.3.2
Monitoring and Evaluation


-
-
i)
HMIS Fellows at Divisional level


-
-
ii)
Mobility for M&E officers at state
level

-

-
iii)
Mobility for M&E officers at
divisional level

-

-
iv)
Mobility for M&E officers at
district level

-

-
v)
Mobility for M&E officers at block
level

-

-
vi)
1 Printer / Scanner / Projector for 22
Districts

-

-
vii)
Internet connectivity State level


-
-
viii)
Internet connectivity divisional
level (one each for DNO, Div.MEO
and Div.Acct.Mgr)

-

-
ix)
Internet connectivity district level
(One each for DPM, DMEO and
DAM

-

-
x)
Internet connectivity block level
(one each for BMEO and BAM)


-

-
xi)
Internet connectivity SMGS/Lal
Ded/ District Hospitals/sarwal
hospital

-

-
xii)
Annual Maintenance of equipments


-
-

Operational Costs (consumables
etc)

-

-
i)
Consumables at State level


-
-
ii)
Consumables at Divsional level


-
-
B.15.3.3
Other M & E


-
-
133

i)
Printing of new registers approved
by GoI

-

-
ii)
Mobile charges for ANM at sub-
centres (Regular ANMs) for
tracking of pregant women and
children/mointoring & Rs 100/-
respctively per month)

-

-
iii)
Reimbursement of Mobile user
charges of ASHA @ Rs 100 per
month

-

-
iv)
Capity bulidings of CMOs / BMOs /
DPMUs / BPMUs at Division level
for re-orienation of HMIS and
MCTS 14 batches (25 paticipants
per batch)

-

-
v)
Capity bulidings of ANMs / LHVs /
Staff Nurses at Block level for re-
orienation of HMIS and MCTS 116
batches (35 participants each batch)


-

-
vi)
Ongoing review of MCH tracking
activities (2 Review meeting to be
held after 6 months for both the
Divisions headed by Secreatry /
Mission Director to review HMIS /
MCTS in both theDivisions )

-

-

Sub Total of Planning
Implementation and Monitoring
-

- - - - -

-

- - - -

-

-

-

- -

PROCUREMENT


-
-

Procurement of Equipment


-
-
B.16.1.2
Procurement of equipment: CH
(NBCC @ Rs. 85000 X 50)


-

-
B.16.1.2
Procurement of equipment: CH for
strengthening of the paediatrics
department SMGS hospital Jammu
and GB Pant Hospital Srinagar
(Training Centre) project submitted


-

-
134


Procurement of Drugs and
supplies

-

-
B.16.2.1
Drugs & supplies for MH


-
-
B.16.2.1
Diagnostic kits/disposable syringes
gloves/cotton/ anti spasmodic/ anti
alergic tablets under RTI/STI


-

-
B.16.2.1
Drug Kit 1 to 7


-
-
B.16.2.2
Drugs & supplies for CH


-
-
i)
IFA tablets to students of primary
schools

-

-
ii)
IFA tablets to students and teachers
School Health


-

-
iii)
Deworming tablets under School
Health

-

-
iv)
Iron Folic under SABLA Scheme


-
-
v)
Deworming tablets under SABLA
Scheme

-

-
B.16.2.3
Drugs & supplies for FP


-
-
i)
IUD Insertion Kits


-
-
ii)
Minilap Sets


-
-

Drugs for AMCHI


-
-
iii)
Procurment of medicines for
AMCHI at PHC level @ Rs. 25000
per annum

-

-
iv)
Procurment of medicines for
AMCHI at CHC level @ Rs. 75000
per annum

-

-
v)
Procurment of medicines for
AMCHI at district hospital @ Rs.
100000 per annum

-

-

Sub Total (PROCUREMENT)
-

- - - - -

-

- - - -

-

-

-

- -
B.20
Research, Studies, Analysis


-
-
135

B.20
Evaluation study of components of
NRHM through NHSRC


-

-

Sub Total (Research, Studies)
-

- - - - -

-

- - - -

-

-

-

- -

Activities which are not
mentioned above
(Plz specify the activity)

-

-




-
-




-
-

Grand Total (Mission Flexipool)
-

- - - - -

-

- - - -

-

-

-

- -


-
-
Immunization

-
-
C.1.a
Mobility Support for supervision for
district level officers.


-

-
C.1.b
Mobility support for supervision at
State level


-

-
C.1.c
Printing and dissemination of
Immunization cards, tally sheets,
monitoring forms etc.


-

-
C.1.d
Support for Quarterly State level
review meetings of district officer


-

-
C.1.e
Quarterly review meetings
exclusive for RI at district level with
one Block Mos, CDPO, and other
stake holders

-

-
C.1.e
Quarterly review meetings
exclusive for RI at block level


-

-
C.1.g
Focus on slum& underserved areas
in urban areas/alternative vaccinator


-

-
136

C.1.h
Mobilization of children through
ASHA or other mobilizers (Rs 150/-
per session for 9 sessions)


-

-
C.1.i
Alternative vaccine delivery in hard
to reach areas


-

-
C.1.j
Alternative Vaccine Deliery in
other areas


-

-
C.1.k
To develop microplan at sub-centre
level


-

-
C.1.l
For consolidation of microplans at
block level
(Rs 1000/- per block/PHC and Rs
2000/- per district)


-

-
C.1.m
POL for vaccine delivery fromState
to district and fromdistrict to
PHC/CHCs
(Rs 1.00 Lakh /year/district)

-

-
C.1.n
Consumables for computer
including provision for internet
access for RIMs
(Rs 400/-month/distt)

-

-
C.1.o
Red/Black plastic bags etc.


-
-
C.1.p
Hub Cutter/Bleach/Hypochlorite
solution/ Twin bucket


-

-
C.1.s
Teeka Express (Operational Cost)


-
-
C.2.a
Computer Assistants support for
State level (Rs 12000/ per month)


-

-
C.2.b
Computer Assistants support for
District level
(Rs 10800/- per month)


-

-
137

C.3.a
Three day training including Hep B,
Measles & JE(wherever required) of
Medical Officers of RI using revised
MO training module)


-

-
C.3.d
One day cold chain handlers traning
for block level cold chain hadlers by
State and district cold chain officers


-

-
C.4
Cold chain maintenance


-
-
C.5
ASHA incentive for full
Immunization
(Rs 100/- for 1st year of life & Rs
50/- for 2nd year)

-

-

Total (Immunization)
-

- - - - -

-

- - - -

-

-

-

- -


-
-

Pulse Polio Operational cost


-
-

Bank Interest (DHS)


-
-

Bank Interest (Blocks/ other
agencies)

-

-

other Disease Control Programmes


-
-




-
-

Grand Total
(A+B+C+PPI+Others+DCP)
-

- - - - -

-

- - - -

-

-

-

- -
138


List of Officers/ officials working in the State Health Society / State Programme
Management Unit

S.
No
Unit Name and Designation of
the Officer
Key Strategies / Functions of unit
1
Mission Director
Dr.Yashpal Sharma,
94191-80709 mdnrhmjk@gmail.com
2
J oint Director (P&S)
Mrs. Satvir Kour
94191-83118 jdpnrhm@gmail.com
3
FA&CAO
Sh. Rajesh Talwar
94191-41294 fmgjammukashmir@gmail.com
4
Maternal Health
pmmhnrhmjk@gmail.com
Programme Manager:
Dr. Harjeet Rai, Divisional
Nodal Officer,
Jammu (M). 9419134458
dnonrhmjammu@gmail.co
m

Dr. Asmat Jan (Facilitator)
1. Delivery Points / MCH Centres.
2. JSY
3. ASHA Component
4. JSSK
5. MDR
6. Referral Transport
7. Safe Abortion Services.
8. Supervision of work of
District Monitors of Jammu
Division, timely submission of
their reports and follow up
actions on their reports/
recommendations
9. IEC / BCC
10. M&E.
Dr. Asmat Jan will look after
the Maternal Health Programme
including all components from
serial no. 1 to 10.
Associate Programme
Manager:
Dr. Rohit Abrol
(M). 9419155351
5
Child Health
pmchnrhmjk@gmail.com
Programme Manager:
Dr. Mushtaq Ahmed Dar,
Divisional Nodal Officer,
Kashmir
(M) 94194-41180
dnokashmir@gmail.com
1. Child Health.
2. Immunization
3. HBNC / FBNC
4. NRC
5. IDR
6. IYCF
7. SNCUs / Stab. Units / Baby
Care Corners.
8. Supervision of work of District
Monitors of Kashmir Division,
Associate Programme
Manager:
Dr. Younis Mushtaq
(M) 9018948862
139

S.
No
Unit Name and Designation of
the Officer
Key Strategies / Functions of unit
timely submission of their
reports and follow up actions on
their reports/ recommendations
9. IEC / BCC
10. M&E.
6
Adolescent and School Health
pmarshnrhmjk@gmail.com
Programme Manager:
Dr. Manoj Bhagat
(M) 94191-15413
drmanojbhagat@gmail.com
1. ARSH
2. School Health
3. RTI / STI
4. Menstrual Hygiene
5. Gender Equity.
6. IEC / BCC
7. M & E.
8. Review Meeting of J &K Rural
Health Mission, Governing
Body, Executive Committee &
High level Monitoring
Committee for IMR, Monthly
Review Meetings by HHM and
Preparation of action taken
report thereof.
Associate Programme
Manager:
Dr. Meenakshi Verma
(M) 9697124144

7
Family Planning and
PC&PNDT
pmpcpndtnrhmjk@gmail.com
Programme Manager:
Dr. B.B. Sharma,
(M) 94191-85245
1. MNGO Scheme
2. Family Planning
3. PC&PNDT
4. IEC / BCC
5. M & E

Assistant:
Mr. Sumit Khajuria, Law
Officer
8
Trainings
pmtrgnrhmjk@gmail.com
Programme Manager:
Dr. Robinder Khajuria,
(M) 9419149925
1. Administrative matters
pertaining to training.
2. Organizing and managing all
types of trainings after getting
inputs from concerned division.
3. Generation of Data base for
State and District level
trainings.
4. IEC/BCC
5. M & E.
Assistant:
Mr. Rakesh Sharma,
DMEIO
9
National Disease Control
Programme
pmndcdnrhmjk@gmail.com
Programme Manager:
Dr. Dhruv J i Raina
(M) 9419144066
1. RNTCP
2. NVBDCP
3. NLEP
4. NIDDCP
5. NCD
6. NPCB
7. Review of monthly District
level meetings and monitoring
140

S.
No
Unit Name and Designation of
the Officer
Key Strategies / Functions of unit
and vigilance Committees of
Jammu Division.
8. IEC/BCC
9. M & E.

10
National Disease Control
Programme &
Bio Medical Waste
Management
pmbmwmnrhmjk@gmail.com
Programme Manager:
Dr. Kewal Krishan Pandita
(M) 94197-81592
1. Biomedical Waste
2. IDSP
3. Mental Health
4. NPPCF
5. IEC/BCC
6. M & E.
7. RNTCP, NVDCP, NLEP,
NIDDCP, NCD, NPCB for
Kashmir Division
8. Review of monthly District
level meetings and monitoring
and vigilance Committees of
Kashmir Division.

11
Tribal & Urban RCH /
Mainstreaming of AYUSH
pmrchnrhmjk@gmail.com
Programme Manager:
Dr. Farooq Iqbal
(M) 9596391445
1. Tribal RCH
2. Mainstreaming of AYUSH.
3. Urban RCH
4. IEC/BCC
5. M&E.
6. Adoloscent and School Health
Programme in respect of
Kashmir Division
12
HMIS / MCTS
pmmctsnrhmjk@gmail.com
Programme Managers
Mr. Misba-ul-Hassan, State
Programme Manager
(M) 9906573180,
Mr. Kapil Ghai, State M&E
Officer
(M) 9419183592

Assistant Programme
Manager
Mr. Junaid Ahmed Zaroo

Assistants
Assistant M&E Officer.
HMIS Fellows.
1. Health Management
Information System(HMIS)
2. Mother and Child Tracking
System (MCTS)
3. Preparation of Data base of all
other Programmes in both the
divisions and regular feedback
to various Units.
4. IEC/BCC
5. M&E.

In addition to above Assistant
Programme Manage will look
after Trainings and Quality
Assurance in respect of
Kashmir Division.

141

S.
No
Unit Name and Designation of
the Officer
Key Strategies / Functions of unit
13
Quality Assurance / Blood
Banks
pmqabbnrhmjk@gmail.com
Programme Manager:
Dr. T.R Raina
(M) 9419132100
1. Quality Assurance
2. Strengthening of Blood Bank /
Units / Laboratories.
3. IEC/BCC
4. M & E.
14
IEC/BCC

pmiecnrhmjk@gmail.com
Programme Manager:
Sh. A.U.Bhatt
(IEC Consultant)
(M) 94191-92632
1. IEC/BCC
2. M & E.

Assistant:
Sh. Sadiq Khan, DMEIO