ORISSA

STATE REPORT
 Orissa

Index

S. No. Content Page No.

1 Summary of approvals 2–5

2 Demographic Profile 6–7

3 Progress of NRHM 8 – 12

4 Reproductive & Child Health 13 – 16

5 Immunization 17 – 17

6 Revised National Tuberculosis Control Programme (RNTCP) 18 – 21

7 National Vector Borne Disease Control Programme (NVBDCP) 22 – 23

8 National Leprosy Eradication Programme (NLEP) 24 – 24

9 Integrated Disease Surveillance Project (IDSP) 25 – 26

10 National Programme for Control of Blindness (NPCB) 27 – 27

11 National Iodine Deficiency Disorder Control Programme (NIDDCP) 28 – 28

12 RoP approvals under Mission Flexible Pool 29 – 35

13 Analysis of some RCH Indicators 36 – 36

1 Orissa
 ORISSA

Summary of approvals

Financial Management under NRHM (Rs. in crore)

% Release
% Expenditure
Years Allocation Release Expenditure against
against Release
Allocation

2005-06 196.72 231.07 136.87 117.46 59.23

2006-07 284.68 238.83 173.27 83.89 72.55
2007-08 345.20 360.45 267.39 104.42 74.18
2008-09 338.1 391.46 331.05 115.78 84.57
2009-10 362.31 0.00
Total 1527.02 1221.81 908.58 80.01 74.36

S. No. Timeline Activities Achievement %

Selection 34252 109
1 ASHA
Training 34117
2 VHSC 37078 72
3 24X7 PHCs 39 3
4 Mobile Medical Unit 0 0
5 Rogi Kalyan Samiti 1444 92

Budget Allocations (2005-09) ( Amount in Crores)

Orissa
Allocation Releases Expenditure
RCH Flexipool
2005-06 58.68 40.50 21.11
2006-07 77.30 60.01 37.23
2007-08 72.25 108.85 96.34
2008-09 94.76 111.24 119.74
2009-10 96.67
Total (A) 399.66 320.60 274.42
NRHM Flexipool
No separate
2005-06 59.32 6.98
allocation
2006-07 64.97 66.91 28.46
2007-08 113.58 107.43 37.41
2008-09 82.55 123.44 66.79
2009-10 85.30
Total (B) 346.40 357.10 139.64

2 Orissa
 National Disease Control Programme
2005-06 52.99 38.76 38.22
2006-07 62.02 45.45 42.38
2007-08 57.76 27.58 23.32
2008-09 52.98 26.33 11.93
2009-10 62.70 0.00 0.00
Total (C) 288.46 138.11 115.85
Grand Total (A + B + C) 1034.52 815.81 529.91

Record of Proceedings (2005-2009) for Mission Flexible Pool

Approval of Infrastructure (Rs. in Crore)

S. No Health Facilities 2005-06 2006-07 2007-08 2008-09 2009-10

1 Sub C 5.93 6.00 0.00 10.15
2 PHC 30.35 0.00 7.50
3 CHC 24.00 22.2 2.20 0.00 27.81
4 DH 8.00 95.10 9.50
5 Equipment 8.21 0.00 5.25
6 Transport 0.00 16.39
7 Others 13.54 46.55 13.54 8.09
Total 29.93 35.74 101.31 108.63 84.70

Approval of Human Resources(Rs. in Crore)

S. No Personnel 2005-06 2006-07 2007-08 2008-09 2009-10
1 Doctors 2.43 0.00 5.11 21.62
2 Specialists 0.00 0.00 0.00
3 Staff Nurses 15.40 0.00 6.78
4 ANM 0.00 0.00 7.03
5 Others 8.10 0.92 25.40
Total 0.00 2.43 23.50 6.03 60.84

Approval of other activities (2005-2009) in Rs. Lakh

2005-06 2006-07 2007-08 2008-09 2009-10
S. No Initiative Remarks
Released Approved Approved Approved Approved
ASHAs
1 ASHA
Selection and 1253.556
2 training of ASHA
878 1312.27 2789.59
ASHA Resource
393.814
3 Centre
4 ASHA Drug kit 449.10

3 Orissa
 Addition Fund
spent from RCH II
18.02
Flexipool for 1st
Phase training

5
TOTAL 878 0 2114.49 1312.27 2789.59
Untied Funds, Annual Maintainence Grants and RKS fundsrelated matters

Rogi Kalyan
250 530 39
Samitis

6
7 RKS DHH 160 160 160
RKS Area
Hospital/Other
8 Hospital 34 120
9 RKS SDH 22 22 22
10 RKS CHC 348
315 1101
11 RKS PHC
Untied Fund for
174.00
12 CHC 174
Untied Fund for
320.5 290.50 290.50
13 PHC 174
Untied Fund for SC 593 592.70
14 668.8 668.8 668.8
Untied Fund for
51.2 1425.84 3802.2 4752.8
VHSC
15
Annual
Maintenance Grant
16 - CHC 231
Annual
Maintenance Grant 641 581.00 639.50
17 -PHC
Annual
Maintenance
18 Grant- SC 62 254.2
TOTAL 593 1855.4 4200.14 5277 8413.8
Infrastructure related matters
19 MMU 1353.6 1353.6 1376.4
TOTAL 1353.6 1353.6 1376.4

4 Orissa
 Status of Infrastructure 2005-2010

As per RHS 2008 New Construction Upgradation / Renovation

Number of Sub Centre 6688 296 1529
Number of PHC 1279 0 428
Number of CHC 231 0 195
Number of DH 32 0 32
As per State Data
Sheet, NRHM

Status of NRHM as on 15.05.2009

Selection 34252
1 ASHA
Training 34117
2 VHSC 28238

3 Joint A/C 17712

4 24X7 Facility 105

5 FRU 31
Doctors & Specialist 9
AYUSH Doctors 1167
6 Contractual Manpower Staff Nurse 263
Paramedics 14
ANM 703
7 JSY Beneficiaries (in Lakhs) 10.53

National Disease Control Programme

Leprosy

Although state has reached elimination of the disease, still large numbers of new cases are being
detected every year indicating active transmission in the community. An in-depth situational
analysis with steps to complete treatment etc is started.

IDSP
It is a Phase II state. The recruitment of human resources needs to be fast tracked. The data
reporting should start from all the districts.

Blindness
Reporting of utilisation of GoI grants need to be accelerated. Cataract performance and IOL
implantation percentage needs to be improved.

NVBDCP
Fill up the human resources (Male MPW, Lab Tech and Malaria Technical Supervisors) gaps.

RNTCP
Total Case Detection and cure rate need to be improved. This appears to be due to gaps in
key HR (STO, DTO, and other levels), weak supply chain management and supervision.

5 Orissa
 Demographic, Socio-economic and Health profile

HEALTH INDICATORS OF ORISSA

The Total Fertility Rate of the State is 2.4. The Infant Mortality Rate is 71 and
Maternal Mortality Ratio is 303 (SRS 2004 - 06) which are higher than the National average.
The Sex Ratio in the State is 972 (as compared to 933 for the country). Comparative figures
of major health and demographic indicators are as follows:
Table I: Demographic, Socio-economic and Health profile of Orissa State as compared
to India figures

S. No. Item Orissa India

1 Total population (Census 2001) (in million) 36.80 1028.61
2 Decadal Growth (Census 2001) (%) 16.25 21.54
3 Crude Birth Rate (SRS 2007) 21.5 23.1
4 Crude Death Rate (SRS 2007) 9.2 7.4
5 Total Fertility Rate (SRS 2007) 2.4 2.7
6 Infant Mortality Rate (SRS 2007) 71 55
7 Maternal Mortality Ratio (SRS 2004 - 2006) 303 254
8 Sex Ratio (Census 2001) 972 933
9 Population below Poverty line (%) 47.15 26.10
10 Schedule Caste population (in million) 6.08 166.64
11 Schedule Tribe population (in million) 8.15 84.33
12 Female Literacy Rate (Census 2001) (%) 50.5 53.7

Table II: Health Infrastructure of Orissa

Particulars Required In position shortfall

Sub-centre 7283 6688 595
Primary Health Centre 1171 1279 -
Community Health Centre 292 231 61
Multipurpose worker (Female)/ANM at Sub 7967 6768 1199
Centres & PHCs
Health Worker (Male) MPW(M) at Sub Centres 6688 3392 3296
Health Assistant (Female)/LHV at PHCs 1279 726 553
Health Assistant (Male) at PHCs 1279 168 1111
Doctor at PHCs 1279 1353 -
Obstetricians & Gynaecologists at CHCs 231 - -
Physicians at CHCs 231 - -
Paediatricians at CHCs 231 - -
Total specialists at CHCs 924 - -
Radiographers 231 8 223
Pharmacist 1510 1984 -
Laboratory Technicians 1510 311 1199
Nurse/Midwife 2896 637 2259
(Source: RHS Bulletin, March 2008, M/O Health & F.W., GOI)

6 Orissa
 The other Health Institution in the State are detailed as under:

Health Institution Number

Medical College 4
District Hospitals 32
Referral Hospitals
City Family Welfare Centre
Rural Dispensaries
Ayurvedic Hospitals 8
Ayurvedic Dispensaries 624
Unani Hospitals -
Unani Dispensaries 9
Homeopathic Hospitals 6
Homeopathic Dispensary 603

7 Orissa
 Note on Progress of NRHM in Orissa
(June 2009)

Orissa has implemented the activities of National Rural Health Mission efficiently and
effectively for attaining the goals and objectives of National Population Policy and Millennium
Development Goals. NRHM has transformed public health service delivery in the State. The
decentralization, responsiveness to local needs, paradigm shift in health system management and
availability of untied funds has improved the facilities and their credibility among members of the
public. The performance of JSY, community mobilization by ASHAs, proper referral transport,
increased number of deliveries, OPDs and bed occupancy have significantly improved and a larger
portion of community are getting benefit under Mission. Brief information on progress vis-a-vi issues
have been highlighted which are as follows:

Institutional Framework of NRHM

Meeting of State & District Health Mission held regularly. Merger of societies is completed in
25 districts. Overall 37, 078 VHSCs has been constituted & 23,302 Joint Accounts at sub-centre level
are operational. Rogi Kalyan Samiti are operational at 32 DH, 231 CHCs & 117 PHCs. All districts
have started developing their own IDHAP.

Infrastructure Improvements

In total 39 PHC have been strengthened with 3 three staff nurse for 24x7 services and 131
CHC are functioning on 24X7 & facility survey has been completed in 231 health institutions at
below district level. A total number of 9 SDH, 25 DH and 4 CHC and other level are functioning as
FRUs.

Human Resources

A total of 34,252 ASHAs have been selected & 25654 are trained upto 4th Module. 34188
ASHAs have been provided with drug kits. In total 5927 Sub-centres are functional with an ANM and
703 SCs have been strengthened with 2nd ANM. The state has appointed 1138 Contractual AYUSH
Doctors for different level of facilities. To augment the manpower contractual appointments of 9
MBBS Doctors, 366 Staff Nurse, 703 ANMs and 29 paramedics have been done under NRHM and
need to strengthen positioning of specialists in the State.

Services

Institutional deliveries in the state have improved from 3.58 lakhs (2006-07) to 4.40 lakhs
(2007-08). During the year 2008-09, 2.80 lakhs Institutional deliveries have been conducted in the
state. JSY beneficiaries increased from 2.27 lakhs (2006-07) to 4.90 lakhs (2007-08). The numbers of
JSY beneficiaries was 3.09 lakh during the year 2008-09. Female sterilizations have increased from
0.93 lakh (2006-07) to 1.19 lakh (2007-08) and male sterlisation has increased from 790 (2006-07) to
1397 (2007-08). During the year 2008-09, 115359 female & 4530 male sterilization have been
reported. 16 districts are implementing IMNCI & 11175 people trained so far. 794815 VHND held
since the launch of NRHM. First Phase of Community Monitoring has been operationalised in the
state.

8 Orissa
General

Overall improvement in health system since NRHM

Achievements made:-

• Impressive use of utilization of untied funds, maintenance grants and RKS grants to improve
preparedness of health facilities
• PRIs, SHGs and ICDS are actively involved with the health system.
• Community processes are strong. 42777 ASHA are selected and 17538 trained up to IVth
module
• 794815 VHND held successfully in the State as a result increase in ANC registrations and
immunization.
• The State and district IDSP are operational.
• Contraception performance has improved marginally.
• Significant number of contractual appointments under AYUSH.
• First phase of community monitoring pilot has been completed in the state.

Areas for Further Improvement:-

• Need to strengthen PHC and Sub center services

• Need to expedite the infrastructure development. Need to prioritize Health Sub Centre
construction.
• An integrated Mother & Child Health, FRU operationalisation,
• Institutions selected for 24X7 services need to be operationalized on a priority basis.
• Scaling up of telemedicine facilities for “hard to reach” areas.
• Need to improve the HR gap - MBBS doctors, Staff Nurses, Specialists and Lab Technicians.

Infrastructure
• There is a huge backlog of construction activities. Infrastructure development mechanisms
(separate engineering unit) initiated by the State need to be strengthened; there is an urgent
need to upgrade the infrastructure at various levels including staff quarters.
Human Resource

• Creation of a public health cadre in the state is required. Restructuring of cadre of Doctors for
creating better promotional avenues is under active consideration.
• There is a shortage of MBBS doctors, Staff Nurses, specialists and lab technicians need to
accelerate the process for hiring contractual manpower to reduce the gap.
• All vacancies for the NVBDCP from District Malaria Officers to Lab. Technicians and MPW
(M) to be filled up.
• Effective pooling of Lab Technicians from malaria, TB, NIV/AIDS for efficient handling of
investigations and diagnostic workload in the DH/SDH/CHC level.
• Proposals are under consideration for up gradation of the nursing college

Service Delivery
• There is increase in patient load and institutional deliveries in CHCs, Sub-divisional &
District Hospitals.
• New born care equipments, childhood illness care at primary level needs strengthening.
• There is improvement in institutional deliveries and cases of male & female sterlisations.

9 Orissa
 An Analysis of Financial Monitoring Report for the year 2008-09

A. RCH Flexible Pool

Component wise expenditure & Utilization under RCH against the approved PIP for the year
2008-09
Rs. In Lakhs
% Utilisation
Activities SPIP Expenditure
against PIP
Maternal Health 13318.82 8372.91 62.87
Child Health 869.84 119.29 13.71
Family Planning
Services 1973.59 1123.55 56.93
Adolescent
Reproductive and
Sexual Health/ Arsh 42.30 0.00 0.00
Urban RCH 324.00 43.69 13.48
Tribal RCH 284.29 60.04 21.12
Vulnerable Groups 67.10 0.22 0.33
Innovations/PPP/ NGO 730.59 96.48 13.21
Infrastructure &
Human Resources 1679.86 722.99 43.04
Institutional
Strengthening 990.53 155.13 15.66
Training 632.96 438.61 69.30
BCC / IEC 210.35 268.07 127.44
Procurement 189.26 98.09 51.83
Programme
Management 787.60 475.05 60.32
Total 22101.09 11974.13 54.18
Based on table above and record available in FMG, observations are as under:-

General Observations:
1. Only Rs 119.74 Crore i.e. 54% of the approved PIP of Rs.221.01 Crore has been utilized by
the state of Orissa under RCH-II as compared to National level expenditure against the PIPs
approved is 71%.

2. There is 26% increase in expenditure as compared to 2007-08.

3. Since the launch of RCH –II ,Rs 273.26 Crore , i.e. 85% has been utilized by the state against
the release of Rs.320.60 Crores during the period 2005-06 to 2008-09.

4. Remarkable expenditure has been noticed under BCC / IEC head, state has spent 127% of the
amount approved in PIP.

5 More than 60% expenditure in MH and Programme Management is quite appreciable.

6. 70% of total expenditure is reported under Maternal Health.

Areas of Concern
1. There is nil expenditure reported under the head ARSH.

10 Orissa
 2. Expenditure of Rs. 60.51 lakhs of Untied Fund is booked under RCH Flexible Pool,
which is highly objectionable.

3 Expenditure of Rs. 5.45 lakhs of Alternate Vaccine Delivery is booked under the head
Child Health which should have been booked in Routine Immunization head.

4. Expenditure of Rs. 0.890 lakhs is booked under Family Planning head which should have
been booked in HMIS.

B. Mission Flexible Pool

Component wise expenditure under NRHM against approved PIP for the year 2008-09
Rs. In Lakhs
%Utilisation
Activities SPIP Expenditure
against PIP
ASHA 1312.27 957.75 72.98
Untied Funds 842.80 582.00 69.05
Hospital Strengthening 970.00 1084.66 111.82
Annual Maintenance Grants 62.00 120.47 194.30
New Constructions/ Renovation and Setting up 5720.00 86.34 1.51
Corpus Grants to HMS/RKS 613.00 639.84 104.38
Action Plans (District, Block, Village) 0.00 16.25
Panchayti Raj Initiative 3802.20 49.10 1.29
Mainstreaming of Ayush 649.51 531.78 81.87
IEC-BCC NRHM 168.00 144.04 85.74
School Health Programme
Additional Contractual Staff (Selection, Training,
427.67 382.18 89.36
Remuneration)
PPP/ NGOs
Training 137.19 0.00 0.00
Planning, Implementation & Monitoring 1576.98 84.24 5.34
Procurements 166.09 1232.29 741.94
New Initiatives/ Strategic Interventions (As per
60.73 0.00
State health policy)
Research, Studies, Analysis 30.00 0.00
Support Service 137.03 10.24 7.47
NRHM Management Costs/ Contingencies 971.08 757.39 77.99
Other Expenditures (Power Backup, Convergence
etc) 634.37 0
Total 18280.92 6678.56 36.53

Based on table above and record available in FMG, observations are as under:-
General Observations:
1. More than 100% expenditure is shown under the head Hospital Strengthening and Annual
Maintenance Grants & Corpus Grants to HMS / RKS.
2. Expenditure under Ayush, IEC/BCC and Additional Contractual Staff is more than 80%
which is quite appreciable.
3. As compared to 2007-08, 83% increase has been noticed in expenditure during 2008-09.

11 Orissa
Areas of Concern

1 Out of Rs. 182.81 Crores approved by the NPCC and Rs.123.44 Crores released, the state has
utilized only Rs.66.79 Crores i.e. only 37% of approved PIP, while the national average of
expenditure against PIP is 68.14%.
2 Since the start of the programme, Rs. 357.10 Crore has been released to the state but the state
has utilized only Rs. 177.18 Crore (50%) and Rs. 179.92 Crore (50%) remains unutilized.
3 Expenditure under RKS Rs. 639.84 lakhs has not been bifurcated.
4 Mission Flexible Pool Part of FMR is not in the prescribed format.
5 No expenditure is reported under the head Training, New Initiatives Research Studies and
Analysis.
6 Expenditure reported under New Construction/Renovation is less than 2% of the amount
approved in PIP , Rs. 57.20.crore.
7 Expenditure reported under Panchayati Raj Initiative is less than 2% of the amounts approved
in PIP , Rs. 38.02 crore .

12 Orissa
 NOTE ON RCH II IN ORISSA

A. Background/ current status

1. RCH II Goals

Orissa’s MMR at 303 (SRS 04-06) has improved from 358 in SRS 01-03, but is still way above the
national average of 254. The IMR (SRS 2007) at 71 is the 2nd highest in the country. TFR at 2.4 (SRS
2007) is lower than the national average of 2.7 (refer Annex 1).

2. RCH II Outcomes

Orissa’s progress during the four year period between DLHS 2 (2002-04) to DLHS 3 (2007-08) is
significant (refer Annex 1):
• Mothers having full ANCs has increased from 13.7% to 23.3%.
• Institutional deliveries have increased from 30.8% to 44.3%.
• Full immunisation in children aged 12-23 months has increased from 53.3% to 62.4%.
• Children with diarrhoea receiving ORS has increased from 48.3% to 49.0%.

However, unmet need for family planning has increased from 19.8% to 24.0%. Further, the use of
modern contraceptives has decreased from 40.3% to 37.8%.

3. Expenditure

Audited expenditure has increased sharply from Rs. 21.11 crores in 05-06 to Rs. 37.23 crores in 06-07
and Rs. 95.18 crores in 07-08; reported expenditure in 08-09 is Rs. 119.74 crores i.e. 54% of
allocation (Rs. 221.01 crores). JSY accounted for 69% of the reported expenditure in 08-09.

B. Key achievements

1. Maternal Health, including JSY

• Number of JSY beneficiaries in the state increased from 2.27 lakh in 06-07 to 4.91 lakh in 07-
08 and decreased to 3.09 lakh in 08-09.
• 22 MBBS doctors have been trained in Life saving anaesthesia skills (LSAS) and 24 in
comprehensive Emergency Obstetric Care (EmOC) so far against the target of 254.
• Selection of trainees for multi skilling is done through open advertisement & counseling of
before admission and post training placement is also decided simultaneously. Further, in a
unique step state has taken decision to place interested couple doctors at FRUs (from no FRU)
before training, so that their sustainability can be ensured.
• 856 SNs/ANMs/LHVs have been trained in SBA so far against the target of 3833.
• Established referral linkages through Janani Express Yojana (which has been proposed for 3
each in 118 Tribal blocks & 1 each in 196 Non tribal blocks in 2009-10)
• In order to strengthen the implementation of VHNDs (Mamta Diwas) guidelines have been
published & widely circulated, awareness-cum-action programmes are being organised during
the VHND sessions which include Health Quiz, Bangle Ceremony, Healthy Baby Show,
Adolescent Mela, Health Rally, Award for best maintained house in respect of cleanliness,
maintenance & sanitation etc.

2. Child Health
• Integrated Management of Neonatal & Childhood Illness (IMNCI) is ongoing in 16 (out of
30) districts of the state. 11175 personnel have been trained in IMNCI so far.
• Orissa has taken some innovative measures for addressing malnutrition, e.g. positive deviance
approach for complementary feeding practices, Prustikar Diwas for management of severely

13 Orissa
 malnourished children, hospital based health workers (Yashodas) for initiating early
breastfeeding.

3. Other initiatives
• Management of PHCs through the NGOs
• Application of GIS Technology for mapping of existing health care facilities, spatial mapping
of incidence of diseases, mapping of service coverage of sub-centres, and identification of un-
served areas.

C. Key issues

1. Maternal Health, including JSY

While number of institutional deliveries under JSY is 3.09 lakhs in 08-09, Orissa is yet to adequately
gear up facilities to meet the load:
• State has operationalised 39 PHCs as 24x7 so far against the target of 1282 PHCs by 2010
and 38 facilities have been operationalised as FRUs as against the target of 254 by 2010.
Blood storage units are not fully operationalised.
• Pace of skill based training needs to pick up: only 22 MBBS doctors have been trained in Life
saving anaesthesia skills (LSAS) and 24 in comprehensive Emergency Obstetric Care
(EmOC) so far against the target of 254; 856 Staff Nurses/ANMs/LHVs have been trained in
SBA so far against the target of 6388 by 2010, however the quality parameters like
partograph, skills on delivery and new-born care, availability of drugs etc, needs to be
properly supervised and practiced.
• Only 20% of planned VHNDs were held in 08-09 (1 lakh out of 5 lakh planned)

2. Child Health
• Neonatal mortality rate (NMR – infant deaths within 4 weeks of life per 1000 live births) at
49 (SRS 2007) accounts for 69% of the IMR, while early NMR (infant deaths within one
week of life per 1000 live births) at 37 (SRS 2007) accounts for 76% of the NMR. An
evaluation of JSY in the state in December 2008 highlighted that only 27% of the
beneficiaries surveyed stayed for at least two days in the health facility after delivery. With
the huge offtake in JSY in the state (3.09 lakh beneficiaries in 2008-09), this is clearly a
missed opportunity to address early neonatal mortality.
• 70 per cent of all infant deaths in India are concentrated in eight states (Bihar, UP, Madhya
Pradesh [MP], Orissa, Rajasthan, Andhra Pradesh [AP], Maharashtra and Gujarat). Only one
SNCU is present in Orissa.
• Care seeking for children with ARI has declined (67.8% to 63.4%), and only 22% of families
know the danger signs.

14 Orissa
 ANNEX 1

A. Progress on Key Indicators

1. RCH II Goals

INDICATOR ORISSA INDIA

Trend (year & source) Current status RCH II/ NRHM
(2012) goal
Maternal Mortality Ratio 358 303 254 <100
(MMR) (SRS 01-03) (SRS 04-06) (SRS 04-06)
Infant Mortality Rate (IMR) 83 (SRS 2003) 71 (SRS 2007) 55 (SRS 2007) <30
Total Fertility Rate (TFR) 2.6 (SRS 2003) 2.4 (SRS 2007) 2.7 (SRS 2007) 2.1

2. RCH II Outcomes

ORISSA INDIA*
S.
RCH OUTCOME INDICATOR DLHS–2 DLHS–3 DLHS–2 DLHS–3
No.
(2002–04) (2007–08) (2002–04) (2007–08)
Mothers who received 3 or more antenatal care
1. 41.7 54.6 50.4 51.0
checkups (%)
2. Mothers who had full antenatal check-up (%) 13.7 23.3 16.5 19.1
3. Institutional deliveries (%) 30.8 44.3 40.9 47.0
Children 12-23 months age fully immunised
4. 53.3 62.4 45.9 54.1
(%)
Children age 6-35 months exclusively breastfed
5. 20.7 42.6 22.7 24.9
for at least 6 months (%)
Children with diarrhoea in the last 2 weeks who
6. 48.3 49.0 30.3 33.7
received ORS (%)
7. Use of any modern contraceptive method (%) 40.3 37.8 45.2 47.3
Total unmet need for family planning - both
8. 19.8 24.0 21.4 21.5
spacing methods and terminal methods (%)
* - Provisional results for DLHS-3

B. Trends in Financial Expenditure

(Rs. crores)
FY 2005-06 FY 2006-07 FY 2007-08 FY 2008-09
Release 40.50 60.01 108.85 111.24
Audited Expenditure 21.11 37.23 95.18 119.74*
* - Audited expenditure for 2008-09 is not yet available; reported expenditure is provided.
- Allocation for 2008-09: Rs. 221.01 crores.

C. Progress on Key Strategies

1. Demand side interventions

S. Indicators Achievement (no. of beneficiaries)

No. 2005–06 2006–07 2007–08 2008–09
1. Janani Suraksha Yojana 26,407 2,27,204 4,90,657 3,09,000
2. Total Sterilisation 83,049 93,739 1,20,983 na
3. IUD Insertions 1,59,725 1,61,574 1,61,051 na
(Source: M&E Division reports, and JSY reports from the states)

15 Orissa
 2. Technical interventions

S. Achievement upto March 2009

Indicators
No. Number %
1. No. of First Referral Units (FRUs) operationalised 14.96 (against the
38
target of 254 FRUs)
2. No. of PHCs operationalised to provide 24-hour 3 (against the target
39
services of 1282 PHCs)
3. No. of private institutions accredited under JSY 17 NA
4. No. of districts implementing Integrated Management 53.3 (out of 30
16
of Neonatal & Childhood Illness (IMNCI) districts)
5. No. of people trained in IMNCI 11175 NA
6. No. of Village Health & Nutrition Days (VHNDs) held 7,94,815 NA
(Source: NRHM MIS report, April 2009)

16 Orissa
 Immunization

Orissa

Evaluated Immunization Coverage

NFHS 2 NFHS 3 DLHS 2 DLHS3

Survey NFHS 1 CES CES
(1998- (2005- (2002- (2007-
Indicator (1992-93) (2005) (2006)
99) 06) 04) 08)
FI 36.1 43.7 51.8 53.2 74.8 53.3 62.4
BCG 63.3 84.7 83.6 94.6 96.2 90.4 94.2
Measles 40.2 54.0 66.5 81.9 85.8 67.9 81.1
DPT 3 56.3 61.9 67.9 80.3 80.0 69.3 74.3

Progress

The State has made good progress in improving the coverage of BCG to 94.2% and Measles to
81.1%.
The state has completed 61.7% (8061/13085) of health workers’ training on Immunization.
The State has constituted district level AEFI committees in 15 out of 30 districts.
The State has been uploading data in RIMS in 2008-09 regularly.

Issues

The State continues to have high dropout from BCG to DPT 3 which is critical for further
improvement in full immunization coverage. As per DLHS3 Survey there are 25.7 %
unimmunized children (based on DPT3 Coverage) which translates to around 2.1 lakh children
per year.
The State needs to expedite the constitution of AEFI committees in the 15 districts. The State
needs to strengthen AEFI reporting further to improve reporting of AEFI cases.
The training plan of Immunization Staff needs to be rationalized on basis of available training
infrastructure and the huge training load. A phased plan covering realistic target this year and
remaining in subsequent years may be considered.

Comments

The State needs to further improve service delivery and other infrastructure as Rubella vaccine is
going to be introduced shortly in form of MR vaccine for children of 16-24 months.

17 Orissa
 Brief on National TB Control Programme in Orissa

1. Infrastructure

Total Population – 403 lakhs

No. of Districts – 31 (All 31 implementing since
24.3.06)
No. of Tuberculosis Unit (TUs) – 106
No. of Designated Microscopy Centres (DMCs) – 546.
Funding - All districts of Orissa are funded by
GFATM
Round 4 since Jan 2006.

2. State Level Performance (Based on the quarterly reports for 1st quarter 2009)

• Overall annualised total case detection rate of 126/lakh and new sputum positive case
detection rate of 55/lakh (64%) are still low..
• Retreatment sputum positive patients are only 15% of all sputum positive patients which
is very low and shows wrong categorization of sputum positive patients which has
perhaps increased NSP case detection rate.
• Sputum conversion rate of 88% and cure rate of 82% in NSP cases are close to the
national targets of 90% and 85% respectively. However, treatment success rate of 86% is
satisfactory.
• Sputum of only 138 TB suspects per lakh population per quarter are examined for
diagnosis which is low.
• Main reasons for low case detection rate are poor OPD attendance in Govt. Health
Facilities particularly in the coastal areas, poor referral of TB suspects and involvement of
only few NGOs and Private Sector health facilities.

18 Orissa
 Annualized New Smear-Positive Case Detection Rate
and Treatment Success Rate in DOTS Areas, Orissa, 2000-2009*

120%

110%

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

0%
Qtr1-00
Qtr2-00
Qtr3-00
Qtr4-00
Qtr1-01
Qtr2-01
Qtr3-01
Qtr4-01
Qtr1-02
Qtr2-02
Qtr3-02
Qtr4-02
Qtr1-03
Qtr2-03
Qtr3-03
Qtr4-03
Qtr1-04
Qtr2-04
Qtr3-04
Qtr4-04
Qtr1-05
Qtr2-05
Qtr3-05
Qtr4-05
Qtr1-06
Qtr2-06
Qtr3-06
Qtr4-06
Qtr1-07
Qtr2-07
Qtr3-07
Qtr4-07
Qtr1-08
Qtr2-08
Qtr3-08
Qtr4-08
Qtr1-09
Annualised New S+ve CDR Success rate
•Population projected from 2001 census
•Estimated no. of NSP cases - 85/100,000 population per year (based on recent ARTI report)

3. District wise Performance: (Based on the quarterly reports for 1st quarter 2009)

• In 5 districts referral of TB suspects is very low (<100 TB suspects/lakh pop examined) in

1st quarter 09.
• TCD rate is less than 50% in 14 districts and NSP case detection rate is <50% in 9
districts.
• Sputum conversion rate is very low (<85%) in 9 districts and cure rate is very low (<80%)
in 8 districts.

Suspects Annualized New sputum

Sputum Cure
examined Total Case positive case
conversion rate rate
Districts /lakh Detection rate detection rate
at 3 months (against
Population (against (against >60/lakh)
(against >90%) >85%)
>161/lakh)
Anugul 156 109 50 58% 93% 88%
Balangir 127 157 49 58% 90% 83%
Baleshwar 115 80 36 42% 86% 75%
Bargarh 124 121 46 54% 92% 84%
Baudh 116 102 49 57% 78% 87%
Bhadrak 87 62 24 28% 84% 78%
Bhubaneshwar Corp 177 109 38 45% 93% 88%
Cuttack 101 81 31 36% 91% 84%
Debagarh 139 112 66 78% 86% 87%

19 Orissa
Dhenkanal 147 107 52 61% 93% 88%
Gajapati 138 160 85 100% 84% 78%
Ganjam 133 157 55 65% 84% 75%
Jagatsinghapur 112 56 27 32% 94% 85%
Jajapur 84 87 34 40% 91% 87%
Jharsuguda 204 150 65 77% 92% 90%
Kalahandi 132 142 58 68% 81% 78%
Kandhamal 197 145 77 91% 91% 77%
Kendrapara 98 61 35 41% 95% 94%
Kendujhar 184 176 86 101% 92% 85%
Khordha 76 98 39 45% 86% 86%
Koraput 143 140 79 94% 87% 83%
Malkangiri 175 209 105 124% 83% 80%
Mayurbhanj 208 213 106 125% 91% 84%
Nabarangapur 83 79 48 56% 88% 83%
Nayagarh 165 160 54 63% 62% 66%
Nuapada 182 161 63 74% 89% 83%
Puri 111 96 29 34% 90% 86%
Rayagada 182 180 108 127% 90% 86%
Sambalpur 198 146 53 62% 90% 84%
Sonapur 118 114 57 67% 90% 73%
Sundargarh 183 164 68 80% 91% 86%
Total 138 126 55 64% 88% 82%

4. Funds Status as on date (31st March 2009) (Rs. in lakh)

Opening Balance Funds released Expenditure Balance

245.24 682.00 728.28 198.96

5. Issues

• Human Resource
o No full time DTO post in 28 out of 31 districts. Programme is managed by 2nd MOs
or Part- time DTOs. These officers in many districts hold additional charges leading
to sub-optimal involvement in the programme. Post of full time DTOs need to be
created in all the districts.
o Posts of 13 MO-TCs and 5 STLSs are vacant. Vacant posts of key personnel need
to be filled up on priority.
o Posts of MO-RNTCP in Koraput, Nuapada and VSS Medical College are vacant.
There is shortage of LTs in the State and many DMCs are manned by trained para
medical staff. NRHM has taken up the matter of appointment of 56 LTs but is
pending since long.
o Post of 6 TB-HVs are also vacant.
• Logistics
o Drugs are released from State Drug Stores in monthly, unplanned staggered
installments leading to problems in accounting and drug management.
o Transportation arrangement for drugs, issued from State Drug Stores to districts, not
in place.
o Infrastructure at district & sub-district drug stores not in place. Proper storage
conditions absent.
• Supervision and Monitoring

20 Orissa
 o There is very little supervision and monitoring from the State level. State visits are
only for internal evaluations. Inadequate TA/DA is one of the reasons leading to
reluctance in supervision by the officers of STC and STDC.
o Very poor supervision at the district/sub-district level. The main reasons are:-
− DTO is given charge of many health programmes and activities
− No monitoring by MO-TCs, as provision for hired vehicle is not utilized.
− Delay in reimbursing claims for POL.
• Performance
o Overall sputum of only 138 TB suspects/lakh pop/quarter are examined which is low
against the national average of 152 TB suspects /lakh pop/quarter. Referral of TB
suspects for sputum examination is vry low (<100/lakh) in 5 districts.
o Overall total case detection rate of 126/lakh is very low due to poor referral of TB
suspects from OPD. However, new smear positive case detection rate of 55/lakh
(64%) is near satisfactory which is due to wrong categorisation of sputum positive
patients. It is evident from the fact that retreatment sputum positive cases are only
15% whereas it should be 30-35% of all sputum positive patients. New sputum
positive case detection rate is less than 43/lakh (50%) in 9 districts.
o Overall sputum conversion rate of 86% and cure rate of 82% in new sputum positive
patients are gradually improving but still low. Sputum conversion rate is very low
(<85%) in 7 districts.
• Recording and Reporting
o Monthly PHI level reports on PM not submitted by many PHIs
o Reporting in windows based EPI Centre yet to be started in many districts.
• TBHIV Collaboration Activities
o State and District TB-HIV coordination committee meetings are not held regularly.
o TA/DA for councilors to attend monthly RNTCP meetings which was to be given by
OSACS is pending in many districts leading to poor attendance of councilors.
• Intermediate Reference Laboratory (IRL)
o Accreditation process of IRL underway. There was a problem with the first round
accreditation process. Errors were identified and corrective measures have been
undertaken. Till that time NRL has agreed to take up culture/DST activities for
suspects from Orissa. Suspects referral to be initiated.
o All districts implementing EQA but only 6 districts visited as part of OSE in 2008
• DOTS Plus
o Proposal for renovation of identified DOTS Plus ward for admitting TB patients
pending with NRHM.
o 75 KV Genset procurement pending.
o Computer, Printer, Scanner, Photocopier and appointment of DEO for DOTS Plus
Site pending.

21 Orissa
 Fact sheet on NVBDCP-Orissa

Background Information

• The State has 30 districts with a population of 411.29 lakh. There are 231 CHCs, 1279 PHCs,
5927 Sub-centres and 51349 villages. There are There are 6768 Multipurpose Worker
(Female)/ANM, 3392 Health Worker (Male), 726 Health Assistants (Female)/LHV, 168 Health
Assistant (Male) and 311 Laboratory Technician. In addition, the state has 13254 functioning
Fever Treatment Depots (FTDs).
Malaria
Epidemiological Situation
Year Total Slide Total Malaria Cases Total Pf Cases Deaths
examined
2006 4957488 380216 331773 257
2007 4945551 371879 323150 221
2008 4888926 359619 314130 218

• Orissa is highest endemic malaria state which contributes 1/4th of total malaria cases of the
country and about 20-40% of deaths due to malaria in the country.
• Large areas of district are tribal, remote, inaccessible and forested with poor infrastructure
and difficulty in carrying out control activities.
• P.falciparum is predominant species in the state which often results to death when timely
treatment is not provided.
• State is being provided Rapid Diagnostic Kits for early diagnosis of Pf cases and Artesunate
Combination Therapy (ACT) for effective treatment of P.falciparum cases.
• 16 districts of the state are being covered under GFATM Supported Project and 14 districts
under World Bank Assisted Project.
• Under World Bank Project, 14 district level VBD Consultants, 78 MTS and 39 LTs are
being provided to the state for which sanctions have been given.

Elimination of Lymphatic Filariasis

• The goal of Elimination of Lymphatic Filariasis in the country is set to be achieved by

2015. In pursuance to achieve this, Government of India during 2004 initiated Mass
Drug Administration (MDA) with annual single dose of DEC tablets to all the
population living at the risk of filariasis excluding pregnant women, children below 2
years of age and seriously ill persons. The population coverage of MDA in the state was
90.11% in 2004, 90.60% in 2005, 87.40% in 2006, 88.47% in 2007 and 84.53% in 2008.
• Line listing of Lymphoedema and Hydrocele cases was also initiated in 2004 for
morbidity management and as per updated report (2007), there are 67607
Lymphoedema and 34109 Hydrocele cases.

Dengue
In 2006 only one case and no death was reported and in 2007, 4 dengue cases were reported. In the
year 2008 and 2009 no case has been reported till 27th May.

22 Orissa
Chikungunya
Total of 6461 suspected Chikungunya fever cases were reported during 2006. Out of the total 171
samples detected 34 were confirmed serologically for Chikungunya. In the year 2007, 4065 suspected
Chikungunya fever cases were reported. Out of the total 423 samples tested, 90 were confirmed
serologically for Chikungunya. In the year 2008, 4676 suspected chikungunya fever case was
reported. Out of the total 238 samples tested, 11 were confirmed serologically for Chikungunya. In
the year 2009, no suspected Chikungunya case has been reported till 27th May 2009.
For proactive surveillance three Sentinel Surveillance Hospitals with laboratory support has been
identified in the state which has been linked with ICMR Virus Unit, Kolkata - the Apex Referral
Laboratory. NIV Pune has been entrusted to supply lgM ELISA test kits for Dengue and chikungunya
to the identified institutes.

Kala-azar and Japanese Encephalities are not reported in the state of Orissa.

Central assistance: - (Rs. In lakhs)

Year Allocation Release/Expenditure
Cash Kind Total Cash Kind Total
2004-05 550.40 2121.21 2671.61 550.40 1744.92 2295.32

2005-06 382.71 4367.96 4750.67 678.57 2125.90 2804.47

2006-07 915.72 3710.22 4625.94 953.31 2623.96 3577.27

2007-08 1327.31 2414.52 3741.83 1476.70 3689.70 5166.04

2008-09 1656.61 2208.22 3863.83 642.56 1510.50 2153.06

2009-10(B.E) 1106.98 2968.98 4075.96

Issues:
Malaria:

• The state has yet to fill up 596 contractual male MPW against the 816 sanctioned posts.
• 9 posts of Malaria Technical supervisor are yet to be filled up against 104 sanctioned posts.
• Assistance is being provided for performance based incentive in twenty high malaria endemic
districts by the Centre. For remaining malaria high endemic districts, similar provision needs
to be made under Village Health and Sanitation Committee of NRHM out of flexi fund.
• State needs to intensify efforts to reduce malaria mortality by establishing proper effective
referral mechanism and treatment facilities for severe cases.
• The quality spray has to be ensured through intensive supervised spray activities.
• Out of 52000 sanction numbers of ASHAs only 34247 have been deployed of each 5000 have
been train. Remaining should be engaged and trained immediately.
Filaria

• State needs to gear up for hydrocele operation and complete the mapping to show the updated
number of lymphoedema and hydrocele.

23 Orissa
 STATUS OF NATIONAL LEPROSY ERADICATION PROGRAMME IN ORISSA

• Epidemiological scenario-
Orissa has achieved the goal of elimination of leprosy (i.e. prevalence rate of less than 1 case
/10000 population). There were 3590 leprosy cases on record as on March 2009.

• New case detection and treatment completion-

During 2008-09, a total of 6381 new leprosy cases were detected as compared to 5685 new
cases detected during the corresponding period of previous year. Out of 6074 cases
discharged during the year, 5927 cases (97.6%) were released as cured after completing
treatment.

• Reconstructive Surgery for leprosy affected persons-

There are 3 Govt. institutions viz. Cuttack Medical College, Leprosy Home & Hospital
(Cuttack) and Berhampur Medical College (Ganjam) and 2 NGO institution i.e HOINA
Leprosy Research Trust in Rayagada and Mission Hospital in Baragarh providing
reconstructive surgery services to leprosy affected persons with disability in the state. In the
year 2008-09, about 258 reconstructive surgeries were performed in these institutions.

• During 2008-09, NLEP action plan amounting to Rs.186.25 lakh has been approved for the
State.

Issues -

1. Large numbers of new leprosy cases are being detected in the state every year which suggest
active transmission of the disease in the community. The state is advised to carry out indepth
situational analysis in districts/blocks reporting large number of new cases and take suitable
actions like –

(i) Ensuring completion of treatment in each of the new cases detected.

(ii) Enhance awareness of the community to improve self reporting of suspected
cases to health facility and
(iii) Carrying out family contact survey against all multibacillary and child cases.

2. The State has listed around 1900 grade II disability cases in the last 5 years. RCS services are
being provided by 5 institutions recognized by GOI. The state should utilize the services of
these institutions effectively for conducting RCS so that the backlog of leprosy cases with
disability could be reduced.

3. There are about 67 leprosy colonies in the state. The state should ensure provision of proper
health care facilities like ulcer care, provision of supportive drugs and dressing materials to
the persons affected with leprosy residing in these colonies.

24 Orissa
 State: Orissa

Integrated Disease Surveillance Project (IDSP) –Fact sheet as on 17 June 2009

The state of Orissa has an area of 155,707 sq. km. and a population of 36.80 million. There are 30
districts, 314 blocks and 51349 villages. The State has population density of 236 per sq. km. (as
against the national average of 312). The decadal growth rate of the state is 16.25% (against 21.54%
for the country) and the population of the state is growing at a slower rate than the national rate.

Orissa is a Phase – II state under IDSP and has been inducted in the Disease Surveillance Project
during 2004-05. Dr. Bikash Patnaik, from Directorate Health Services, Govt. of Orissa, has been
designated as the State Surveillance Officer.

1. Manpower and Training:

• Surveillance Officers and RRT members at state and district Headquarters designated.
• Consultant Finance and Consultant Training at SSU need to be appointed.
• Training of core trainers, Medical Officers, Health workers and LT completed as per PIP.
• The offer letter to the recommended candidates for the positions of state/district
epidemiologists (20) and microbiologists (2) pending; to be issued by state/district NRHM
society, after receipt of the confirmation of remuneration for the candidates.

2. Information Technology:
• EDUSAT: (Total-4) Installed at SSU and 3 Medical Colleges.
• Training centre equipments /Data centre equipments installed in all districts.
• Broadband connectivity problem in some DSUs (Bargarh, Bolangir, Bhadrak. Deogarh,
Jharsuguda, Keonjhar & Sonepur) needs to be sorted out.

3. Data Reporting:
• All districts need to start reporting on revised P & L forms and to initiate on-line data entry in
IDSP portal (www.idsp.nic.in).
• Data Managers of SSU and DSUs need to do the disease-wise trend analysis of the weekly
surveillance data of the districts regularly.
• Medical Colleges to be followed up strictly to start reporting surveillance data and outbreak
reports (also in IDSP portal).
• Data reporting in revised P & L forms to start from Medical Colleges and IDH.

4. Outbreaks reported

Year No. of outbreaks reported Type of outbreak

Acute Diarrhoeal Disease, Food poisoning, Measles,
2008 17
Malaria, Anthrax and Chicken pox
2009 (Jan- 12 Acute Diarrhoeal Disease, Food poisoning, Measles &
May) Anthrax

5. Community based disease surveillance:

• The action plan for community based disease surveillance activities in the Blocks of
Dasmanthpur and Similiguda of Koraput district is being executed with the active
involvement of local stake-holders. Training of the first batch of stake-holders has been
initiated.

6. Laboratory Strengthening
• One priority district laboratory at Koraput has been identified for strengthening
• Procurement of equipments for the priority district laboratory is under process.
• Bio-waste management practices and guidelines need to be adhered to in health facilities.

25 Orissa
7. Finance:

Year Release (Lakhs) Expenditure (Lakhs)

(Total amount of FMRs furnished)
2004-2005 18.20 -
2005-2006 351.40 -
2006-2007 - 15.63
2007-2008 - 164.09
2008-2009 - 50.36 (upto 31.12.08)
Total 369.60 230.08
Balance = Rs. 139.52 Lakhs
• Audited Accounts and Utilization Certificate for the year 2007-08 received.
• FMR for March 2009 yet to be received in the revised format.

26 Orissa
 NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS
STATUS NOTE ON ORISSA

Magnitude:
Prevalence of blindness: 2001 1.40%
Estimated blind persons: 5.14 lakhs

Infrastructure developed
Upgraded Medical Colleges 3
Regional Institute of Ophthalmology 1
Upgraded District Hospitals 30
NGO/Private Eye Hospitals 8
District Blindness Control Societies 30
Mobile Eye Care Units 21
Eye Banks 2
Upgraded PHC’s 217

Cataract Performance

YEAR TARGET ACHIEVEMENT

2007-2008 124000 96045
2008-2009 150000 110716

School Eye Screening

YEAR TEACHER TRAINED SCREENED DETECTED PROVIDED

IN SCREENING FOR WITH FREE
REFRACTIVE REFRACTIVE GLASSES
ERRORS ERRORS
2007-08 0 302128 14680 7355
2008-09 0 483409 26078 10942
Total 5071 2058252 83835 38294

GIA released to Distt. Blindness Control Societies/State Blindness Control Society.

(Rs in lakhs)
YEAR RELEASED EXPENDITURE
BALANCE
2007-2008 222.50 110.78 111.72
2008-2009 829.38 886.18 -56.80

Issues

• UCs for GIA released to State Blindness Control Society are not being received timely.
• SOE for Cash Grant are also not being received timely.
• Performance of School Eye Screening Programme needs to be improved.

27 Orissa
 NIDDCP

Approval issued for the year 2009-10

Amount
Amount
S. No. Activity Approved Remarks
proposed
(Rs. in lakh)
1 Establishme 6.00
nt of IDD
Control Cell No PIP The State Government may
2 Establishme proposal 3.50 carry out the activities as per
nt of IDD the fund allocation of GOI.
Monitoring
Lab
3 Health 8.00
Education
and Publicity
4 IDD surveys 2.50
Total 20.00

28 Orissa
 Mapping of Record of Proceedings of the NPCC of NRHM for 2005-06 to 2009-10

This has been prepared to indicate allocations to the State in the previous years for different
activities as per the State Programme Implementation Plan. The mapping charts the NRHM
Mission Flexipool approvals contained in the RoP in following broad thematic chapters.

1. ASHA (including selection, training, drug kits, mentoring, specific performance

incentives and anything else associated with ASHA)
2. Infrastructure related matters (including construction, strengthening, renovation, new
construction etc), equipments, transport (ambulances, EMRI, associated expenses) and
others)
3. Human Resource related matters (including HR salary, contractual payments,
incentives, etc)
4. Programme Management related matters (including PMUs, SHS/DHS, SHSRC,
IDHAP, M&E, Mobility support to SHS etc)
5. Untied funds, AMG & RKS related mattes
6. Training & Capacity Building related matters (including trainings, workshops, training
institutions including their upgradation or new construction, courses, etc)
7. Innovations (including Procurement of medicines, School Health, Health Mela,
Insurance, Accreditations, Monthly VHND etc)

NATIONAL RURAL HEALTH MISSION

Orissa
Total MFP Approvals 5899.81 16374.37 18280 29585.84
RoP Approvals for Various Years in Rs. Lakh
2005-06 2006-07 2007-08 2008-09 2009-10
S. No Initiative Remarks
Released Approved Approved Approved Approved
ASHAs
1 ASHA
Selection and training of 1253.556
2 ASHA 878 1312.27 2789.59
3 ASHA Resource Centre 393.814
ASHA Drug kit
4 449.10
During 07-
08, amount
spent is over
and above
Addition Fund spent the grant of
from RCH II Flexipool 18.02 Rs. 936.08
for 1st Phase training Lakhs during
2005-06 as
per
instruction of
5 GOI
TOTAL 878 0 2114.49 1312.27 2789.59
Infrastructure related matters
6 Infrastructure 4655 9509.75

29 Orissa
 Construction /
7 Upgradation of DH 800 950
Construction /
Upgradation of Sub- 600
8 Centre 1015
9 Upgradation of SDH 220 527.5
Upgradation of CHC to
24 2220 1410
10 IPHS
During 07-
08,68
PHC/CHC @
Upgradation of
3035 Rs.35 lakh
PHC/CHC
and 131 new
PHC @ Rs.5
11 750 lakh
In 09-10,
upgradation
of 131
institutions
Additional Grant for other than
Upgradation of Health CHCs to
12 Institution 455 24X7
Strenghthening Cold
13 Chain Maintenance Unit 36
During 09-
10, Repair &
Renovation
of class room
in 3 Medical
Colleges
including
EmOC &
Anesthesia
Repair / Renovation of training
14 Medical Colleges 18 venue
15 MMU 1353.6 1353.6 1376.4
Construction of Block
16 level Drug Store 300
Equipment & Others for
68 PHC/CHC@ RS.5 340
17 Lakhs
Equipment & Others for
32 DHH @ 472.32
18 RS.14.76Lakhs
19 Aneasthesia equipment 200
TOTAL 24 3573.6 10122.32 10863.35 7037.9
Human Resources related matters
20 Staff for SPMSU 129.89
21 Staff for DPMSU 65.55
22 Staff for BPMSU 738.12

30 Orissa
 During 07-
08,
managemden
t support for
Mission
Directorate
Rs.26.96),
Additional Manpower 810.2 435.64
BPMU
(Rs.715.92),
SDH
(Rs.14.52),
District HQ
Hospital
23 0.4 (Rs.52.80)
In 09-10, for
Special allowance for EMoC +
24 Doctors 36.54 Anaesthesia
Salary of AYUSH
184.96 510.96 2125.44
25 Doctors 42.56
Salary Of AYUSH
40.00
26 Paramedics 20 92.10
27 Staff Nurse 118.35 263.56
28 Addl. ANM 121.5 202.5
PLACE
SPLIT
1539.55 FIGURES
Additional Staff FOIR ANM
29 Nurse/ANM AND SN
30 Lab Technician 59.27
In 09-10, for
31 Accountant 697.2 PHC(N)
TOTAL 42.56 260.25 2574.71 603.06 4753.71
Programme Management related matters
Operational cost for
maintanance of
computerised salary Operational
32 system"Betan" 6 Cost
33 SHSRC 17 100 50
34 PIP-State level 10
35 PIP- District level 15 15
PIP-Block & villlage
36 level 62.8
District level quarterly During 08-
review meeting of two 09, District
(2) office bearers from level review
RKS at PHC/CHC meeting of
level(one among which all Block
should be a community chairperson
37 member) 6 4.7 and member
38 Recurring Expenditure 114.10 744.96
Monitoring &
39 Supervision 1005.71
40 Implementation of 52.08

31 Orissa
 Community Monitoring
Strengthening Logistic
management at State
41 Level 38.87
Strengthening Logistic
management at District
42 Level 69.9
43 Logistics for SPMSU 50
44 Model State Data Centre 9.84
45 Hospital based MIS 400 86.75
Procurement of
28.5
46 computer harware 15
Preparation of Hospital
Development Plan by
Facilities up to block
47 PHC/CHC(402 nos.) 23.42
During 09-
10, for
Data Centre at recurring
48 Secreteriate 6 expenses
Printing
guidelines,Referrence
49 material etc. 100
Includes
induction
training of
Block
Accountant
& data
Assistant;
Programme
Development of Quality Management
50 Assurance protocol 113.2 Cost
TOTAL 15 0 131.1 544.34 2454.39
Untied Funds, Annual Maintainence Grants and RKS fundsrelated matters
During 06-
07, as per
details
received in
Rogi Kalyan Samitis 250 530 39 respect of 21
DH, 9 SDH
and 136
Block
51 PHCs/CHCs
52 RKS DHH 160 160 160
RKS Area
53 Hospital/Other Hospital 34 120
54 RKS SDH 22 22 22
55 RKS CHC 348
315 1101
56 RKS PHC
57 Untied Fund for CHC 174.00 174
58 Untied Fund for PHC 320.5 290.50 174 290.50

32 Orissa
59 Untied Fund for SC 593 592.70 668.8 668.8 668.8
During 08-
09, formation
and
Untied Fund for VHSC 51.2 1425.84 3802.2 4752.8 registration
of VHSC in
remaining
60 villages
Annual Maintenance
61 Grant - CHC 231
During 09-
Annual Maintenance 10, for PHC
641 581.00 639.50
Grant -PHC (N) & Block
62 PHC.
Annual Maintenance
63 Grant- SC 62 254.2
TOTAL 593 1855.4 4200.14 5277 8413.8
Training & Capacity Building related matters
Training of AYUSH
22.45
64 Assistant
Exposure visit of GKS
6
65 members
Exposure visit SPMU &
10
66 DPMU persdonnel
Training of GKS
481.63
67 representatives
In 09-10, @
Bhatkumurda
Renovation of ANMTC , Ganjam;
Haladia,
68 27 Khurda.
During 08-
Exposure visit 09, for RKS
69 6 9 members
Refresher training of
RKS Office bearer @
70 Distt level (ToT) 3
One day orientation of
PHC(N), RKS office
71 bearers (2 members ) 25 3.05
TOTAL 0 0 66.45 526.68
Innovations related matters
72 Health Melas 168 168 168 168 Innovation
AYUSH Camps @
24
73 District level
During 09-
10,
Scholarship
for GNM and
Swasthya Sevika Yojana 137.19 54.34
B.Sc Nursing
.
During 08-
74 09, for GNM

33 Orissa
 course for
282 students

75 RKS Reward 3 3 Innovation

Drug Procurement
73.09
76 Logistic & Management
Sub-centre kit (Kit A +
Kit B) @Rs.6105 x
816.60
78 13376 kits
PHC kit @Rs.62136.03
79 x 1282 kits 796.58
CHC kit @Rs.64635.50
80 x 348 kits 224.93
First Referral Unit
(FRU) kit
1365
@Rs.220718.63 x 96 211.89
81 kits
Transportation of
NRHM Drugs @
Rs10,000 to 32 DHH
34.60
and 314 Block
82 PHC/CHC
Transportation of
NRHM Drugs from
Central Drug Store to 4.00
83 DHH Warehouse
Expenditure towards
Quality testing &
Establishment
1.72
Expenditure (Attendant
84 & Vehicle)
Internet, Telephone,
Stationaries @
Rs.3000/- per month x 12.60
85 35 units for 12 months
AMC of Computer,
UPS, Printer @
Rs.6000/- P.A. x 35 2.10
86 units
AMC of Computer,
UPS, Printer @
Rs.6000/- P.A. x 18 1.08
87 units
Computer consumables
88 & Stationaries 2.84
AMC & Repair of
Photocopier
1.00
89 Machines(2) nos
Equipmenst/Instruments
90 maintenance Cell 29.28
Maternal Health Drug
91 kits 2000 Procurement

34 Orissa
 Including
Iron, Vit A,
Zinc,
Albendazole
92 Child health drugs Kits 557.19 etc
Procurement of drugs
93 for IMNCI 134.4 Procurement
94 MTP Drugs 22.68 Procurement
95 Procurement Minilap set 9 Procurement
Procurement of NSV
96 kits 1 Procurement
Procurement of IUD Kit
97 for additional ANMs 8.6 Procurement
98 MVA Equip. 10 Procurement
99 Suction equipment 12.5 Procurement
Procurment of new Dhai
delivery kit & replenish
esssentials for Dhais
already given Kits in
100 previous years 5 Procurement
Procurement of
equipment for facility
based newborn care
Corner in 24X7
facilities: 95 (Existing)
+ 150 (New) (95 old
machine need to be
101 replaced) 245 procurement
102 Advocacy for NRHM 98.16 60.73 94.61
Award for Sustha
103 Panchayat 10
Additional funds for
136.83
104 Malaria
Additional Funds for
0.2
105 Chikunguniya
During 09-
10, for hand
compression
pump;
storage
facility –
State
/District
/Block;
procurement
of mosquito
106 Under NVBDCP 245.17 bed nets
TOTAL 1365 168 2376.11 603.04 3609.77

35 Orissa
 Districtwise Information on RCH indicators : Orissa

Mother received
Institutional
Districts at least one TT Full Vaccination Contraceptive Use
Deliveries
injection

India 73.5 47 69.6 54.1

Orissa 82.4 44.3 81.1 47
Angul 91.2 40.7 89.2 51.7
Balangir 100 52.1 76.6 38.8
Baleshwar 99.4 52.4 86.8 65.7
Bargarh 96.9 43.6 81.2 44.6
Baudh 99.2 28.7 80.9 32.4
Bhadrak 97.9 42.8 85.3 58.8
Cuttack 98 68.2 83.2 58.1
Debagarh 93.6 44.4 85.6 35.6
Dhenkanal 98.9 46.9 83.5 53.7
Gajapati 95.9 19.9 60.7 37.7
Ganjam 97.7 55.4 65.9 44.5
Jagatsinghpur 100 79.8 97 55
Jajapur 99.6 61.5 86.6 53.6
Jharsuguda 97.3 65.1 93.7 46.4
Kalahandi 97.3 65.1 68.3 46.4
Kendrapara 99.2 46.9 80.3 53.7
Kendujhar 96.8 34.3 75.7 48
Khandamal 99.1 25.3 83.4 32.3
Khordha 96.9 70.7 83 57.8
Koraput 97.3 81.8 44.5
Malkangiri 96.9 14.8 81.2 32.4
Mayurbhanj 99 43 82.9 49.8
Nabarangapur 99 15.9 78.7 33.4
Nayagarh 97.1 44.1 68 49.9
Nuapada 99.4 28.7 67.6 31.4
Puri 99.2 63.8 88.2 59
Rayagada 96.8 18.1 63.2 35.8
Sambalpur 98 56.6 86 44.4
Sonapur 99.1 41 91 33.7
Sundargarh 96.7 45.6 88.5 47.2
source DLHS-III

36 Orissa