RFD

(Results-Framework Document) For Department of Health and Family Welfare (2012-2013)

Section 1

DEPARTMENTS VISION, MISSION, OBJECTIVES AND FUNCTIONS

Vision:

To achieve acceptable standards of Health Care for the people of the country by the end of the 12th Five Year Plan.

Mission: 1. To ensure availability of quality healthcare on equitable, accessible and affordable basis across regions and communities with special focus on under-served population and marginalized groups. 2. To establish comprehensive primary healthcare delivery system and well functioning linkages with secondary and tertiary care health delivery system. 3. To Reduce Infant Mortality rate to less than 27 per 1000 live births and Maternal Mortality Ratio to less than 100 per 100,000 live births by 2017. 4. To reduce the incidence of communicable diseases and putting in place a strategy to reduce the burden of non-communicable diseases. 5. To ensure a reduction in the growth rate of population with a view to achieving population stabilization. 6. To develop the training capacity for providing human resources for health (medical, paramedical and managerial) with adequate skill mix at all levels. 7. To regulate health service delivery and promote rational use of pharmaceuticals in the country. 8. To provide quality Leprosy treatment services to all section of the population and achieve the target of less than 1 case per 10,000 population (Elimination) in all districts of the country & also reducing the burden of disability due to Leprosy during 12th plan period Objectives: 1. Universal access to primary health care services for all sections of society with effective linkages to secondary and tertiary health care. 2. Improving Maternal and Child health. 3. Focusing on population stabilization in the country. 4. Developing human resources for health to achieve health goals. 5. Reducing overall disease burden of the society. 6. Strengthening Secondary and Tertiary health care. Functions: 1. Policy formulation on issues relating to health and family welfare sectors. 2. Management of hospitals and other health institutions under the control of Department of Health and Family Welfare. 3. Extending support to states for strengthening their health care and family welfare system. 4. Reducing the burden of Communicable and Non-Communicable diseases. 5. Focusing on development of human resources through appropriate medical and public health education. 6. Providing regulatory framework for matters in the Concurrent List of the Constitution viz. medical, nursing and paramedical education, pharmaceuticals, etc. 7. Formulation of guidelines on issues relating to implementation of National Leprosy Elimination Programme & strengthening supervision and Monitoring support to States/UTs.

Section: 2

INTER SE PRIORITIES AMONG KEY OBJECTIVES, SUCCESS INDICATORS AND TARGETS

SECTION 2 - RESULTS- FRAMEWORK DOCUMENT (RFD) 2012-13 Sl. No . 1 1 Success Indicator Objective 2 Universal access to primary health care services for all sections of society with effective linkages to secondary and tertiary health care Weight Action Points 3 36.5 4 Strengthening of Health Infrastructure Success Indicator 5 Operationalisation of 24X7 Facility at PHC level Operationalisation of CHCs into First Referral Units (FRU) Equipping Districts with Mobile Medical Units Operationalisation of Patient Transportation Services Construction of New Sub Centre Building Establishment of Special New Born Care Units in District Hospitals Establishment of Stabilisation Units for new born in CHCs Establishment of New Born Care Corners in PHCs Constitution of new Village Health, Sanitation & Nutrition Committees (VHSNC) Holding Village Health & Nutrition Days Augmentation of Availability of Human Resources Capacity Building Deployment of new ANMs Deployment of new Doctors/Specialists Deployment of new Staff Nurses Deployment of new Paramedical staff ASHA Training (up to VI th & VIIth Module) Personnel trained on IMNCI Doctors trained on LSAS Doctors trained on EMoC ANMs/SNs/LHVs trained as SBA Navjat Shishu Suraksha Karyakram (NSSK) Unit 6 Number Number No.of districts Number Number Number Number Number Number Weight w (%) 7 4 3 2 3 2 1 1 1 1 10.96 8.22 5.48 8.22 5.48 2.74 2.74 2.74 2.74 Excellent 8 500 200 50 600 950 100 220 3300 30000 Very Good 9 450 180 45 550 900 90 200 3000 25000 Good 10 400 160 40 500 850 80 178 2670 20000 Fair 11 350 140 35 450 800 70 156 2340 Poor 12 300 120 30 400 750 60 134 2010

Strengthening of Community Involvement

18000 15000

Lakh Number Number Number Number Number Number Number Number Number Number

2 2 2 2 2 2 1.5 1 1 1 2

5.48 5.48 5.48 5.48 5.48 5.48 4.11 2.74 2.74 2.74 5.48

60 8000 1100 3000 2600 130000 22200 288 230 10400 16650

55 7200 1000 2500 2500 125000 20000 282 227 10250 15000

48 6400 900 2200 2400 11000 0 17800 268 216 9730 13350

42 5600 800 2000 2300 1000 00 1560 0 254 204 9220

36 4800 700 1800 2200 60000 13400 244 197 8880

11700 10050

SECTION 2 - RESULTS- FRAMEWORK DOCUMENT (RFD) 2012-13 Sl. No. 1 2 Objective 2 Improving Maternal & Child Health Weight 3 8.0 Action Points 4 Promote Institutional Deliveries Support through Janani Suraksha Yojana Tageting Full Immunisation (Age group of 0-12 months) Female Sterilisation Male Sterilisation Intra Uterine Device (IUD) Insertion Strengthening & Upgradation of Govt. Medical Colleges Setting up one National Institute of Para-medical Sciences(NIPS) and 8 Regional Institutes of Paramedical Scis (RIPS) Establishment of Nursing Institutes at various levels Revision of Medical education Curriculum Reduce incidence of Malaria cases Reduce incidence of Filariasis Reduce incidence of Kalaazar Success Indicator Success Indicator Unit 5 6 Institutional Deliveries as a % percentage of total deliveries JSY Beneficiaries (in Lakhs) Target Children immunised Female Sterilisation acceptors (in Lakhs) Male Sterilisation acceptors (in Lakhs) IUD Insertion (in Lakhs) Completion of Upgradation of identified Medical Colleges Commencement of Work for NIPS Commencement of Work for RIPS Number % Number Number Number Number Date Number Weight w (%) 7 3 2 3 2 2 2 4 1 1 1 1 1 2 0.5 0.5 1 37.50 25.00 37.50 33.33 33.33 33.33 44.44 11.11 11.11 11.11 11.11 11.11 12.90 3.23 3.23 6.45 Excellent 8 72 115.00 82 47.00 2.10 62.00 25 OCT. 31, 2012 6 27 28 11.11.20 12 1.20 90 55 475 Very Good 9 70 110.00 80 46.00 2.00 60.00 20 Good 10 67 104.50 76 43.70 1.90 57.00 16 Fair 11 66 99.00 72 41.40 1.80 56.00 12 Poor 12 65 95.37 69 39.88 1.73 55.00 10

Focusing on population stabilization in the country

6.0

Developing human resources for health to achieve health goals

9.0

NOV.30 DEC.31, JAN.31 FEB.28 ,2012 2012 ,2013 ,2013 5 25 25 31.12.2 012 1.30 85 50 450 3 20 20 31.01.2 013 1.52 80 45 400 2 15 15 28.02.2 013 1.67 75 40 380 1 3 10 31.03.2 013 1.80 70 35 285

Approval for DPRs for new ANM Number Schools Approval for DPRs for new Number GNM Schools Creating a Draft Curriculam Annual Parasite Incidence (API) Coverage of eligible people under Mass Drug Administration(MDA) Endemic Districts(250) achieving Micro Filaria rate of < 1 % BPHCs reporting less than 1 case of Kala-azar per 10000 population out of 514 such BPHCs Date
per 1000 population

Reducing overall disease burden of the society

15.5

% Number Number of BPHCs

SECTION 2 - RESULTS- FRAMEWORK DOCUMENT (RFD) 2012-13 Sl. No. 1 Objective 2 Weigh t 3 Action Points 4 Success Indicator Success Indicator Unit 5 6 Annual prevalence rate of < 10 Number of per Lakh population in High Districts burden Districts (209) Reconstructive Surgeries conducted New Sputum Positive (NSP) Success rate Control of Tuberculosis New Sputum Positive (NSP) case detection rate Detection and Putting on treatment MDR TB Cases. Cataract Surgeries performed (in Lakhs) Reduction in Prevalence of Blindness No. of spectacles to school children screened with refractive error (in Lakhs) Collection of donated eyes for corneal transplantation Strengthening facilities for diagnosis and treatment of cancer Development of District Cancer Facilities Strengthening of Tertiary Cancer Centres Number Weight w (%) 7 1 6.45 Excellent 8 70 Very Good 9 60 Good 10 50 Fair 11 45 Poor 12 40

Reduce incidence of Leprosy

0.5

3.23

3000

2700

2400

2100

1800

6.45

88.50%

88.00% 85.00% 75.00% 70.00%

6.45

74.50%

74.00% 67.00% 60.00% 52.00%

Number Number Number Number Number of Districts Number of Centres

0.5 0.5 0.5 0.5 0.5 1

3.23 3.23 3.23 3.23 3.23 6.45

10500 68 4 62000 75 5

10000 65 3.5 60000 70 4

9500 60 3.2 55000 65 3

9000 55 3 50000 60 2

8500 50 2.8 45000 50 1

SECTION 2 - RESULTS- FRAMEWORK DOCUMENT (RFD) 2012-13 Sl. No. 1 Objective 2 Weight 3 Action Points 4 Establishment of Tobacco Testing laboratories Success Indicator Success Indicator 5 Operationalization of Tobacco Testing labs for Nicotine and Tar Starting of Academic Session in Centres of Excellence Approval for starting up of PG courses in Mental Health Specialities Set up NCD Clinics and Cardiac Care Units in District Hospitals Screening of NCDs at CHCs and below initiated in Districts Operationalization of Geriatric OPD and 10 beds ward at District Hospitals Establishment of Regional Geriatric Centres 6 Strengthening Secondary and Tertiary health care 10.0 Setting up of AIIMS like Institutions (6 No.) commencement of Academic Session in Medical Colleges completion of construction work in Hospitals Upgraded facilities at Govt. Medical Colleges made functional Start of construction in Medical Colleges Unit 6 Number Weight w (%) 7 0.5 3.23 Excellent 8 6 Very Good 9 4 Good 10 3 Fair 11 2 Poor 12 1

Number

6.45

Ensure availability of minimum mental health care services

Number Number of districts Number of districts No. of Districts Number Number % Number

0.5

3.23

25

20

15

10

Opportunistic screening, diagnosis and management of Diabetes, Cardiovascular Diseases and Stroke

0.75

4.84

80

70

60

50

40

0.75

4.84

73

70

60

50

40

Provide Health Care to the Elderly Population

0.5

3.23

80

70

60

55

50

0.5 2.75 2.75 3

3.23 27.50 27.50 30.00

4 5 85 6

3 4 80 5

2 3 75 4

1 2 70 3

1 60 2

Upgradation of Govt. Medical colleges (8 No.) Upgradation of Govt. Medical colleges in II Phase (3 No.)

Number

1.5

15.00

MANDATORY SUCCESS INDICATORS RFD 2012-13

S. No. 1 1 Objective Actions Success Indicators Unit
Weight

2 Efficient functioning of the RFD System Administrative Reforms

4 Timely submission of draft for approval Timely submission of results Imp. mitigating strategies for reducing potential risk of corruption Imp. ISO 9001 as per the approved action plan Identify, design and impl. major innovations Implementation of Sevottam

6 7 Mandatory Success Indicators On-time submission Date 2% March 5, 2012 March 8, 2012

Excellent 100% 8

Target / Criteria value Very Good Good Fair 90% 80% 70% 9 10 11 March 9, 2012 March 10, 2012

Poor 60% 12 March 11, 2012 May 6, 2012 80

On-time submission % of implementation

Date %

1% 2%

May 1, 2012 100

May 3, 2012 95

May 4, 2012 902

May 5, 2012 85

Area of Operations covered

% Date %

2% 2% 2%

100 March 5, 2013 100

95 March 6, 2013 95

90 March 7, 2013 90

85 March 8, 2013 85

80 March 9, 2013 80

Improving Internal Efficiency / responsiveness/ service delivery of Ministry/ Deptt. 3 Ensuring compliance to the Financial Accountbilty Framework

Implementation of identified innovations Independent Audit of implementation of Citizen's Charter Independent Audit of implementation of public grievances redressal system Timely submission of ATNS Percentage of ATNs submitted on Audit Paras of CA&AG within due date (4 months) from the date of presentation of report to parliament by CAG during the year Timely submission of ATRs to Percentage of ATRs submitted the PAC Secretariat on PAC within due date (6 months) from Reports the date of presentation of report to parliament by PAC during the year Early disposal of pending Percentage of outstanding ATNs ATNs on Audit Paras of disposed off during the year C&AG Reports presented to Parliament before 31.3.12. Early disposal of pending Percentage of outstanding ATRs ATRs on PAC Reports disposed off during the year. presented to Parliament before 31.3.2012.

2%

100

95

90

85

80

0.5%

100

90

80

70

60

0.5%

100

90

80

70

60

0.5%

100

90

80

70

60

0.5%

100

90

80

70

60

Section: 3

TREND VALUES OF SUCCESS INDICATORS

SECTION 3
Sl. No. 1 1 Objective Weight Action Points

TREND VALUE FOR SUCCESS INDICATORS RFD 2012-2013

Success Indicators Actual value Unit 5 Number Number No.of districts Number Number Number Number 200910 7 1128 114 53 NA NA 95 265 Actual value 201011 6 1100 660 150 NA NA 65 280 Actual value (Anticipated) 2011-12 7 800 450 90 500 900 72 315 Projected value 2012-13 8 450 180 45 550 900 90 200 Projected value 2013-14 9 450 180 45 550 900 90 200 Projected value 2014-15 10 450 180

Success Indicator 2 Universal access to primary health care services for all sections of society with effective linkages to secondary and tertiary health care 36.5 3 Strengthening of Health Infrastructure 4 Operationalisation of 24X7 Facility at PHC level Operationalisation of CHCs into First Referral Units (FRU) Equipping Districts with Mobile Medical Units Operationalisation of Patient Transportation Services Construction of New Sub Centre Building Establishment of Special New Born Care Units in District Hospitals Establishment of Stabilisation Units for new born in CHCs Establishment of New Born Care Corners in PHCs Strengthening of Community Involvement Constitution of new Village Health, Sanitation & Nutrition Committees (VHSNC) Holding Village Health & Nutrition Days Augmentation of Availability of Human Resources Deployment of new ANMs Deployment of new Doctors/Specialists Deployment of new Staff Nurses Deployment of new Paramedical staff

45 550 900 90 200

Number

1200 1622

1100

1080

3000

3000

3000

Number

25000

25000

25000

Lakh Number Number Number Number

54.8 8514 2196 2430 12010

68 8000 3600 9000 5000

55 7200 1000 2500 2000

55 7200 1000 2500 2500

55 7200 1000 2500 2500

55 7200 1000 2500 2500

SECTION 3
Sl. No. 1 Objective Weight Action Points

TREND VALUE FOR SUCCESS INDICATORS RFD 2012-2013

Success Indicators Actual value Unit 5 Number Number Number Number Number Number % Number 200910 7 243354 58105 230 110 9500 NA 52 92.29 Actual value 201011 6 200000 50000 260 156 10000 24000 55 103 Actual value (Anticipated) 2011-12 7 100000 45000 180 135 8100 12000 60 105 Projected value 2012-13 8 125000 20000 282 227 10250 16650 70 110 Projected value 2013-14 9 125000 20000 282 227 10250 15000 70 110 Projected value 2014-15 10 125000 20000 282 227 10250 15000 70 110

Success Indicator 2 3 Capacity Building 4 ASHA Training (up to VI th & VIIth Module Personnel trained on IMNCI Doctors trained on LSAS Doctors trained on EMoC ANMs/SNs/LHVs trained as SBA Navjat Shishu Suraksha Karyakram (NSSK) 2 Improving Maternal & Child Health 8.0 Promote Institutional Deliveries Support through Janani Suraksha Yojana Tageting Full Immunisation (Age group of 0-12 month) Female Sterilisation Male Sterilisation Intra Uterine Device (IUD) Insertion Strengthening & Upgradation of Govt. Medical Colleges Setting up one National Institute of Para-medical Sciences(NIPS) and Regional Institutes of Paramedical Scis. Establishment of Nursing Institutes at various levels Revision of Medical Education Curriculum Institutional Deliveries JSY Beneficiaries (in lakhs)

Target Children immunised Female Sterilisation (in Lakhs) Male Sterilisation (in Lakhs) IUD Insertion (in lakhs) Completion of Upgradation of identified Medical Colleges Commencement of Work for NIPS

% Number Number Number Number Date

61 47.4 2.71 57.64 Nil Nil

71.4 46 2.60 55.00 40 Nil

70 50.00 3.00 60.00 30 Dec., 31, 2011 4 12 31 -

80 46 2.00 60.00 20 Nov, 30,2012 5 25 25 31.12.2012

80 46 2.00 60.00 20 -

80 46 2 60 20 -

Focusing on population stabilization in the country Developing human resources for health to achieve health goals

6.0

9.0

Commencement of Work for RIPS Approval for DPRs for new ANM Schools Approval for DPRs for new GNM Schools Creation of Draft Curriculum

No. Number Number Date

Nil Nil Nil

Nil 54 54 -

5 25 25 -

5 25 25 -

SECTION 3
Sl. No. 1 5 Objective Weight Action Points

TREND VALUE FOR SUCCESS INDICATORS RFD 2012-2013

Success Indicators Actual value Unit 5 per 1000 population % Number No. of BPHCs No. of districts Number % % Number Number lakh Number 59.06 5.06 46589 319 200910 7 1.4 86.7 Actual value 201011 6 1.4 84.1 355 Actual value (Anticipated) 2011-12 7 1.1 86.3 393 Projected value 2012-13 8 1.3 85 50 450 Projected value 2013-14 9 1.3 85 50 450 Projected value 2014-15 10 1.3 85 50 450

Success Indicator 2 Reducing overall disease burden of the society 3 15.5 To reduce incidence of Malaria cases Reduce incidence of Filariasis 4 Annual Parasite Incidence (API) Coverage of eligible people under Mass Drug Administration (MDA) Endemic districts(250) achieving Micro Filaria rate of < 1% BPHCs reporting less than 1 case of Kala-azar per 10000 population out of 514 BPHCs Annual prevelence rate of < 10 per lakh population in high burdon districts (209) Reconstructive Surgeries performed New Sputum Positive (NSP) Success rate New Sputum Positive (NSP) case detection rate Detection and putting on treatment MDR TB cases. Cataract Surgeries performed (in Lakhs) Reduction in Prevalence of Blindness No. of spectacles to school children screened with refractive error Collection of donated eyes for corneal transplantation

Reduce incidence of Kala-azar

Reduce incidence of Leprosy

10.93 2856 87.0% 71.0%

2570 88.0% 71.0% 60 3 40000

3200 88.0% 74.0% 65 3 60000

60 2700 88.0% 74.0% 10000 65 3.5 60000

60 2700 88.0% 74.0% 10000 65 3.5 60000

60 2700 88.0% 74.0% 10000 65 3.5 60000

Control of Tuberculosis

SECTION 3
Sl. No. 1 Objective Weight Action Points

TREND VALUE FOR SUCCESS INDICATORS RFD 2012-2013

Success Indicators Actual value Unit 5 Number of Districts Number of Centres Number Number Number Number of districts Number of districts No. of Districts No Number % Number 200910 7 Nil Nil Nil 7 19 Actual value 201011 6 30 45 Nil 3 4 Actual value (Anticipated) 2011-12 7 70 6 4 1 36 Projected value 2012-13 8 70 4 4 3 32 Projected value 2013-14 9 70 4 4 3 32 Projected value 2014-15 10 70 4 4 3 32

Success Indicator 2 3 Strengthening facilities for diagnosis and treatment of cancer Establishment of Tobacco Testing laboratories Ensure availability of minimum mental health care services 4 Development of District Cancer Facilities Strengthening of Tertiary Cancer Centres Operationalization of Tobacco Testing labs for Nicotine & Tar Starting of Academic session in Centres of Excellence Approval for starting up of PG courses in Mental Health Specialities Opportunistic screening, diagnosis and management of Diabetes, Cardiovascular Diseases and Stroke Set up NCD Clinics and Cardiac Care Units in District Hospitals Screening of NCDs at CHCs and below initiated in Districts Operationalisation of Geriatric OPD and 10 Beds ward at District Hospitals Establishment of Regional Geriatric Centres commencement of Academic session in Medical Colleges completion of construction work in Hospitals Upgraded facilities at Govt. Medical Colleges made functional Start of construction in Medical Colleges

Nil

30

70

70

70

70

Nil

30

70

70

70

70

Provide Health Care to the Elderly Population 6 Strengthening Seconday and Tertiary health care 10.0

Nil Nil Nil Nil Nil

Nil Nil 15 5

70 8 50 7

70 3 4 80 5

70 3 4 80 5

70 3 4 89 5

Setting up of AIIMS like Institutions (6 Nos.) Upgradation of Govt. Medical colleges (8Nos) Upgradation of Govt. Medical colleges in II Phase (3 Nos)

Number

Nil

Nil

Section: 4

DESCRIPTION AND DEFINITION OF SUCCESS INDICATORS AND PROPOSED MEASUREMENT METHODLOGY

Operationalisation of 24 x 7 facility at PHC level

To ensure round the clock access to public health facilities, Primary Health Centres are expected to provide 24-hour service in basic Obstetric and Nursing facilities. Under NRHM, PHCs are being operationalized for providing 24X7 services in a phased manner by placing at least 1-2 Medical Officers and more than 3 Staff Nurses in these facilities. All 24x7 PHCs, providing delivery services, would also have newborn care corners and provide basic new born care services including resuscitation, prevention of infections, provision of warmth and early and exclusively breast feeding. State will take due precaution to fulfill all critical & most desirable criteria as per GOI guidelines while upgrading these PHCs along with facilities for ENBC. All these PHCs have delivery facility, operation theatre & ambulance services.

First Referral Units (FRUs)

Upgradation of District Hospitals, Sub District Hospitals and Community Health Centres as First referral Units is being attempted to provide for Comprehensive Obstetric Care for Women and Acute Respiratory Infection (ARI) treatment for children. It requires holistic planning by linking Human Resources, Blood Storage Centers (BSCs) and other logistics. The definition of FRU includes the following three components. Essential Obstetric Care Provision of Blood Storage Unit New Born Care Services

During 2012-13, the focus is on functionality and ensuring that threshold levels of physical infrastructure and associated human resources are in place for functioning of the 24x7 services at optimum levels. Therefore rather than having large numbers of 27x7 services functioning at sub-optional levels, focus is on functional consideration and targets for 2012-13 have set keeping in view the functionality focus.

FRU Guidelines could be refer to, if necessary.

2.

Mobile Medical Units (MMU)

The main objective is to provide basic healthcare facilities in remote, far-flung hilly and tribal areas through the use of Mobile Medical Units. As a first step, it is envisaged to have one MMU in all the districts in the country. Mobile Medical Units have been constituted with 1 Medical Officers and vehicle. The Medical officer visits each and every village and hamlet to identified malnourished and seek children and provide medical services at their homes. If required the child is referred to nearest health center. He also examines pregnant and lactating mothers and other people and provide them medical care Similarly activities such as collection of Water samples, Visits to Ashram Schools are carried out.

3. Patient Transport Services:

. It has been observed that most of the times due to delay in reaching health care facility like FRU, 24x7 PHCs, Secondary or Tertiary centers, mothers are deprived of emergency obstetric care resulting in maternal death, still birth and neonatal deaths. The main objective is to prevent all these complications, it is important that mothers should be referred to the health care facility on time as due to lack of money they avoid going to centers at distant place and because of delay in reaching appropriate center for proper treatment they fall prey to death.

As per the statistical data available, about 10% of Critically ill Children are high risk requiring urgent care by specialist either at FRU or District Hospital or Tertiary level hospitals. Many such cases dies for want of referral transport and special services, hence, it is essential to shift such cases as early as possible to avoid the Child morbidity and mortality. For speedy & effective transfer of ill children to referral higher center a provision of a special hired vehicle on 24x7 hrs. services is provided in each block at selected RH/SDH level and call center will be established at district place to inform the driver of vehicle so as the patient will be transferred to the necessary referral center

4 . Special New Born Child Care units (SNCU)

These are specialised new born and sick child care units at district hospitals with specialised equipments, which include phototherapy unit, oxygen hoods, infusion pumps, radiant warmer, Laryngoscope and ET tubes, nasal cannulas Bag and mask, and weighing scale. These units have a minimum of 12 to 16 beds with a staff of 3 physicians, 10 nurses, and 4 support staff to provide round the clock services for a new born or child requiring special care such as managing newborn with neonatal sepsis and child with pneumonia, dehydration, etc., prevention of hypothermia, prevention of infection, early initiation and exclusive breast feeding, post-natal care, immunisation and referral services.

Stabilisation units (SU)

Stabilisation Units are meant for providing facilities for newborn babies and children referred by the peripheral units (Primary Health centres) so that the babies can be stabilised through effective care. These are being set up in Community Health Centre (CHCs) / First Referral Units (FRUs). These units provide services, which include resuscitation, provision of warmth, early initiation of breast feeding, prevention of infection and cord care, supporting care including oxygen, Intra Venous (IV) fluids, provision for monitoring of vital signs including blood pressure and referral services. These units have specialised equipments, which include open care system (radiant warmer), laryngoscope, weighing scale and suction machine.

6. New born baby corners

These are special corners within the labour room where support for effective management of a newborn is provided. The services include resuscitation, provision of warmth and prevention of infection, cord care and early initiation of breast-feeding. The equipments at newborn care corners include Weighing scale, radiant warmer, suction machine and mucus sucker.

7. Life Saving Anaesthetic Skills (LSAS)

To increase trained manpower for provision of services during Emergency Obstetric situation, Medical Officers are trained in Life Saving Anaesthetic Skills (LSAS), so that more doctors are able to provide emergency obstetric care services at the designated FRU/CHCs.

8. Rogi Kalyan Samitis (RKS)

For effective community management of public health facilities/Institutions, Hospital Development Committees / Rogi Kalyan Samitis [RKS] are constituted at the PHC / CHC/ District Hospital level. It comprises members from Panchayati Raj Institutions, civil society and representatives from public hospital. Untied grants are provided to RKS at various levels i.e. PHC /CHC/District level to carry out activities considered essential for improving services delivery. RKS is also authorized to retain the user fees at the institutional level for meeting the day-to-day needs of the institutions.

9.

Village Health and Sanitation Committee (VHSC)

VHSC is expected to prepare village level health action plan. It comprises Panchayat president / member, representative from civil society, Anganwadi Worker (AWW) and Auxiliary Nurse Midwife (ANM). To encourage Panchayats to constitute VHSCs, untied grants are given through NRHM. These grants are used to meet local health needs of the villages, including maintenance needs of the Sub centres.

10.

Integrated District Action Plan

The objective of the District Action Plan is to identify the gaps and identify health requirements of the district through local level planning. The district plan would be an aggregation of block /village plans. These plans would cover health as well as other determinants of health like nutrition, drinking water, sanitation, etc.

11.

Accredited Social Health Activist (ASHA)

The Accredited Social Health Activist (ASHA) is the essential link between the community and the health facility. A trained female community health worker ASHA is being provided in each village in the ratio of one per 1000 population. For tribal, hilly, desert areas, the norms are relaxed for one ASHA per habitation depending on the workload. ASHAs are involved in doorstep delivery of contraceptives which has been welcomed by the communities and are involved in delivery of sanitary napkins to females in reproductive age group along-with Home based New born care by being trained in the 6th and 7th module.

12.

Contractual Appointments

To overcome shortage of manpower in management of health facilities, NRHM provides additional manpower in the form of contractual staff to health facilities at various levels. For Sub-centre, NRHM provides Auxiliary Nurse Mid-wives (ANMs), Staff Nurses at PHCs to ensure round the clock services. Similarly, contractual appointment of doctors /specialists, paramedical staff is being made to meet the requirement of states as per NRHM norms. States have given flexibility for recruitment of contractual manpower including specialists.

13.

Integrated Management of Neonatal and Childhood Illness (IMNCI)

Integrated Management of Childhood and Neonatal Illness (IMNCI) strategy encompasses a range of interventions to prevent and manage five major childhood illnesses i.e. Acute Respiratory Infections, Diarrhoea, Measles, Malaria and Malnutrition and the major causes of neonatal mortality, i.e. prematurity, and sepsis. In addition, IMNCI teaches about nutrition including breastfeeding promotion, complementary feeding and micronutrients.

14. Navjaat Shishu Suraksha Karyakram (NSSK)

Care at birth i.e. prevention of hypothermia, prevention of infection, early initiation of breastfeeding and basic newborn resuscitation are important for any neonatal programme. The objective of this new initiative is to have one person trained in basic newborn care and resuscitation at every delivery. The training package is based on the latest available scientific evidence. The training is for 2 days and is expected to reduce neonatal mortality significantly in the country.

15. Facility based Integrated Management of Neonatal and Childhood Illness (F-IMNCI)
F-IMNCI is the integration of the Facility based Care package with the IMNCI package, to empower the Health personnel with the skills to manage new born and childhood illness at the community level as well as the facility. Facility based care IMNCI focuses on providing appropriate inpatient management of the major causes of Neonatal and Childhood mortality such as asphyxia, sepsis, low birth weight in neonates and pneumonia, diarrhoea, malaria, meningitis, severe malnutrition in children. The interventions in the training manuals are based on the latest available scientific evidence and the manuals will be updated as new information is acquired. The training is for 11 days. The long-term program needs for new born & child care will be met by the health personnel and workers possessing the optimum skills (F-IMNCI) for managing newborn and children both at the community level as well as the facility level.

a.

Emergency Obstetric Care (EMOC)

Medical Officers are being trained in Obstetric Care and skills including Caesarean Section (EmOC Training), so as to make more doctors available to provide Emergency Obstetric Care Services at the designated FRU/CHCs.

b.

Institutional Deliveries

Institutional Deliveries include the deliveries in the following categories of health facilities: c. Hospitals Dispensaries / Clinics UHC/UHP/UFWC CHC/ Rural Hospital PHC Sub Centre AYUSH Hospital/ Clinic Janani Suraksha Yojana (JSY)

Janani Suraksha Yojana is a safe motherhood intervention under the NRHM being implemented with the objective of reducing maternal and neo-natal mortality by promoting institutional deliveries. Under this scheme, cash incentives are provided to the beneficiary as well as village link worker / ASHA to come to the institution for delivery and also the cost of transportation. Besides this Janani Shishu Suraksha Karyakram (JSSK) has also been launched on 1st June 2011 to provide completely free and cashless services to pregnant women including normal deliveries and caesarean operations and sick new born (up to 30 days after birth) in Government health institutions in both rural & urban areas. Sick Neonatal Care Unit, New Born Baby Corners; Stabilization Units are being operationalized in the health facilities.

d. i) Malaria:

Vector Borne Diseases

The following indicators are used for assessment of Malaria: a. Surveillance Annual Blood Examination Rate (ABER): Percentage of total no of slides

examined annually out of total population under surveillance. This is calculated as:

Number of Slide Examined in the Year --------------------------------------------- X 100 Population under surveillance b. Incidence of Malaria Annual Parasite Incidence (API) : Confirmed Malaria Cases annually per 1000 population under surveillance. This is calculated as : Number of confirmed malaria cases in the Year -------------------------------------------------------- X 1000 Population under surveillance
ii)

Kala azar

The indicator used for Kala-azar detection is annual new case detection of Kala-azar per 10,000 population. Number of Kala-azar cases in the Year -------------------------------------------------------Kala-azar Endemic Population iii) Filaria X 10000

The indicator for elimination of Lymphatic Filarisis is the coverage of eligible people under Mass Drug Administration (MDA) This is calculated as : Number of people administered with anti-filarial drugs during MDA ---------------------------------------------------------------------------------- X 100 Eligible population at the risk of filaria e. Leprosy: Annual New Case Detection Rate (ANCDR) Number of new cases detected during the year --------------------------------------------------- X 100000 Population as on 31st March

f.

Tuberculosis

The term case detection denotes that TB is diagnosed in a patient and is reported within the national surveillance system. Smear-positive is defined as a case of TB where Mycobacterium tuberculosis bacilli are visible in the patients sputum when properly stained and examined under the microscope.

New Case denotes a patient who has never taken TB treatment in the past or has taken anti TB treatment, but for less than 1 month.

New Smear positive case detection rate is calculated by dividing the number of new smear positive cases notified in the specific cohort (quarter/year) by the estimated number of new smear positive cases in the population for the same quarter/year expressed as a percentage.

The term new smear positive treatment success rate denote the proportion of new smear positive TB cases cured or treatment completed to the total number of new smear positive TB cases registered in the specific cohort (quarter/year). g. District Mental Health Programme (DMHP)

The main objective of DMHP is to provide basic mental health services to community & to integrate these with general health services. It envisages a community based approach to the problem, which includes:

Provide service for early detection & treatment of mental illness in the community

(OPD/Indoor & follow up). Training of mental health team at identified nodal institutions. Increase awareness & reduce stigma related to Mental Health problems.

LIST OF ABBREVIATIONS Sl.No. 1 2 3 4 5 6 7 8 9 10 ABER ACDR ANM API ART ASHA AWW AYUSH BPHCs BSS Annual Blood Examination Rate Annual Case Detection Rate Auxiliary Nurse Midwife Annual Parasite Incidence Anti Retroviral Therapy Accredited Social Health Activist Anganwadi Worker Ayurveda Yoga-Naturopathy Unani Siddha & Homoeopathy Block Primary Health Centres Behaviour Surveillance Survey

11 12 13 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56

CCEA CGHS CHC DHF DLHS DOTS DPMR DPMU EFC ELF ELISA EMoC EPW FRU FMG GNM HIV/AIDS ICMR ICTCs IDSP IEC IFPS IMNCI IMR IT IUD JSY JE LHV LSAS MDA MPW MBA MDR-TB MIS MMR MMU MO MOU NACO NCD NCMP NEIGRIMS NFHS

Cabinet Committee on Economic Affairs Central Government Health Scheme Community Health Centre Dengue Hemorrhagic Fever District Level Household Survey Directly Observed Treatment Short course Disability Prevention and Medical Rehabilitation District Programme Management Unit Expenditure Finance Committee Elimination of Lymphatic Filariasis Enzyme - linked Immunosorbent Assay Emergency Obstetric Care Empowered Procurement Wing First Referral Unit Financial Management Group General Nursing and Midwifery Human Immuno Deficiency Virus/ Acquired Immuno Deficiency Syndrome Indian Council of Medical Research Integrated Counseling and Testing Centre Integrated Disease Surveillance Project Information, Education & Communication Innovations in Family Planning Service Integrated Management of Neonatal & Childhood Illness Infant Mortality Rate Information Technology Intra Uterine Devices Janani Suraksha Yojana Japanese Encephalitis Lady Health Visitor Life Saving Anaesthetic Skills Mass Drug Administration Multi Purpose Health Worker Management Business Administration Multi Drug Resistance - Tuberculosis Management Information System Maternal Mortality Ratio Mobile Medical Unit Medical Officer Memorandum of Understanding National AIDS Control Organization Non Communicable Diseases National Common Minimum Programme Institute of Health & Medical Science for the North Eastern Region National family Health Survey

57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93

NGO NHP NHRC NIC NID NIPS NLEP NPCB NRHM NSV NVBDCP PHC PIP PMSSY PPP PR PRI RCH RHRC RKS RNTCP SBA SC SHRC SNID SNs SOE SPMU SRS TB TFR TI UC UHC UHP UFWC VHSC

Non-Government Organization National Health Policy National Health Resource Centre National Informatics Centre National Immunization Days National Institute of Paramedical Sciences National Leprosy Eradication Programme National Programme for Control of Blindness National Rural Health Mission Non Scalpel Vasectomy National Vector Borne Disease Control Programme Primary Health Centre Project Implementation Plan Pradhan Mantri Swasthya Suraksha Yojana Public Private Partnership Prevalence Rate Panchayati Raj Institutions Reproductive & Child Health Regional Health Resource Centre Rogi Kalyan Samiti Revised National Tuberculosis Control Programme Skilled Birth Attendant Sub Centre State Health Resource Centre Sub National Immunization Days Staff Nurses Statement of Expenditure State Programme Management Unit Sample Registration System Tuberculosis Total Fertility Rate Targeted Interventions Utilization Certificate Urban Health Centre Urban Health Post Urban Family Welfare Centre Village Health & Sanitation Committee

Section: 5

SPECIFIC PERFORMANCE REQUIREMENTS FROM OTHER DEPARTMENTS

Section-5 Specific Performance Requirements from other Departments

Department / Ministries Relevant Success indicator What do you need? Why do you need it? How much you need ? What happens if you do not get it ?
It would hamper the achievement of National targets and programme outcomes.

Panchayati Raj Women & Child, HRD, Drinking Water Sanitation Tribal Affairs, Home, Defence, Youth affairs AIDS Control, AYUSH, Health Research, Medical Council of India, Dental Council of India, Pharmacy Council of India, Indian Nursing Council All State Governments

Guide To Full support Numbers of persons strengthen lines for and trained under mainthe incorporating commitment. streaming training. national various response to Increasing scope & Health & promote coverage of programmes Family health care of the Welfare of fellow schemes and Departments/institutions citizens. to promote quality of life training programmes, impacting health care of Const citizens of this country. ant Numbers of persons monitoring trained for providing to promote health services (medical, quality paramedical & Health & Family managerial) with adequate welfare skill mix at all levels . services in the country.

100% commi- The progress Number of persons Implement- To of enhance tment & provided quality ation and implementatithe quality timely support for healthcare services with on will slow of life of reporting effective special focus on under- the progress fellow down implemavailability of served and marginalized- of various citizens in entation with quality the group. Health & constant healthcare on country family monito-ring. Number of comprehensive equitable with welfare accessible and primary healthcare thrust on programme affordable delivery system health s and basis across established & their wellregions & care. outcomes. communities functioning linkages with with special secondary & tertiary care focus on health delivery system. under-served population & Majority Health related marginalized parameters.
groups.

Section: 6

Outcome/Impact of Department/Ministry

SECTION 6- OUTCOME /IMPACT OF ACTIVITIES OF THE MINISTRY/DEPARTMENT

Department of Helath & Family Welfare 2012-2013

Sr. No.
1

Outcome/Impact of Ministry/Department
Improved access to health care services

Jointly with

Success Indicator

Unit

2010-11

2011-12

2012-13

2013-14

2014-15

States/UTs Average number of primary health care centres per 1000 population. Average number of primary health care centres per district

Number

0.0201

0.0201

0.020

0.0199

0.0199

Number
Per 1000 live births Per 1000 population

36.99 47 7.2 78.5 89.3 2.5 1.10 (Provisional) 88 0.074

36.99 43 7.1 79.0 70.0 2.4

37.45 39 7.0 80.0 80.0 2.4

37.89 35 7.0 81.0 80.0 2.4

37.89 35 7.0 81.0 80.0 2.4

Reduction in Mortality Rate

States/UTs

Infant mortality rate Crude death rate

Improvement in Maternal Health

States/UTs

Institutional Deliveries as a % of Total deliveries Full Immunization (age group 0-12 Month)

% %
children born per woman Per 1000 population

Reduction in growth rate of population Reduction in the burden of communicable and non communicable diseases

States/UTs Total Fertility Rate States/UTs Annual Parasite Incidence (Malaria) New Sputum positive (NSP) Success rate

1.30 90 0.075

1.30 92 0.076

1.30 92 0.076

1.30 92 0.076

% Number

Development of human resources

States/UTs Number of doctors per 1000 population

Note: The indicator Infant Mortality Rate (IMR)- Point decline over per 1000 live births The indicator Crude death rate - Point decline over per 1000 population