Karnataka Health Systems Development Project
Item
- Title
- Karnataka Health Systems Development Project
- extracted text
-
4
Karnataka Health Systems Development Project
Notes for the
World Bank Review Mission
Visiting Bangalore
on March 8 to 11,1997
03/07/97/Let Mar
Contents
Page Nos.
1
Financial performance of KHSDP upto January, 1996,
and anticipated expenditure upto March 31, 1997.
1 to 7
2
Health Sector Development Policy Programme in
Karnataka
8 to 10
3
Procurement of Civil Works
11 to 24
4
A brief note on the installation of Blood Banks
25 to 26
5 ^Training Components of KHSDP
27 to 30
6 - Note on Procurement Activities
31 to 44
7 ^ Activities of Strategic Planning Cell of KHSDP
45 to 48
8
Hospitals Management
49 to53
9
Access to Disadvantaged Sections
54 to 58
10
Improvement of Access to Health Services for Women
59 to 64
11 "Hospitals Based Quality Assurance Programme
12
Proposal for Setting up Equipment Maintenance
Facilities
65 to 72
73 to 79
Financial performance of KHSDP upto January, 1996,
and anticipated expenditure upto March 31,1997
The Project activities should have started from 1st of April 1996. However, the launching
of the project itself was delayed by nearly 3 months. After the launching, finding of office
accommodation took two months hence in the beginning, for nearly 5 months activities could not
start. There are various components under which expenditure should have been booked as
provided in the S.A.R. The Component wise provision during the financial year 1996-97, the
expenditure incurred upto December, 1996 and the probable expenditure by 31st March is
discussed as detailed below:
INVESTMENT COSTS:
1. Civil works renovation: An amount of Rs. 9.06 crores is provided for the year 1996-97 as in
S.A.R. No expenditure is booked under this head as the civil works are yet to commence.
There are 47 hospitals in 1st phase of the project. Each hospital is considered as a work and a
comprehensive estimate is prepared covering renovation, hospital and staff quarters. Works
are yet to start, no expenditure is booked upto January, 1996 and it is also not possible to
make any expenditure under this head as for 15 works tenders are floated only in the last
week of February, 1997.
2. Civil works extension: An amount of Rs. 28.63 crores is provided for the year, 1996-97 Upto
December, 1996, no expenditure is booked under this head as the civil works as explained
above are yet to start. However, as approved by the Project Governing Board, extension work
to the existing food laboratory building behind the Public Health Institute to accommodate the
Staff of the project is started. As the work is already in progress, it is anticipated that an
amount of Rs. 15 lakhs will be spent by March end, 1997.
T
3. Professional Services: An amount of Rs. 3.5 crores is provided for the year, 1996-97 as in
S.A.R. This amount is provided in the project to meet the expenditure towards payment of
professional fee for the work done by persons like private architects, etc. engaged by the
project office. So far 30 architects have been empanalled by the project office to finalise the
drawings of 150 hospital works. An amount of Rs. 8.7 lakhs is paid to these architects so far
and it is expected that another Rs. 9.5 lakhs will be spent by 31st March, 1997. As only an
advanced payment is made in most of the cases, the expenditure incurred under this head is
less compared to the amount available. However, in the first quarter of the financial year,
1997-98, the expenditure under this item will increase as in majority of the works, sufficient
progress will be made in finalising preliminary drawings and final drawings.
4. Furniture: An amount of Rs. 31 lakhs is provided for the year, 1996-97 as in S.A.R. This
amount is provided to meet the expenditure incurred towards providing furniture to the
hospitals included in the first phase of procurement plan and also for providing furniture to the
project office. The furniture to the hospitals forms part of the National Competitive Bidding
Process and the document for NCB is already approved by the World Bank. In the beginning,
as importance was first given to float tenders for purchase of hospital equipment, the tender is
03/06/97, Note-fm-stt
1
as importance was first given to float tenders for purchase of hospital equipment, the tender is
yet to be floated for furniture. This tender will be issued in the first quarter of financial year,
1997 clubbing the requirements of the first phase and the second phase as in the procurement
plan. However, an amount of Rs. 7.4 lakhs is already spent to purchase furniture required to
the project office. An amount of Rs. 7.6 lakhs is likely to be spent before 31st March, 1997 to
provide furniture to the officers of the Additional Directors and the remaining officers posted
to the project. This expenditure is booked following the procedure of local shopping as
provided in the project.
5. Equipment (Medical): No amount is provided under this head for the year, 1996-97.
6. Equipment (Others): An amount of Rs. 3.28 crores is provided for the year, 1996-97 as in
S.A.R. This amount is provided to procure the hospital equipment including the Bio-medical
equipment as in the procurement plan. Out of 149 packages, most of the packages of
procurement are under National Competitive Bidding, except 6 packages which are under
International Competitive Bidding. The procurement of equipment for the first two phases of
the procurement plan is clubbed and the Bank has already cleared the bid documents and the
technical specifications. So far for more than 90 packages both under NCB and ICB the
tenders are floated. The evaluation in respect of 31 packages is completed and 49 packages is
under progress. The subject will be finalised by 15th of March, 1997. Therefore, most of the
expenditure will come in first two quarters of the financial year 1997-98 as the time of
delivery of equipment as per the terms and conditions of the bidding document varies from 60
to 120 days. So far an amount of Rs. 10.2 lakhs is spent under this head to procure the
equipment required for project office following the local shopping norms. It is anticipated that
as an advance payment to the successful bidders of the packages which are already cleared
under NCB by Steering Committee and also for the Blood Bank equipment, it is expected that
an amount of Rs. 1 crore will be spent by March end, 1997.
7. Vehicles: An amount of Rs. 91 lakhs is provided for the year, 1996-97 as in S.A.R. So far an
amount of Rs. 24.6 lakhs is spent under the local shopping norms for procurement of vehicles
required to the project office. Under this component, the vehicles for Taluka Medical Officers,
the District Surgeons, ambulances and the vehicles required to the engineering wing and
surveillance wing are also to be procured. The procurement is under ICB norms and the
tender document is cleared by the World Bank in February 2nd week. Here also the
procurement of the vehicles by the first two phases is clubbed and it is also likely that the
remaining expenditure under this component will be possible only in the second quarter of the
financial year, 1997-98.
8. Medical Lab Supplies: An amount of Rs. 50 lakhs is provided for the year, 1996-97 as in
S.A.R. Under this component the procurement of equipment to the laboratories of the
surveillance wing, pathology lab, etc., are included. For some of the equipment, the bids are
already in the final stages and it is expected that an amount of Rs. 3.5 lakhs will be paid as
advance amount to the successful bidders by March, 1997. Major portion of the expenditure
will be booked in the first quarter of 1997-98.
03/03/97, Note-fm-stt
2
9. Medicines: An amount of Rs. 1 crore and 25 lakhs is provided for the year, 1996-97 as in
S.A.R. So far no expenditure is booked under this head. There are 3 components under this
head for procurement as follows:
(i) The medicines required for the additional beds created under the project;
(ii) Medicines required for Women’s Health Care Programme;
(iii) Medicines required under Yellow Card Scheme;
Medicine required for the first component cannot be procured as the additional beds have
not been created so far. As regards item (2) and (3). Action has been taken to accord sanction
procurement of medicines worth Rs. 81.55 lakhs for Women Health care programme and those
of Rs. 31.99 lakhs for SC/ST population health check up camp (Yellow Card) in five districts
10. Other Supplies: An amount of Rs. 58 lakhs is provided for the year, 1996-97 as in S.A.R.
This includes the items like Workshop equipment incinerators, computers, typewriters,
photocopiers and fax machines to the hospitals. For procurement of incinerators which is
under ICB, the bid document was finalised, but the IFB was not issued as there is an
instruction from the Central Pollution Control Board not to install the incinerators till the
standards are finalised by the Board. Regarding the computers, the agency which was
entrusted with the study of feasibility report have given the draft report which is discussed and
suggestions are given before a final report is given by them. Based on this, the configuration
of computers will have to be finalised. The typewriters, photocopiers and fax machines will be
procured on NCB norms for which the tenders will be floated in the first quarter of 1997-98.
11. MIS and IEC Materials: An amount of Rs. 87 lakhs is provided for the year, 1996-97 as in
S.A.R. So far no expenditure is booked under this item as the feasibility report on the
Management Information System is recently given and after discussions based on the
feasibility report the software component, etc. will be worked out. It may not possible to book
any expenditure by March, 1997 in view of the above reason. However, it might be possible to
start this in the first quarter of 1997-98. Regarding EEC materials, the strategic plan wing has
been entrusted with the responsibility. The Strategic plan wing have finalised a monthly
bulletin to be approved shortly under this activity. Further, the clinical protocols and referal
protocols are also being discussed. It might not be possible to finalise these items before
March end, 1997.
12. Local Training: An amount of Rs. 20 lakhs is provided for the year, 1996-97 as in S.A.R. So
far two batches of doctors have been trained as part of this programme. Further to develop
resource persons, a trainers training programme is also done with the support of JIPMER
from Pondicherry. In respect of various disciplines, the training programme will be finalised
shortly and it will be possible to speed up this program in the coming months. It is anticipated
that an amount of 10 lakhs will be spent before March end, 1997.
13. Consultants: An amount of Rs. 29 lakhs is provided for the year, 1996-97 as in S.A.R. So far
an amount of Rs. 5.9 lakhs is spent under this item. It is anticipated that an amount of Rs. 11.9
lakhs will be spent for the remaining months during the year, 1996-97. Under this component,
03/03/97, Note-fm-stt
3
Page 3
that an amount of Rs. 7 lakhs will be spent for the remaining 3 months. Under this item, the
T. A. for the staff, printing and stationery, advertisement charges, etc. are included.
■<
5
03/03/97, Note-fm-stt
Page 5
Financial Performance Upto January 1997
The Total Budget for The Project 55.00 Crores.
SL.
NO.
1
PARTICULARS
___________ 2____________
INVESTMENT COSTS:1. Civil Works (Renovation)
2. Civil Works (Extension)_________
3. Professional Services___________
_____________ __
4. Furniture
5. Equipment (Medical)___________
6. Equipment (Others)____________
7. Vehicles _________________ __
8. Medical Lab Supplies__________
9. Medicines
10. Other Supplies_______________
11. MIS/IEC Materials____________
12. Local Training_____
13. Consultants_____________ _____
14. Studies_____ ___________ __
15. Workshops_________ _________
16. Fellowships _____________ __
______________
17. NGO’s
TOTAL INVESTMENT
COSTS_____________________
RECURRENT COSTS:18. Salaries and Additional Staff____
19. Operational Expenses__________
20. Building Maintenance__________
21. Equipment Maintenance________
TOTAL RECURRENT COSTS
TOTAL BASELINE COSTS
22. Physical Contingencies_________
23. Price Contingencies___________
TOTAL PROJECT COST
Total
Provision
as per the
Project
Proposal
('«
millions)
Provision
for
1996-97
(in millions)
PROBABL
E
EXPENDI
TURE BY
31st
MARCH,
1997
(in millions)
6
ACTUAL
EXPENDI
TURE
UPTO
Jan’97
('«
millions)
3
4
5
251.6
954,4
110.6
104.1
90.60
286.30
35.40
3.10
0.011
327.7
151.4
124.8
418.2
116.1
32,3
100.1
19,5
28.0
21.5
8.4
12.7
3107.60
32.80
9.10
5,00
12.50
5,80
8.70
2,00
2.90
3.50
2.10
2.60
4.30
506.70
1.220
2.464
574,6
301.7
57.4
59.5
993.2
372.8
984.5
5458.00
Vrm.doc
Page 6
0.997
0.953
0,15
0,95
0.76
10.5
0.35
12.10
0.195
1,00
1.19
0.15'
0.538
0.759
0.225
7.138
27.375
5.70
3.00
0.680
2.345
0.26
0.70
8.8
515.5
50.60
20.60
586.60
3.025
10.163
0.96
16.235
10.163
28.335
Health Sector Development Policy Programme in Karnataka
The State Government has begun a serious exercise to assess the strengths and
weaknesses of its Health care system. The major issues on which the State
Government is engaging its attention, and the direction of its future Reform package
has been spelt out in the Health Sector Development Policy matrix seen below.
______ Issue
1. Adequacy of the
overall size of the
health budget to
meet public
health goals
___________ Effect____________
Public health expenditure is about
5% of the state budget and 1.48 %
of GDP. These health expenditures
are inadequate to provide essential
primary health care together with a
basic package of clinical/curative
services.
2. Imbalances in
public
expenditure
between different
levels of the
health sector
3. Redressing
Regional
imbalance
With increasing expenditure on
tertiary level health care, there has
been a relative decline in the
and
investment
in
primary
secondary level facilities. This
imbalance needs correction.
The six districts of Gulbarga, Bidar,
Bijapur, Raichur, Dharwad and
Bellary show poor health indicators
on account of uneven development
in the health infrastructure and
delivery of services
4. Quality of and
access to hospital
services
Quality of medical services is
inadequate; in addition, access to
health care services is limited
especially for populations in the
least developed areas of the State,
particularly women, scheduled
castes and scheduled tribes.
Proposed Change or Action
Recognising the link between basic public
health provision and poverty alleviation,
the Government will not only maintain the
share of health sector allocations within the
overall budget as reflected in 1995-96
Budget, but will step up the allocations
progressively.
Budgetary allocations for the health sector
in 93-94 was Rs.7400 lakhs and during 9697 it was Rs.8966.75 lakhs._____________
The State recognises the need for focusing
attention on the primary and secondary
levels of health care and also to step up
allocations for the same levels. A major
portion of the increased allocation will go
the primary and secondary levels.________
Through both project as well as non
project interventions, a policy of positive
discrimination in favour of the under
developed districts and the less developed
regions within advanced districts (i.e. tribal
areas) will be followed to reduce the
existing imbalance. This differential policy
is
already
under
implementation.
Additional resources are being provided
out of State’s own funds for filling critical
gaps in primary health care through
Hyderabad
Karnataka Development
Board._____________________________
Quality and access will be improved by: i)
upgrading and
expanding physical
capacity;
ii)
upgrading
clinical
effectiveness and quality of services at
Community, Taluka, and District hospitals;
iii) improving the referral system; iv)
adopting staffing and technical norms in
line with the recommendations of the high
level committee. In respect of Scheduled
Caste and Scheduled Tribes access will be
improved through a system of annual
health check-ups.
Patients below poverty line who cannot
aiioru nigh cost ireatiiieni ioi serious
ailments such as oncologic and cardiac
disorders will be assisted through a
specially constituted society for providing
______ Issue
5. Strategic
Planning
___________ Effect___________
Inadequate strategic planning
capacity in the health sector has
resulted in sub-optimal use of
resources. Decisions on public
health spending priorities presently
do not take into full consideration
the size and scope of services
provided by private-commercial
and voluntary sectors; the health
manpower supply situation; and the
predicted future epidemiological
profile in Karnataka.
6. Work force
Improvement of services at
hospitals is significantly restricted
by workhorse problems, both in
terms of quality and quantity. The
number of staff sanctioned at
hospitals does not fit current needs;
there are many vacancies due to
poor and cumbersome recruitment
procedures, and unimaginative
personnel policies.
7. The role of the
private sector
and voluntary
organisations
The distribution of medical
specialists is not commensurate
with the need e.g.: a general
surgeon in place of an Obstetrician
& Gynaecologist.______________
The health services development
strategy of the Government has not
taken sufficient account of the
scope and coverage of nonGovemmental providers and the
role of this sector in delivering
quality health care.
Page 914
_____ Proposed Change or Action_____
The capacity for strategic planning will be
enhanced through establishment of a
Planning Cell directly reporting to the
Secretary Health and Family Welfare.
This will, either independently or through
sponsored specific research projects: study
the role of the private sector; review the
suitability of present regulations; Study
evolving epidemiological profile in
Karnataka; monitor the burden of disease
and recommend cost-effective means for
achieving the best use of limited
resources; and undertake periodic review
of the health manpower supply situation
and training needs in the state. A study of
the scope and prospects of enlisting the
private sector support for promotion of
health care at primary and secondary
levels will be undertaken._____________
No ban on recruitment will be imposed
with regard to recruiting staff. In a short
period the problem of mismatching in
medical staff will be solved; the practice of
deputing staff to non essential
assignments will be put to an end; doctors
recruited on contract where direct
recruitment process is slow and doctors
will be asked to serve a mandatory' period
of six years in rural areas before being
considered for posting at more preferred
places.
Since there is a large number of lady
Doctors’ vacancies, participation by
private lady Doctors in Government
facilities will be encouraged.
Legislation will be introduced to regulate
all medical institutions. The role of the
private sector would be continuously
monitored, the quality of services provided
by private care practitioners would be
assessed and regulations relating to
improvements in service quality would be
evaluated. Nursing home and private
doctors are contemplated.____________
Referrals between private primary care
and the public sector secondary level
diagnosis, treatment and care would be
encouraged through District Health
Committees.
______ Issue______ ____________ Effect____________
8. Cost sharing and Cost sharing has not been properly
implemented resulting in low levels
service
of funding for supplies, operations
improvement
and maintenance.
9. Prevention and
control of major
communicable
diseases.
The existing surveillance system is
very weak especially at Secondary
level and in urban areas.
10. Contracting
services
Contracting services are under
utilised.
11. Safeguarding the
operations and
maintenance of
the
health
budget.________
12. ConsolidationVs-Expansion of
Institutions
The existing secondary hospitals
face operational deficiencies and
function poorly due to lack of non
salary recurrent funds.
13. Poverty
alleviation
The State has been rapidly
expanding the number sub-centres,
PHCs, CHCs, Taluka level, and
sub-district
hospitals without
focusing on improving the physical
facilities
in
the
existing
institutions.__________________
About 40 % of households are
below the poverty line in
Karnataka. In this group, health
indicators such as mortality and
morbidity rates, are especially
adverse.
Page 145
_____ Proposed Change or Action_____
The Government will set up a working
group to examine the issue of cost sharing,
last revised in 1988, while protecting the
poorest sections of society. The guiding
principle of cost sharing would be to
partly cover non salaiy recurrent costs.
In addition, adequate administrative and
organisational
mechanisms
for
implementing schemes for cost sharing
would be put in place. A mechanism to
give back a major portion of revenues
raised by the institution will be
introduced._______________________
The project aims to establish an effective
surveillance system which will contribute
to reducing morbidity and mortality rates
due to major communicable diseases. The
post of Addl. Director (Communicable
Diseases) has been filled up. His job
responsibility has been defined.________
The Department will monitor cost
effectiveness and quality of existing
contracted services. Furthermore the
Government will review as appropriate
new proposals for contracting-out health
services especially support services, such
as
laundry,
cleaning
services,
manufacturing I V fluids etc. On a
confirmation basis. In district hospital of
Karwar and Tumkur cleaning service has
been contracted at._____ ____________
The State will make adequate provision in
the health budget for drugs and other
medical supplies, and for maintenance of
equipment and buildings.
Further expansion of beds, and hospital
institutions will be strictly need-based, and
will be undertaken only after ensuring the
existing facilities are properly maintained
and utilised.
The investment made in this project
specially through special programmes for
the disadvantaged section viz., SC/ST and
women, will aim at augmenting the
productivity/eaming potential through
better health status.
Growth in Share of Expenditure on Health by Sctors
Etjevenne Expemiinire
O’ban Health Services - Allopathy
Lhrten Health Services - Outer Systems
Rumi Health Sendees - Allopathy
Rural Health Services - Other Systems
Family Welfare
Public Health
A_ssistaDce to Local Bodies
Total Prunary & Secondary Heakh
Adlecical Education
Total Revenue Expendnurc
1994-95
Accounts
Plan Non-Plan
1728.46 12239.55
206.55
2.17
384.79
128.08
55.57
24.30
464.17
7654.88
1689.80
1388.81
11445.09
4059.41
14986.11 26485.52
1397.55 2905.82
16383.66 29391.34
Pdcem increase over p’es’ious year
Slure ofPnmaiy & Seccruday Sectors
91.47
90.11
CZapital Expenditure
T^otal Primary Secondary Health
XZledical Educadon
TTotal Capital Expen±nire
394.30
696.94
1091.24
0.00
0.00
0.00
F*er^ent increase over previous year
Share of Primary & Secondly Sectors
36.13
1995-96
Revised
Plan Non-Pla
Total
13991.0
1741.74
13968.01
227. S
6.00
208.72
359.9
524.53
512.87
64^
42.15
79.87
509.3
8119.05 9681.73
2023.3
2384.60
3078.61
15504.50 3883.60 12647.6
41471.63 18264.35 29824.B
4303.37 1052.75 4O75.£
45775.00 19317.10 338994
Rupees Lakhs
1996-97
Budget
Total
Plan Non-Plan
Total
2451332
15733.14 8848.00 15665.32
292.01
10.50
281.51
233.83
1335.48
287.58
1047.90
883.92
103.82
64.82
39.00
106.74
596.90 11244.84
10191.31 10647.94
2389.50
5681.72
4408.13 3292.22
16531.56 4435.50 14022.44 18457.94
48088 63 28321.06 33308.07 61629.13
1455.42 4635.29 6090.71
5128.31
53216.94• 29776.48 37943.36 67719.84
90.60
17.90
94.55
15.4
87.‘8
16.26
90.36
54.15
95.11
11.93
87.78
27.25
91.01
394.30
696.94
1091.24
708.69
193.00
901.69
0.0
0.0
0.0
708.69
193.00
901.69
1525 00
473.00
1998.00
0.00
0.00
0.00
1525 00
473.00
1998.00
36.13
-17.37
78.60
-17.37
78.60
121.58
76.33
Page 1
121.58
76.33
Procurement of Civil Works
1. Preamble:
Phase
The procurement of civil works under KHSDP to be taken up in 4 phases is as follows:_____
Category of Hospital________________ Total Number
Total cost
SDH
TLH
MCH
CHC
of Hospitals
in Millions
DH
05
07
04
07
30
27
29
24
02
07
III
IV
03
02
07
05
07
11
18
03
Total
17
23
110
12
I
II
03
47
54
58
42
267.02
295.78
300.49
331.71
39
201
1195.00
2. Present Stage:
Out of the 201 hospitals, work on preparation of plans etc., has been assigned in respect of 154
hospitals covered under Phase I & II. Of them, the World Bank Architect has cleared the plans in respect
of 28 hospital. However, written communication regarding the clearance for 6 hospitals (H.D. Kote,
Mudhol, Khanapur, Byadgi, Hangal and Korategere) is yet to be received from World Bank. Final
drawings are prepared by the architects for 19 hospitals and 3 have backed out. Alternative arrangements
have been made to appoint other architects. In respect of 17 hospitals tender formalities are completed
and bids have been invited. For 2 more hospitals detailed drawings are ready and no sooner the sample
bid document for less than Rs.30 lakhs cost is approved by the World Bank tenders are to be floated.
With this Rs. work is tendered to be tendered. Work on these hospitals may begin by ls^ week of May.
Detailed drawings and estimates are already ready for 6 more hospitals. They will be tendered when
once the World Bank gives its clearance.
Apart from the above 28 hospitals, preliminary drawings have been cleared by the Building
Scrutiny Committee in respect of 25 hospitals. Further steps can be taken on these drawings after they
are cleared by the World Bank architect.
Clearance from World Bank office, New Delhi is awaited to the simple bidding document for
works costing less than Rs. 30.00 lakhs. In respect of 7 hospitals mentioned below IFB has been
published in the News Papers (copy enclosed). A bar chart showing the present stage is enclosed.
As per the SAR target all 101 hospitals coming under Phase I & II of the programme should have
been tendered by now. However, this has not happened so far. All attempts are being made to expedite
the civil work procurement activities with these corrections it should be possible for the project
authorities to tender all the civil works in Phase I & II by May 1997. With this the work at site would be
initiated by August 1997 in all the Phase I & II sets. In addition hospitals covered under the Phase III of
the programme will have to be tendered by July 1997 and the work will have to start by September 1997
If this is achieved work amounting to Rs.55 crores would have been initiated by June 1997.
%
Request to the World Bank Review Mission :
1) The pending 25 preliminary drawings may please be cleared at the earliest so that we can go
ahead with the final drawings.
2) Communication may please be sent regarding the clearance of World Bank for the
preliminary drawings in respect of 6 hospitals.
3) Programme of the visit of World Bank architect in the month of April and May, may please
be finalised in March itself so that the architects can be suitably informed.
1
03/03/97, KHSDP-PROC
Page 11
Annexure I
Progress of Construction Programme, as on 28.2.97
District
Centre
Beds
Million Rupees
=T9 Targeted stage of work as on 20.2 97
O)
s
s8-
8
Is
Q)
3•5
<5
______Of
UJ
re
•5
________ UJ
a?
E
00
Quarters Hospital Quarters Hospital
Phase I
1 Kolar
Bagepalli
50
50
024
211
052
6 55
9.42
2 Kolar
Gudibanda
40
50
024
1 39
0.26
1.51
3.40
3 Bangalore Rural Devanahalli
30
30
0.00
0.56
1.66
0.70
2.92
4 Kolar
Chikballapur
60
100
0.09
2.76
2.46
449
9.80
5 Kolar
Chintamani
74
100
0.07
2.26
1.04
600
9.38
6 Kolar
Sidlaghatta
50
50
0.25
1.99
0.40
589
8.54
7 Kolar
Bangarapet
35
30
0.17
1.35
040
1.38
3.30
8 Kolar
Robertsonpet, ED
24
24
0.12
0.00
000
0.90
I
re
o
€
w
a>
£
E §
n
= Present stage of work
re
£
V)
■o
O)
O)
s
ilo si?
c
m CD
1 <0
Ih
.1 & *
E ?
S. 5
2
&
E
S’*
0? *re
I I- oo co ors os a,el
o an
g $° u_ re flZ a if
CD O
o
■O
01
I
.1
■o
I?
I
bJ
1.62
—
■ ■■
ata
9 Bangalore Rural Magadi
30
30
0.28
0.25
080
425
5.58
10 Bangalore Rural Nelamangala
12
50
0.00
0 14
054
541
6.09
11 Tumkur
Kunigal
32
50
000
012
028
392
4.32
12 Hassan
Harisave
20
30
0.05
0.54
028
0 17
1.03
13 Mandya
Nagamangala
30
30
0.00
017
1 66
007
1.90
14 Chlkmagalur
Tarikere
50
50
0.21
098
0 14
766
8.99
]
15 Shimoga
Bhadravathi
30
50
0.00
1.07
1.90
1.35
4.32
J
16 Chikmagalur
Birur
50
50
0.00
1.12
080
243
4.34
J
17 Chitradurga
Holalkere
30
50
0.00
1.02
000
550
6521
1
Page 1 of 13
Atonexure 1
Progress of Construction Programme, as on 28.2.97
District
Centre
Beds
Million Rupees
-T9 Targeted stage of work as on 20 2.97
- Present stage of work
c’
s
f
UJ
o
CL
s
8
I
i
SQ.
4)
I I
76
o
_____ g
_______ UJ
Quarters Hospital Quarters Hospital
so
a?
£
o
H,
•i
o
C <2
c
ro
w
o>
o
sE
ll
O- Q
Cd
Io
s
115 I- fE Wc I I f ! v
i
I
o
I
h S. 5
c
I or oo 2? 5 W ? I i. ro& o 2
oll
V)
0)
o
o>
■U
O, 75 CO
g_
>
q
18 Shimoga
Channagiri
50
50
0.70
078
0.52
1.62
3 621
J
19 Shimoga
Shimoga
600
600
4.50
1350
000
000
18.001
20 Shimoga
Honnali
6
30
052
043
028
000
1.23
1
1
21 Hassan
Belur
10
50
000
1.70
0.50
11.90
14.10
22 Hassan
Holenarsipura
100
100
0.00
0.85
026
689
8.00;
23 Kodagu
Madikeri (W & C)
210
210
0.00
1.88
6.82
605
14.75
Gonikoppal
50
50
0.00
366
026
5.37
9.29
25 Mysore
Heggadadevankote
50
50
000
0.11
2 18
1 03
3.32
26 Mysore
Hunsur
50
100
000
096
246
677
10.19;
27 Mysore
Periyarpatna
30
30
0.00
0 47
028
0.30
1.05
shi 24 Kodagu
]
k.
]
■
28 Mysore
T Narasipura
40
100
000
/ 0 62
384
600
1046
29 D. Kannada
Mangalore Lady Goshen
260
260
085
r o oo
626
1 22
8 33i
30 D. Kannada
Mangalore Wenlock
70S
705
0.08
2.26
000
000
234
31 D. Kannada
MulW
44
50
0 05
2 85
2 18
1 36
644
32 D. Kannada
Bantwal
30
30
0.19
1 96
079
402
688
J
33 D. Kannada
Belthangadi
30
30
2.57
245
028
0 00
5.30!
1
34 D. Kannada
Puttur
64
100
072
221
384
3 22
9.99
Page 2 of 13
1
Annexure I
Progress of Construction Programme, as on 28.2.97
District
Centre
Million Rupees
Beds
a>
5o
§
s
0)
Khanapur
28
36 Blegaum
Kfttur
6
37 U. Kannada
DhandeH
38 U. Kannada
Haliyal
39 U. Kannada
40 U. Kannada
•5 □
hi co
000
030
000
3.16
3.46;
30
0.00
038
0 14
030
0.821
50
1.98
000
0.00
30
30
0.00
0 57
1 66
000
2.23
Uoida
10
30
0.00
0 24
000
000
0.24
Yellapur
30
30
0.00
0.85
1 66
000
251
Saundattl / Yellamma
50
50
0.00
058
000
291
3.49
42 Belgaum
Yaragattl
6
30
0.00
030
000
030
0.60
Belgaum
Ramdurg
50
5tr
(TOOl
030
052
Dharwad
Nargund
24
30
0.00
0.76
0.71
295
4.42
Dharwad
Dharwad
170
250
1.00
4 10
12 00
1831
Bi)apur
Basavana Bagewadi
10
50!
0.00
0.30
1.89
Muddebihal
30
50
0.00
1.38
052
1.90
14.88
66.00
136.44
267.02
Belgaum
47 Bijapur
TOTAL of Phase I
0.00
Phase li
48 Bangalore
Bangalore, Vanivilas
49 Bangalore
Bangalore, HSIS W & C
605
120
120
000
-=2
re
o
O’
€
u
a>
CO
<
2.
£
Quarters Hospital Quarters Hospital
35 Blegaum
= Present stage of work
=T9 Targeted stage of work as on 20.2.97
1600
000
000
000
000
000
Page 3 of 13
f
i/)
I-s i
c
E
O)
a>
a a?
o
3
CO
a>
u.
E
«
23 C
o
or2 o
o
0
ei
ra
u. n;
(A
cn
■O
■O
o
O)
s
■a
a>
■i
o
I
S
I
w
Annexure I
Progress of Construction Programme, as on 28.2.97
District
Centre
Beds
= Present stage of work
=T9 Targeted stage of work as on 20.2.97
Million Rupees
O)
s
f
O)
I
g- £
S
o
2
*0
ro
o
v
9______ U1
_____ a:
Quarters Hospital Quarters Hospital
•s
a?
d
co
o
o
(Z
<
a
o
H <O
•5)
c
a> c
E ro
.-=
2 c
a>
Hco
o
tr o
f
.£
co
•C
1
I f <0
I
E 3
f 8“ el E2. ?
§
w
'o
O)
o
o>
ii
O
t5 CO
£ 3 £ u-.11
re
o
o
sE
P
I
-O
H
Ih
8%
35 Blegaum
Khanapur
28
30
000
030
000
3 16
3.46
36 Blegaum
Krttur
6
30
000
0 38
0 14
030
082
]
37 U. Kannada
Dhandeli
46
50
1.98
1.14
000
0.00
3.12j
1
38 U. Kannada
Haliyal
30
30
0.00
057
1 66
000
2.23
39 U. Kannada
Joida
10
30
0.00
0 24
000
000
024
40 U. Kannada
Yellapur
30
30
0.00
0.85
1 66
000
251
41 Belgaum
Saundattl / Yellamma
50
50
0.00
058
000
291
3.49
42 Belgaum
Yaragattl
6
30
0.00
030
000
030
0.601
iwn
43 Belgaum
Ramdurg
501
50
ot
T
osa
052
(136
TTS'
]
44 Dharwad
Nargund
24
30
0.00
076
071
2 95
442!
45 Dharwad
Dharwad
170
250
1.00
)4.10
1 21
12 00
1831
46 Bijapur
Basavana Bagewadi
10
50
0.00
0.12
1.47
030
1.89
47 Btjapur
Muddebihal
30
50
0.00
1.38
000
052
1.90
14.88
66.00
49.71
136.44
267.02
]
I
J -
TOTAL of Phase I
7
.
Phase II
48 Bangalore
Bangalore, Vanivilas
605
605
2 15
1600
000
000
49 Bangalore
Bangalore, HSIS W & C
120
120
000
000
000
000
Page 3 of 13
1
■
•
Annexure I
Progress of Construction Programme, as on 28.2.97
District
Centre
X
<5
&
Beds
UJ
Million Rupees
=T9 Targeted stage of work as on 20.2.97
S
S
§
o
s
ga?□
o
o
(X
______ (E
Quarters Hospital Quarters Hospital
0.65
072
0.71
065
Q.
0)
cn
______ LU
I
o
m
u
£
g
go 2a?
F co
15
o>
SB
L
Ho
£ s
E |
Present stage of work
i
f
(T O
0
•O
w
"c
I I. I
§
I
1
1
f
□ I
“
I
2.5
5
.2 &
CT
tg c
*o
o
o>
o
£0 O>
E V)
I
m0
a_ q co
I
O)
■O
0) £
a. q >
U- CQ
a. o
CD O
to
O CO
UJ
50 Bangalore
Anekal
18
50
51 Bangalore
K.R. Puram
10
100
0.00
0.00
384
15.75
1959
52 Bangalore Rural Hoskote
23
30
000
000
1 23
5.05
6.28
53 Bangalore
9
100
000
000
332
15.75
19.07
54 Bangalore Rural Doddaballapur
50
50
0.00
1 44
2 18
062
424
1
55 Kolar
Bathlahalli
30
30
0.00
0.90
000
000
0.90
J
*> - 56 Kolar
Gauribidanur
110
110
0.34
2 42
2 18
6 69
11.62
]
r: 57 Tumkur
Tumkur
330
400
0.00
248
608
0.00
8 56
58 Tumkur
Korategere
30
50
000
0 44
000
801
8.45
59 Tumkur
Gubbi
16
30
000
0.79
0.28
059
1.66
60 Hassan
Arsikere
100
100
0.02
2 42
1 21
5 17
8.82
61 Tumkur
Tiptur
56
100
000
1 09
0 26
699
8 34
62 Tumkur
Chikkanayakanhalli
30
50
0.00
0 14
071
675
7.601
1
63 Tumkur
Turuvekere
16
30
0.00
Oil
0 28
475
5.13^
!
64 Chitradurga
Chitradurga
389
450
000
0 69
507
1388
1964
j
65 Chitradurga
Nayakanahatti
0
30
0.00
024
028
6 15
667
66 Chitradurga
Parashurampura
30
30
0.00
059
044
0.18
0.91
Yellahanka
Page 4 of 13
2.73
1
j
J
Annexure I
Progress of Construction Programme, as on 28.2.97
District
Centre
Beds
= Present stage of work
=T9 Targeted stage of work as on 20.2.97
Million Rupees
O)
I II
re
o
i
1
o
§
go
re
•5
__ 5
re
_____ g
Quarters Hospital Quarters
0.00
033
069
a?
£
CO
£I
I
o □
co
c
<D c
E re
ts
2
c
re o
or o
L- f
o>
^■9
E 3
E s O
ui
a_ c
q cd
r
re
o
t§ 1
L
If 2l 1liI
o
f&
u» re
Q. Q
<A
C
■O
re
E
s
f i I
O)
p
CD
■U
*0
Q
■O
V
5
o 5
O CO
UJ
Hospital
1.62
264
000
490
5.10
0.22
0.71
3 69
4.62!
0.00
0.69
028
3 12
409
30
0.00
019
1.66
7 14
8.99
100
100
0.31
4.76
1.42
210
859
Nrtte
6
30
1 69
081
1 66
000
4.161
74 Shlmoga
Hosanagara
30
50
000
1.39
0.00
000
0.80
75
Tirthahalli
100
100
000
244
1 38
3 83
6.59
76 Mandya
K.M. Dodcfl
6
30
0 15
226
0 28
0^0
2 87
77 Mandya
Malavalli
50
100
0.03
0.05
220
2.47
6.95
78 Mysofe
Mysore, SMT
52
50
0.00
005
097
030
1.321
j
79 Mysore
NPCW&C
22
30
0.00
0.00
000
000
0.00
I
80 Mysore
V.V.Puram W & C
22
30
0.00
002
000
223
O.OOl
J
81 Mysore
Bannur
6
30
000
0.30
097
0.30
1.57
82 Mysore
Talkad
6
30
0.00
0.32
000
050
0.82i
]
83 D. Kannada
Kundapur
82
100
0.00
1.85
237
000
422
1
67 Chftradurga
Chellkare
30
50
68 Chftradurga
Molkalmuru
• 50
50
0.00
0.20
69 Chikmagalur
Koppa
50
50
0.00
701 Chikmagalur
Narasimharajpuram
18
30
71 Chikmagalur
Shringeri
18
72 D. Kannada
Karkal
21 73 D. Kannada
3________
*
£
S
55
S
Q.
*0
I
Page 5 of 13
]
6
District
Centre
Annexure I
Progress of Construction Programme, as on 28.2.97
Beds
Million Rupees
=T9 Targeted stage of work as on 20 2.97
= Present stage of work
O)
4
<5
s
sa.
fo
I
UJ
O-
2
<D
a?
o
_____ UJ
Hospital Quarters
2.12
1 66
Hospital
052
4.30
□
co
I
ro
o
1
o t
CL C
O
*0
c jG
E "
3 3
c in
o c
0) o
(T O
h
II
1E°
2 « w.
To
.£
O)
IS! f
in
IE
o
in
O>
c
0
o
o>
■u
s
o
x;
§
h £S. -I i-g I 5 I?
u
c
a>
□
o «
o <n
84 D. Kannada
Shirva
21
30
______ <g
Quarters
0 00
85 U. Kannada
Bhatkal
40
50
0.00
1.50
0.00
000
1.50
]
86 D. Kannada
Udupi
124
124
078
3 16
341
1.49
8.84
I
87 D. Kannada
Udupi, W & C
76
76
0.12
050
207
1280
15.49
88 Dharwad
Byadgi
30
30
0.05
1.18
0.00
222
3.45
89 Dharwad
Haven
58
100
0 41
1 53
000
2.13
4.07
y90 Dhaiwad
Ranibennur MCH
30
30
0.00
080
1.66
1.21
3.67
Dharwad
Ranibennur TLH
30
50
0.00
031
2.18
368
6.17
92 Dharwad
Hangal
30
30
0.40
1.59
052
0.18
2.68
93 U. Kannada
Sirs!
56
100
0.00
2.32
043
288
5.63
94 Belgaum
Athni
28
50
000
025
2 18
269
5.12
95 Bijapur
Biligi
6
30
0.00
0.59
0 57
008
1.24
96 Bijapur
Jhamkhandl
50
100
000
037
1.38
037
2.12i
97 Bijapur
Mudhol
30
30
000
023
043
580
6.46
98 Belgaum
Bailhongal
50
50
0.00
0 17
0.28
0 30
075
99 Bijapur
Rabkavi Banhatti
30
30
0.00
0 16
0.28
030
0.741
100 Bijapur
Mahallngapur
6
30
000
0 12
0.57
0 30
0.99
Page 6 of 13
H co
O- Q co
O. Q
CO o
LU
0
J
Annexure I
Progress of Construction Programme, as on 28.2.97
District
Centre
Beds
Million Rupees
1
§
55
|
101 Bijapur
Talikota
30
o
oZ
30
TOTAL of Phase II
= Present stage of work
=T9 Targeted stage of work as on 20 2.97
a
S
fo
aT
Q.
a>
_____ til
Quarters Hospital Quarters Hospital
0 00
0 70
000
0 16
o
£□
GO
I
w
o
-
i
*0
c £2
2 EI
C
Q. C
O 3
H GO
o>
V)
f
Si
.£
o
O)
f
h&
H
.2
£
ill
o
CZ)
tr o
flu o m
U-
tp
2 ?
S/5
2» 2
g_ q
tn
sI
w
■O
o
I
-a
CO Q
s s
o
o
5
o 5
O <0
LU
087'
7.09
64.68
59.98
164.03
295.78
Phase ill
102 Tumkur
Madhuglri
50
50
000
004
1 32
0 31
1 67
103 Tumkur
Sira
30
56
000
0 19
028
0.44
091
104 Tumkur
Pavgada
30
50
000
049
000
3 28
3.77
105 Chitradurga
Hosadurga
36
50
0.00
0.29
0
4.55
4.84;
yc 5 06 Chitradurga
Hiriyur
74
100
0.00
0.48
071
000
1.191
707 Dharwad
Hirekerur
26
50
0.26
096
1.06
1.34
361
108 Shimoga
Sagar
100
100
0 12
1 23
028
0 00
1.63
109 Shimoga
Shikaripur
28
50
0 54
096
0 28
000
1.78
110 Shimoga
Siralkoppa
6
30
0.00
1 13
0 14
000
1.27
111 Shimoga
Sorab
18
50
000
0 46
2 18
4 59
7.23
112, Shimoga
Kannagl
24
30
033
037
071
000
1.40|
113 Uttar Kannada
Slddapur
30
30
000
0 59
086
000
1.45^
114 Hassan
Arkalgud
30
50
0.03
1 55
1.49
1.44
4.51
115 Hassan
Haiti Mysore
14
30
001
050
075
000
1.25
116 Hassan
Konanur
15
30
0.03
048
0 22
0.00
0.72
1
1
g_______
Page 7 of 13
1
1
]
'
*Annexure 1
Progress of Construction Programme, as on 28.2.97
District
Centre
Beds
Million Rupees
I
5
<5
ro
o
s
O)
o
5
Q-
= Present stage of work
76
£
V)
•8
=T9 Targeted stage of work as on 20 2.97
ac
Is
I SF i
£
§
I
_____ ul
_____ or
Quarters Hospital Quarters Hospital
o
ST
2:2
(/)
O 2
H CO
*o
C £
Q)
O)
I
-
E
2 c
o
o: o
k I- I “ i
CD
E 3 o
Q CO
o
$
sE
hHp
D il £1
w
o
Q- Q
co Q
o
c
■O
"U
s
*6
11
is2
5
LU
o s
o co
117 Hassan
Hassan
344
500
1 80
5.78
357
0.90
12.05
118 Hassan
Channarayapatna
46
50
000
431
1 32
3.59
922
119 Hassan
Dudda
6
30
016
0.46
1 02
000
1.64
120 Mandya
Krishnanajpet
30
30
0.16
289
080
0.00
3 851
]
121 Mysore
Krishnarajanagara
80
100
000
038
1 64
0.62
2.64
J
122 Mysore
ha
-------%23 D. Kannada
Saligrama
10
30
0.03
022
0.14
027
0.75]
Sulya
30
50
093
240
2 18
000
552
1
{*24 Kodagu
Madikeri
200
200
0.00
647
7 68
39 04
53.19
J
125 Kodagu
Kushalnagar
50
50
0.00
0 59
1 23
688
8.70
J
126 Kodagu
Sanivarasanthe
30
30
000
082
028
000
1.10
127 Kodagu
Somvarpet
120
120
0.03
Oil
1 60
274
448
128 Kodagu
Kutta
28
30
000
1.19
071
3 17
507
129 Kodagu
Polibetta
40
50
002
093
1 23
045
2.621
130 Kodagu
Sldapura
40
50
Oil
1 14
1 64
1 39
428
131 Kodagu
Virajpet
240
240
000
8 61
268
1095
22 24
J
1
132 Mysore
Mysore, ED
50
50
000
0.15
2 18
030
133 Mysore
Gundlupet
50
50
1.80
5.18
022
058
zZOBBBZZ
J
J
Page 8 of 13
J
1
Aiinexiii e I
Progress of Construction Programme, as on 28.2.97
District
Centre
=T9 Targeted stage of work as on 20.2.97
o>
Million Rupees
Beds
I*
fl
8
O)
X
LU
55
o
ol
I
«
_____ g
Quarters
f
75
w
(A
■U
s
I *o "o§ 5o
I
1.
M
s
E
"
cr
w
.9
co
2 £ 11 f is
o
a?
E S O
“
I
o c
£ a>
?
° la a.S.«? Q52
o s
5 h
o
e
»
“
o
H in O CO
(/) |- co 1 g o £L CO £ £ § U- re
I .8
S
I
= Present stage of work
O)
c
0)
SQ.
0)
______ UJ
Hospital Quarters
Hospital
Kabbahalli
7
30
0.10
1.67
1.23
1 55
4.55
135 Mysore
Yelandur
6
30
0 13
093
0 97
3 13
5.16:
136 Bangalore
Banalore, ED
128
128
0.00
384
000
0.00
3 84
137 Bangalore Rural
Channapatna
100
100
0.00
1.24
284
596
11.04
138 Bangalore Rural
Kanakapura
50
50
000
064
026
870
9.60
139 Bangalore Rural
Ramanagaram
50
50
0.14
Oil
3 48
000
2.43
Dharwad
Akki Alur
30
30
0.17
1.02
0 14
1 91
3.23
141 Dharwad
Savanur
30
50
0.26
1.22
0 14
1.94
142 Dharwad
Shlggaon
30
50
0.43;
111
0 14
1 04
2.72
143 Dharwad
Hubll
144 Dharwad
Kundgol
30
30
0.36
1 60
0 14
1.46
3 56;
145 Dharwad
Kalghatgi
6
30
000
0.92
000
4.45
146 Dharwad
Lakshemeshwar
25
30
0.10
069
000
1 56
2.351
147 U. Kannada
(Tibetan) Mundgod
50
50
0.00
000
000
000
000
148 U. Kannada
Mundgod TLH
6
30
0.00
0.18
1 66
360
5.44
149 Belgaum
Belgaum
740
740
0.00
0 55
0.00
13 84
14 39
150 Belgaum
Chikodi
13
50
0.00
026
1 21
000
1.47
c
O)
■O
o
CO Q
CO
1341 Mysore
O)
0J
bJ
Page 9 of 13
3.57!
_-
5.37
;
;
<
* Anntxure I
Progress of Construction Programme, as on 28.2.97
District
Centre
Million Rupees
Beds
= Present stage of work
=T9 Targeted stage of work as on 20.2.97
o>
s
Io
I
3
<4
al
S0
>.
c
8.
___ £
____
■5
Quarters Hospital Quarters Hospital
151 Belgaum
Nipanl
10
30
0 00
1.04
028
3.50
4.82
152 Belgaum
Raybag
6
30
0.00
030
000
039
069
153 Belgaum
Gokak
40
50
000
081
0.78
683
8.42
154 Belgaum
Hukeri
30
30
0.00
0.15
000
030
0.45
155 Bijapur
Bijapur ✓
396
400
000
1 26
643
698
14 67
156 Bijapur
Indi
50
50
000
021
028
007
056:
Tadavalga x
6
30
000
025
097
351
4.73|
Kalgl
6
30
000
047
0 57
041
1.451
30
50
000
0 14
080
000
094
8.04
71.93
62.48
158.04
300.49
-ffl------------(jg57 Bijapur
nJ
^8 Bijapur
159 Bijapur
Singi
x
Total of Phase III
2
CO
I I
I
76
o
'o
€.
a> c
to
8 f
o
r co
«
f
c
L
£
O)
■O x>
F
2 0
o
or o
o
w
5
E
•o
•U
o
o>
o
f g || i
Fi I
Oo
£ ro 0
.G I
i!
Q. Q m
a- y m
■O
(U
Is h
O «
Q <0
LU
1
J
Phase IV
160 Kolar
Kolar
317
400
000
8.13
427
993
22 34
161 Kolar
Robertsonpet, KGF
140
150
0.00
392
602
080
10 79
162 Kolar
Robertsonpet, W & C
85
100
0.00
246
242
363
8.50
163 Kolar
Malur
32
50
020
219
000
1.16
355
J
164 Kolar
Mulbagal
30
50
027
1 81
000
234
442
J
165 Kolar
Srinlvaspur
74
50
0.15
1 56
0 95
1 20
3 86
Page 10 of 13
?
?A
Annexlire I
Progress of Construction Programme, as on 28.2.97
District
Centre
Beds
f
i
5
UJ
s
O
- Present stage of work
re
.£
V)
•o
=T9 Targeted stage of work as on 20 2 97
Million Rupees
8
I
55
c
8.
4)
o
____ jS
ol
____
Quarters Hospital Quarters Hospital
1.14
1 89
1.01
0.00
404
a?
£
a
co
I
5
o
1
8
O
3
r <n
1
O)
I
L
O>
?E
L
’o
n § Ic I
8 -y I
I
s
“
o
h Q 2 1 35 oo tnJ2
0 > 11 u.2 &ro o.Fl
II
£1.
■O
r.f
11
1
8
§i
0) o
O
’o
w
h
3
■U
0)
CD
O-
Q >
CD
Q
ID
166 Chitradurga
Bharamasagara
8
30
167 Chitradurga
Sirigeri
30
30
0.00
0.75
000
0 97
1.72
168 Chitradurga
Davanagere MCH
100
100
001
229
1 42
1038
14.10
J
169 Chitradurga
Davanagere SDH
900
850 “
--------- 0.00
820
4 32 ’
592
18 44
1
170 Chitradurga
Harihara
50
50
0.00
1.36
218
4.86
8.40
]
171 Chitradurga
Jagalur
50
50
0.00
0.46
000
400
4.46
1$ Chikmagalur
Chickmagalur W&C
88
100
0.53
1 98
1 42
328
1
1|$ Chikmagalur
Chickmagalur
177
300
0.30
0.58
269
22.27
]
174 Chikmagalur
Kadur
50
100
0.06
1.05
235
6 12
9.58
175 Chikmagalur
Mudigere
64
100
000
1.28
246
1 10
484
176 Hassan
Alur
30
30
001
1.50
1.66
1.47
464
177 Hassan
Sakleshpur
133
150
0.05
251
265
375
896
178 Mandya
Mandya
310
400
0.20
706
615
28 35
41.76
179 Mandya
Maddur
40
50
0.00
1 81
1 66
357
7.04
180 Mandya
Pandavapur
50
50
0.05
1 70
000
000
1.75
181 Mandya
Srirangapatna
30
30
0.01
085
1 66
600
8.52
182 Mysore
Mysore, Cheluvamba
390
400
000
022
928
2 88
12.38
_____
Page 11 of 13
$
1
1
Annexure I
Progress of Construction Programme, as on 28.2.97
District
Centre
Beds
- Present stage of work
=T9 Targeted stage of work as on 20.2.97
Million Rupees
O)
D)
§
55
I
Uj
o
oZ
§
t5 •
M
SQ.
•5
________ UJ
_____ ae _
Quarters Hospital Quarters Hospital
0.14 "
576
4 12
1.35
11.37
£
CO
I
“o
c
<2
0) E
.t:
E c
i
L
rs s f 1.
.£
■o -o
o>
o
•e
<0
•E
O)
E
o
If
2 ?
a
E5
O? “I 2. § I ? f
tr I or8 oo o
>11 f &
o
h- (O
O
CO
co
O-
Q >
u. w
a> JO
Q- D
■O
0)
CD
Q
S
o
1
I 'g
C
o 5
O
183 Mysore
Chamarajanagar
112
150
184 Mysore
Kollegal
100
150
0.02
205
5 16
200
9.23
185 Mysore
Nanjangud
30
100
0.00
000
000
000
0.00
186 U. Kannada
Karwar
300
400
000
3.39
738
000
1077
187 U. Kannada
Ankola
12
50
000
0.53
092
000
1.45
J
188 U. Kannada
Honnavar
30
50
0.98
0.42
043
000
1.83
1
U. Kannada
Kumta
30
50
000
086
2.18
000
3.04
Dharwad
Gadag
114
114
009
1 53
1.11
2.48
521
191 Dharwad
Gadag, W & C
45
50
007
0 85
2 18
3 19
6.29
192 Dharwad
Mundargi
30
30
004
089
040
1 86
3.19
193 Dharwad
Shirhatti
17
30
046
1.21
0 14
1 35
3.16
194 Dharwad
Gajendragarh
30
30
000
0 75
1 66
1 25
366
195 Dharwad
Ron
30
50
0.47
097
080
1.47
371
196 Bijapur
Badami
30
30
000
0.94
000
0 16
1 10
197 Dharwad
Navalgund
18
30
000
0 62
040
6 62
7.64
1
198 Bijapur
Guledagudda
30
30
0.08
058
097
1 01
264
1
199 Bijapur
Bagafkot
150
150
000
000
086
1626
17 12
Page 12 of 13
J
Annexure I
Progress of Construction Programme, as on 28.2.97
District
Centre
Beds
=T9 Targeted stage of work as on 20.2.97
o>
Million Rupees
I
s
fo
I
£
«>
•R
2W Bijapur
201
Bijapur
45
50
Hospital Quarters
UTT ”noTS
O75U
likal
36
50
0 00
033
4.33
34.34
TOTAL of Phase t, II, III
5 IV
8"
aT <
£
CO
________ UJ
Hungcmd
TOTAL of Phase IV
2
8-
_____ o:
Quarters
UJ
52
§
5>
a
Hospital
032
T22
1.49
014
1.96
72.75
84.90
169.74
331.71
275.36
257.07
628.25
1195.00
$
KJ
4^
Page 13 of 13
co
"o
c J2
a* c
£
o
H co
I
L
■O
= Present stage of work
U)
.£
1 8 q ■s
g o
a. •g m
2 S q
*0
co
sE
■O
I- h I 3 s .s1 L
Hl h
FI
s
■o -o „
I8
8 5
o>
ol Q >
0- Q
P
to v
*0
o
-U
5
UJ
o fl
O u>
A brief note on the installation of Blood Banks
Out of 33 Blood Banks to be located PWD has taken up Construction/Renovation of Blood
Banks in 10 places as detailed below. In one place i.e. District Hospital, Mangalore is
informed that District Surgeon has taken up the work. KHSDP(Engineering Wing) has taken
up Renovation work at District Hospital, Raichur & District Hospital, Belgaum. For the
remaining 20 places Drawings & Estimates are to be prepared.
Taken up by P. W.D. Taken up by
District Surgeon
D.H. Mangalore
D.H., Bijapur
D.H. Dharwad
- Karwar
a
- Udupi
u
- Chitradurga
- Tumkur
u
- Mandya
u
- Kolar
u - Madikeri
“ - Shimoga
ll
li
Drawings & Estimate to be prepared
<
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
D.H. Mysore
D.H. Hassan
D.H. Bellary
D.H. Chickmagalur
D.H. Gulbarga
H.S.I.S. Hospital, Bangalore
SDH, Hospet
D.H. Bidar
SDH. Davanagere
SDH Hiriyur
SDHGadag
SDH Haveri
SDH Yadgir
SDH Virajpet
SDH Kollegal
SDH Lingasugur
SDH Sagar
SDHSirsi
SDH Puttur
SDH Bagalkot
Page 25
Taken up KHSDP
(Engineering Wing)
D.H. Raichur
D.H. Belgaum
Position of Installation of Blood Banks as on 21-2-97.
Position of Blood Bank building for installation
Position of Equipment procurement
of equipments
DTB = Draft Tender Bid approval; TDF = Tender Document
Staff in position
+ = posted
Fund; TE = Tender Evaluation; WO = Work order issued; S =
Supplied; C = Commissioned
Blank = Not Intended as it is available
w
o
a>
a>
CD
re
C
>.
£
§
§
_________ 1___
Z2
5
>D)
I
I
i
3
■3
CT
■3
re
CL
3 3§
re
Q.
4
s
6
3
CL
7
c
a;
2 1
8
E
o
9
a.
E
o
3
£
o
■£
■x
3
o
>. §
■3
■c
I
Id
o
J2
o
ro
ai
cp
a>
O
O
V)
10 TT 12 13 14 "l?
PWD
16
WO
17
WO
3. DH Mysore
4. DH Shimoga
o
w
= S
ai
□
1. DH Hassan
2. DH Mandya
aj
N
I o 1 te I c
£
o s £ c 3
I
,E
J
t)
o
o
o
□ s
JL m
E
2 3- cL w
£X
£
5
a>
0
re
o
Q.
O
re
ai
CD
8
s
a:
u
aj
E
o
Te
WO
O
o
u
€
E
8
c
CQ
19
TE
s>>
0
2
w
□
*
E
CD
□
o
S
re
0
oi
>re
o
E
22
23 24 25
I I
£
<
20
TE
CD
o
A
o
c
<v
w
§
ra
s
<v
E
10
o
ra
QJ
O)
O)
a>
ai
o
s
1
5 E I $ £ I 6
■s
Q.
Q.
0)
w
a>
Z
$ s
a>
a>
< V)
z
26 21 28 29 30 31 32 33 34
Nl Nl
TE
TE
TE
TE
TE
TE
+
Nl
Not needed as it is available
PWD
WO
5. DH Bidar
WO
WO
TE
TE
TE
TE
TE
TE
TE
TE
6. DH Bijapur
PWD
WO
7. DH Dhan/vad
PWD
Not needed as equipments are already available
8. DH Kolar
PWD
WO
9. DH Tumkur
PWD
WO TE
10. Udupi
PWD
WO TE"
11. DH Belgaum
KHSDP
WO TE
12. DH Raichur
KHSDP
WO
13. DH Karwar
PWD
WO
14. DH Bellary
WO
15. HSIS Hospital,
Bangalore
NA
+
TE
TE WO
WO
TE
TE
TE
TE
TE
TE
TE
TE
TE TE
TE TE
+
TE
TE TE TE
TE TE TE
TE
TE
TE
TE
+
TE TE
TE
+
TE
TE TE
+
TE TE
16. DH Chikmagalur
TE
17. DH Chitradurga
PWD
WO
18. DH Mangalore
(Wenlock)
DS
wo7]te/ WO/ TE/ TE/ TE/|TE/ te7|te/|te/|te/
19. DH Gulbarga
20. DH Madikeri
PWD
21. SDH Hospet
22. SDH Davangere
23. SDH Hiriyur
24. SDH Gadag
25. SDH Haveri
26. SDH Yadgir
27. SDH Virajpet
28. SDH Kollegal
29. SDH Lingsugur
30. SDH Sagar
31. SDH Sirs!
32. SDH Puttur
33. SDH Bagalkote
1
WO
TE
TE
TE TE
TE
TE
TE
wo TE WO
TE
TE
TE TE
TE TE TE TE
WO
WO
TE
TE
TE TE
TE TE
TE
WO
WO
TE- TE
TE
TE
TE
TE
+
+
+
TRAINING COMPONENT OF KHSDP
One of the main components of the KHSDP is to upgrade the technical skills of the
Medical and Para-Medical Staff working in various categories of the Health Institutions of
Government of Karnataka through in service training. This is in order to improve the quality
& effectiveness of hospital services in a Government Sector. All categories of Staff will be
trained to update their Clinical, Managerial and Maintenance skills. The strengthening of
services at these hospitals will improve referral system provide better quality of service and
reduce the burden on tertiary hospitals. The State has prepared a comprehensive training
programme for all categories of staff to be implemented during the project period. The
comprehensive training programme has identified the target group to receive training, the
subjects that need to be addressed, number of staff in each category to be trained, training of
trainers, development of training material and modules and number of trainees each year.
The clinical training deals primarily with the obtaining knowledge, attitude and skill to
carryout a specific procedure or activity. This training is based on competency based training
or learning by doing. There are two distinct groups who are to be provided appropriate
training for upgrading clinical skills.
1. Doctors who have post graduate qualification but working in CHC/Taluk Level
Hospitals. Their skills acquired during post graduate studies are not fully utilised.
2. Doctors who are M.B.B.S. without any post graduate training. They are mainly
posted at the CHC/Taluk Hospitals.
The first priority list of clinical skills for physicians have been identified in the areas of
Internal Medicine, OBG, Neonatalogy, Surgery and Anaesthesia. The training of these
Physicians will be conducted at the District Hospitals where a class room has been identified
and Audio Visual Aids are being procured.
Status of the Training Components of the Project (1996-97):
A. Training of Physicians of Community Level/Taluka Level Hospitals at the District Hospital.
•
•
•
St. John’s Medical College was identified to train the Master Trainers as TOTs for
each district.
Two Specialists from five specialities namely Medicine, Surgery, OBG, Paediatrics
and Anesthesia were selected from each district to undergo training at St. John’s as
Master Trainers. These trainers would in turn train the CHC - Taluk level doctors
at the district hospital.
The detailed Objectives, Methodology and the Training Programme conducted
during January 1997 in each speciality at St. John’s is as follows :
1. To familarise the working group and provide guidance in curriculum
development
2. To train working groups in training technology related to clinical in
communication skills.
3. To enable working groups prepare action plan for training of CHC/Taluk
level doctors.
Mydoc/Kish-Trg
Page 27
B. Training of Specialists from District hospitals at Specialised Institutions:
•
•
•
Nurses:
•
•
•
Letters have been sent to the list of institutions which had been identified for
training specialist doctors and their consent is being obtained to train our doctors.
15 out of 37 institutions identified have responded favourably. Reminder letters
have again gone to institutions who are yet to respond.
A detailed list of specialist doctors was obtained from the Directorate of Health
Services and database created at the KHSDP office. Using this a training matrix
has been developed for the Project period. Keeping the training objectives in mind
the syllabus and course content has been prepared.
The specialist training will be operational at various institutions from April 1997.
A detailed list of Nurses has been obtained from the Directorate of Health Services
and the database is being finalised to prepare the training course content.
The course content and syllabus has been defined and the various institutions for
training also been identified and their consent is being obtained.
The first batch of nurses is expected to be trained from April 1997.
Clinical Protocols (1996-97):
The clinical protocols are primarily intended to provide guidelines and standards for
management of common conditions for physicians especially for those who do not have post
graduate qualification. Clinical Protocols in 67 topics have been obtained from Andhra
Pradesh Health Department. A list of specialists affiliated to various teaching institutions in
Bangalore have been identified. They have been given the A.P. Clinical Protocols and asked to
update them within a time frame of two weeks.
The Clinical Protocol for OBG topics is ready for printing and will be circulated
shortly. The remaining topics of other subjects will be ready for printing within a weeks time
i.e., by end of March first week, 1997.
Status of Referral System (1996-97):
Quality of Medical care will be maintained only when a proper and effective referral
system is formulated and implemented. Presently, there is no formulated referral system.
Under the referral system, the patient will be encouraged to avail the facilities available at the
primary level of hospitals before proceeding to secondary or tertiary care hospitals. The
referral card will be used whenever a patient is referred.
The referral system is planned to be implemented in Chitradurga District on a Pilot
basis. In this connection, a sensitisation meeting was held at the District Surgeons Office at
Chitradurga 2 months ago. This was attended by all the doctors of the Taluk and CHC
Hospitals. They were brief about the objectives and implementation of the referral system. A
draft referral manual has been prepared based on the A.P. Model. A referral card has also been
prepared and these cards will be printed for Chitradurga District by April, 1997 for
implementation. A zoning system has also been devised for the district. The District Referral
Committee is yet to be set up and this is proposed to be functional by April, 1997.
03/03/97/Kish-Trg
Page 28
Specialists drawn from various teaching institutions/KHSDP were trained as Master Trainers.
Two District Surgeons were also included. Seven participants were from Medical Colleges.
The details of their specialisation are as follows :
Medicine
Surgery
OBG
Paeditrics
Opthalmology
Anesthesia
Radiology
Administration-4
-3
-3
-4
-2
-1
-2
-1
Methodology of the Programme
1. In an initial meeting of the participating specialists the course co-ordinator
explained the objectives of the programme and mechanics.
2. The course is residential, participants have been provided accommodation
in the campus.
3. The Doctors spend one month in their respective speciality departments. In
each department formal session/discussions are held in the topics provided.
In addition participants are posted in various areas of the department of
practical experience. Schedule of training for each department is enclosed.
4. Pre test and post test are conducted. Sample papers are enclosed.
5. Sessions in Education technology are held with Pre and post test
evaluation.
• A two hours session on genetic counseling are also held for each batch. Item 5 & 6
are common for all doctors.
• A five day workshop was conducted at Bangalore by the NTTC - JIPMER team of
Pondicherry on Training Methodologies for various specialists especially from the
Teaching Faculty of the Medical Colleges in Bangalore. The objectives and the list
of Specialists is enclosed as Annexure.
• So far three batches of twenty each (TOTs) have completed the training at St.
John’s. These specialists are from the various districts of the State and the
categorisation is enclosed as an Annexure.
• It is proposed to have two more batches of NTTC-JIPMER training programmes
at Bangalore in the month of March & June, 1997.
• The training of the CHC-Taluk level doctors training programme is being initiated
at Chitradurga and Belgaum District Hospital from 10th of March. The training
curriculum and subject contents have already been defined and necessary audio
visulal aids have been procured. All the teaching sessions will be at the District
Hospital only.
Mydoc/Kish-Trg
Page 29
Status of Trainers Training:
At St. John’s Medical College, Bangalore four batches of Training for Trainers are
arranged during Nov - Dec 96, Jan 97, Feb 97 and March 97 and 78 Specialist Doctors are
trained in the following Specialities.
Type of Speciality
Nov - Dec 96
Jan 97
Feb 97
4
4
4
3
4_
19
4
3
4
5
4
20
3
3
5
5
3
19
Medicine
Surgery
O.BG.
Paediatrics
Anaesthesia
Total
Mar 97
(Tentative)
4
4
4
3
5
20
Total
15
14
17
16
16
78
Statement showing the numbers of Specialists trained - District Wise
at St. John’s Medical College, Bangalore
SI. No.
District
1.
2.
3.
4.
5.
6.
7.
8.
9.
Bangalore
Bangalore (R)
Belgaum
Bellary
Bidar
Bijapur
Chickmagalur
Chitradurga
Dakshina
Kannada
Dharwad
Gulbarga
Hassan
Kodagu
Kolar
Mandya
Mysore
Raichur
Shimoga
Tumkur
Uttara Kannada
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
Total
Mydoc/Kish-Trg
Medicine
Surgery
OBG
Paediatrics
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
5
3
5
5
4
5
4
1
1
2
1
1
1
1
1
1
1
1
5
4
6
4
5
5
1
1
1
1
1
1
1
1
1
1
5
5
5
2
17
16
16
78
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
15
14
Page 30
Total
Anaesthesia
1
1
Activities
1996
o In |d J F
Curriculum
Development
Modules
Development
Training of
Trainers
Training of
Specialists
Training of
General Doctors
Nurses
Training of other
Technicians
1997
mJj JTa S O
w
Clinical Training - Implementation Plan
2000
1999
1998
M A Mjj J A S O N D J F M A W J A s 0 N D J F M A
J F M A mJj J A S O N D
2001
J A S 0 N D
Activities
Preparatory_____________ _
1 .Curriculum Development
2. Development of Syllabus
3. Development of Course
contents_________________
4. Identification of trainers
training resource personnel
Year_l_1996-97
J jJaT£ O | N
J
I —
Year I11997-98
A| M|J
E [a}s|0|n|d;j|f|m
Year V 2000-2001
Year IV 1999-2000
Year III 1998-99
A | M 1 J } J [ A | S | O | N 1 D | J | F j M | A | M { J [ J | A 1 S | O { N I D | J I F | M | A] M| J| Jj A| S|O| N| D| J!~FrM~
[lit
E3!
—— t
I I
J
5. Identification of institutions
6. Identification of trainees
7. Formulation of training
methodologies___________ _
8. Approval of Steering
Committee.
________
Training of Trainer*
1. Identification of Trainers
2. Idenitification of trainees
for trainers training______
3. Detailing of trainers
training course_________
w
=
ill!
I i I
Ti
zzz
nm
4. Formulalion of trainers
team at each district hosprtaj
Training of Special!tts
1. Internal medicine
2. Cardiology_________
3 General Surgery
4. ENT
5. Ophthalmology_____
6. Orthopaedics_______
7. Endoscopy______ _
8. Neurosurgery______
9. Psychiatry_________
10. Anaesthesia______
11.OBG____________
12. Paediatrics_______
13. Dental
14. Anaesthesia (For MBBS)
15. Skin
_
□. o c n
Note on Procurement Activities
First IFB Procurement
1. The first IFB for procurement of equipment for 13 packages was issued on 1-101-996. 2. The
Bids were opened on 13-11-1996. As per the bid documents the validity of these bid documents
is 12-2-1997. As approved by the Steering Committee, the notices have been sent to all
responsive bidders for an extension of time by 60 days along with the extension for Bid Security.
As per this extension the last date for deciding the LI with all verification is 12-4-1997. Out of 13
packages, the bids in respect of 3 packages in full have been rejected. On one package out of 3
equipment, the bids in respect of 2 equipment have been rejected. 3. The letters have been sent on
24-2-1997 to all the responsive bidders to give Performance Statement to decide on eligibility
criteria. A period of 15 days is given to furnish these details.
Second IFB Procurement
The second IFB for procurement for 50 packages was issued on 15-10-1996. The Bids were
opened on 16-11-1996. As per the Bid documents, the validity of these bid is Rs. 16-2-1997. As
approved by Steering Committee notices have been issued to all the Bidders for an extension of
time by 60 days along with the extension of Bid Security. As per the extension, the last date for
deciding LI with all verification is 15-4-1997. Out of 50 packages, the bids received in respect of
12 packages are already rejected by the Steering Committee. For 1 Bid there was no response. In
respect of 9 bids, Steering Committee has given its approval. In respect of 3 packages the
Steering Committee have asked for certain details. In respect of remaining 25 packages, the
preliminary work for scrutiny of bid is over. The Tender Sub-Committee has to hold meetings and
decide on the ranking to be given before it is placed for Steering Committee’s decision. The
notices are sent to the responsive bidders on 24-2-1997 asking them to furnish the performance
statement.
Third IFB Procurement
1) The third IFB was issued on 25-11-1996. 2) The Bids were opened on 27-12-1996. The
preliminary scrutiny of all the bids with reference to commercial aspects and technical aspects
(excluding evaluation on technical specifications) has been done. As all these packages are for
procurement of surgical equipment, it might be better to go for a demonstration of equipment
directly by the Tender Sub-Committee. The last date of Bid validity for theses packages is 27-31996. However, the bid validity may have to be extended by another 60 days in respect of these
packages also to ensure that there is no vitiation of any proceedings.
Fourth IFB Procurement
The fourth IFB was issued on 11-12-1996. The bids were opened on 11-1-1997:
validity date is 11-4-1997. The preliminary scrutiny is yet to start.
The Bid
1
03/06/97, Note-proc-act
Page 31
Fifth IFB Procurement
The fifth IFB on ICB norms was issued on 11-12-1996. The Bids were opened on 28-1-1997:
The Bid validity date is 28-4-1997. The preliminary scrutiny is yet to start.
Sixth IFB Procurement
The sixth IFB on ICB norms is ready for publication. The ICB document is cleared by World
Bank. This IFB is for procurement of Vehicles and Autoclaves.
Further as and when cleared by the Steering Committee, after verifying eligibility criteria
(Now the letters have been sent to the responsive bidders), final notices have to be sent to the
Bidders. Before it is initiated the STEM Consultants (R.P. Rao, Manjunath Road and Sudhesh)
may be asked to verify the details of LI again. Further Sri Sudish may be requested to prepare
evaluation report, in respect of the rejected ones, before it is taken for rebidding as the World
Bank clearance is required for re-bidding.
Note on Procurement of Blood Bank Equipment on Local Shopping Norms
•
Considering the urgency of the matter as approved by the Project Administrator,
Quotation were obtained from the surgical firms for supply of Blood Bank equipment. The
Steering Committee in its meeting held on 24-12-1996 approved for procurement of two
equipment. However in respect of the remaining equipment as decided by the Steering
Committee, the demonstration of equipment and verification of rates will have to be done by the
Tender Sub-Committee. So far, the Tender Sub-Committee after demonstration of the equipment
has cleared 3 more equipment. In respect of the remaining 6 equipment for which quotation were
taken, the Committee has asked for certain clarifications. This has to be sorted out early.
However, there is no time limit for this process as this equipment procurement for Blood Bank is
under Local Shopping Norms.
03/06/97, Note-proc-act
2
Page 32
Note on the position of procurement of equipments as on 28-2-97
First Set of 13 Packages issued as on 1.10.96
S
SI.
Name of the Equipment
NO.
No. of units required to be purchased during
the years
I
I£
§
5
f
£
£c
2 £
h
?3
c
1996-97 1997-98 1998-99 99-2000 2000-2001
rea.
Pl S •£
2 1“ * 3
il lil
1 ECG
88
33
36
157
86
17000
2669000
88
2 Cardie Monitors
4
28
23
55
4
25000
1375000
4
Defibrilators
16
12
9
37
16
65000
2405000
16
3 Audiometer
9
6
5
20
9
50000
1000000
9
4 Baby Incubators
13
8
8
29
13
20000
580000
13
Phototherpy Unit
29
15
17
61
29
6000
366000
29
5 Operating Microscope
A
5
5
14
4
65000
910000
A
6 Foetal Moniter
9
6
5
20
9
6000
120000
9
7 Shortwave Diathermy
7
24
14
45
7.
20000
900000
7
8 Ventilators
16
12
9
37
16
75000
2775000
16
9 Boyles Apparatus with fiou tech
6
3
2
11
6
125000
1375000
6
19
9
13
41
19
60000
2460000
19
10 Qpthalmo Scope
5
24
12
41
5
5000
205000
5
11 Slit lamp
A
4
4
14
6
21000
294000
6
Retino Scope
5
2
5
12
5
3000
36000
5
Perimeter
8
4
4
16
8
6000
96000
8
90
59
42
191
90
20000
3820000
90
62
39
33
134
62
0
62
18
11
12
41
18
41000
18
U)
UJ
Boyles Apparatus without flou tech
12 Emergency Resuscitation Kit
Baby Emergency Resuscitation Kit
13 Head light
Decision of the
Stage of procurement
Steering Committee
o 4>
*0
Si
CTC
3
a»
§ .
1000
Draft bld
Draft bid
Bid
Bids
Bids
document
document
floated
opened
evaluated
To Rebid Accepted
i
5
B
o
E
o
1 o
v>
£
e
c
s
Q.
V)
£
iu
Q-
§
s
s
W
Q
£
5Q.
5
o
c
Q.
X
I I I I
re
re
Note on the position of procurement of equipments as on 28-2-97
Second Set of 50 packages issued as on 16-10-96
c
•6
d
st
§ at
si.
No.
Name of the Equipment
No. of units required to be purchased during
the years
I£
I
i
=s
p o
*2-
£
E
at
c
* §
5
2
Z ft-
Hi
«5
h
o o
Pi
Decision of the
Stage of procurement
Steering Committee
tn
H _ W QRs 000s
s
2
O O
Draft bld
1996-97 1997-98 1998-99 99-2000 2000-2001
?
i Bs 82
Rs 000s
1 Endoscope Fibre Optic
4
10
5
19
4
200
3800
4
2 Cyrosurgery (Deluxe)
4
6
4
14
4.
8
112
4
3 Pulse Air Tonometer
7
9
5
21
7
5
105
7
4 AMC Equipment
8
7
5
20
8
25
500
8
5 Dental Unit
70
45
30
145
70
28
4060
70
Dental Chair
66
42
27
135
66
14
1890
66
6 Airotor
31
9
14
54
31
21
1134
31
7 Operation Table (ordinary)
59
21
30
110
59
8
880
59
Operation Table (Hydraulic)
26
18
12
56
26
35
I960,
26
8 Shadowless Lamp (Mobile)
87
54
42
183
87
8
1464
87
O.T. Lights (Shadowiess)
116
68
48
232
116
45
10440
116
Focusing Lights (Mobile)
80
44
35
159
80
1
159
80
9, Suction Apparatus (High Vacuum)
96
56
44
196
96
8
1568
96
Suction Apparatus (Electrical)
121
64
56
241
121
5
1205
121
Foot Suction Apparatus
114
70
51
235
114
1
235
114
10 Vacuum Extractors
112
54
50
216
112
2
432.
112
11 Instrument Sterlizer
434
278
220
932
434
3
2796
434
12 Diathermy Machine
35
11
19
65
35
12
780
35
Page 1
<A
n
Draft bid
document
document
finalised
cleared by W,B-
Bid
Bids
floated opened
Bids
evaluated
To Rebid
Accepted
o
fo
o
a.
c
>»
a.
a
£
f
Q.
U
OJ
in
1 5 I
fl
at
X
|
I I2* %
Q
ra
Note on the position of procurement of equipments as on 28-2-97
Second Set of 50 packages issued as on 16-10*96
c
■Q
e
SI.
No.
Name of the Equipment
No. of units required to be purchased during
the years
I
0
st
^2
o
II
HI =o 23
8 g.
iA. 11 h
Hl 11
tr
i
«0
L
Stage of procurement
Decision of the
Steering Committee
c r»
3 0
U o
■= Jr 0
1996-97 1997-98 1998-99 99-2000 2000-2001
Gynaec Electric Cautery
MS
w
(A
Rs 000s
Rs 000s
151
55
58
264
151
1
264
151
13 Automist
123
67
59
249
123
5
1245
123
14 Dental Lab (Bath, Motor, Lathe)
13
1
5
19
13
20
380
13
15 Microscopes (Binocular)
70
41
35
146
70
9
1314
70
16 Chemical Baiances
16
6
9
31
16
6
186
16
Simple Balances
80
36
31
147
80
1
147
80
17 Photo Electric Calorimeter
27
8
12
47
27
8
376
27
18 Flame Cell Photometer
34
6
13
53
34
18
954
34
19 Spectro Photometer
7
7
4
18
7
22
396
7
20 Auto Analyser
7
6
5
18
7
40
720
7
21 Micro Pipettes
4
4
4
12
4
5
60
4
22 Water Bath
85
45
39
169
85
3
507
85
23 Hot Air Oven
114
57
51
222
114
8
1776
114
24 Incubators
31
1
11
43
31
8.
344
31
25 Distilled Water Stills
31
3
12
46
31
3
138
31
26 Centrifuges
97
45
42
184
97
4
736
97
27 Hot Plates
27
6
12
45
27
2.
90
27
28 Rotor/Shaker
6
5
5
16
6.
2
32
6
Page 2
f
§
Draft bid
document
Draft bid
document
■MM
Blds
Bids
Bid
To Rebld Accepted
floated opened evaluated
a
a
Eo
X
o
i 1
o>
2
Q.
E
a*
a.
o
v>
Q.
f
§
O
0
•o
S
I I
UJ
0
Q.
Q
I
1
Note on the position of procurement of equipments as on 28-2-97
Second Set of 50 packages issued as on 16-10-96
€
®
SI.
No.
Name of the Equipment
-I
i!
*5
£
~
c
p o
□
the years
li
?!
£1
2
•
® Q.
It n * ° 3
5
Steering Committee
2
S
= 2
“ o o
■= J;
Rs 000s
30
134
64
1
134
64
PH Meter
5
6
4
15
5
15
225
5
30 Glucometer
94
49
40
183
94
6
1098
94
90
58
49
197
90
1
197
90
31 Microtom
13
2
5
20
13
12
240
13
32 Oven (Wax embedding)
10
5
4
19
10
8
152
10
33 Tissue Processor
6
7
5
18
6
70
1260
6
34 Quick Test Kit for Aslo, Trtre, ESR
210
134
116
460
210
.0
210
35 Timer Stop Watch
87
42
35
164
87
0.7
114.8
87
Alaram Clock
34
2
13
49
34
0.4
19.6
34
36 Refrigerators 300 ltrs.
115
84
54
253
115
20
5060
115
37 A/C Machines with Stabilizer
82
77
61
220
82
28,
6160
82
38 Water Coolers
95
53
46
194
95
15
2910
95
391 Two Body Mortuary (Cold Storage)
26
2
10
38
26
100
3800
26
40 Generator 5 KVA
23
19
10
52
23
100
5200
23
Generator 15 KVA
30
12
13
55
30
150
8250
30
Generator 50 KVA
28
8
36
28
200
7200
28
Generator 62.5 KVA
10
15
34
10
250
8500
10
(TO
Page 3
5
a
2
m
Draft bid
Draft bid
document
document
Bid
Bids
floated opened
Bids
evaluated
To Rebid
Accepted
w
■o
o>
Q.
2
c
o
®
HI 11
40
9
Decision of the
C T3
64
Himoglobin Meter
Stage of procurement
2 -2
Rs 000s
1996-97 1997-98 1998-99 99-2000 2000-2001
9
®
No. of units required to be purchased during
€I29 Counting Chamber
e
o
>.
a.
(/>
®
o
S
£
UJ
3
s
i
2
Q.
c
®
Q.
l I
I £ i
o
Note on the position of procurement of equipments as on 28-2-97
Second Set of 50 packages issued as on 16-10-96
SI.
No.
d
il
5
Name of the Equipment
No. of units required to be purchased during
the years
fa>
o-
2
c
>0
2
®
§ o
p o
«I
ii h ron
n it HI 11
1996-97 1997-98 1998-99 99-2000 2000-2001
*0
Rs 000s
Rs 000s
80
49
223
94
20
4460
94
42 X-ray Viewing Box
186
107
96
389
186
1.5
583,5
186
43 Developing Tanks (X-ray)
68
44
42
154
68
0.75
115,5
68
44 Safe Light X-ray Dark Room
52
36
27
115
52
0.25
28.75
52
45 Casettes X-ray
68
36
34
138
68
0.4
55.2
68
46 Intensifying Screen (various)
82
56
43
181
82
2
362
82
47 Lead Aprons
73
48
39
160
73
2.6
416
73
56
39
25
120
56
7.5
900
56
48 Chest Stands X-Ray
60
42
30
132
60
0.91
118.8
60
49 Stethoscope
205
134
92
431
205
0
205
50 B.P. Apparatus infant,
425
313
202
940
425
470
425
93
48
48
189
93
oj
93
B.P. Apparatus43 size cups,
Stage of procurement
Steering Committee
’o §=
94
0.5
Decision of the
C "O
41 Hot Water Systems (Solar Unit)
Lead Protection Screen
v>
m£
11 ii
Page 4
Is 4 1 I
5
mo.
I
o
E
g
£ o
Draft bid
Draft bid
Bid
Bids
Bids
document
document
floated
opened
evaluated
To Rebid
Accepted
o»
e
c
£
Q.
0
a
3
iu f
§
v>
&
I S
Q.
TJ
I I A.P
JAL
o
W
Note on the position of procurement of equipments as on 28-2-97
Third Set of 13 Packages issued as on 25.11.96
£
si.
No.
Name of the Equipment
No of units required to be purchased
during the year
E
3
2o
i!
£
c E
* 3
11
£ o
> a.
«oo O-Ia>
u
Stage of procurement
*3
S “■ O
£1
Rs 000s
1 D.D.&C.
218
110
94
422
218
1.2
506.4
M.T.P
218
110
94
422
218
1.2
506.4
Cervical Biopsy
146
74
67
287
146
0.7
200.9
Evacuation
109
52
47
211
109
0.55
116.05
Normal Delivery
260
120
114
494
260
1
494
P.N. Sterilisation
180
78
88
346
180
Episiotomy
260
120
114
494
260
0.7
345.8
Venisection
260
120
114
494
260
0.8
395.2
Caesarean Section
106
53
54
213
106
2
426
Incisition & Drainage
260
120
114
494
260
1
494
Vaginal Hysterectomy
74
38
40
152
74
3,
456
Abdominal Hysterectomy
74
38
40
152
74
5
760
37
19
20
76
37
2.5
190
Appendectomy
37
19
20
76
37
2.5
190
Hydrocele
37
19
20
76
37
1.2
91.2
C.J.
37
19
20
76
37
2.5
190
3 Suture Removal
146
74
67
287
146
0.4
114.8
Suturing Tray
146
74
67
287
146
0.9
258.3
2 Vagotomy
§
££
0
orc
00
2
M . fi
« a.
es
Rs 000s
1996-97 1997-98 1998-99 99-2000 2000-2001
«0
o
£
§«
3 t.
Page 1
Draft bid
document
Draft bid
document
MlMH
Bld
Bids
Bids
floated opened evaluated
Decision of the
Steering Committee
n
I
0>
E
Io
To Rebid Accepted
v>
TJ
□>
Q.
eQ.
C
£•
Q.
io
s
o>
3
§
1
a.
a*
v>
c
1 I s
I I I
UJ
O
tn
Q.
Note on the position of procurement of equipments as on 28-2-97
Third Set of 13 Packages issued as on 25.11.96
5
SI.
No.
Name of the Equipment
No of units required to be purchased
during the year
£
d
fl
ii
00
Is
0
§ »
> Q.
fl
n
«I
2 £
^•2
C "O
I§ q
ii 11
o a.
^0
o 3
0>
Rs 000s
Q.
C
>.
Q.
V)
Rs 000s
231
122
111
464
231
0.45
208.8
5 Cholecystectomy
16
38
10
64
16
0.8
51.2
6 Thyriodectomy
16
14
10
40
16
3
120
7 Caterization Tray
252
131
121
500
252
0.1
50
8 I.M. Nailing
37
19
20
76
37
1
76
S.P. Nailing
37
19
20
76
37
1.5
114
Dynamic Compression Plating
37
19
20
76
37
3.5
266
A.M. Prosthesis
16
14
10
40
16
1.5
60
Dynamic Hip Screw Fixation
37
19
20
76
37
10.5
798
Fixation of Radius & Ultra
37
19
20
76
37
0.25
19
106
53
54
213
106
5.8
1235.4
Needling and Cataract Evacuation
74
38
40
152
74
6
912
Iridectomy
74
38
40
152
74
1
152
Iridenclisis
74
38
40
152
74
2
304
Extra Capsular Operation
74
38
40
152
74
2.25
342
Chalazion
74
38
40
152
74
0.67
101.84
Tarsorraphy
74
38
40
152
74
0.85
129.2
Enucleation
106
53
54
213
106
1
213
Page 2
Draft bid
Draft bid
Bld
Bids
Bids
document
document
floated
opened
evaluated
To Rebid Accepted
■o
ra
2
o
a b.
4, L.P. Tray
9 Cataract Operation
Steering Committee
5
o
o 0
1996-97 1997-98 1998-99 99-2000 2000-2001
I s 2 i
i
II e s
I1
5
Decision of the
Stage of procurement
O
■o
o
g
i
UJ
$
£Q.
o
<c
«>
e
Q.
Note on the position of procurement of equipments as on 28-2-97
Third Set of 13 Packages issued as on 25.11.96
5
SI.
No.
Name of the Equipment
No of units required to be purchased
during the year
?
.5
O’
£
2
el
Hw
£
*c
i£
*3
c
§ ®
5 q.
o fl>
<A
§
® o.
Stage of procurement
Pl I?
o Qo «
L
Hl
5 £.
1996-97 1997-98 1998-99 99-2000 2000-2001
•0
®
&
3t
Rs 000s
Rs 000s
Probing of Lacrymal Passages
106
53
54
213
106
0.2,
42.6
D.C.R.
74
38
40
152
74
0.35
53.2
Lachrymal Sac Excision
74
38
40
152
74
0.35
53.2
Traveculectomy
74
38
40
152
74
3.3
501.6
Pterygium Excision
74
38
40
152
74
0.86
130.72
Enteropion Correction
74
38
40
152
74
0.25
38
Foreign Body in Cornea
74
38
40
152
74
0.55
83.6
Foreign Body in A.C.
106
53
54
213
106
1 35
287.55
Conjectival Cyst Excision
74
38
40
152
74
0.9
136.8
10 Ear Examination
74
38
40
152
74
1.7
258.4
Mastoidectomy
74
38
40
152
74
10
1520
Macro Ear Set Myringo, Tympano,
Stapedo Plasty
74
38
40
152
74
23,
3496
Nasal Set SMR Septoplasty
74
38
40
152
74
9.8
1489.6
D.N.S.
74
38
40
152
74
Zj
1064
Rhinoplasty
74
38
40
152
74
6.8
1033.6
Adeno Tonsillectomy
74
38
40
152
74
7.5
1140
Tracheostomy
146
74
67
287
146
0.4
114.8
Endo Laryngeal Micro Surgery
16
14
10
40
16
16.5
660
Page 3
Decision of the
Steering Committee
s
5»
o
I
1£
Bo
£
Draft bid
document
Draft bid
document
Bids
Bids
To Rebld Accepted
Bld
floated opened evaluated
£
I
c
>.
ft.
0
Q.
O
1 i.
s
I
i
■o
v>
X
i I I
£
m
Q
c
®
Note on the position of procurement of equipments as on 28-2-97
Third Set of 13 Packages issued as on 25.11.96
«6
SI.
No.
Name of the Equipment
No of units required to be purchased
during the year
I
fl
o -2
j-
§ ®
2 2
c
>
£1
•
0 Q.
O M
Rs 000s
Rs 000s
74
67
287
146
1.6
459.2
11 General Anaesthesia Kit
106
53
54
213
106
4
852
12 General Orthopaedic Kit
106
53
54
213
106
20
4260
13 Dental Kit
138
67
62
267
138
5
1335
*0
JQ
re
Page 4
I
I
1£
s
§
<5
■u
o
Q.
146
ENT General
Steering Committee
= 2
o 3
3 h.
c *
Decision of the
Stage of procurement
££
Ip
i«
o «
1996-97 1997-98 1998-99 99-2000 2000-2001
fl
Q.
sK
I
I
P o
Draft bld
Draft bid
Bid
Bids
Bids
document
document
floated
opened
evaluated
finalised
cleared by W-B-
To Rebid Accepted
0
E
o>
2
a.
E
I*
Q.
I
Q.
io
■u
i
s S
c
2
IM
a>
v>
§
s
Q.
C
0>
0
5
I * i
Q
E*
<Q
re
Note on the position of procurement of equipments as on 28-2-97
Fourth Set of 23 packages issued as on 11.12.96
c
i
Name of the Equipment
No.
No. of units required to be purchased during
the years
I
I
§
1996-97 1997-98 1998-99 99-2000 2000-2001
K
re o
> t
<u
SI.
2 g.
If
11
Decision of the
Stage of procurement
Steering Committee
£
ill £1
Rs 000s
95
50
48
193
95
951
2 Digital Thermomemeter
176
94
93
363
176
176|
3 Weighing machine Adult
103
58
43
204
103
0.6
122.4
103|
Weighing machine Infant
144
67
60
271
144
0.6
162.6
1441
4 Infra Red lamps
126
214
54
394
126
0.4
157.6
1261
5 Oxygen Cylinders
1967
825
882
3674
1967
2.8
10287.2
19671
Nitrogen Cylinders
242
127
114
483
242
2.8
1352.4
2421
514
196
201
911
514
1.5
1366.5
514|
7 Standing B.P. Apparatus
28
42
20
90
28
8 Ambu Bags
125
51
52
228
125
0.6
136.8
125|
9 Hot Plate Domestic
193
113
93
399
193
1.2
478.8
1931
10 Emergency lamp
236
146
116
498
236
1
498
236j
11 Fire Extinguishers
385
162
177
724
385
1.5
1086
385!
12 Laryngoscope Adult
123
73
51
247
123
0.6
148.2
123
blades
100
59
51
210
100
13 Otoscope
140
64
58
262
140
0.4
104.8
1401
14 Universal Bone drill
36
12
14
62
36
1.2
74.4
36
6 Regulator & Flowmeter for medical
281
Baby Laryngoscope with 3 sides
1001
Page 1
5
§
a
a>
su> % 3 s 8
2
5
g s
a.
Q.
I sIIi
Q.
c
O
O
§ ifo
o o
1 Transcutaneous Billirubinometer
gases
<A
fl
h
it IL I?
Rs 000s
*0
£
*0
Draft bid
Draft bid
document
document
Bid
Bids
floated opened
Bids
To Rebid
| Accepted-
evaluated
J
a.
tn
JAL
o
re
Q.
5
ra
i
Note on the position of procurement of equipments as on 28-2-97
Fourth Set of 23 packages issued as on 11.12.96
d
si.
No.
Name of the Equipment
No. of units required to be purchased during
the years
o 52
*■
<U
I
1996-97 1997-98 1998-99 99-2000 2000-2001
ba
♦-
II
v>
=
al
> t
o o
^3-
£1
a>
fl
re o
Stage of procurement
<2 £
S’
o £
£
00
Decision of the
Steering Committee
C T3
-o 3
5 2
-Z.gL
" ’ t*
h
HI
I- Q, E
Rs 000s
Rs 000s
659
315
300
1274
659
0.5
637
659'
16 Patella Hammer
202
176
108
486
202
0.1
48.6
202
17 Tongue Depressor
923
402
353
1678
923
0.03
50.34
923'
18 Oxygen Mask
319
187
143
649
319
0.13
8437
3191
19 Torch Light
558
294
277
1129
558
0.05
56 45
558
20 Baby Mask various sizes
186
106
96
388
186
186
21 Pleural Aspiration set
292
137
149
578
292
292
22 Exchange transfusion set
120
51
60
231
120
1201
23 j Nebulizer
103
49
53
205
103
103,
Page 2
I
§
Draft bid
document
15 Instrument Tray
5
Draft bid
document
To Rebid Accepted
Bids
Bids
Bid
floated opened evaluated
5
w
<u
■Q
£g>
c
O
>.
O
a.
io
Ia>
uI
"S
|
§
l
uj
Sa>
Q
a></)
5Q.
v>
a>
c
O>
Q.
*
i
re
s
re
Note on the position of procurement of equipments as on 28-2-97
Fifth set of 3 Packages issued as on 11.12.96
SI.
No.
Name of the Equipment
No. of units required to be purchased during
the years
Ii
TO
£
§
t-
U1
&
ff
3 4>
£
o
fi
p o
S
OQ.
“■ £
Stage of procurement
2
3
a>
* 3
F- a
Rs 000s
Q.
Draft bid
document
Rs 000s
Draft bid
document
imi
1 Supply, Installation &
*0
JC
rb
•u
4-
Commissioning of 500 mA X-Ray
Machine.
4
5
4
13
4
950
12350
4
Supply, Installation &
Commissioning of 300 mA X-Ray
Machine
48
24
22
94
48
800
75200
48
Supply, Installation &
Commissioning of 100 mA X-Ray
Machine
96
45
35
176
96
430
75680
96
Supply, Installation &
Commissioning of 60 mA X-Ray
Machine
26
10
11
47
26
150
7050
26
2 Supply of Dental X-Ray Machine
27
12
15
54
27
60
3240
27
29
11
13
53
29
700
37100
29
Supply of Ultra-sound
3 Scannerflinear sector)
Page 1
S a
S
I
1i
E
c u
=> £
o 3
5 Q.
2
Z
1996-97 1997-98 1998-99 99-2000 2000-2001
Decision of the
Steering Committee
| Bid
To Rebid Accepted
Bids
Bids
| floated opened evaluated
£
£
TO
2Q.
C
2*
Q.
2
io f
Q.
§
m£
I
Q
e
5Q.
O
2
c
a.
s
£ a
e I
Activities of Strategic Planning Cell of KHSDP
Karnataka Health Systems Development Project is being implemented in the
entire state with financial assistance from the World Bank. As per the suggestions and
discussions with the World Bank authorities in the pre-project period, it was suggested
to create a Strategic Planning Cell in the Department of Health & Family Welfare
directly under the control of Secretary, Health and Family Welfare and has been
entrusted with some issues of the health sector development policy and monitoring and
evaluation of health programmes. The cell has been created in the Government Order
No. HFW 61 WBA 96 dated 31-5-96.
Composition of the Strategic Planning Cell:
Additional Director
Joint Director
Senior Assistants
First Division Assistants
Typists
Drivers
Group ‘D’
1 Post
3 Posts
4 Posts
4 Posts
2 Posts
4 Posts
2 Posts
Total
20 Posts
Out of the above posts, Additional Director, one Joint Director (Officer on
special duty), one typist and one Group ‘D’ official are presently working in the cell.
The cell is temporarily functioning on the premises of the Population Centre, K.C.
General Hospital Complex, 2nd Cross, Malleswaram, Bangalore - 560 003.
____________ Action Plan of the Strategic Planning Cell, 1996-97,
____________ Action Plan______________
Action Taken
1) Data Bank
To set up a data bank with a view to • A data bank has been set up.
collecting data related to various aspects
Information is being collected from all
of health and population policies and
the district on all important socio
programmes. The data bank should be of
economic, demographic and health
use in formulating policies and
indicators along with taluka and
programmes by the Department of Health
district maps and infrastructural
and Family Welfare
facilities available.
2) Quarterly Newsletter
It is proposed to publish a quarterly • The first issue of the quarterly
Newsletter.
The objectives is to
Newsletter is being brought out.
disseminate information on the progress
of various programmes,
including
externally assisted projects, under
implementation by the Department.
Page 45
The Newsletter will be published both
in Kannada and English
3) Commissioning of studies
a) A study on User Charges :
The World Bank has been urging •
the Government of Karnataka to ask
the people to pay for government
health services and retain the proceeds
in the same hospital so that facilities
and services can be improved. Before
taking a policy decision in this regard,
it is necessary to find out the opinions,
willingness and ability of people to
pay for government health services.
b) Burden of Disease Study :
It is also proposed to commission
a study on burden of disease in
Karnataka.
All these years, •
researchers have concentrated either
on mortality or on life expectancy to
gauge the health status of the people.
But it is also necessary to find out the
incidence of handicaps and disability
to gauge the health status of the
people.
c) Knowledge,
Attitudes
and
Awareness of AIDS :
With the assistance from the •
Government of India, an AIDS Cell
has been set up in the Directorate of
Health & Family Welfare Services and
information is being disseminated on
the symptoms and causes of AIDS and
various mode of transmission of HIV.
However, there is no baseline data on
the
knowledge,
attitudes
and
awareness of AIDS. It is, therefore,
proposed to commission a baseline
survey on the knowledge, attitudes
and awareness of AIDS with a view to
facilitating the evaluation of the
impact of AIDS control programme in
Karnataka.
03/05/97/SPC Status
Page 46
Proposals are invited from various
research institutes. One proposal on
this study is already received from the
Centre for Studies in Community
Development.
Letters have been addressed to
various institutions inviting research
proposals for conducting the study.
One proposal was received from the
Centre for Environmental and Social
concerns and discussed with the
Project Administrator. It was decided
to suggest the proposal to the Addl.
Director (AIDS) for funding.
1
d) Evaluation of Health Checkup
Scheme (Yellow Card Scheme)
A health check-up scheme •
(Yellow Card Scheme) for Scheduled
Castes and Scheduled Tribes is being
impelemented in five districts of
Karnataka. According to this scheme,
each member of SC/ST families will
be given a Yellow Card which entitles
him/her to a free health check-up
every year either in their own village
or nearby health centre. A study to
evaluate the scheme is being
commissioned.
A research proposal has been received
from STEM which would like to
conduct the study in collaboration
with
the
Population
Centre,
Bangalore. The proposal has been
reviewed and interview schedule have
been discussed. The proposal will be
discussed
with
the
Project
Administrator.
4) Seminars / Workshops :
a) District Level Workshops :
It is proposed to conduct 20 one- •
day district level Workshop on
KHSDP. The aim is to inform the
people concerned about the objectives
of the KHSDP and inputs that would
be going into each district and enlist
their support in the implementation of
KHSDP. The participants in these
workshops would include ZP officials,
CEOs, DSs, DHOs, and Mos of Subdivisional and taluk hospitals and
representatives of NGOs.
b) State Level Seminar :
The World Bank has been insisting
to integrate externally assisted •
projects with on-going programmes
with a view to having synergistic
effect. However, the methods of
integration are not very clear. It is,
therefore, proposed to conduct a twoday state level seminar on the methods
of integration of externally assisted
projects and Government of India
assisted projects like AIDS control
programme
with
on-going
programme.
03/05/97/SPC Status
Page 47
The proposal approved by the
Steering Committee. The Strategic
Planning Cell is scheduling these
workshops for the year 1997-98.
The proposal to conduct a two-day
State level seminar on integration of
externally assisted projects with on
going programmes in the department
has been approved in principle by the
Project Administrator. Papers would
be invited from experts and seminar
held in May/June 1997.
The
participants would include some
experts in planning and programming,
DHOs, DSs and officers of the
Directorate of Health & Family
Welfare services and KHSDP.
2
5) Setting up of library
•
A library has been set up and
important and relevant books are
being purchased and journals are
being subscribed.
Convening of the District Level Health Systems Committee :
District Level Health Systems Committees have been set up vide Government
order No.HFW 30 EAP (V) Bangalore, dated 26-12-1995 with the Chief Executive
Officer of the District as Chairman, District Health and Family Welfare Officer as
Member and District Surgeon as Member-Secretary, Additional Director and Officer
on Special Duty visited Hassan, Chikmagalur, Kadur and reviewed the collection of
user charges and utilisation of money thus collected. A report has been prepared and
submitted to the Secretary, Health & Family Welfare, and Project Administrator.
A Study of the Existing System of Management of Hospital Waste (Clinical Waste)
District Hospital, Hassan, Chikmagalur, General Hospital, Kadur and HSIS
Hospital for Women and Children, Bangalore have been visited to know about the
existing system of management of hospital waste. At present, the placentas are being
collected by dai as per the decision of the government and an amount of Rs.2/- is being
collected for each of the health placenta and this amount has been credited to the
Government treasury. The infectious waste is being dumped in one of the corner
places in the vacant hospital premises and sometimes disposed off by burying in the pit
or by burning. A study will be commissioned to examine the existing system and
suggest proper method as per the guidelines of the world Bank.
03/05/97/SPC Status
Page 48
3
Hospitals Management
1.
Introduction
Hospital Administration covers not only delivery of patient care
services but also management of existing facilities and ensuring that gaps in facilities as
compared to norms are filled. While patient care gets maximum attention the other
important activities that are often neglected in government hospitals especially in the
smaller hospitals are:
1. housekeeping, i.e., maintaining the premises in clean/ aseptic condition
depending on the area,
2. proper storage of clean linen, dirty linen waiting to be collected by the
laundry,
3. ensuring availability of drugs and hospital supphes etc.,
4. maintenance of equipment,
5. maintenance of building, sanitary and electrical fittings,
6. disposal by sale of condemned equipment, furniture and non-hazardous and
recyclable waste, and
7. handling of hazardous hospital waste.
The first two functions are the responsibility of the Nursing Superintendent/
Matron. The third item is generally handled by the pharmacist/storekeeper. The
remaining items are not assigned to any individual and the Chief Medical Officer/
Hospital Superintendent is supposed to look after. The other doctors in the hospital
also give greater attention to patient care than to other hospital administration
components.
Apart from the preoccupation with patient care, the hospital superintendent has
no administrative and financial powers to condemn and order disposal of
• time barred drugs,
• linen, glass ware and mattresses which have become unserviceable by their ware and
tear, and
• damaged and unusable books, instruments, equipment, furniture and glassware etc..
2.
Provisions in the Project & Action to be Taken
Disposal of condemned furniture, equipment, date expired drugs etc.
The KHSD Project approved by the Government of Karnataka envisages
delegation of administrative and financial powers to officers at various levels. If the
Government Orders are issued in this connection and the hospital superintendents are
informed of the delegation of powers, accumulation, of unusable items will not take
place due to lack of administrative and financial powers. Once the condemned items
Page 4f
and waste materials are disposed of in the prescribed manner precious space will be
released for more useful activities.
Contracting out of Housekeeping Services
The GO No. HFW 274 HSH 80, Bangalore dated 16.10.1980 provides one
Group D staff for every three beds in hospitals with less than 250 beds and one for two
beds in hospitals with bed strength equal to or exceeding 250. The working group on
staffing has recommended that services like cleaning, laundry and wherever possible
kitchen services should be contracted out and recommended one Group D for every 6
beds instead of 3 beds as provided in the said G.O. The Staffing norms have been
accepted by the government and the additional staff sanctioned for the project are
based on the recommendations of the working group. As per the revised norms, in all
5,830 Group D staff are required for the hospitals covered by the project, while there
are 3,626 persons in position. Of the shortfall of 2,204 posts, 1,113 posts are due to
expansion of selected hospitals.
Steps should be taken to contract out cleaning, laundry and wherever possible
kitchen. Upper limits for contract value for each type of service in relation to bed
strength have to be prescribed by the Government and communicated to the CEO,
DHO, DS of each district and hospital superintendents for implementation.
Maintenance of Building, furniture and Equipment
The project provides setting up of Engineering wing for new civil works as well
as annual maintenance of existing buildings. The annual budget for maintenance will
be under the control of the Engineering Wing instead of the PWD. The State
Government has to provide two percent of the replacement cost of the buildings
instead of original cost as being currently provided maintenance by the Engineering
Wing after renovations have been carried out under the Project. The project provides
for meeting maintenance expenses during the project period for the maintenance
expansions carried out during the project period. One fourth of the provision (1/2% of
the replacement value of building) will be made available for the Hospital
Superintendent for urgent repairs. The balance amount will be available to the
Engineering Wing for annual maintenance.
Maintenance of Furniture and Equipment
An Equipment Maintenance Team is proposed to be set up in each district to
undertake preventive and breakdown maintenance of equipment. The Team will be
under the Administrative control of the District Surgeon and maintain equipment in all
Community Health Centres, Sub-district, District and Teaching Hospitals and will
also attend to minor repairs of sanitary and electrical fittings. The Teams will be
technically supported by a Central Equipment Maintenance Wing.
Page 5^
Handling of Hospital Waste
The Central Pollution Control Board (CPCB) has issued guidelines for
Management of Hospital Waste. The Board has also finahsed specifications for
incinerators and discharge of effluents. The Karnataka and Maharashtra Pollution
Control Boards have given clearance to some of the hospitals in the private and public
sectors to install incinerators.
The Project provides for purchase and installation of equipment for hospital
waste management. The guide lines issued by the Pollution Control Board have to be
reviewed and procedures defined for wastes not covered by the guidelines CPCB. The
specifications for containers for storage of different types of waste, their movement
and disposal required to be finalised for each hospital type.
Detailed guidelines for cohection, segregation, storage, movement and final
disposal have to be written and equipment and containers procured.
3.
Action Plan
Preparatory Activities
The Project Administration has studied the Environmental Standards And
Guidelines For Management of Hospital Wastes issued by the Central Pollution
Control Board and has arrived at a waste management plan for different sizes of
hospitals. The typical layout plans of 30,50,100 and 250+ bed hospitals were studied
and waste generating points by category of waste identified. The number of bins
required for storing segregated waste and wheel barrows for moving them by hospital
size is presented below.
Hospital
Size
No. of Beds
30
50
100
150
250
400
500
740
Number
of
Hospitals
Total number
Wheel barrows
Closed Bins
88 _ ______ 16 ___________ 4
18 ___________ 5_
92
30 _________ 8_
39
4 _______ 35 ___________ 9
58 ___________15
7
21
9 _______ 93
3 ______ 116 __________ 29
44
174
6
Approximately a quarter of the containers are required for storing hazardous
wastes. Disposable polythene bags are required to use as a liner for these containers as
the contents including the bag have to be incinerated.
Page 513
The waste sharps, glass syringes and bottles will be autoclaved and shredded.
The autoclaves available in most of the hospital have adequate capacity. Additional
autoclave will be provided in case additional capacity is required. Shredders will be
procured and provided to each hospital.
Oil fired incinerators meeting specifications of CPCB and approved by state
Pollution control Boards will be provided to hospitals. The waste handling capacity of
the incinerator will depend on the size of the hospital as given below:
Waste Handling
Capacity Kg/hr.
10
25
50
100
200
Hospital
Bed Strength
30/50
100
250
500
750
Provision is made in the World Bank Project for meeting the Investment cost of
Rs. 675 lakhs and operating expenses of 682 lakhs. In addition, A provision of Rs. 176
lakhs for waste handling equipment has been made in the agreement between the
Government of Karnataka and KfW.
Conduct of Workshop
It is proposed that a two day workshop on Hospital Management covering the
subjects described above be conducted to orient the Superintendents . As the
workshop could effectively be managed with 20 to 25 participants, a workshop for two
small districts and one for large districts are planned. The workshops would be
conducted by specialists from Project Management and Consultants. The participants
would be DHO, DS and Hospital Superintendents of the districts. The cost of
conducting one workshop is estimated as Rs. 35,000, Rs. 20,000 for organising the
workshop and Rs. 15,000 towards TA/DA of participants. In all 14 workshops will be
conducted at a total cost of Rs. 4.90 lakhs. The workshops are scheduled from April 3,
to May 30, 1997.
Delegation of Powers
G.O. No. HFW/447/IFW 96 dated 8.3.96 defining the administrative and
financial powers delegated to the officers at various levels in the Directorate, the DHO
and DHS in the districts and the superintendents of hospitals. The hospital
Superintendents have to be made aware of the financial admimstrative powers
delegated to them. A copy of the GO is presented in Annexe I
Contracting out of Services
With the implementation of new staffing norms, cleaning and laundry services
may be contracted out. The upper limit for of payment for cleaning of the premises and
laundry services is fixed at Rs. 400 per bed per month on the basis of anticipated
savings in salary of permanent staff. The hospital Superintendent will contract out on
Page 524
the basis of quotations invited from local parties. Contracting out of kitchen services
will be explored.
Maintenance of Buildings
The budget for maintenance of buildings be determined on the basis of two
percent of the replacement value of the building and not original value. The budget
provision be made as part of the Budget of Health Department instead of the present
practice of including in the budget. The annual maintenance of the buildings will be the
responsibility of the Engineering Wing created in the Health Department. For this
purpose the 75 percent of the Budget provision be given to the Engineering wing and
the balance to the Hospital Superintendent to meet the expenses for urgent repairs of
plumbing and electrical fittings, clearing clogged drains etc. The equipment
maintenance teams under the control of the district surgeons would undertake
preventive maintenance of plumbing and electrical work and breakdown maintenance
at District Hospital. At other hospitals the hospital superintendent be authorised to
engage local latx)ur to undertake breakdown maintenance.
The electrician, plumber and carpenter at district hospital should be placed
under the control on the equipment maintenance engineer posted at the hospital.
Maintenance of Equipment
The preventive and breakdown maintenance of hospital plant and equipment
will be the responsibility of the equipment maintenance unit under the control of the
District Surgeon and will be located at the district Hospital. Preventive maintenance
schedule will be drawn up for each equipment in each hospital by the Engineer Inchar^e of the maintenance unit and implemented. Requests for breakdown service will
be made to the District Surgeon who will send the mobile unit foe executing
emergency repairs.
Participation of NGOs in Management of Hospital Waste
An NGO has been asked to study Talujca Hospital at DevenahaDi and Submit
propps^s by March 13, 1997 for review and examining the feasibility of involving
NGQs in Management of Hospital Waste.
Page 5$
Access to Disadvantaged Sections
The Health Check-up Scheme for SC/ST population (Yellow Card Scheme)
It is proposed to introduce a system of health check-up on an annual basis in respect of
SC/ST families residing in the rural areas. Each member of every SC/ST household would undergo a
thorough medical examination which would include:
(1) Complete physical examination and identifying individuals requiring diagnosis tests and /
or treatment and referral where ever required.
(2) Simple laboratory investigations like examination of urine, blood etc., for early detection
of diseases, if any.
The Camp will be organised at the sub-centre or in the villages covered by it provided
suitable premises are available.
On an average the SC/ST population per sub-centre is estimated at 981 persons. A sub-centre
covers about 3.5 villages, hence approximately 280 persons belonging to SC/ST have to be examined
in a village.
A team led by the Medical Officer of the PHC will carry conduct health check-up of the
SC/ST population and provide free treatment to those who are ill. The team will consist of:
•
•
•
•
•
•
•
Medial officer of the PHC.
Lady Medical Officer (Private doctor to be engaged if Govt, doctor is not available)
Lab Technician
Senior Health Assistant (Female) (LHV),
Senior Health Assistant (Male),
Junior Health Assistant (Female) (ANM) of Sub-centre, and
Junior Health Assistant (Male) of Sub-centre if available.
Operationalisation of the Scheme
Planning by MO of PHC
The MO of the PHC will draw up an annual calendar (giving date and venue) for conducting
health check-up camps in the villages covered by his PHC and forward to the Taluka Medical Officer
along with estimated fund requirement for the year with break down by month.
The MO will also indent for the drugs required from the list of approved drugs given in
Annex 5.
The fund requirement will include the following :
1. Honorarium to lady doctor from the private sector if proposed to be engaged.
2. Charges for hiring vehicle for conveying the medical team to the camp site and back and
3. Expenses for coffee/tea and snacks to the members of the team.
Action by Taluka Medical Officer
The Taluka Medical Officer will scrutinise the annual plan for forward his recommendations
to the DHO for release of funds and supply of drugs.
03/07/97/Access YC
Page 54
Action by PHO
The DHO will consolidate the requests from Taluka Medical officers and request the Project
Administrator for Release of Funds for the Year.
The DHO will also collect each month the statement of accounts for the health Check-up
scheme from the MO of the PHC, consolidate the statements and submit at the end of each quarter to
the Project Administrator.
Activities to be undertaken prior to the camp
The Jr. Health Worker (Female) and where available Jr. Health Worker (Male) will prior to
the scheduled date of the camp visit each SC/ST house hold in the selected village and inform them
of the date and the objectives of the health Check-up camp to create awareness and the need to attend
the health check-up camp. She/he will also fill out the first two pages of the “Yellow Card” for each
permanent member of the household and hand over to the head of the household and ask him/her to
bring the family members along with their “Yellow Card”
Activities to be undertaken at the camp
The Senior Health Workers male and female will carry out the initial examination of the
patient and record results on pulse, B.P anaemia, height and weight, general appearance. They will
adopt syndrome approach to ascertain whether detailed futher examination by the medical officer is
necessary.
The MO/LMO will carry out detailed examination of those identified by Sr. Health Worker
and order blood and / or urine tests if required. The will also treat the sick persons and dispense
drugs. If the patient requires detailed diagnosis and specialist treatment, he she will be referred to the
nearest hospital where such facilities exist.
Where ever cases are referred to the next higher hospital, the patient will be given a Referral
slip (in duplicate). The patient should be asked to produce the referral slip and the Yellow Card at
the referral hospital to receive prompt attention. The referral hospital doctor should give a feedback
about the treatment suggested by filling in the copy of the Referral Slip and returning to the patient
for follow up by the PHC doctor/staff.
The scheme will be implemented during 1996-97 in the districts of Bijapur, Kolar, Hassan,
Mysore and Raichur. The scheme will be extended to Belgaum, Bellary, Chitradurga, Dakshina
Kannada and Gulbarga districts during 1997-98 and to the remaining districts in 1998-99.
Health Check-up for Women
In the first phase of the Project, the focus will be on the following new interventions, which
are relatively easy to introduce :
1. Promotion of positive health practices, such as personal hygiene especially during
menstruation, adequate nutrition etc.,;
2. Screening for and treatment of reproductive tract interventions and sexually transmitted
diseases ;
3. Screening and management of gynaecological problems ;
4. Cervical cancer screening and treatment ;and
03/07/97/Access_YC
Page 55
5. Increased policy dialogue and strategic efforts to reduce gender discrimination and
violence.
In the second phase a beginning will be made in introducing the following additional
interventions :
6. Management of problems associated with onset of menarche and menopause;
7. Screening and treatment for Breast Cancer; and
8. Prevention and treatment of infertility.
It needs to be emphasised that while the above range of services have important health
components, they also require interventions which are much beyond the scope of the Department.
The Programme will cover all other women not covered by the Health Check-up scheme for
SC/ST. The ANM will adopt the syndrome approach to identify cases among women aged 10-60
needing further screening and referral. She will identify suspected cases for each type of
disorder/disease among the following target groups by syndrome approach and refer to LHV/MO of
PHC for detailed check-up and treatment if found necessary.
Role of District Officials
The health check-up schemes will be successful if only participation by, Panchayat members
at the Zilla, Taluka and Village level. Further the involvement of anganwadi workers to promote
positive health practices, such as personal hygiene especially during menstruation, adequate nutrition.
The CEO should arrange for involvement of Panchayat Members, Social Welfare
Department. The DHO is responsible for implementing the Health Check-up scheme in his/her
district. He/she should brief the Taluka Medical Officers and they in turn brief the MOs of the PHCs.
The PHC doctors should train paramedical staff to carry out the preliminary investigations.
Implementation of the yellow card scheme during the 96-97
During the year 96-97 the scheme was implemented in 5 districts. The details of the
number of persons treated under the Yellow Card scheme. I shown in the statement
appended. A brief review of the implementation of the Yellow Card scheme was taken up
with the help of the STEM consultants. They have suggested some modifications which will
be considered during the implementation of the programme during the year 97-98.
An amount of Rs.80.93 lakhs is estimated towards the cost of drugs to be supplied
under Yellow Card scheme. In addition an amount of Rs. 100.00 lakhs is estimated towards
the POL, hiring of vehicles and the honorarium to the private doctors is also mentioned.
Programme for the year 1997-98.
During the year 1997-98 the yellow card scheme is proposed to cover the whole state
of Karnataka. Data on approximate number of cards to be issued and the cost of drugs is
shown in table 2.
03/07/97/Access_YC
Page 56
Statement showing the performance during April 1996 to March 1997 under
Yellow Card Scheme
Table 1
SI. No.
2
2
45
Name of
the
District
Total
SC/ST
Populatio
n
No. of
villages
screened
No. of
Taluks
screened
No. of
persons
examined
/screened
No. of
patients
treated
Kolar
Mysore
Bijapur
Hassan
Raichur
TOTAL
2.21 lakhs
3.16 lakhs
2.92 lakhs
1.56 lakhs
2.30 lakhs
359
78
84_
7
2
_2_
2
2
15
4898
7105
18158
12258
9569
51980
3152
~5519
7356
6735
6645
29407
_5.L
78
656
No.
referred
for
special
treatment
12
105
68
35
12
232
Statement showing the population of SC/ST District wise and amount to be spent for printing
of yellow cards and supply of Drugs during the year 1997-98.
Table 2
SI.
No.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
District
Bangalore (U)
Bangalore (R)
Belgaum
Bellary_____
Bijapur_____
Bidar_______
Chikmagalur
Chitradurga
D. Kannada
Dharwad
Gulbarga
Hassan______
Kodagu_____
Kolar_______
Mysore_____
Mandya_____
Shimoga
Raichur
Tumkur_____
U. Kannada
03/07/97/Access_YC
SC/ST population
(in lakhs)
7.66 ___
3.76
4,90 ___
5.30
2,92
2.65
2.23
4.51
2.82
5.16_____
7.18
1.56
1.00
2.21 ___
3.16
2.39
4.13
2.30
5,77
1.03
Cost of Yellow
Cards (in lakhs)
7.66
3.76
4.90
5.30
2,65
2.23
4.5 f
2.82
5.16
7.18’
1.00
2.39
4.13
5.77
1.03
60.44
Page 57
Cost of Drugs
(in lakhs)
1.40
2.86
____5.98
2.60
4.51
2,29
3.33 __
4.54
7.06
5.91
5.07
4.61
1.63
3.73
6.85
3.75
3.77
3.74
4.16
3.14
80.93
Total
9.06
6.62
10.88
7.90
4.51
4.94
5.56
9.05
9.88
11.07
12.20
4.61
2.63
3.73
6.85
6.14
7.90
3.74
9.93
4.17
141.37
improvement oi
Access to Health Services for Women
1.
Introduction
The Family Planning programmes was launched to control population growth,
through promotion of contraceptive methods with emphasis on terminal methods.
During the course of implementation of the programme it was realised that real
headway in acceptance of contraception can be made if child survival could be
ensured. The Family Planning Programme was converted into a Family Welfare
Programme which beside promoting contraception, initiated programmes for child
survival through ante-natal, intra-natal and postnatal care of pregnant women and
immunisation of children against vaccine preventable diseases.
The Child Survival and Safe Motherhood (CSSM) Programme launched in
1992, aimed at providing access to some essential services to improve women’s
health. The services, which are being emphasised include:
•
•
•
•
•
•
Immunisation against vaccine preventable diseases and ORT for
diarrhoea.
Offering wider choice of short and long term contraceptive methods;
Enhanced maternity care;
Safe pregnancy and delivery services;
Nutrition assistance to pregnant, nursing and lactating mothers; and,
Prevention and management of unwanted pregnancies.
Subsequently it was felt that instead of setting targets as has been practised
hitherto, a target free approach which caters to client’s perceptions and needs would
yield better results.
Management of reproductive health infections and sexually transmitted
infections has recently been added to the existing components and a project
“Reproductive and Child Health” with the assistance of World Bank is being
finalised by the MoHFW, Government of India.
2.
Interventions Planned under KHSDP
The interventions made so far or being contemplated under RCH project,
mainly relate to maternal health. Recent literature has pointed to the urgent need to
address other aspects of women’s health which go beyond her role as a mother.
Women’s low social status and reproductive role expose them to high health
risks. The health of women is an important concern as it affects the next generation,
and her productivity in economic activities. There is overwhelming evidence to show
that many of the interventions that address women’s health problems are highly costeffective. Special attention is required to reach females during adolescence, when
reproductive and other lifestyle behaviours set the stage for later life.
While formulating the project proposals for Karnataka Health Systems
Development project in 1995, it was felt that programmes should be evolved to
improve access for women to health services. One should view women’s health
through the life cycle approach that takes into account both the specific and the
cumulative effects of poor health and nutrition. Many of the problems that affect
women of reproductive age, their new bom, and older women begin in childhood and
adolescence. The strategy to improve women’s health must revolve round promoting
gender sensitive policies, on the one hand, and strengthening women’s health services
on the other. Towards this end, during the Project period, a range of expanded
services are proposed to be introduced, both with and without specific project
interventions. In the first phase of the Project, the focus will be on the following new
interventions, which are relatively easy to introduce:
1. Promotion of positive health practices, such as personal hygiene especially
during menstruation, adequate nutrition etc.;
2. Screening for and treatment of reproductive tract interventions and sexually
transmitted diseases;
3. Screening and management of gynaecological problems;
4. Screening and treatment of cervical cancer; and
5. Increased Policy dialogue and strategic efforts to reduce gender
discrimination and violence.
In the second phase a beginning will be made in introducing the following
additional interventions:
6. Management of problems associated with onset of menarche and
menopause;
7. Screening and treatment for Breast Cancer; and
8. Prevention and treatment of infertility.
It needs to be emphasised that while the above range of services have
important health components, they also require interventions which are much beyond
the scope of the Department.
The Project envisages support to the primary health care sector by providing
technical services, referral facilities and financial assistance.
The Programme will cover all other women in the age group 10-60 years. The
ANM will identify suspected cases for each type of disorder/disease among the
following target groups by syndrome approach and refer to LHV/MO of PHC for
detailed check-up and treatment if found necessary.
Table 1. Proposed Strategy for Detecting and Treating for RTI and STD
Disorder/Disease
Menstrual disorders
Sexually transmitted
diseases &
Reproductive tract
infection
Gynaecological
Disorders
Age Group/
(Women/Cases)
10-19 unmarried
(140/28)
15-49
(770/154)
Screening
by______
LMO
Diagnostic
Test
Treatment
by______
LMO
LMO
STD/ RTI
Sensitivity
LMO
15-60
(880/132)
LHV/
LMO
Malignancy
(Cervical cancer)
35-60
(630/25)
LMO
PAP Smear
Infertility
20-30
(77)___
15-44
(120/30)
15-44
(120/15)
LMO
Semen
Exam.
High Risk Pregnancy
(detected during ANC)
High Risk Pregnancy
(detected during labour)
LMO
Shift immediately to
50 bed
Hospital/
District
Hospital
Cancer
treatment
centres
District
Hospital
50 bed
Hospital
50 bed
Hospital
An ANM has to screen approximately 1020 females in the age group 10-60 or
approximately four cases per day. The number of cases referred to LMO of PHC will
be less than 300 in a year. An LMO from PHC or a lady doctor from private sector
visits the sub-centre one day in a month to examine the cases referred to by the ANM
and provide treatment or refer to appropriate hospital indicated in the last column of
the Table 1 .
In order to cope with the expected increase in diagnostic tests, it is proposed to
add one laboratory technician to each 100 bed hospital.
Training of Medical and Paramedical Staff
These cadres will be imparted essential skills for screening and identifying
individuals who need detailed examination by Medical Officers.
ANMs will be given training in identifying suspected cases by syndrome
approach and LHV in screening for gynaecological disorders. The duration of training
will be three days and will be imparted at 100 bed or district hospitals.
The Laboratory technician has to be trained at the district/teaching hospital.
Clinical protocols have to be developed for training the LMOs of PHCs and
specialists at CHCs, taluka and district hospitals.
IEC
There is expected to be vast improvement in the range of services at the out
reach and CHCs and taluka level hospitals through Project interventions. However,
mere availability is not enough. Improved services must translate themselves into
improved utilisation. IEC activity will aim at providing information on the services
available at various levels as well as the health check-up schemes for SC/ST
population and women planned under the project. It will also motivate the target
groups to avail of the services offered in the outreach and at hospitals. The IEC
activity will also focus on increasing awareness of and educating adolescent girls and
women on positive health practices.
The existing multipurpose workers are likely to be over-stretched and will not
have adequate time for IEC activity. It is proposed to involve four types of institutions
in IEC activity:
Sub-Centre Health Advisory Committees: The Sub-centre Health Advisory
committees proposed under IPP-IX should be made aware of the
Grama Panchayats: The State has 5640 elected Grama Panchayats, which at
present have 35,153 elected women Members, constituting 43.6% of the total elected
Members. The Karnataka Panchayat Raj Act, 1993 has specifically included
implementation of programmes relating to family welfare and women as functions to
be performed by the Grama Panchayats. The elected Members, more specifically
women Members are vast reservoir of potential leaders who are available at the
village level to support interventions for improving the health status of their
community.
Non Governmental Organisations: The State has an extensive network of
voluntary organisations working in the area of health. Their support is could be
enlisted in expanding interventions relating to health of the disadvantaged sections.
Mahila Swastha Sanghas: 4000 Mahila Swastha Sanghas have already been
established by the Department. Under IPP IX 1000 Sanghas are proposed to be
strengthened. These sanghas can be effectively utilised in spreading awareness on
issues relating to women’s health.
Anganwadis: The State has 185 ICDS Projects and as many as 30,000
Anganwadis. The Anganwadi workers could be utilised to create awareness of the
proposed health care services for the disadvantaged sections.
3.
Suggested Implementation Plan
Overall responsibility
The responsibility of implementing the RCH project at the State level rests
with the Additional Director (FW & MCH) and with the at the District level with the
District MCH Officer. As the KHSD Project component, improving access to basic
health services for women forms a part of RCH Project, The responsibility for
implementation of women’s health component of KHSDP may be entrusted to the
Additional Director (FW & MCH).
Training of Staff
Training of Medical and Paramedical Staff in screening and treatment for
Gynaecological problems and STD should be the first step. The development of
training modules for different categories of staff will be the responsibility of
Additional Director, (FW & MCH). The actual training will be imparted by SIHFW
and District Training Centres planned under IPP-IX. The faculty for training will be
drafted from existing resources till such a time as the Technical Staff sanctioned under
RCH Project are in place.
The Additional Director (FW & MCH) will draw up a list of diagnostic aids
for screening suspected cases and medicines for treatment. The Project Administrator,
with the approval of the World Bank Mission, will float tenders for supply drugs and
diagnostic aids to draw up a list of eligible suppliers and approved rates.
Operationalisation of the Scheme
The LLMO of each PHC will draw up an annual implementation plan and its
break up by quarters for the settlements covered by his PHC and submit to the District
MCH officer who will submit in turn to the DHO for approval. The DHO will in turn
submit the consolidated district plan to the CEO of the Zilla Panchayat. The CEO
will request the Project Administrator for release of funds. At the end of each quarter,
the CEO will submit a statement of expenditure with supporting documents to the
Project Administrator.
The CEO will in turn release through DHO funds to the LMO of PHC as per
the approved plan. The funds are to be utilised for engaging the services of private
lady doctor if there is no lady doctor posted at the PHC, hire charges for vehicle for
outreach activity, if no vehicle is provided to the PHC or POL for Govt, vehicle
provided to the PHC and purchase of drugs and diagnostic aids.
The budget provision in the project for various components are:
Fees to private lady doctor :
Hire charges for vehicle :
Diagnostic aids:
Medicines for STD/RTI:
300 per visit to Sub-centre
2,400 per year for visits of
Health Check-up team
Rs. 6,800 per sub-centre (or 1000 females
in the age group 10-60)/annum
Rs. 13,000 per sub-centre (or 1000 females
Rs.
Rs.
Medicines for SC/ST:
population
in the age group 10-60)/annum
Rs. 3 per person per year
IEC:
Under IPP-IX a number of IEC activities were planned. These include setting
up of Sub-centre Health Committees to encourage community participation, enlisting
female volunteer workers at the village level, production of films, flip-charts etc.
Provision is also made under KHSDP and RCH project.
Experts in mass communication should be engaged as consultants to plan and
implement IEC activity for IPP-IX, KHSDP and RCH projects. The world Bank
mission for IPP-IX has approved the TOR and the budget for consultancy services.
Action need to be initiated to review IEC present activity, define strategy, design
effective action plan and assist in developing IEC materials.
Proposal for Setting Up Equipment Maintenance Facilities
1. Background
The SAR of KHSDP envisages setting up of work shop facilities at Project
Headquarters and in each of the 20 districts. The capital investment and staffing is to
be undertaken by the Government of Karnataka. The funding for capital equipment
and operating expenses during the project period is included in the Project.
The districts have been classified into four categories on the basis of the
number and size of hospitals. The general hospitals and hospitals for ophthalmic
diseases, tuberculosis, leprosy and mental problems which are not included in the
project for renovation/extension are however, included for maintenance coverage. The
classification of districts, capital investment and staffing are presented below. (All this
is provided in the SAR)
Project
HQ
Districts
*
Number of Workshops
Capital Cost Million Rs.
Staffing Number
Joint Director
Dy. Director
Engineers
Technicians
Administrative
Driver/Group D
Recurring Costs/Year
Million Rs.___________
Staff Salaries
Operation Expenses
Maintenance Spares
Total Recurring Costs
1
Category
C~
A
B
Bangalore
U&R
Chitradurga
Dharwad
Mysore
3
6
All
D
Belgaum
Bellary
Bijapur
D. Kannada
Gulbarga
Hassan
Kolar
Shimoga
Bidar
Chikmagalur
Kodagu
Mandya
Raichur
Tumkur
U. Kannada
8
7
25
73.35
1
1
3
9
10
14
9
3
15
30
’12
18
42
24
9
18
16
56
24
24
7
49
14
21
65
187
88
81
20.70
3.19
21.71
45.60
The equipment maintenance staff of 65 Engineers, 187 technicians and 88
Administrative support staff and 81 Group D staff have to be recruited by the
Government and absorbed in Government on a permanent basis after the Project
completion. Government has given sanction for the creation of all the above posts. As
some of them are not provided in the C&R lists of HFW Department, steps are being
taken to form special recruitment rules.
Page 75
Under IPP—III, equipment maintenance workshops were set up at Belgaum and
Gulbarga and four Engineers, five diploma holders and nine ITI trained technicians
were appointed and trained. The groups were disbanded and posted elsewhere after
the project was completed. The present position where these personnel are working is
in no way related to the with which they were recruited, as evidenced from Annex I
Besides these there are two Engineers and eight diploma holders in the transport
workshop. Further there are four technicians in the equipment maintenance group in
the Directorate. It is proposed to absorb the above personnel in Equipment
Maintenance Wing and the remaining personnel are to be recruited following
procedures of the State Government.
At present, all recruitment of personnel is centralised through the Public
Service Commission and subject to Constitutional and other provisions relating to
reservation, age limit, recruitment rules etc. On a conservative estimate it would take
12 to 18 months before recruitment process can be finalised. In the circumstances it
was felt that the maintenance activity could be started immediately by engaging
consultants to manage the maintenance activity
for an initial period and
simultaneously to assist the state in recruiting and training engineers and technicians
to take over the maintenance activity. The world Bank agreed with this suggestion and
requested the State to submit TOR for consultants. The matter was placed before the
PGB and approval was given for inviting proposals from consultants and selecting
suitable consultants. (Copy of the PGB proceeding is enclosed)
It is in this background, the following proposals are made for initiating
maintenance activity immediately to be prepared for receiving, installing and
commissioning equipment which is currently being procured.
2. Proposal
A consulting firm will be hired to set up;
a) Basic maintenance facilities at each of the four divisional head quarters.
b) Equipment Maintenance workshop at Bangalore, Mysore, Dharwad and
Gulbarga districts by utilising the services of maintenance staff already
employed in the Directorate.
c) maintenance facilities in Bijapur district by hiring the services of outside
consultant as an experimental measure.
The consulting firm engaged for setting up of facilities at divisional head
quarters will provide technical support and guidance to maintenance staff manned by
departmental staff and supervise the work of consultant engaged for providing
maintenance facilities in Bijapur district.
3. Maintenance by Departmental Staff
It is proposed that one engineer and four technicians be posted for each
maintenance unit. There are 6 engineers, 13 diploma holders and 13 technicians
Page 7^
available for re-deployment. With this manpower, a maximum of 6 maintenance
teams can be raised. As per the project document Bangalore requires three
maintenance teams, Mysore and Dharwad districts requires two maintenance each and
Gulbarga requires one maintenance team. It is proposed to deploy one maintenance
unit in Bangalore and Gulbarga districts and two each in Mysore and Dharwad
districts. However, to cover the maintenance activity for the balance 15 districts, the
project envisages to engage a consulting agency to set up equipment maintenance unit
in each of the divisions covering these districts.
These equipment maintenance units in each division will report to the
Divisional Joint Director, stationed in the divisional headquarters, for administrative
purposes . For planning and technical guidance these units will be supervised by the
consulting agency at the headquarters.
The administrative support staff for these units will be provided by re
deployment from the respective districts. The administrative personnel as envisaged in
the Project are Office Superintendent, FDA, SDA, Driver and Group D.
Maintenance Workshop equipment will be procured after examining
availability of the equipment procured under IPP-III for Belgaum and Gulbarga
divisions.
4. Maintenance by Consultant
The district maintenance unit for Bijapur district is proposed to be handed over
to an outside consultant.
5.
Prime Consultant for Setting up of Maintenance System
The prime consultant is expected to set up maintenance units at each
divisional headquarters to undertake maintenance activities in districts which have
not been handed over to either departmental staff or outside consultants and
hospitals in Bangalore district not assigned to departmental staff. Apart from this,
the prime consultant has to assist the State Government in recruiting and training
maintenance staff to ultimately take over all maintenance activity.
The consultant has to engage one Bio-Medical engineer, one X-ray
engineer and ten technicians at each divisional headquarters to cater to the
maintenance needs of the hospitals in the division.
6.
Obligation of the Government
•
•
•
Providing administrative staff.
Equipment and vehicles for all the workshops.
Spares valued at Rs. 17.57 million (cumulative) will be procured by
the Project Administration and stored at Headquarters and also at
Page 75
district headquarters. The procurement and stocking procedures will be
based on ABC and XYZ analysis of spares consumption.
7. Budget Estimate
The number of staff to be employed by the department / consultants is
given below
Staff Category
Bio-medical Engineer
X-ray Engineer
Engineer
Technicians
Dept.
Staff
Bijapur
Consultant
0
0
6
24
0
0
1
4
Prime
Consultant
Total
4
4
0
40
4
4
7
68
The estimated cost of the proposals in Section 3 to 5 are provided in the
following table along with the provisions made in the project proposal.
Comparative Costs of Proposed Project and Revised Maintenance System
All cost in Rs. Million
Item of Expenditure
Maintenance Cost by
Dept. Staff
Capital Expenditure
Building
Furniture
Equipment
Other Facilities
Vehicle
Sub Total
Recurring Expenditure
Staff Salaries (Technical)
Staff Salaries
(Administrative)
Senior Consultants
Total Staff Salaries
TA&DA
POL
Other
Operating
Expenses
Total Expenditure
Total
Provision in
the project
Proposal
22.57
4.14
25.60
4.65
9.40
66.36
Bijapur
Prime
Consultant Consultant
6.84
1.14
9.00
1.20
2.25
20.43
0.76
0.15
0.95
0.15
0.38
2.39
14.06
2.67
16.40
2.70
'6.37
42.2
21.66
3.96
26.35
4.05
9.00
65.02
1.9
1.39
0.67
0.23
7.13
3.94
9.70
5.56
0.00
3.29
0.45
0.54
0.99
0.00
0.90
0.23
0.09
0.32
1.20
12.27
2.16
1.53
3.69
1.20
16.46
2.84
2.16
5.00
24.71
3.61
58.16 86.48
*
* This excludes cost of spares.
Page 76
20.70
3.19
90.25
Immediately on setting up of various maintenance groups as mentioned above,
there will be 8 workshops in operation. The balance 16 workshops and central
workshop will have to be established within next three years and avail the full
reimbursement cost.
The recruitment of the balance departmental staff to phase out the consultancy
groups has to be initiated and completed fast as the reimbursement of the recurring
cost for this group will be diminishing with time. The reimbursement cost is 90 % in
the first years, 75 % in the next two years and 40% in the last year. With any delay in
the recruitment of the departmental staff for maintenance activity, the burden on the
State will increase.
Page 7 7
Action taken on Communicable Diseases under Surveillance Bureau
Proposals
Action Taken
1. Shifting of Communicable Disease
Intelligence Unit, Mandya, along with
its 38 staffs to Bangalore and attach to
the Additional Director (CMD) State
Communicable Disease Surveillance
Unit, and to function as District
Surveillance Unit for Bangalore Urban
and Rural Districts.
_____
New building is being constructed at
Bangalore for the surveillance unit. The
present unit at Mandya will be shifted to
Bangalore by the December of 1997.
2. Up-gradation of existing 18 District Notification is being issued.
Laboratories and re-naming as District
Surveillance Unit.
Special recruitment
formulated.
3. Recruitment of the following staffs :
18
a. Micro Biologists
18
b. Asst. Entomologists
18
c. Senior Health Assts.
18
d. Drivers
20
e. Witlets Operators
■X'
rules
are
being
4. Re-Deployment the following staffs Orders are being issued.
from the Health Department to 18
District
Communicable
Disease
Surveillance Units.
a. Asst. Statistical Officers 18
18
b. Typists-cum-clerks
18
c. Senior health Assts.
36
d. Group ‘D’ servants
5. Sanction of the creation of
following supportive staffs to
Addl. Director (CMD)
a. Gazetted Assistant
b. Office Superintendent
c. First Div. Asst.
d. Second Div. Asst.
e. Stenographer
f. Typist-cum-clerk
g. Statistical Officer
h. Asst. Statistical Officer
Sr. Health Asst.
i.
Group
‘D?
1
the Posts have been sanctioned. Staff are
the being posted.
01
01
02
03
01
01
01
02
04
04
The office of the State Surveillance Unit
is being set up in the premises of
6. There is a Bureau of health
Epidemic Diseases Hospital, Indiranagar,
Intelligence with 14 following staffs,
Bangalore. A decision has been taken to
OR
Page 7*5
6. There is a Bureau of health
Intelligence with 14 following staffs,
which is now attached to the
Directorate of health & F W Services,
Bangalore under the control of Joint
Director (H & P). This B.H.I. is now
shifted and attached to the Additional
(CMD) State Communicable Diseases
Surveillance Bureau to :
Epidemic Diseases Hospital, Indiranagar,
Bangalore. A decision has been taken to
attach the staff of Bureau of Health
Intelligence to this State Surveillance
Unit.
a. Perform the survey conducting
work, compile morbidity and
mortality data, by disease, for
planning and working out the
priorities and strategies.
b. Evaluate the effectiveness of
interventions instituted to
control epidemics.
c. Carry out research studies and
suggest
innovative
innovative
and
effective
methods
of
intervention.
Staff:
Being posted
Statistical Officer -1
Asst. St. Officer -2
F.D.A
-3
S.D.A
-2
Group ‘D’
-4
Stenographer
Typist cum
1
Clerk
1
7. Purchase
of
equipments
and Procurement procedure are being
laboratory supplies as per annexure
(8) ofthe KHSDP report.
8. Purchase of 19 Jeeps (vehicles)
IFB is cleared. Bids are being invited.
9. Purchase of furnitures to the Procurement
additional staff of 18 district initiated.
Communicable Disease Surveillance
Units
procedure
are
being
10. Formation of Intersectoral Co Constituted at State level. Orders are
ordination committees at various letel. being issued to the district level.
11. Training programme of various A detailed training programme is already
prepared._________________________
categories of staff in 18 districts.
12. Repairs and additions to the District All district laboratories have been visited
by Engineer.
Estimates are being
Laboratory Buildings.
prepared.
Page^
- Media
4905.pdf
Position: 1784 (5 views)