ANNUAL REPORT1993-94 DEPARTMENT OF FAMILY WELFARE
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ANNUAL REPORT1993-94
DEPARTMENT OF FAMILY WELFARE - extracted text
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ANNUAL REPORT1993-94
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MINISTRY OF HEALTH AND FAMILY WELFARE
GOVERNMENT OF INDIA
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CONTENTS
T
11
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.I
PART-I
DEPARTMENT OF FAMILY WELFARE
Chapter-I
Highlights
1
Chapter-II
Organisation
5
Chapter-Ill
National Family Welfare Programme
7
Chapter-IV
Budget Outlays and Expenditure
11
Chapter-V
Facilities and Services
17
Chapter-VI
Maternal and Child Health Programme
29
Chapter-VII
Rural Health Services
39
Chapter-VIII Demographic Research and Evaluation
43
Chapter-IX
Organised Sector and Voluntary Organisation
45
Chapter-X
Information, Education and Communication
53
Chapter-XI
Performance
63
Chapter-XII
International Assistance and Area Development Projects
71
Chapter-XI11 Autonomous Bodies and Subordinate Organisations
PART-II
Page No.
p-
77
DEPARTMENT OF HEALTH
Introduction
89
Chapter-I
Organisation
95
Chapter-II
Health Plans
99
Chapter-Ill
Medical Relief and Supplies
103
Chapter-IV
National Health Programmes
117
Chapter-V
Prevention and Adulteration of Food and Drugs
133
Chapter-V I
Medical Education, Training and Research
137
Chapter-VII
Indian System of Medicine and Homoeopathy
185
Chapter-VIII Facilities for Scheduled Castes and Scheduled Tribes
under Special Component(Plan for Scheduled Castes and
Tribal Sub-Plan)
203
Chapter-IX
Use of Hindi in Official Work
209
Chapter-X
International Cooperation for Health and Family Welfare
211
/
I
annexures
Annexure-I
Organisation Chart of Department of Family Welfare
Organisation Chart of Department of Health
Chart-of Directorate General of Health Services
Annexure-lII Organisation
welfare
Offices
rhe
Annexure-lV Subordina.e
under
and
Minis.r,
of
Welfare
Henlrh
Fannl,
Subordinate Offices under the Ministry o
Annexure-II
Annexure-V
4
Subordinate
Offices under
the Directorate
under the
Subordinate Offices
Directorate General of Health Services
Annexure-Vl ^oHnsbtuton^^
s. :
ing the year 1993-94 as on 31-12-1993.
Annexure-VH Listef ^.ifutions/
1993-94 as on 31-12-93.
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The President, Dr. Shanker Dayal Sharma releasing the Two-Rupee
coin with the slogan 'Chhota Pariwar Khushian AapaP on the occasion of
the World Population Day, 11th July, 1993.
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POPULATION OF INDIA
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HIGHLIGHTS
Shri B. Shankaranand and Shri Paban Singh
Ghatowar assumed charge as Minister and
Deputy Minister respectively on January
19, 1993. Dr. C. Silvera has assumed charge
as Minister of State on February 18, 1994.
1.1.2 The population of the country was
846.3 million on 1st March, 1991 (1991
Census) as against 683.3 million in 1981.
The absolute addition to the population in the
decade of 1981-91 was 163 million, which is
almost equal to the population added during
the three decades 1931-41, 1941-51 and
1951-61. The annual average exponential
growth rate of population has come down
marginally from 2.22% during 1971-81 to
2.14% during 1981-91.
The sex ratio
(number of females for every 1000 males),
which was 934 in 1981, declined to 927 in
1991. The literacy rate among females went
up from 29.75% in 1981 to 39.29 in 1991.
The high growth of population is likely to
over-shadow the achievements that the nation
has made on the economic front. Every year
around 17 million people are added to the
population, which creates a demand tor
additional resources for clothing, housing,
food, education, health, schooling, etc. With
2.4% of the world land area, India supports
16% of the world’s population.
1.1.3 The provisional data from the Sample
Registration System (SRS) for 1992 indicate
that the estimated annual live birth rate has
gone down to 29.0 from 29.5 in 1991.
Within this, however, the States exhibit a
wide variation in the estimated live birth
rates. The States of Kerala and Tamil Nadu
have returned live birth rates of 17.5 and
20.7 respectively. The States of Assam,
Bihar, Haryana, Madhya Pradesh, Rajasthan
and the Union Territory of Dadra & Nagar
Havel i have returned live birth rates
significantly in excess of the national
average. In the rural areas, the birth rates
are significantly in excess of the national
average. In the rural areas, the birth rate
continues to be higher (30.7), as compared to
\
CHAPTER-1
1
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(23 1) The death rate has gone
jrban areas •7 to 0.0 in 1992, as compared
IP marginally
hieeer Slates had dropped io
E•o 9.8! in,617"
80 V w The drop is sign.SeanL
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Munalnj «>>« sis""’ i0
natural growth rate,
• . —birth rates
SRS data shows a decline
rates
and death
i?97% in 1991 to 1.9% in 1992.
from I. —
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114 The achievements of the
Welfare Programme since tts mceptmn are
given below.
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achievements
of
THE FAMILY welfare
Parameter
\ s.
No.
1.
Birth Rate
2.
Death Rate
3.
Total Fertility Rate
4.
Infant Mortality Rate
(per 1000 live births)
5.
6.
Couple Protection Rate
(percent)
1951-61
1981
1991
41.7
37.2
22.8
15.0
5.97
4.5
146.0
110.0
29.0
SRS 92
10.0
SRS 92
3.8
SRS 90
79.0
SRS 92
10.4
(1970-71)
22.8
43.4
31.3.93
0.4
43.4
155.0
31.3.93
Cumulative Number of
Births Averted
(in million)
ton016A.D. India’s fertility and mortality
t0 "
distribution ot tne
4 thp
1.1.5
during
\
census.
1
Plan document ot the
1.1.6 The Eighth
Commission estimates mat the
Planning
Of population^shoukl be E78%
growth rate c. , .
by the end of Eighth Plan,
down to 1.65”% during 1996 to
should come down to 1.'
2001. It has •been> reckoned that the NRRmay be attained only in the pertod -01
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PROGRAMME
Xy be achieved only after several decades.
1.2
The Child Survival and Safe
Motherhood Programme
Survival and Sate
,2.1 A new Child
1.2.1
(CSSM)
is under
Motherhood Project
It
since
1992-93.
involves
implementation t----
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ACHIEVEMENTS UNDER FAMILY WELFARE
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1961 *
1951-61 *
IMR
TFR
546
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110
5.97
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<* IMR
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** Source :SRS
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participation. The new schemes have a clear
thrust towards promoting spacing methods
for ensuring population stabilisation. Closer
involvement of organised sector in adoption
of areas and in taking family planning
programmes outside their own employees are
being promoted.
sustaining the high coverage levels achieved
under UIP in good performing areas and
strengthening the programme in areas where
the coverage is still not satisfactory. It also
provides for augmenting various activities
under the Oral Rehydration Therapy (ORT)
programme, universalizing the prophylaxis
schemes for the control of anaemia in
children and pregnant women and control of
blindness in children and initiating a
programme of control of Acute, Respiratory
Infections (ARI) in children. Under the Safe
Motherhood Component, training of
traditional birth attendants in selected high
IMR/MMR districts, provision of aseptic
delivery sets and strengthening of first
referral units to deal with high risk and
obstetric emergencies are being taken up.
1.4
1.4.1 A new approach has been given to
the Information, Education and
Communication on the family welfare
programme with greater emphasis on
interactive local specific software and field
activities with concentration in the identified
weak States and Districts. Inter-personal
communication at the grass-root level is
being strengthened by giving impetus, to
training of Mahila Swasthya Sangh members,
organising Opinion Leaders Sensitisation
Camps and extending the IEC training
scheme to cover additional States and
Districts. Video Vans are being used in a big
way to ensure exposure of rural population to
the enter-educate electronic media software.
Streetplays and other folk formats are being
extensively organised to disseminate the
message of population control, family
planning and mother and child health.
1.2.2 Under the Child Survival Component
the UIP, ORT and Prophylaxis schemes and
essential maternal care at the community
level are already being implemented in all
districts of the country. Additional activities
related to ARI control has been taken up in
51 districts in 1992-93 and 103 districts in
1993-94. The Safe Motherhood component
of the Programme is being implemented in a
phased manner starting with 21 districts in
the year 1992-93. Another 30 districts have
been taken qp in 1993-94.
1.2.3 The CSSM Programme approved for
a period of 7 years with an outlay of
Rs. 1125.58 crore, is being supported by
UNICEF and the World Bank.
The
approved outlay for the Programme in the
8th Plan has been kept at Rs. 633.00 crore
only.
During the year 1992-93, the
estimated cash and commodity assistance to
the States / UTs has been calculated at
Rs. 100.73 crore. For the year 1993-94, the
Programme has been provided with an outlay
of Rs. 125 crore.
1.3
Information, Education and
Communication (IEC)
1.5
U.P. Project
1.5.1 An USAID assisted project named
‘Innovations in Family Planning Services in
U.P.’ has been launched in the State of Uttar
Pradesh. The project will cost U.S. $ 325
million over a period of ten years and has the
following goals
(i)
(ii)
Non-Governmental
Organisations
1.6
Decline in total Fertility Rate from
5.4 to 4; and
Increase in the Couple Protection
Rate from 35% to 50%.
Social Safety Net
1.6.1 The Department of Family Welfare
has identified 90 poor performing districts
categorised by high birth rates, high infant
1.3.1 Schemes for the involvement of
NGOs/voluntary organisations have been
revamped, to provide for greater community
3
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mortality rates and low levels institutional
delivery. 83 of these districts are located in
the States of Uttar Pradesh, Madhya Pradesh
Bihar and Rajasthan. To reduce the high
maternal mortality rate, increase institutional
deliveries and provide care to high risk
nre'mancies, it has been decided to utilise the
entire assistance likely to be available under
the World Bank's Social_ Safety. Net
Programme over a period ot five years from
1992-93. on upgradation ot facilities at the
rate of Rs. 10 lakh per PHC and five PHCs
per selected districts per year.
1.6.2 The items on which this assistance
are to he utilised are a well-equipped
operation theatre, a labour room, an
observation ward with six beds, two quarters
for the LHV and ANM, a generator, running
water supply and one ambulance per block.
Rs 45 crore has been released each year to
the States in 1992-93 and 1993-94. The State
Governments have been given flexibility in
implementation of this Scheme to avoid
overlapping with other programmes. Actum
for construction work is in advanced stage in
most States. Posting of lady doctors and
training of doctors is also under progress.
1.7
Area Projects
1 7 1 Currently, 11 Area Projects are being
implemented in 15 States and the U.l. ot
Delhi at a total cost of Rs. 1190.18 cror .
with financial assistance from World Bank,
United Nations Fund tor Populatum
Activities (UNFPA), Overseas Development
Administration (ODA) and Oamsh
International
Development Agency
(DANIDA). These projects have contribu ed
substantially to the strengthening ot the
Health and Family Welfare infrastructure m
the States. As many as 13,630 sub-Centres
350 PHCs/CHCs/LHV quarters and 15)
Training Institutions have been ^’nstru ^
and equipped under projects upto Oct., 1993.
In addition, about 3.43 lakh medteal and
para-medical functionaries have been trained.
1 7 2 The mid-term and end line evaluation
studies of Area Projects have indicated that
significantly
the Projects have contributed
c.....
towards the development of the physical
infrastructural facilities in the Project Area,
in addition to improvements in the quality of
delivery of
of Health
Health and Family Welfare
delivery
Services to the people leading to substantia
reduction in birth rate and Maternal and
Child Mortality.
4
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ORGANISATION
The Department of Family Welfare is
headed by a Secretary to the Government of
India. The Secretary, Family Welfare is
assisted by three Joint Secretaries who look
after various programmes being implemented
by the Department.
2.1.2 Policy Formulation, Technical
Operation, Intelligence and Evaluation,
Planning and Budget Formulating;
Autonomous Bodies and Subordinate Offices-;
Supply of Contraceptives; International Aid
for Family Welfare; Urban Family Welfare
Programme and Contraceptive Research
Programmes are looked after through various
divisions under a Joint Secretary.
2.1.3 Maternal and Child Health Services
including Child Survival Programmes like
Universal Immunization, Control of Acute
Respiratory Infections, Oral Rehydration
Therapy Programmes, Related Training
Programmes and special Area Development
Projects in selected States/ Districts are also
under the charge of a Joint Secretary.
2.1.4 Administration and Finance are
jointly looked after for both the Departments
of Health and Family Welfare in the
Ministry.
2.1.5 Information, Education and
Communication; Rural Health Services
including Village Health Guide Scheme and
Training of Medical and Para Medical
Personnel, setting up of Sub-Centres,
monitoring of setting up Primary Health
Centres, Community Health Centres;
Voluntary Organisations and Cooperatives
and Organised Sectors are looked after by
another Joint Secretary.
2.1.6 The Department directly operates one
subordinate office and three autonomous
bodies/ PSUs. Various regional offices under
the control of Director General of Health
Services also form part of the overall
organisation.
CHAPTER-II
2.1.7
5
The tbllowing Technical Divisions
I
X)
are functioning in the Department
i)
Programme Appraisal and
Special Schemes;
ii)
Technical Operations;
iii)
Maternal and Child Health;
iv)
Evaluation and Intelligence;
v)
Information, Education
Communication;
vi)
Supply Division;
vii)
Transport;
viii)
Universal Immunisation
Programme;
Area Projects; and
ix)
and
Rural Health Division.
2.1.8 The Technical Divisions look after
the technical aspects of family planning.
Evaluation and Intelligence Division help in
perspective planning and momtormg and
evaluation of the performance of various
programmes. It coordinates demographic
Research. The Rural Health Division looks
after health infrastructure at the periphery
level overseas training and extension
components and facilities and services.
2 19 The IEC Division is responsible for
providing communication, educational
publicity and extension support to the
programme through Mass Education and
Extension Education with emphasis on inter
personal communication. It is also looking
after population education activities.
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Increasing the coverage of
low parity eligible persons
through promotion of spac
ing methods is an important
policy initiative.
L
Promoting child survival
through proper monitoring
of growth.
i
< )
NATIONAL
FAMILY WELFARE
PROGRAMME
The National Family Welfare Programme
was launched in India in 1951 with the
objective of reducing the birth rate to the
extent necessary to stabilise the population at
a level consistent with the requirement of the
national economy.
In keeping with the
democratic traditions of the country, the
Family Welfare Programme seeks to promote
responsible and planned parenthood through
voluntary and free choice of family planning
methods, best suited to individual acceptors.
People’s participation is sought through local
self-government including voluntary
organisations and opinion leaders at different
levels. Imaginative use of mass media and
interpersonal communication is made for
highlighting the benefits of small family
norm and removal of socio-cultural barriers
for adoption of family limitation
programmes.
3.1.2 The long-term demographic goals, as
laid down in the National Health Policy
(1983), is to achieve a Net Reproductive Rate
of Unity (NRR-1) by the year 2000 A.D.
This corresponds to achieving a birth rate of
21 per thousand, death rate of 9 per thousand
and natural population growth rate of 1.2%.
The National Health Policy also envisages
reducing infant mortality rate to below 60 per
thousand live births by the turn of the
century.
3.1.3 The Seventh Plan Document
visualised that the goal of reaching NRR-1
may be achievable only in the period 20062011 A.D.
3.1.4 Keeping in view the present levels of
achievement, it has been stated in the Eighth
Five Year Plan Document that NRR-1 would
now be achievable only in the period 2011-16
A.D. The goals to be achieved by the end of
the Eighth Plan under the Family Welfare
Programme are given below:
Indicator
a) Crude Birth Rate
(per 1000 population)
CHAPTER-III
i
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Goal to be achieved
by end ofEighth Plan
26.0
i
b) Infant Mortality Rate
(per 1000
live births)
70.0
c) Couple
Protection
Rate
56%
3.1.5 The Sample Registration System tor
1992 brings out the marked inter-State
variation points to the need for differential
strategies and greater efforts on the part of
States, which have recorded Infant Mortality
Rates and live birth rates significantly above
the national average.
Policy Initiatives
3.2
3.2.1 Action Plan: To impart dynamism to
the Family Welfare Programme, a resultoriented Action Plan has been evolved by the
Ministry of Health and Family Welfare m
close consultation with the States/UTs. It
was unanimously endorsed in the conference
of Health Ministers held at New Delhi on 6-7
January, 1992. The Action Plan highlights
the need for evolving a national consensus in
support of the Family Welfare Programme
and to obtain the willing participation of all
sections of the society. Its key features
include, (i) improving the quality and
outreach of family welfare services; (n)
differential strategy for special focus on 90
poor performing districts (birth rate of 39 per
thousand population and above as per 1981
census); (iii) developing a mechanism to
make available funds to States/UTs on the
basis of reduction of actual birth rate; (iv)
increasing the coverage of younger- age
couples through vigorous promotion of
spacing methods; (v) introducing new
contraceptives and improving the quality of
contraceptives; (vi) strengthening family
welfare schemes in urban areas, especially in
slum pockets; (vii) revitalising training
activities of medical/para medical personnel
with emphasis on motivational and
counselling aspects; (viii) sustaining the good
work done under the Universal Immunisation
if
Programme and strengthening of other
interventions for Maternal and Child Health
Care; (ix) re-orientation of information,
education and communication efforts to focus
on the quality of life issues and inter-personal
•communications; (x) involving voluntary and
non-governmental organisations in a big way
to promote active community participation in
the Programme; (xi) gearing up of the
implementation machinery in the States/UTs;
and (xii) evolving high level inter-sectoral
coordination mechanism at the national, State
and district levels, etc. All the States/Union
Territories have been requested to
operationalise the d ifferent components of the
Action Plan. The progress of implementation
is being periodically reviewed by the
Department.
3.2.2 Constitution of NDC Committee on
Population: It was stated in the National
Health Policy (1983) that in view of the vital
importance of securing a balanced growth of
population, it is necessary to enunciate,
separately, a National Population Policy. A
National Population Policy has yet to be
evolved. The National Development Council
(NDC) in its meeting held on 23-24th
December, 1991 gave broad approval to the
strategies calling for demonstrating strong
political will, evolving a national consensus
in support of the population control
programme, sustained administrative efforts
and adopting population stabilisation
measures based on a holistic and multi
sectoral approach. In pursuance of the
decisions taken in the NDC, a Committee of
the NDC on Population was constituted by
the Planning Commission under the
Chairmanship of Chief Minister, Kerala in
February, 1992. The Committee was, interalia entrusted with the task of recommending
appropriate formulations for a National
Population Policy, identifying effective
intervention strategies, both at macro and
micro levels, on a holistic and multi-sectoral
basis and suggesting mechanisms for securing
commitment and support of leadership of all
denominations and at all levels, tor a
National Population Policy and the
implementation of the population control
programme. The report of the Committee
was endorsed by the NDC in its meeting on
l&th September, 1993.
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ACHIEVEMENT UNDER FAMILY WELFARE
50
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Source : SRS
1970-71
1981
e
CUMALITATIVE No. OF BIRTHS AVERTED
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3.2.3 National Population Policy: A group
of experts has been set up under the
Chairmanship of Dr. M.S. Swaminathan to
prepare a draft ot the National Population
Policy. The group has met twice on 14th
August and 23rd and 24th October, 1993.
3.2.4 Prescription of Policies through
Legislation, Rules and Regulations : (i)
Introduction of the Pre-Natal Diagnostic
Techniques (Regulation and Prevention of
Misuse), Bill, 1991: With a view to curbing
the abhorrent practice ot misuse, ot pre-natal
diagnostic techniques, tor determination ot
the sex ot the toetus leading to temale
foeticide, a Draft Bill entitled ‘Pre-natal
Diagnostic Techniques’ (Regulation and
Prevention of Misuse) Bill, 1991 had been
introduced in the Lok Sabha on 12.9.1991.
It was subsequently referred to a Joint
Committee under the Chairpersonship ot
Sml. D.K. Thara Devi Siddhartha, ex
Minister of State tor Health and Family
Welfare. The Committee has submitted its
report during the Winter Session ot the
Parliament in December, 1992. I he Bill, as
reported by the Joint Committee, could not
be taken up for consideration and will now
be taken up in the Winter Session.
r-J
inclusion in (he Fundamental Duties, a duty
to promote and adopt the small family norm
by the citizens. It is also proposed that a
person shall be disqualified for being chosen
and for being a Member of either House ot
the Parliament or either House ot the
Legislature of a State, it he has more than
two children. These amendments will,
however, have prospective ettect and will not
apply to any person who has more than two
children on the date of commencement ot the
proposed amendment or within a period ot
one year of such commencement. The Bill
could not be taken up for consideration in the
last Session.
3.2.5 Action on the Constitution (Seventy
Third Amendment) Act : The Constitution
(73rd Amendment) Act, 1992 has come into
force with effect from 24.4.93.
The
Constitutional
stipulates
amendment
constitution of panchayats at the village,
intermediate and district levels. Under
Articles 243 (G) of the Constitution, State
Legislatures —t
may endow the panchayats with
’1'* -mthuritv
powers aand
authority in respect of the
subjects shown in the Eleventh Schedule to
the Constitution, which include family
welfare as well as related subjects like
child development, health and
t-- ----women and
sanitation, social welfare, education and
maintenance of community assets.
3.2.4 (ii) introduction of the Constitu
tion (Seventh-ninth Amendment) Bill, 1992:
With a view to demonstrating strong political
will and commitment for population control,
the Constitution (Seventy-ninth. Amendment)
Bill 1992 has been introduced in the Rajya
Sabha on 22.12.1992. The Bill stipulates
amendment of the Directive Principles ot
State Policy to provide that the State shall
endeavour to promote population control; and
3 2.6 A suggestive list of activities
connected with family welfare that could be
entrusted to the panchayats at various levels
has been drawn up in consultation with the
State Health Secretaries in a meeting held on
3rd September, 1993.
-
9
BUDGET OUTLAYS
AND
VOTTXT'FlIT5! TT? IT
H/Al tLll il l I U 1x11/
The financial outlays under the programme
have been increasing over the successive Five
Year Plans. The Family Welfare Programme
,s being implemented as a Centrally
Sponsored Scheme under which cent per cent
assistance is provided to the States.
Expenditure in Successive Plans
4.2
4.2.1 The figures of expenditure under the
programme from the First to Seventh Five
Year Plans are given in Table 1.
4 2.2 The main reason tor sharp increase in
the volume of expenditure is that committed
liabilities of the previous plans have been
passed on to successive Five Year Plans.
This is a unique feature ot the Family
Welfare Programme.
a
4 2 3 An allocation of Rs. 1,270.00 crore
(including Rs.210.00 crore for liquidation of
arrears) has been provided tor 1993-94. The
departmental figure of exPen(J^r(?1to^lle1
Five Year Plan and during 1990-91, 1991-92
anticipated expenditure during 1992-9.2 and
outlay for 1993-94 are as shown in Table 2.
4.3
Outlays for Important Schemes
Rural Family Welfare Centres:
4.3.1
There are 5,435 Rural Family Welfare
Centres, functioning in the country at
present. These centres were established at all
the block level PHCs sanctioned upto 1.4.80.
After 1.4.1980, Family Planning Services are
being provided through integrated facilities at
PHCs. No further Rural Family Welfare
Centres have been sanctioned. These Centres
are entrusted with the responsibility of
implementing the Family Welfare
Programme, i.e. Planning Mobilisation
Monitoring, Administration and Supervision
in their areas. A provision of Rs. 152.00
crore has been made in B.E. 1993-94.
Sub-Centres-. In order to provide
4.3.2
comprehensive Primary Health Care Services
at the grass-root level, it is envisaged to have
CHAPTER IV
11
I
one Sub-Centre for ever) 5,000 rural
population in plain areas and 3,000
population in the tribal and hilly areas.
I hese Sub-Centres are the only peripheral
health institutions which provide basic health
and family welfare services to the rural
1,31.118 Sub-Centres are
population.
functioning as on 30.7.93 as against 82,946
•is on 1.4.85. A provision of Rs. 185.00 crore
has been made in B.E. 1993-94 for
continuation of Sub-Centres already
established.
Programme for prevention of
deaths due to dehydration;
and
(c)
4.3.3 Urban Family Welfare Centres .For
providing family welfare and MCH services
in urban areas, 1,529 urban family welfare
centres have been sanctioned in the country.
To improve the outreach service-delivery
system in urban slums. Urban Revamping
Scheme has been introduced. The scheme of
revamping of urban family welfare services
envisages the reorganisation of existing
Urban Family Welfare Centres / Establish
ment of various categories of Health Posts in
the cities/towns with more than 1,00,000
population and having at least 40% of the
population residing in slum areas. So far, 936
health posts under the scheme have been
sanctioned by Govt, of India out of which
870 are in position.
I
4.3.4 (i) Two pilot programmes have been
launched with UNICEF’s financial
financial assis
tance. These are:
(a)
(h)
(b)
Oral
4.3.4 (iv) The Project has the following two
major components:
Immunisation
(a)
Rehydration Therapy
12
I
An intensified programme
of Acute
for control
Respiratory Infection among
children.
The various child survival
4.3.4 (iii)
interventions, particularly in terms of
logistics, administration and training have
now been integrated into one project, namely
Child Survival and Safe Motherhood Project.
This project has been formally launched on
the 20th August 1992.
4.3.4 Child Survival and Safe Motherhood
The
Universal Immunisation
Project:
Programme and other maternal and child
health care programmes aim at achieving
reduction in infant mortality to below 60 per
thousand live births and child mortality rate
to 10 per thousand by the year 2000 A.D. To
move towards this direction, the following
specific programmes are being implemented
bv the Department of Family Welfare;
Universal
Programme;
Intensified Dais Training
Programme for improving
prenatal and delivery care;
and
4.3.4 (ii)
Whereas the UIP, ORT and
Prophylaxis schemes
are now being
implemented in the entire country, the two
pilot projects mentioned above are being
implemented only in selected districts of the
country.
4.3.3 (i) A provision of Rs.28.00 crore has
been made in B.E. 1993-94 for maintenance
of Urban Family Welfare Centres and
revamping of urban level organisations.
(a)
Prophylaxis schemes against
nutritional anaemia among
pregnant
and
lactating
mothers as well as children
upto 5 years of age and
against blindness due to
Vit. A
deficiency among
children under 5 years of
age.
UIP Plus package consisting
of UIP. ORT, Prophylaxis
schemes and ARI Control
Programme; and
&
1
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3
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(b)
Safe Motherhood initiatives
for the six high I MR States
of Assam. Bihar, Madhya
Pradesh, Orissa, Rajasthan
and Uttar Pradesh.
4.3.4 (v) Activities relate*! to ARI control
along with training of medical and para
medical personnel (termed as Child Survival
component) was initially taken up in 51
districts in 1992-93 and further extended to
another 103 districts in 1993-94. Similarly,
setting up of First Referral Units tor
improving emergency obstetric care in the
States of Assam, Bihar, Madhya Pradesh.
Orissa, Rajasthan and Uttar Pradesh (termed
as Safe Motherhood component) which was
taker up in 21 districts in 1992-93 has been
further-extended to 32 districts d u r i n g
1993-94.
4.3.4 (vi) An amount of Rs. 125.00 crore
has been kept in B.E. 1993-94 for this
Project.
4.3.5 Transport: Mobility plays a crucial
role in effective supervision and providing
outreach service delivery system. Vehicles at
various levels are provided by the
Government of India to States. Assistance tor
maintenance for these vehicles @ Rs. 15,000/per annum per petrol-driven vehicle and
Rs.9,000/- per annum per diesel-driven
vehicle is provided.
Besides,
old
unserviceable vehicles are replaced at the rate
of approx. 10% of total fleet of 7.788
vehicles every year.
Rs.200
per case
I.D.D.
Rs.! 2
per case
(Rs. 15
if the
acceptor has
two
or less
children).
4.3.6 (ii) A provision of Rs. 100.00 crore
exists in B.E. 1993-94 for the purpose.
4.3.7 Posi-Partum Programme: The PostPartum Programme is a maternity-centred
hospital-based approach to Family Welfare
Programme. The objective of the pro
gramme is to provide ante-natal and post
natal services to expectant mothers and also
to provide family planning services. A total
of 550 district level hospitals including 206
medical colleges have been covered with
Post-Partum Centres. In order to detect
cervical cancer among women acceptors, a
scheme of PAP Smear Test facility has been
105 Medical Colleges
introduced in
/Institutions of the country. Encouraged with
the success of the programme at district
level, Post-Partum Programme was extended
to sub-district level in a phased manner
starting from the year 1980-81. There are
1.012 sub-district level Post-Partum Centres
functioning at present.
4.3.7 (i) A provision of Rs. 49.05 crore
exists for the programme in B.E. 1993-94.
4.3.5 (i) A provision of Rs. 15.80 crore
exists in B.E. 1993-94 for maintenance of
existing vehicles and replacement of old
unserviceable vehicles.
4.3.8 Supplies of Contraceptivesfor Spacing
Methods: Recognising the tact that more
younger couples are entering the reproductive
age group, terminal methods of family
planning, namely sterilisation cannot be
advocated for them. To respond to the needs
of the younger couples,
various
contraceptives under spacing methods of
Family Planning such as oral pills, condoms.
Copper T’s , etc. are offered- under the
programme.
4.3.6 (i) Compensation : To compensate
acceptors of IUDs as well as terminal
methods of Family Planning against the loss
of wages, cash compensation at the following
rates is presently admissible:
Vasectomy
Tubectomy
Rs. 180
per case
13
4.3.8 (i) A provision of Rs. 125.00 crore
exists in B.E. 1993-94 under the programme
for supply of conventional contraceptives.
Oral pills. Copper Ts and Laparoscopes -both
under free and social marketing schemes.
I
Union Territory of Delhi with financial
assistance from World Bank, UNFPA,
ODA(UK) and DANIDA. A provision of
Rs. 70.00 crore has been made in B.E.
1993-94 tor the purpose.
4.3.9 In.formu.tion, Education and Communi
cation. In order to achieve wider adoption of
Family Planning methods, a broad based
information, education and communication
approach has been adopted. The activities
under this scheme are carried out by
respective Mass Education and Media Units
of the States by the IEC Division at the
Centre through units of the Ministry of
Information and Broadcasting and through
activities of various Ministries/ Departments
of the Govt, of India. These activities are
coordinated and monitored by the
Information, Education and Communication
(IEC) Division at the Centre which prepares
proto-types, formulates policies and provides
guidelines and support for the
operationalisation of the total media
endeavour in the country to promote family
welfare and popularise the small family
norm.
-1
4.3.12 Village Health Guides: The Village
Health Guide Scheme aims to train local
persons, preferably a woman, from the
community to provide Primary Health Care,
Family Planning and MCH Services to the
people. Under the Scheme, a Health Guide is
selected by the Village Community for every
1,000 population or a village and is provided
an honorarium of Rs. 50/- per month. As on
30.9.93, 3,24,727 VHGs were in position of
which 0.80 lakh are males. A provision of
Rs. 21 crore has been made in B.E. 1993-94
for the scheme.
4.3.13 Research and Evaluation: For
purpose of research in contraceptives
technology and demography and conducting
evaluation studies, grant-in-aid is being
provided to Indian Council of Medical
Research, National Institute of Health and
Family Welfare, Central Drugs Research
Institute in Ayurveda and Siddha and Central
Council for Research in Unani Medicines
under the programme. A net-work of 18
population research centres is operational in
various universities and institutions of
National repute to conduct studies on die
Family Welfare Programme, demographic
and other related subjects. A small provision
has also been kept in the budget for
Ad-hoc
concurrent evaluation.
research/evaluation studies and experimental
research are provided under the programme,
while a National Centre for Technical
Evaluation of IUDs and tubal rings has been
set up at IIT, New Delhi.
4.3.9 (i) A provision of Rs. 25.00 crore has
been kept for IEC activities during 1993-94.
I
4.3.10 Training: The success of family
welfare programme depends to a large extent
upon the availability of qualified and trained
workers. Training is, therefore, given due
weightage under the programme.
I
4.3.10 (i) The training at various levels is
imparted through the network of ANM
Training Schools, Multi-purpose worker
(Male) Training Schools, LHV Training
Schools and Health and Family Welfare
Training Centres, Family Welfare Training
Research Centre, Bombay.
4.3.13 (i) An outlay of Rs. 12.98 crore has
been provided during 1993-94.
(ii) ;An amount of Rs. 19.70 crore
I■ 4.3.10
has been provided iin the B.E. 1993-94 for
|
4.3.14 Social Safety Net: Under the Social
Safety Net it is proposed to bring about:(i)
Reduction in
maternal
mortality in remote rural
areas to a level of 1-2/1000;
training purposes.
4.3.11 Area Projects:
Area projects are
, currently being implemented in 15 States and
14
j
1
i
(ii)
Increase the number
insttitutional deliveries
aseptic conditions; and
(iii).
Bring down
Mortality Rate
the
of
is
Infant
.2/. '. (i)
'.) This is sought to be done by
4.3.14
providing Primary Health Centres (30,000
population) in 90 demographically poor
performing districts with a well equipped
operation theatre, a labour room and an
observation ward with six beds, running
water, power and staff quarters. The total
project outlay for the year 1992-93 to 199697 is envisaged at Rs.320.00 crore and a
provision of Rs.4000.00 lakh has been made
during 1993-94.
■r
4.3.15 Innovations in Family Planning
Services Project for Uttar Pradesh : A
project agreement was signed with the
USAID on 30.9.1992 regarding the
implementation of Family Welfare Project in
Uttar Pradesh. The main thrust of the project
is to bring down the total fertility rate in
Uttar Pradesh from 5.4 to 4.0 and to increase
the Contraceptive Prevalence Rate from 35%
to 50% during the period of 10 years. This is
to be achieved through
the following
1
interventions
(A)
(B)
4
the areas of technical assistance, training,
supply of contraceptive,etc. over a period ot
ten years. A provision of Rs.3000.00 lakh
h'as been made for this project.
4.3.15 (ii) Details of infrastructure in the
States/UTs funded under the family welfare
programme (as on 30.6.93) is shown in
Table 3.
4.4 Audit Inspection Report
4.4.1 As per information received upto 15th
September, 1993, from various Accountant
General and Director General of India, Central
Revenues, the number of Audit Objections and
the number of Audit Inspection Report ARI on
the accounts of the Department of F.W.
outstanding as on 15.9.1993 whereas under:
:
4
Inspection Reports
Audit Paras
10
Audit Objections
79
All efforts continue to be made to settle the
outstanding Audit objections and Audit
Inspection Report Paragraphs. An adhoc
Committee has also been setup to continuously
nonitor the process of settlement.
1
table
EXPENDITURE UNDER THE
PROGRAMME FROM THE FIRST TO
SEVENTH FIVE YEAR PLANS
(Rs. in crore)
Period
By increasing access to
Family Planning Services to
the population through a
massive involvement of the
public as well as non
governmental sector; and
First Plan (1951-55)
Second Plan (1956-61)
Third Plan (1961-66)
Annual Plan
(Inter Plan) 1966-69 ?
Fourth Plan (1969-74)
Fifth Plan (1974-79)
Annual Plan (1978-79)
Annual Plan (1979-80)
Sixth Plan (1980-85)
Seventh Plan (1985-90)
Annual Plan (1990-91)
Annual Plan (1991-92)
1992-93*__________
To improve the quality of
Family Planning Services by
expanding the choice ot
contraceptive methods and
by improving the technical
competence of personnel .
4.3.15 (i) The total assistance to be received
under this project is to be in the order ot 225
million dollars to be spent in the State tor
Family Planning activities, and 100 million
dollars to be spent directly by the USAID in
* Antici paled
15
Expenditure
’0.14
2.15
24.86
70.46
284.43
408.98
107.60
118.52
1,425.73
3,105.21
949.89
1,022.53
1,186.48*
r
?
i
_____
expen diture
SI. Name of (he Scheme
No.
1- Services and Supplies
2. Training
3. IEC
4. Research and Evaluation
5. MCH
6. Organisatioin
7. VHG
8. Area Projects
9. Other Schemes
10. Arrears
Total
for
the
CABLE 2
seventh
FIVE YEAR PLAN
Expenditure during Expenditure
during 1990.9]
VII Plan
1991-92
1762.37
23.74
61.43
61.86
735.52
63.59
132.67
264.00
.03
439.97
7.52
15.32
11.14
260.57
10.69
23.28
81.34
0.06
100.00
501.21
8.65
16.10
13.07
316.39
13.85
19.96
133.20
0.10
3105.21
— 949.89
1022.53
(Rs. in crore)
Anticcpatcd Outlay for
Exp. 1992-93 1993-94
554.94
8.79
18.85
13.04
336.75
14.20
20.00
73.66
46.25
100.00
516.87
8.70
25.00
12.98
322.75
10.95
21.00
70.00
71.75
210.00
1186.48
1270.00
______
TT/KBLE
DETAIL °F ’WRASTRUCTURE IN THE STATES / UTs FUNDED UNDER THE
FAMILY WELFARE PROGRAMME (AS ON 30-6-1993)
SI. No
Name of the Unit
1.
State Family Welfare Bureau
2.
District Family Welfare Bureau
3.
Health & Family Welfare Training Centres
4.
Multi-purpose Workers (Male) Training Schools
5.
Auxiliary Nurse Midwives Training Schools
6.
Promotional Schools for Lady Health Visitors
7.
Post-Partum Centres at District Level
8.
Post-Partum Centres at Sub-district Level
9.
Urban Family Welfare Centres
10.
Health Posts
11.
12.
Rural Family Welfare Centres
13.
No. of Units
25
416
47
80
462
44
550
1,012
1,529*
870
5,435
Sub-Centres
97,600#
Village Health Guides (in position) as per
information compiled upto 30.9.1992
3,24,727
IneIudes 208~w-ith Min. <.f Labour. Railways and Defence
The actual number of Sub-Centres is 1.31.1 18 but only about 97.600
16
are Centrally funded.
J
I
I1
I
I?'
’di
t.
0*
■•'■'’ m;
■*te-
Is '
151
B*’ *
I
Ensuruig mobility of medical and para-medical functionaries
*
M
•:rf
=
____
>
''
■
s' .•’'•.•< -'
il
w
J
■*
<
I
-'•Wk ;
C
f
Couples may
select any con
traceptive of
their choice.
F
FACILITIES
and
SERVICES
Advice, facilities and services to help
eligible couples plan their families are
provided free of charge in all sub-centres,
PHCs, CHCs and Rural Family Welfare
Centres, District Hospitals, etc. throughout
the country. Services are provided through
trained medical and para-medical staff.
5 1 2 All the methods of contraception are
tested for ensuring their
rigorously
effectiveness and safety to the users, before
they are introduced in the programme. Para
medical personnel involved in administering
methods like lUD/Oral Pill, are suitab y
trained. A check-list has been provided to
them for a proper selection and screening of
cases. A cafeteria approach is followed.
(Eligible
couples may select any
contraceptive of ’iieir choice offered m the
National Family Planning Programme.
■
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5.2
Procurement and Supply
5 2 1 In order to help a smooth flow of
services and supplies, procurement and
distribution of different contraceptives is
done by the Department of Family Welfare.
5 2 2 Condoms, Oral Contraceptive Pills
and IUDs are procured cemrally and
distributed to various States/UTs, NGOs,
Railways and Defence establishments under
free distribution scheme.
5.3
Condom
5.3.1 Rubber condom is a simple, reversible
and non-clinical method of contraception and
widely accepted by the younger age couples
for spacing. Condoms are found to be
effective in prevention of STD/AIDS diseases
also.
5.3.2 Condoms, under brand name ‘Nirodh’
are made available to acceptors tree ot
charge through Primary Health Centres,
Rural Family Welfare Centres and Sub
Centres in rural areas and through hospitals,
dispensaries, MCH Centres and Post-Partum
Centres in Urban Areas. This Scheme will
CHAPTER-V
i
17
J
States/UTs, Railways and Defence
organisations till the end of November 1993
agamst a target of 960.84 million pieces for
the whole year. Regular supplies to the
implementing agencies will be ensured during
1
5.3.4 Against a required quantity of 960 84
milhon pcs corresponding to the target of
Stai/HT’r 10n CC USCrS t0 be achiev«l by
X oa Governments and other agencies for
rnrn 9
3
°f 420'60 mill'On PCS.
from
ion?5
been distributed
t0 °CtOber 1993 as against
344 57 m" I
44.57 million pieces distributed during the
corresponding period in 1992-93.
I
L3;5 .. Wlth a view t0 improving the quality
of Indian condoms, Schedule ‘R’ of the
Drugs and Cosmetics Rules, 1945 is being
pended for ensuring that condoms conform
to WHO specifications. All condom
manufacturers in India have been advised to
gear up for ‘L
the change.
5.4
Oral Contraceptive Pills
5.4.1
brand Unde5w£bis scheme, OCRs under
brand name Mala-N' are distributed to the
acceptors free of cost. The raw materials
required for formulations of these pills are
received from UNFPA as commodity
assistance. Tabletting is done through
indigenous pharmaceutical firms.
5.4.2 A quantity of 415.89 lakh cycles of
Mala 4N’
supply) has been supplied to
era,
States/UTs, till the end of November 1993
!
ofB45Tlakh cycles f«r tbe
Xnsi993alf
year 1993-94. Regular supplies to the
durin tehntlng agencies wil1 be ‘tontinued
r^ma,n*ng part of the year with a
vfow fn
view to meet mg the target.
FUDs (Copper-T)
5.5
5-5.1 Copper-Ts are distributed to
acceptors free of cost. Til! 1991-92. this
i
^™Cept,Ve was Sported through
\vNkPt/1USAID as commodity assistance,
with the indigenous production/ assembly
facilities fully developed, the requirement for
the year 1993-94 is being met wholly from
the indigenous firms.
5.5.2 Against the annual target of 73.30
lakh Cu-T for the year 1993-94, 53.74 lakh
pieces have been supplied to the States/UTs
till the end of November, 1993. Regular
supplies will be continued during the
remaining period of the current year with a
view to meeting the annual target.
5.5.3 During the current year against the
annual target of 73.30 lakh Cu-T
achievement of 26.12 lakh Copper-T ha^
been reported till October, 1993 as against
in the eorresponding period of
5.6
Contraceptive Social Marketing
Programme
5.6.1
C •
Condoms:
The Contraceptive Social
Marketing Programme (CSM^^r^rrodh’
was launched in the country during 1968 with
the help of large and reputed consumer goods
pharmaceuticals and oil
marketing, pharmaceuticals
companies, both in public and private
sectors. This is the first and the largest
Under this
programme in the world.
programme, Nirodh is being sold at highly
subsidised price through numerous outlets of
these companies viz. ITC, Brooke Bond,
TOMCO, Hindustan Lever Ltd., Reliance
Bulk Drugs and Formulations, Indian Oil
Corpn., Bharat Petroleum Corpn. 'and
Hindustan Petroleum Corpn. Dry variety of
condoms has been phased out and three
brands of Nirodh are presently being sold
These are (i) New
under the scheme.
Lubricated Nirodh at a price of 50 paise for
a pack of 3 pcs.; (ii) Lubricated coloured
under the brand name ’Deluxe’ at price of
Rs. 1.50 for a pack of 5 pieces; and (iii)
Thin, coloured and lubricated variety ‘Super
Deluxe at a price of Rs.3/- for 4 pcs.
5.6.2
Besides,
Parivar Sewa
I
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i
1
1
1
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II
■W
-ft
f
t
Sansthan
18
1
I
11
(PSS), a Voluntary Organisation, is
marketing condom under the brand names
‘Sawan’ and ‘Bliss’ throughout India.
Population Services International (PSI) is
marketing Nirodh since 1988-89 in the States
of Punjab, Haryana, Jammu & Kashmir,
Himachal Pradesh and Rajasthan. They are
also selling their brand ‘Masti’ throughout
India. Two more brands are likely to be
introduced in the market during the current
year - ‘Tamanna’ by Reliance Bulk Drugs
and Formulations and ‘Dream’ by Parivar
Kalyan Kendra, a trust. Efforts are being
made to bring in more Voluntary/NonGovernmental Organisations for selling
Condoms under their own brand names.
5.6.7 A provision of Rs. 24.00 crore
has been made in B.E. 1993-94 against
Rs. 30.926 crore in R.E. 1992-93 and
Rs.30.00 crore in B.E. 1992-93.
5.7
Oral Pill
5.7.1 The Scheme of Social Marketing of
Oral Pills was launched in 1987. The brand
name Mala ‘D’ has been given to the product
under the Social Marketing Programme. The
raw material for manufacture of OCPs is
received as commodity assistance from
UNFPA and supplied free to domestic
companies for tabletting. These were till
recently being tabletted by M/s Indian
Drugs and Pharmaceuticals Ltd., Gurgaon /
Hyderabad and M/s Eupharma Laboratories,
Bombay. Now additional firms M/s Pfimex,
Hyderabad, M/s Pharmasia, Hyderabad and
Hindustan Latex Limited (Belgaum plant)
have been inducted for tabletting of oral pills.
Mala ‘D’ is sold at a subsidised price of
Rs.2/- per cycle. Each cycle consists of 28
tablets (21 active pills and 7 placebos).
5.6.3 Nirodh publicity campaign through
TV., AIR, Press and Cinema is being carried
out by D.A.V.P. and other publicity such as
hoardings, wall paintings, point-of-sale
material, arranging displays, participation in
melas etc. is being carried out by the
participating marketing companies. For this
activity. Government provides assistance at
the rate of 3 paise per piece sold, subject to
the marketing companies contributing at the
rate of 1 paise per piece sold, from their own
resources for this national endeavour.
5.7.2 It is marketed by M/s Hoechst India
Ltd., in the Northern Region, M/s Rail is
India Ltd., in the Western Region, M/s
Dey’s Medical Stores (Mgs) Ltd., in the
Eastern and Southern Regions, M/s RelianceBulk Drugs Formulations Ltd., Chandigarh,
in the States of Andhra Pradesh, Bihar and
Uttar Pradesh and M/s Hindustan Latex Ltd.,
Thiruvananthapuram in Rajasthan, Madhya
Pradesh, Tamil Nadu, Kerala and Karnataka.
5.6.4 The progress of Nirodh off-take is
estimated regularly by Operations Research
Group (ORG), Baroda, an independent
Organisation.
5.6.5 Although the sales declined in 199192, the performance witnessed an
improvement in 1992-93 by registering a
sale of 278 million pieces. The sale in
1993-94 during April to October, 1993 was
104.46 million pieces against a target of 324
million pieces for the whole year.
5.7.3 Some Voluntary Organisations such
as M/s Parivar Sewa Sansthan, New Delhi
and Population Services International, New
Delhi have been allowed to market OCP
under their own brand names of ‘ECROZ’ &
‘PEARL’ respectively. Similarly, DKT
(India), Bombay is allowed the brand
‘CHOICE’. These voluntary organisations
have been allowed to use their own brand
names as part of the multi-brand strategy
and these organisations are free to fix the
consumer price of their brands of pills.
5.6.6 In order to ensure that condoms are
easily available even in remote rural areas,
distribution of condoms through Public
Distribution System has been implemented in
the States of Andhra Pradesh, Assam, Bihar,
Haryana, Himachal Pradesh, Karnataka,
Kerala, Madhya Pradesh, Punjab, Rajasthan,
Tamil Nadu,U.P. and in the UT of Delhi.
5.7.4
It has been decided to encourage
19
L
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■
marketing of oral pills by reputed
pharmaceutical companies under their own
brand name on the same terms and conditions
as applicable in case of Mala ‘D*. Under
this arrangement M/s Reliance Bulk Drugs &
Formulations Ltd., Chandigarh has been
permitted to market OCP ‘MOTF on all
India basis. Similarly M/s Dey’s Medical
Stores (Mfg) Ltd., Calcutta have been
allowed to market their own brand of OCP
on all India basis.
1
5.7.5 The main objective of the programme
is to generate acceptability of oral pills for
contraception on large scale.
5.7.6 The progress of Sale of Mala ‘D*
over the last four years is indicated below:Sale
(Lakh Cycles)
Year
1990-91
1991-92
1992-93
1993- 94
(upto Oct. ’93)
58.25
89.30
79.26
38.92
57.17
5.7.7 A target of 175 lakh cycles has been
fixed for the year 1993-94. The Budget
Provision for the Oral Pill Scheme is given
below:
PLAN
BUDGET
B.E. (1992-93)
R.E.(1992-93)
B.E.(1993-94)
- Rs.400 lakh
- Rs.400 lakh
- Rs.400 lakh
5.8.2 These Laparoscopes/Laparocators are
being supplied to States/UTs as per their
requirements and norms fixed by the
Government of India. There is a provision
of supplying @ 1.5 per trained team. The
number of Laparoscopes/Laparocators
supplied and available in States/UTs and
various Institutions upto 31st March, 1993
was 6483 while the number of teams
trained/functioning in Laparoscopic
Sterilisation techniques in States/UTs in this
period was 4214 as per information received
from the States/ UTs.
5.8.3 UNFPA have also been supplying the
standard KLI Tubal Rings for use in
Laparoscopes/Laparocators for undertaking
Laparoscopic sterilisation operations under
the National Family Welfare Programme to
avoid failure of sterilisation and
simultaneously to ensure quality assurance to
the acceptors of sterilisation. A total of 3.00
million KLI Tubal Rings were supplied by
UNFPA during 1990-91 and also 3.00
million during 1989-90. 1.3 million KLI
brand of Tubal Rings have also been
procured during the current financial year
1993-94 through GO1 funds. Sufficient stock
of KLI Tubal Rings is available with the
Ministry to meet the requirements of
States/UTs during the year 1993-94.
14,44,000 pairs of Tubal Rings have been
supplied to States/UTs during the year 199293 and 7,46,500 till 30th November 1993.
During the year 1993-94 following budget
provisions have been made for purchase of
Laparoscopes:
I
B.E.
5.8.
Procurement of Laparoscopes/
Tubal Rings
5.9
5.8.1 The Ministry have been getting KLI
Laparoscopes (Single/Double Puncture) either
from UNFPA under the commodity
assistance programme or purchasing from
Government of India Funds. These brands of
Laparoscopes are currently approved by the
Government of India for undertaking
Laparoscopic Sterilisation operations under
the programme.
- Rs. 300 lakh
A
1
I1
I
Central Laparoscopic
Training Centres
S.2.1
5.9.1 The Government have so far
established 22 Central Laparoscopic Training
Centres in different parts of the country.
Training in Laparoscopic Sterilisation
technique is imparted by the requisite
Gynaecologist and Obstetrician
in the
medical college/hospital to a team consisting
of a doctor, an operation theatre nurse/sister.
I
20
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I
and an operation theatre technician/ attendant
as and when they are deputed for training by
the State Government concerned.
The
minimum educational qualifications required
by the doctor for this training programme are
MD (Obst. and Gynae) or MS (General
Surgery) or MBBS with DGO having worked
for a minimum period of three years in a
Government hospital or any other medical
institutions. The training programme is ot
two weeks duration. 4214 teams have been
trained upto 31.3.93. The doctors so trained
in Laparoscopic sterilisation techniques help
to ensure quality assurance, particularly in
sterilisation activities under the programme.
During the year 1993-94 following budget
provisions were made for the Central
Laparoscopic Training Centres.
B.E.
- Rs. 10 lakh
5.10 Medical Termination of Pregnancy
5 10 1 The MTP
programme is being
and Family Welfare on year to year basis. A
total of Rs. 150.00 lakh was allocated to
State/ Union Territory Gov“^e^c*e
vear 1993-94 for expansion ot Ml H services.
The scheme consists of the following
important components:
(<)
(i>)
(iii)
Provision of Rs. 15/' for Drugs and
dressing per MTP conducted.
(iv)
5.10.2 The work done on implementation of
MTP programme in States/UTs, is monitored
and evaluated through quarterly Pr0^^
reports. All those women, on whom M1F
has been performed, are required to be
motivated to follow one or the other method
of contraception. Altogether 22845 doctors
have been trained in MTP technique as on
31.3.93.
5.10.3 During the year ending 1993-94
following budgetary allocations were made
for the MTP programme.
B.E.
5.11
- Rs. 150 lakh
Quality Control and Assurance in
Family Welfare Programme
5.11.1 With a view to providing quality
assurance to the acceptors, to introduce high
standards of services in the Programme and
for reducing complications and failures after
sterilisation operations, the Govt, of India
constituted an “Expert Committee on
Technical Matters” m the Ministry in
September, 1990 keeping the following
objectives in view:
CO
Setting up of a small MTP Cell at
State/UT level wherever on an
average 10,000 MTPs and above are
undertaken for the last three years,
Training of doctors in MTP
techniques and other surgical
procedures and spacing methods; and
Purchase of MTP Suction aspirators
with IS1 mark by State/UT
governments for supply of the same
to PHCs/CHCs where doctors have
been trained in MTP techniques and
physical facilities like operation
theatre, etc. are available tor
conducting MTP operations, and
(ii)
(Hi)
21
To consider and advise the
Government of India on all matters
including administrative,
organisational and technical matters
connected with the implementation of
the National Family Welfare
Programme with particular reference
to IUDs, Sterilisation Procedures,
MTPs, Oral Contraceptives and any
other method of contraception;
To review the effectiveness of the
working of various Tubal Rings,
IUDs
Suction Aspirators and
different brands of Laparoscopes/
Laparocators, etc. for use under the
programme;
To advise on the various aspects of
Ir-
t
Laparoscopes to be used under the
Programme; and
(iv)
(v)
fo suggest modifications in t:.^
the
specifications and standards of the
Rings, etc
testing of IUDs/ Tubal Rings.
being developed at IIT, Hauz Khas’
New Delhi.
(i)
To promote basic research in
reproductive biology for newer
contraceptive technologies which
have relevance for India;
(ii)
To support clinical trials and
introductory studies to accelerate the
programme use of new technologies;
(iii)
To coordinate the activities of
various research
institutions
undertaking research in the field of
reproductive biology and
contraceptive technology;
(a)
To lay down the minimum
standards
for
Laparoscopes/
Laparocators;
(b) To review the existing standards
and specifications laid down under
7080 (Part I and II) for MTP Suction
Aspirators and suggest changes, if
required ; and
1
research activities in contraception being
carried outt by various institutions and
departments• a
National Committee for
Research in 1Human Reproduction" (NCRHR)
has been constituted under the Chairmanship
ot Secretary(FW) hy the Govt, of India in
March. 1992 keeping the following objectives
in view;-
(c) To standardise the specifications
tor MTP Suction Aspirators; and
(vi)
To discuss any other item
importance in the field
contraceptive technology.
of
of
(iv)
To promote linkages with
pharmaceutical industries for local
production of contraceptives; and
5.11.2 The leading gynaecologists and public
health specialists/ experts and other senior
oiricers working in the Government of India,
Institutions and in the Ministry itself are
members of the above Committee. The term
of the Committee is for a period of three
years with effect from 21.9.90. Since the
constitution of the above Committee, a
number of meetings were held under the
Chairmanship of the Director General of
Health Services. A number of items viz.
Introduction of Oral Pill Contraceptive (Mala
D); Centchroman, the Weekly Oral Pill
contraceptive; Norplant; Net-en Injectables,
Standard Tubal Rings; MTP Suction
Aspirators; and manufacturing of Copper-T
200 B IUDs were discussed at length and
planned for necessary action in the Ministry.
(v)
To promote research in the field of
counselling and follow up leading to
better utilisation of newer
contraceptives.
| 5.11.2 (i)
'
The Committee is now being
; reconstituted.
P.11.3 With a view to coordinate different
22
5.11.4 Leading Gynaecologists and public
health specialists and senior officers working
m the Govt, of India institutions and in the
Ministry itself are members of the above
Three meetings of the
Committee.
Committee have taken place since the
constitution of this Committee.
5.12
I
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4
■4
Centres of Excellence in Standards
of Sterilisation and Micro-Surgical
Recanalisation
Jhe UNFPA
Project entitled
establishment of Centres of Excellence for
training in sterilisation and recanalisation was
signed by the Central Ministry of Health &.
FamiJy Welfare with UNFPA/AVSC in April
19«« for a period of 5 years with a view to
I
I
■^achieving the following objectives under
National Family Welfare programmes:
have also been shipped to 10 ot these medical
colleges directly by AVSC. New York.
(i)
To improve the techniques and
quality of sterilisation services;
(ii)
To establish micro-surgical facilities
for male and female recanalisation
training and services at regional
centres of excellence;
(iii)
To establish 12 centres of excellence
in selected States in India; and
5.12.4 The doctors/medical officers in
States/UTs are being trained in standards ot
sterilisation for males and females at the tour
regional Centres of Excellence to ensure
quality
assurance to the acceptors of
sterilisation and for accelerating the
sterilisation programme. A total of 1025
doctors/medical officers have fyeen trained in
standards of sterilisation in States/UTs as on
31.3.93.
(iv)
To develop an effective quality
control and assurance scheme for
sterilisation and recanalisation
services.
1
5.12.5 The monitoring and evaluation of
activities of Centres of Excellence have been
entrusted to National Institute ot Health and
Family Welfare. Necessary funds are being
released to them.
The project duration has since been extended
to December ’94.
|
I
|
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5.12.6 During the year 1993-94 following
budget provisions were made:
5.12.2 As a result of implementation of the
said project by this Ministry, four Regional
Centres of Excellence for training-cumservice in standards of sterilisation and
micro-surgical recanalisation have since been
established at the following medical
institutions in the country under Phase I:
K.E.M. Hospital & Seth
Medical College, Bombay;
(ii)
R.G. Kar Medical College, Calcutta;
(iii)
Kasturba Hospital, Darya Ganj, New
Delhi in collaboration with Maulana
Azad Medical College, New Delhi;
and
■>
5.12.8 Two surgeons from LNJP hospital
and NIHFW were sent to Thailand for
training in the new technique ot vasectomy
called "No Scalpel Vasectomy" (NSV).
After their return, these surgeons have so far
trained twenty three doctors in this technique.
The "NSV" has since been included in the
programme under this scheme. The response
to this New technique has been very
encouraging as about 150 men had availed
this facility during a camp organised tor tour
days just after a simple advertisement in the
newspapers. Inspite of declining trend in
vasectomy during recent years, over 1645
Kilpauk Medical College, Madras in
collaboration with Medical College,
Madras.
I 5.12.3 During phase-II the core officers
I comprising of one senior Gynaecologist and
I one senior surgeon of all the 12 medical
4 colleges have been trained in standards of
i male and female sterilisation and microl surgical recanalisation technique till 30th
I November, 1993. Micro-surgical equipments
23
L
- Rs. 50.00 lakh
5.12.7 The Centres of Excellence are
primarily concerned with the training-cumservice in standards of sterilisation for males
and females and micro-surgical recanalisation
and holding of seminars/ workshops, etc. to
further improve the working of these
Centres. These Centres held a number of
workshops on training ot trainers m standards
of sterilisation for males and females and
trained a total of 1123 doctors in these
workshops till 30.9.93.
G.S.
(i)
(iv)
B.E.
I?
J
I
operations have been performed at LNJP and
NIHFW till 31.9.93. Now many States have
evinced keen interest in this new technique
and have requested for training of their
doctors in the technique. A new project
proposal is in the preliminary stages of
preparation for training of other surgeons in
this new technique of Vasectomy.
■
5.13
to the local manufacturers of Copper-T-200
B The standards for Copper-T-200 B and f
Tubal Rings were finalised by the Centre and ||
clearance was accorded by the Bureau of
Standard tor publication thereof in the Drugs f
and Cosmetics Act. 1945 and the amendments I
made thereto. These standards have since S'
been published. The Centre have also given W
technical guidance to BIS for laying down ft
standards for MTP Suction Aspirators.
During the year 1993-94, following budget t
provisions have been made:-
National Centre for Technological
Evaluation of IUDs and Tuba I
Rings at Indian Institute of
Technology, New Delhi
B.E.
5.13.1 This Centre is mainly concerned with
the testing of IUDs and tubal rings hiotechnically before these articles could be
introduced into the programme. National
Centre for Technological Evaluation of IUDs
and Tubal rings was set up at the Centre of
Bio-medical Engineering, Indian Institute of
Technology, Hauz Khas, New Delhi by the
Department of Family Welfare with financial
support in collaboration with UNFPA during
the year 1988-89. This project continued
functioning with UNFPA ’s assistancetill 31st
March 1992. It is now being provided with
100% assistance in the form of grants-in-aid
by the Department of Family Welfare w.e.f.
1st April 1992.
1
- Rs. 40.00 lakh
5.13.3 Monitoring and Analysis of Post- j^
Sterilisation Deaths / Complications:- The®
Technical Operations Division in the®
Department of Family Welfare has been®
monitoring and evaluating the reports of g
deaths due to sterilisation in States/UTs on’B
quarterly basis. The post-sterilisation deaths |
are being reported by States/UTs to this &
Department in the prescribed proforma by M
techniques/ or methods of sterilisation
operations viz. Laparoscopic, traditional
tubectomy, mini-laparotomy, interval and W
post-partum sterilisation and the same are ■>
compiled at National level. The recorded !
number of post-sterilisation deaths in the
country during the years 1990-91 to 1992-93
are given at Table 1 as per information B
received from the States/ UTs.
5.13.2 The Centre has been imparting
training on quality assurance of these devices
TABLE - I
POST-STERILISATION DEATHS DURING THE YEARS 1990-91 TO 1992-93
Year
Total sterilisation
operations done
1990-91
1991-92
1992-93
41,22,630
39,86,039
41,76,160
Post-Sterilisation
deaths recorded J
228
104
95
II
I
■
5.14
Surveillance System for
Sterilisation
had initiated the said project in the two States i
of Rajasthan and Tamil Nadu where the
incidence of post-sterilisation deaths and
complications, etc. are higher as compared to
the rest of the country. The project is being
•5.14.1 During the year 1990-91, this
Department in collaboration with UNFPA,
24
I
I
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i
■
particularly to boost up the spacing
method; and
financially supported fully by UNFPA with a
total contribution of US $ 2,56,962 for three
years from January, 1990.
A small Family Welfare Ceil has
been functioning at IMA
headquarters in New Delhi with
effect from 1st June 1989 for
dissemination of information on
family welfare and its policy as
approved by this Ministry.
(iv)
5.14.2 During the year ending 1993-94
following budgetary allocations have been
made for the purpose of surveillance system
of sterilisation:-Rs. 10 lakh
B.E.
5.15
Indian Medical Association
5 15 1 The Indian Medical Association with
its headquarters in Delhi has been functioning
for over 63 years through a network of 1,200
branches with a total membership of over
85 000 doctors throughout the country. It is
one of the largest voluntary organisations
worliing in the field of public health, medical
education and for the propagation of family
welfare programmes through its local
branches in States/ UTs. The Govt, of Inuia
has been involving the Indian Medical
Association in the implementation of Ute
family welfare programme by way of giving
grants to them on year to year basis.
5.15.2 In brief, the Indian Medical
Association is entrusted with the following
activities in the field of Family Welfare/
Population Control Programme in
collaboration with the Ministry of Health and
Family Welfare..
(i)
.j
(ii)
(iii)
5 15 3 A total of 45 teams from IMA have
so far been trained in Laparoscopic
sterilisation techniques since
the training programme. Alt0^r ?2
Laparoscopes (Single puncture) have so far
been supplied to IMA for onward supply o
the concerned doctors, who were trained in
Laparoscopic sterilisation techniques by *e
Central Laparoscopic Training
During the year 1993-94, following budget
allocations were kept for IMA. ------------
BE
5.16
(i)
/-jj Post-Partum
All India Hospitals
and Subc.—
Programme at district
District level;
(i'0
PAP Smear Test Facilities in Medical
Colleges;
(iii)
Sterilisation beds scheme; and
(iv)
Urban Revamping Scheme:
(a)
(b)
Supply of laparoscopes to IMA
doctors after training in laparoscope
sterilisation techniques with 25%
reduction in the original cost of the
equipment;
family
workshops/seminars
welfare
Special Schemes
5 16.1 The Special Scheme Division is
responsible for the implementation of unde mentioned programmes.
Training of IMA doctors in
laparoscopic sterilisation techniques
in the Central Laparoscopic Training
Centre, functioning at the seJectfmedical colleges/ institutions in the
States/UTs;
Holding
- Rs. 5 lakh
Urban Health Posts
Urban Family Welfare
Centres
India Hospitals Post-Partum
5.16.2 AU
District and Sub-Distnct
at
Programme.
'cewl: The Post-Partum Programme start in
the vear 1906 when the Population Council
New York took ,in
up anan internatlOnal
i-----
on
programme.
25
I
experiment in 25 hospitals of various
countries to test the idea of motivating
women in the post-delivery (post/partum)
period as that is the time when they are most
amenable to accept advice on family
planning. From India two hospitals, viz.
Safdarjang Hospital, New Delhi and S.A.T.
Hospital, Trivandrum participated in the
experiment. Encouraged with the results of
tins experiment in two hospitals, Govt, of
India decided to extend the programme to
other hospitals in the country with effect
from 1969. As on today, there are 550
established Post-Partum Centres at District
level which include all medical colleges and
post-graduate institutions. Later in 1981-82
die programme was further expanded to
include Sub-district level hospitals;there are
at present 1012 sub-district hospitals having
post-partum centres. The post-partum
programme at sub-district has been getting
substantial assistance from Government of
Norway.
I
1
5.16.3 The
Post-Partum
Programme
defined as maternity-centred hospital based
approach to die family welfare programme
and aims to motivate women within the
reproductive age group (15-44 years) and
their husbands tor adoption of the small
family norms through education and
motivation, particularly during pre-natal and
post-natal period. The basic objectives of the
programme are: (i) to provide an integrated
package of maternal and child health (MCH)
and family planning services; (ii) to
undertake information, education and
communication motivates; (iii) to conduct
skill based training programme for providing
MCH and Family Planning Services to
medical personnel and peripheral workers,
and (iv) to provide outreach services in the
allotted areas.
s
.1
5^16.4 Performance: During the year 1992. 3’/he performance of reporting institutions
both at district and sub-district level post
partum centres is given below.
is
THE PERFORMANCE OF REPORTING INSTITUTIONS
DURING THE YEAR 1992-93
1992-93 (Provisional figures)
District level hospitals
j
>
Sub-district level hospitals
No. of Institutes
approved
550
1012
No.of Institutes
reported
464
726
447357 (44.3%)
11645 ( 1.2%)
459002 (45.5%)
240961 (38.08%)
5686 ( 0.90%)
246647 (38.98%)
251861 (24.9%)
67284 ( 6.7%)
231622 (22.9%)
123670 (19.55%)
50343 ( 7.96%)
212025 (33.51%)
1009769 (100.00%)
632685 (100.00%)
Method-wise distribution of
Acceptors
j Tuhectomy
; Vasectomy
\ Total sterilisation
I.U.D.
• Eq. O.P. users
I Eq. C.C. users
Total acceptors
26
1
5.16.5 Pap Smear Test Facility Programme:
In order to detect cervical cancer and precancerous lesions among women acceptors
and non-acceptors, PAP Smear Test Facility
Programme has been introduced in all 105
medical colleges all over the country. Under
the scheme, a post of a cyto-technician as per
State/UT government pay scales and financial
assistance for contingencies for purchase of
glassware and chemicals have been provided
by Government of India. So tar 76
institutions have been sanctioned by the State
Governments.
I
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5.16.6 Sterilisation Bed Scheme: A Scheme
for reservation of sterilisation beds in
hospitals run by Government, Local Bodies,
and Voluntary Organisations was introduced
in the year 1964 so as to provide immediate
facilities for tubectomy operations in
hospitals where such cases could not be
admitted due to non-availability of beds etc.
Further in the year 1976 with the
introduction of Post-Partum programme at
district and sub-district level hospitals in the
country, some of these sterilisation beds were
transferred to Post-Partum programme.
Maintenance grants of Rs. 3000 per bed per
annum is paid to each institution subject to
the condition that a minimum of 75/60
tubectomies per bed per annum are achieved
by the Government/ Voluntary agencies
respectively. The State Government releases
the grant to the organisations on the
recommendations of their respective grant-inaid committees. A total of 3610 beds have
been sanctioned by Government of India.
During 1992-93, 1,09,533 tubectomies have
been performed as reported by State
Governments in respect ot 2057 beds. So tar
during 1993-94, 4 States out of 18 have
reported information for the first quarter
ending June, 1993 and performed 4934
tubectomy operations in respect of 503 beds.
1
5.16.7 Urban Revamping Scheme: (i) Urban
Family Welfare Centres: Since 1950 these
centres provide family welfare services in
l
urban areas. There are three types of urban
family welfare centres, i.e. Type- I, II and1
III, depending upon the staff sanctioned_and
the population covered by them. In all, there
are 1529 urban family welfare centres 1
functioning in the States/ Union Territories as
on 31.3.1993 of which 208 are run by central
sector, i.e. Ministry of Defence, Railways
and Labour, etc. The Urban Family Welfare
Centres were required to be relocated in
Urban slums under revamping scheme.
5.16.7 (ii) Urban Health Posts: The Urban
Revamping Scheme has been introduced with
a view to provide improved service delivery
out-reach services of primary health care,
family welfare and maternity services in
urban areas particularly slum areas. So far,
936 health posts have been approved in
various States of the country. The State
Governments have sanctioned/
operationalised it in 870 health posts and 10
city family welfare bureaux.
5.16.8 External Assistance for Family
Welfare Programme: Royal Government of
Norway have been providing financial
assistance during the years 1971-1985 for
district-level
Post-Partum Programme
(Family Welfare-I Project) and from 1981
onwards agreed for providing financial
assistance for Sub-district level Post-Partum
Programme. Norwegian Agency for the
International
Development (NORAD)
provides partial financial assistance for
implementation of the Post-Partum
Programme at Sub-district level Post-Partum
Centres. Under the scheme 1012 Sub-district
level Post-Partum Centres have been
sanctioned by the State Governments.
NORAD has provided an assistance of 60
nillion NDK during 1991-1993 which
nclude 6 million NDK for innovative
projects in Orissa and Karnataka. A training
intervention project is also being
implemented at the Indian Institute of Health
Management and Reserach, Jaipur completed in
January, 1994.
1
■
11
B1
1
i
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I ~
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Pre-Natal and Post-Natal care.
I
MATERNAL AND
CHILD HEALTH
PROGRAMME
'•
Care of mothers and children occupies a
paramount place in our health services
delivery system. This is reflected from the
fact that 9 out of the 17 goals listed in the
National Health Policy (1983) relate to
maternal and child health.
6 12 As part of the overall strategy for
reduction of infant mortality to below 60 per
thousand live births; child mortality,to below
10 per thousand; child P0Pulatl™
maternal mortality to below 200 per 100,000
live births by 2000 AD, following specific
programmes have been under implementation
in the country as 100% Centrally sponsored
family welfare schemes:
. 2 (j)
Universal
Immunization
Universal
of. .vaccme
Programme (UIP)
(LIP) for control
----L •
diphtheria,
[preventable diseases' namely,
i
pertussis, tetanus. childhood tuberculosis,
poliomyelitis and measles.
6.1.2 (ii) Oral Rehydration Therapy (ORT)
Programme for control of deaths due to
dehydration caused by diarrhoea. It is
estimated that about one million childreni die
of diarrhoea every year and most. o these
deaths can be prevented if dehydration i.
checked in time.
6 1 2 (iii) Prophylaxis Schemes against
nutritional anaemia among pregnant women
and against blindness due to V amm A
deficiency among children of under 3 years
of age.
6 1 3 The'impact of the above interventions
is becoming perceptible in the dec ining
trends of disease incidence and Infant
Mortality Rate. The Universal 1™,sat ion
Programme started in 1985 86’
„
particularly succeeded in establishing
system of contact between the beneficiaries itas and children - and .he r»»”^al
workers - the ANMs located at the Sub
Centres.
-1
6 | 4
The access established under the
immunisation programme is now
now being
CHAPTER-VI
29
I
i
i
utilised to extend and intensify other services
related to maternal and child health under the
( hild Survival and Safe Motherhood (CSSM)
Programme which was launched in the year
1992-93. I he programme, being implemen
ted with the financial assistance of World
Hank and UNICEF with an overall approved
outlay of Rs. 1.125.51 crore over a seven
year period (1992-93 to 1997-98), has the
following components:
fe
i
(i)
Sustaining and strengthening the
Oral
ongoing
Immunization,
Rehydration Therapy (ORT) and
Prophylaxis Schemes;
(ii)
Improving maternal care at the
community level by providing an
enhanced reporting fee of Rs. 10.00
per case to the Traditional Birth
Attendants (TBAs) and disposable
delivery kits to pregnant women;
(iii)
Expanding in a phased manner, tiie
programme tor control of Acute
Respirator, I ii lections (ARI)
children hclow 5 years of age;
tor
(IV)
Im|W\'ing newborn care; and
(v)
Setting up. in a phased manner, a
network of sub-district level First
Referral Units (FRUs) for improving
emergency obstetric care in the States
of Assam. Bihar, Madhya Pradesh.
Orissa. Rajasthan and Uttar Pradesh.
6.1,5 The •UIP,
— ORT. Prophylaxis Schemes
of IFA and Vitamini A administration to
pregnant women and children respectively,
respectively.
and Dais Training, etc. are ongoing activities
m all ('■
’
...........
districts..
Additional
interventions
relating to ARI control (alongwith training/
retraining of medical and paramedical staff)
and setting up of First Referral Units in the
six States, will be expanded in a phased
manner. For convenience, these have been
termed as "Child Survival" and "Safe
Motherhood" components respectively. The
phasing plan is as shown inTable-1.
TABLE -1
CHILD SURVIVAL AND SAFE MOTHERHOOD
i
Year
Child Survival
Cumulative
1992-93
51
51
21
21
103
154
31
52
99
253
51
103
99
352
48
151
114
466
67
218
1993-94
1994-95 r
1995-96
1996-97
6 1.6 The ensuing paragraphs give an
overview of the progress made under the
Programme during the year under report
6.2
Immunization
6.2.1
Universal Immunization Programme
Safe Motherhood
Cumulative
(k VIP) declared as one of the Technology
Missions m 1986, was launched in 1985 as
part of the overall national strategy to bring
down infant and maternal mortality in the
country by providing immunization to all
•nfants against six vaccine preventable
diseases and pregnant women against tetanus.
30
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DISTRICTS UNDER CSSM
CHILD SURVIVAL
300 —
250
«
.2 200
154
ft.
Q 150
o
o 100
50
0
103
101
E
51
1992-93
1993-94
NEW ^CUMULATIVE
199
measles and BCG vaccines. About 27 million
pregnant women are also to be administered
two doses of tetanus toxoid (TT) as
prevention against tetanus to them and to
their newborn.
Towards this, additional inputs in the form of
cold chain equipment, vaccines, training of
medical and paramedical staff and I EC
material, etc. were provided to all the
paramedical staff and I EC material, etc. were
provided to all the districts, in a phased
manner. Beginning with 31 districts in 198586, the programme was expanded to all
districts by 1989-90.
6.2.3 At the beginning of the Programme
in 1985-86, vaccine coverage levels ranged
between 29% for BCG and 41% for DPT.
By the end of March 1993, coverage levels
have improved significantly and was above
85% for all vaccines for infants. Coverage of
pregnant women with 2 doses was 79%. The
year-wise and antigen-wise achievement
during 1985-86 to 1992-93 is shown in
Table II.
6.2.2 Under the UIP, about 25 million
infants are to be vaccinated every year before
they are one year old with three doses of
DPT vaccine (Diphtheria, Pertussis and
Tetanus), three doses of polio vaccine (orally
administered) and one dose each of the
TABLE - II
YEAR-WISE AND ANTIGEN-WISE ACHIEVEMENT
DURING 1985-86 TO 1992-93
Note:
YEAR
DPT
OPV
BCG
MSL
TT(PW)
1985- 86
1986- 87
1987- 88
1988- 89
1989- 90
1990- 91
1991- 92
1992- 93
41.12
35.66
48.41
60.46
74.83
82.30
101.54*
91.26
90.81
28.84
52.19
70.70
79.29
89.04
1.34
16.17
44.06
55.17
69.32
90.85
84.99
85.75
39.85
45.27
56.48
65.15
58.83
79.70
77.57
79.40
56.55
72.23
79.61
82.93
100.72*
90.89
90.19
92.83
96.41
Measles vaccine was introduced in the programme from >985-86.
Over 100% figures due to inclusion of children over one year age under immunisation
State wise details of 1992-93 given in the Appendix I at the end of this chapter.
poliomyelitis and neonatal tetanus are
maintained and cases of poliomyelitis are
followed up 60 days after onset of paralysis
to confirm diagnosis. The decline in the
reported disease incidence, under this
background, is encouraging.
6.2.4 Considerable efforts have gone into
developing a reliable surveillance system.
The immediate reporting of cases of neonatal
tetanus and poliomyelitis has been made
mandatory. Nil reporting by hospitals and
health facilities has been introduced to
confirm that cases are not being missed due
to incomplete reports. Active surveillance for
suspect cases of poliomyelitis and neonatal
tetanus has started. Line lists of cases of
6.2.5 Reported1 incidence of vaccine
preventable diseases in India are shown in
Table III.
31
L
102.99*
I
TABLE- HI
u
REPORTED INCIDENCE OF VACCINE
PREVENTABLE DISEASES : INDIA
Total
Me. a
~Pol
NN7
Tet
Per
Year Dip
546264
19051' 124036 ’
1980 ' 39231 :320109 43837
197129 659997
38090
1981 26315 359288 39175
26302 146196 509279
1982 17191 279635 39955
24727 129639 412294
1983 13776 211282 32870
23250 190881 450302
1984 17058 189148 29965
22584 160216 420501
1985 15686 184368 37647
20169 155076 382890
1986 9426 167225 30994
28264 247519 484365
1987 12952 163786 31844
24257 157800 380864
1988 17146 145469 24343 11849 13866 162560 352467
1989 9790 137374 17763 11114 10408 87446 242651
1990 8425 113016 14043 9313
6028 79655 198030
1991 1255C 73520 15036 11241
9440| 92185 247488
1992 8115| 119854 11268| 6626
1987.
Tet - includes cases in adults. Cases of NNT also included upto
,6.2.6 In ten States/UTs (Haryana,
[Himachal Pradesh, Karnataka, Kerala,
Maharashtra, Punjab, Tamil Nadu,
Chandigarh, Goa and Pondicherry) which
account for more than 252 million
Population, the reduction has been far more
Pronounced. These States/UTs may achieve
(the objective of neonatal tetanus elimination
land poliomyelitis eradication before 1995 and
£000 A.D. respectively - the global, targets
het by the World Health Organisation.
6.2.7
On
the other
AVAILABILITY
1/4; CAPACITIES
IcRI, Kasauli
iPII, Coonoor
jBCG, Gundi
/HBPCL, Bombay
^SVI, Patwadnagar
Sil, Pune
iBE, Hyderabad
Radicura Pharma
Bibcol__________ _
I TOTAL CAPACITY
B: REQUIREMENT:
hand,
despite
a
DPT |
23.00
16.50
5.00
114.00
24.00
182.50 |
I
120.00 |
I
I
tetanus in 1992.
Availability of Vaccines used for
Immunization
6.3
6 3 1 The average annual requirement of
different vaccines used under the Programme
and its availability in the country is shown in
Table IV.
TABLE-IV
OF VACCINES I ISF.D FOR IMMUNIZATION
I
I
■^PV
Fb CG
35.00
37.50
120.00
100.00
257.50 |
155.30 |
I
.
(Million joses)_
TT
TT I MEASLES I DI
25.00
30.00
11.00
11.00
12.00
2.00
150.00
24.00
______L_—35.00 | 229.00 |
50.60 | 119.00 I
6.00
70.00
40.00
I
1
4
70.00 | 82.00
50.00 | 35.00
^2
4
II
4
J
PERCENTAGE COVERAGE
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208'92
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60'88
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6.3.2 The country is self-sufficient in all
vaccines except for Oral Polio Vaccine which
is only being blended from imported
concentrate by HBPCL,Bombay and Radicura
Pharma, Delhi. The third firm, namely
BIBCOL, an Undertaking of the Department
of Biotechnology, is yet to start the blending.
6.3.3 When the Programme was initiated in
1985, the entire quantity of measles vaccines
required was imported but today this vaccine
is being indigenously produced at the Serum
Institute of India and spare capacity of
measles vaccine is now available. The
indigenous capacity of BCG is being
enhanced to 500 lakh doses.
6.4 Cold Chain for the Vaccines
6.4.1 The Cold Chain System for the
storage, distribution and transportation of the
vaccines consists of 113 Walk in Cold Rooms
and 10 Walk in Freezer Rooms at the
regional level: Icelined Refrigerators and
Deep Freezers at the District level and a twin
set of ILR/Freezer at the PHC level. From
the PHCs, the vaccines are taken in vaccine
carriers as no storage is envisaged at the Sub
Centre level.
6 4 2 The above basic cold chain system is
supported
by
(a) Cold
boxes
tor
transportation of vaccines trom the regional
storage points to the districts and trom the
districts to the PHCs: (b) Sterilization
equipment for the PHCs and Sub-Centres,
and (c) Needles and syringes every year
calculated on the basis of estimated
beneficiaries.
6.4.3 Overall supplies made to the
States/UTs since the inception ot the
programme till September, 1993 m respect ot
major items are given in Table V.
TABLE -V
CUMULATIVE SUPPLIES TILL SEPT. 1993
ITBM
3041
653
1755
16184
16196
17916
22582
191360
173515
15235
163646
130327
179046
ILR - 240 Ltr.
ILR - 300 Ltr.
Chest Freezer - 300 Ltr.
Chest Freezer - 140 Ltr.
Chest Refrigerator - 140 Ltr.
Cold Box - 22 Ltr.
Cold Box - 5 Ltr.
Vaccine Carriers
Vaccine Day Carriers
Autoclaves
Sterilizing Drums
Steam Sterilizer Pressure Cookers (DR.)
Stove Kerosene
and syringes being supplied during 1993-94
6.4.4 The details of allocation of needles
is shown in Table VI.
TABLE VI
BEING SUPPLIED DURING 1993-94
ALLOCATION OF NEEDLES AND SYRINGES
58.12 Lakh
2 ml. Syringes
19.38 Lakh
1 ml. Syringes
9.70 Lakh
5 ml. Syringes
19.38 Lakh
23 g. Needles Box
6.47 Lakh
26 g. Needles Box
1.63 Lakh
20 g. Needles Box
1
33
L
£
-
6.5
Maintenance of Cold Chain
Equipment
T.B.Hospital, Bhopal and HER Training
Centre, Madras. During the year 1993 (upto
Oct. 1993) 52 trainees have been trained in
Refrigerator Repair Training Course, 78
trainees have been trained in WIC Repair
Training Course and 42 have been trained in
Voltage Stabiliser Repair Training Course.
6.5.1 Till 31.3.1991, the maintenance of
cold chain equipment was under contract
between UNICEF and commercial agencies.
With effect from 1.4.1991 all the States/UTs
have taken over the responsibility qf
maintenance of cold chain equipment. In
January 1992, the States were requested to
review the existing arrangement for
maintenance of cold chain equipment with a
view to identify the strengths and weaknesses
of the existing system and take remedial
action in this regard.
6.6
I
Quality of Cold Chain
6.6.1 Statutory testing of vaccines is done
by the National Quality Control Laboratory
at Kasauli. The protocols of all vaccines are
scrutinized before use and are released only
after declared standard by this laboratory. In j
addition, samples of OPV are picked up from
iS
various levels of storage and sent to
RL;
designated laboratories for potency testing to
ensure effectiveness of the Cold Chain
System. Earlier there were only three testing
laboratories, i'.e. CRI, Kasauli; NICD, Delhi
and Enterovirus Research Centre, Bombay.
Seven new additional laboratories have been
set up for OPV testing.
6.5.2 To assist the States to formulate
Action Plans for maintenance of cold chain,
workshops are being held in States jointly by
Ministry of Health &. Family Welfare and
UNICEF. So far (upto Sept.*93), workshops
have been held in the States of U.P., Bihar,
West Bengal, Assam, Gujarat, Rajasthan,
Kerala, Punjab, Haryana, H.P., Tamil Nadu,
M.P., Maharashtra, Orissa and Andhra
Pradesh.
S
6.6.2 The test results for the last seven
years indicate steady improvement in the
efficacy of the cold chain system in keeping
vaccines safe. In 1987 about 40% of the field
samples failed. At present the failure ^ate is
only about 7 per cent shown in Tabic II.
6.5.3 In addition, Govt, of India have also
been organising Trainings for Refrigeration
Mechanics at the State Health Transport
Organisation,
Pune; HER Division,
SHTEMO, Guwahati, HER Unit, Hyderabad,
TABLE-II
-
j
-■S
t
1
POTENCY TEST REPORTS OF FIELD SAMPLES OF OPV
Year
Sample Tested
1987
1988
1989
1990
1991
1992
1993
(upto July *93)
1290
2196
5423
8148
9208
13936
8748
Samples Satisfactory
790
1454
4580
7550
8354
12287
814«
% age Samples
Satisfactory
61%
66%
84%
93%
91%
88%
93%
i
.i
I
4
34
i
i
J
DISTRICTS UNDER CSSM
SAFE MOTHERHOOD
120
100
(0
♦«*
o
.$2
o
o
z
80
52
60
31
40
20
21
H
P
■■
0
1993-94
1992-93
new
El cumulative
Oral Rehydration Therapy for
Diarrhoea Control Among Children
6.7.1 • The Oral Rehydration Therapy
Programme was started in 1986-87 in a
phased manner. The main objective of the
programme is to prevent diarrhoea-associated
deaths in' children due to dehydration. The
training programmes and health education
material highlight the rational management of
diarrhoea in children, including increased
intake of home available fluids, breastfeeding
and continued feeding ot the child. ORS is
promoted as the first line of treatment and
rational use of intravenous fluids • and
antibiotics are recommended. Preventive
measures to reduce disease incidence by
measles immunization, exclusive
breastfeeding, health and hygiene practices,
safe water supply and improved sanitation are
supported.
6.7
fl
6.7.2 Diarrhoea still remains one of the
leading causes of death among children under
5 years. However, as a result of activities
under the Programme, positive achievements
have been noted. These include the increasing
community awareness about ORT and
weeding out of anti-diarrhoeal drugs from
government health facilities. Many large
hospitals have recorded fall in case fatality
rates, indoor admission rates and duration of
stay of inpatients.
II
6.7.3 Diarrhoea Treatment and Training
Units (DTTUs) have been set up in 55
medical colleges and another 20 such units
are being set up in the current year. 1993-94.
The network of the DTTUs is being extended
to the district hospitals under the CSSM
programme and, during 1992-93.
paediatrician from 99 district hospitals have
been trained.
|
J
I
6.7.5 In order to make ORS packets widely
available. States have been advised for
marketing of ORS packets through the Public
Distribution System.
6.7.6 A National Standard for ORS packets
has been developed. The standard consists of
a logo, a packet design and instructions
(written and graphic) for use on ORS
packets.
6.7.7 The Programme emphasises rational
use of drugs for the management of
diarrhoea. Anti-diarrhoeal drugs have no
place in the treatment of diarrhoea; while
antibiotics are recommended only for specific
indications like Cholera and Dysentery.
States have been advised to delete antidiarrhoeal drugs from their procurement lists.
6.7.8 A Committee of Experts in the Office
of Drug Controller, India has recommended
banning the sale of paediatric anti-diarrhoeal .
Action to ban these formulations is now
being taken by the Drug Controller, India.
6.7.9 Inter-personal communication for
promotion of ORT through mothers meeting
was started in 1990-91. During 1992-93 an
amount of Rs.231.31 lakh was released to the
States for this activity and the States have
reported to have trained 11.06 lakh mothers
in home management of diarrhoea. An
allocation of Rs.232.80 lakh has been made
during 1993-94 for the States.
6.8 Prophylaxis Schemes
6.8.1 Anaemia Prevention and Control
amon^ Pregnant Women: Anaemia, which
accounted for 19% of the maternal deaths in
the country in 1990 is one ot the leading
causes of maternal mortality and is an
aggravating factor in haemorrhage, toxaemia
and sepsis. Although administration of IFA
tablets to pregnant and lactating women was
started in the 4th Plan period, its effective
coverage remained, due to resource
constraints, around 30 per cent ot the total
eligible target group. TheCSSM programme,
therefore, has prioritised pregnant women for
6.7.4 ORS supplies are being organised by
the Govt, of India Centrally and 2.25 crore
packets were procured and supplied to the
States and UTs during 1992-93. For 199394, provision has been made for supply of
3.47 crore packets. In the CSSM districts.
ORS is being supplied as a part of the Sub
Centre kits.
35
t'—
'r
'<■ t
I
II
1FA Administration. During 1992-93,
158 61 lakh (58.9%) pregnant women were
provided with the recommended dosage ot
IFA tablets.
6 8.2 Prevention and Control of Vitamin A
Deficiency among Children: Vitamin A
deficiency, which can lead to blindness, has
■ prevalent
’ t in the country,
been widely
the
j
children.
especially among t pre-school
.
for
Programme
National
Therefore, a f
Blindness
of
due
to
Vlt.A
Prevention
deficiency was launched in the 4th Plan
period. The Programme sought to atlntmister
six-monthly doses of concentrated Vit.A to
the children between 1 to 5 years of age.
However, due to resource constraints the
coverage with Vit.A so far has been
approximately 30% of children ot 1 to 5
years of age.
Dais has also been enhanced from Rs.3.00
|
per case to Rs. 10.00 per case under the | I
CSSM programme. The programme has also > I
made a provision for cash assistance to the
I
States/UTs for supply of disposable delivery ’ 1
kits to the pregnant women.
t
6 8 3 The CSSM programme priorities
administration of Vit.A to all children m the
a«e group of 9 months to 3 years of age, as
vulnerable. The first dose of Vit-A (1J kh
international units) is to be
nine months of age alongwith meas es
vaccine followed by another dose alongwith
the booster dose of DPT/OPV yaccme^
During 1992-93, 106.07 lakh (43.7%
infants were administered the measles- inked
dose while the DPT/ OPV booster mked
dose was administered to 56.48 lakh (28.7%)
children in the age group of 1-2 years.
6.9
■ •'w
■
6.9.2 The cash assistance provided to the | I
States for the above activities was to the tune
I
of Rs.550 lakh in 1992-93. During 1993-94,
I
the cash assistance has been earmarked at
I
Rs.650 lakh.
|
6.9.3
During 1992-93, the States have .> |
Dais^ The .
reported to have trained 9,382 Dais
target for 1993-94 is to train another 31,100 .
Dais.
r
• 'I.
Acute Respiratory Infections
(Pneumonia) Control
cause ®
6.10.1 Pneumonia is another
in
children
■
of deaths of infants and young c....lldia accounting for 20% of the under five
ipaths
The ARI control strategy was
Jevdoped during the period 1989 and
implemented in 24 d.stncts on a pdot basts ■w
includes
6.10
4
g&russ,
level was also adequate.
6 10 2 The rational treatment of ARI and
prevention of deaths due to pneumonia s
S » integral pan .,f CSSM^*
workers are being imparted practical skiii
mng in ARI management. Contrtmoxazole
" being supplied to the health workers
through the CSSM drug kit.
I
Communications will focus on recognition of
symptoms and referral, and w111 be
,nter’
channelled through mothers
personal communication with ANMs
other sectors such as ICDS.
Essential Maternal Care: Dais
Training, Their Reporting ees
And Disposable Delivery Kits for
the Pregnant Women
6 9 1 The SRS data for 1990 indicates that
the' proportion of deliveries attended by
untrained hands is still very high, particularly
in the rural areas of States of Assam, Bihac
M.P., Orissa, Rajasthan and U.P. The CSj M
Programme, therefore, accords a high
priority to speeding up the training o
Traditional Birth Attendants (Dais) in all
States/UTs, particularly in the above
mentioned States. The reporting fee to the
6.11 Training Under CSSM
6.11.1 The CSSM training, to be expanded
36
J
■<
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o
MORTALITY RATE PER 1000 CHILDREN <5 YEARS
hO
ro
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FRUs (for 300,000 to 500.000 population)
are expected to be established in each district
and will be in addition to the district hospital.
Easier accessibility to adequate medical care
is essential for an effective referral system
and for promoting timely and early referral
under the CSSM. Since the CSSM outlays
are limited, in this regard, the States of Uttar
Pradesh, Madhya Pradesh, Rajasthan, Bihar,
Orissa and Assam, other States are to
mobilise their own resources for upgrading
health facilities for providing emergency
obstetric care and medical treatment of
maternal complications.
6.11.2 Upto September 1993, 24 regional
6.13 Assistance to States in 1992-93 &
traimng/orientation workshops for State Core
1993-94
Members have been organised in which 511
DIO / DHOs, Principals of HFWTCs and
6.13.1 During the year 1992-93, the
other medical officers have been trained.
estimated cash and commodity assistance to
Training of para-medical workers in the 51
the States/UTs has been calculated at
districts taken up in 1992-93 (Phase I) has
Rs. 100.73 crore. This consists of Rs.26.54
already been completed, while training of
crore as cash assistance and Rs.74.18 crore
Medical Officers and para-medical workers is
as kind assistance. The kind assistance
comprised of vaccines, cold chain equipment,
in progress.
iron and folic acid tablets, Vit. ’’A" solution,
6.11.3 An integrated training module on
Oral
Rehydration Salt (ORS) packets for all
management of diarrhoea, ARI and newborn
and medicine kits for the 51
districts
care for the clinicians has also been
districts.
developed.
6.13.2 For the year 1993-94, the programme
First Referral Units (FRUs) for
6.12
has been provided with an outlay of
Emergency Obstetric Care
Rs. 125.00 crore. Out of this outlay the cash
and kind assistance earmarked for the
with
6.12.1 Selected rural health facilities,
a
States/UTs has been estimated at Rs. 123.93
I sanctioned post of a gynaecologist and an
crore. This will consist of Rs.27.80 crore as
operation theatre, are being upgraded by
cash assistance and Rs.95.00 crore as kind
I providing essential equipment and skill based
assistance.
| training, where required. About 6 to 12 such
APPENDIX-I
REPORTED COVERAGE LEVELS : 1992 - 93_________________
in a phased manner, beginning with 51
districts in 1992-93, has two objectives: (i) to
retrain the medical and para-medical workers
for the continuing activities, viz.
immunization, ORT, prophylaxis schemes
and (ii) to impart skill based training to the
medical and para-medical personnel for
pneumonia control activities and essential
new born care. Thus, the training for the
programme managers, medical officers and
the para-medical staff' has been integrated to
include the entire range of maternal and child
health care interventions.
I
STATE
ACHIEVEMENT :
■
t
1
as % age of estimated
infants and pregnent woman
DPT
OPV
BCG
MSL
TT(PW)
2
3
4
5
6
98.96
80.08
77.76
99.08
80.29
77.58
106.88
90.86
84.52
93.41
72.33
70.75
103.70
62.21
63.32
LARGER STATES
Andhra Pradesh
Assam
Bihar
37
APPENDIX-I (CONTD.)
1
Gujarat
Haryana
Karnataka
Kerala
Madhya Pradesh
Maharashtra
Orissa
Punjab
Rajasthan
Tamil Nadu
LLP.
W.B.
2
3
4
5
6
92.18
85.97
90.20
99.08
77.21
96.78
89.31
103.88
91.65
103.84
91.95
86.87
93.74
89.86
90.45
97.35
100.68
98.61
110.90
81.25
100.73
98.61
113.62
95.21
115.49
95.78
87.77
88.27
91.63
84.02
90.38
79.18
87.08
75.80
91.26
100.17
65.06
85.42
76.43
96.67
82.01
102.60
77.34
99.00
89.77
104.41
91.81
104.57
91.97
87.99
91.02
81.74
105.20
90.56
102.29
89.62
70.51
i
:
100.12
72.42
76.30
;
SMALLER STATES
H.P.
J&K
Manipur
Meghalaya
Nagaland
Sikkim
A&N Islands
Arunachal Pradesh
Chandigarh
D&N Haveli
Delhi
Goa
Daman & Diu
Lakshadweep
Mizoram
Pondicharry
93.71
66.60
83.31
43.82
51.97
93.51
60.82
99.90
63.92
139.50
100.18
97.37
117.33
108.33
107.28
117.98
113.43
ALL INDIA
89.50
Tripura
93.23
70.50
83.16
41.59
50.95
93.59
61.10
99.95
59.85
100.03
84.57
87.80
62.79
73.62
95.93
94.73
100.02
115.61
70.40
144.53
98.85
115.14
130.72
102.17
109.78
104.52
129.64
90.16
95.74
140.90
100.06
99.68
117.56
108.99
105.56
117.48
90.61
62.02
70.20
28.98
53.64
80.75
64.35
95.08
45.34
1 14.91
86.41
98.80
111.57
101.20
109.70
110.87
108.56
85.05
_______
80.01
28.74
77.86 Hr
35.33
••
34.91 ||
60.95
38.85
89.05
38.06
120.97
74.79
91.84
97.84
100.91
117.06
99.70
114.60
I
It
1I
78.50
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Immunization session in progress.
Primary Health Centre for every 30,000 population in plain areas and 20,000
in hilly and tribal areas.
IV
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F-
RURAL
HEALTH
SERVICES
Health Infrastructure in rural areas is of
prime importance for realisation of the
objectives set forth in the National Health
Policy and for attaining the goal of
"HEALTH FOR ALL BY THE YEAR 2000
A.D." Co-ordinated efforts are being made
under various Rural Health Programmes to
provide effective and efficient services to the
people in the rural areas.
7.1.2 Numerous programmes and schemes
are being implemented under the Minimum
Needs Programme to provide Primary Health
Care relevant to the actual needs of the
community in the rural areas. The status of
establishment of the Sub-Centres, PHCs and
Community Health Centres under the
Minimum Needs Programme, is detailed in
ensuing paragraphs.
7.1.3 Sub-Centres: A Sub-Centre is
established on the basis of one Centre tor
every 5.000 population in plain areas and for
3.000 population in hilly and tribal areas.
Till the end of the 7th Plan. 1,30,336 Sub
Centres. were functioning while their number
rose to 1,31.471 by the end of September,
1993 against the estimated requirement of
1.38 lakh Sub-Centres for the Seventh Plan.
Due to non-availability of funds for opening
new Sub-Centres the targets were not allotted
to the States/UTs during-the years 1990-91.
1991-92, 1992-93 and 1993-94.
7.1.4 Primary' Health Centres: Primary
Health Centres are established on the basis of
one PHC for every 30,000 population in the
plain areas and for every 20,000-popula'tion
in hilly, tribal and backward areas. Number
of PHCs functioning in the country was
18,981 by the end of 7th Plan (1.4.90) which
rose to 21.024 PHCs by the end of
September, 1993.
I
7.1.5 Community Health Centres (CHCs):
Rural hospitals with specialist facilities
established by upgrading PHCs have 30 beds
to cover a population ot 80.000 - 1.20 lakh.
By the end of 7th Plan ([.4.90) the number
of CHCs functioning was 1.911 which rose
CHAPTER Vll
39
to 2.293 CHCs by the end of June, 1993.
The CHCs act as referral Centres for four
PHCs in a Block.
7.2
I
I
7.2.1
community selects a volunteer as VHG, who
after training acts as a link between the
community and the Governmental Health
System. He/She mainly provides health
education, and creates awareness on MCH &
F.W. Services. He/she has to keep track of
communicable diseases and treat minor
ailments and provide first aid to the patients.
Auxilliary Nurse Midwives (Female
Health Worker) Training
Programme
- ■ r
is manned
Each• Suh-Centre
by one
Male Health Worker and one Female Health
Worker
Midwife). In
worker (Auxilliary Nurse Midwife).
order to train the required number of ANMs
in the rural areas, there are 462 ANM
Training Schools functioning in the country
with an annual admission capacity of 19,290.
The duration of the training is 18 months. It
is proposed to utilise these training
institutions for providing continuing
education programmes for ANMs on a
variety of subjects, besides providing the
basic training programme of 18 months
duration.
,.1
1
7.3
7.4.2 4.15 lakh VHGs have been trained
till now. Each trainee is imparted 3 months
training at the PHC level during which
period he/she is paid a stipend of Rs. 200
per month. During training, a VHG is also
provided kit containing common articles of
use and medicines and a manual. At present •
3,24,727 VHGs are on the role of State
Governments/UTs. Each VHG is paid an
honorarium of Rs.50 per month.
i
T
i
O’
§
i
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£
B
. ‘ v'*’.
7.5
Multi-Purpose Worker (Male)
7.5.1 As per the norms, each Sub-Centre is
required to be manned by a trained Female
Health Worker (ANM) and a trained Male
Health Worker known as Multi-Purpose
Worker (Male). The Govt, of India had
initiated a scheme of training and thereby
converting the uni-purpose workers under
various programmes to multi-purpose worker
in 1978. This training was continued till
1990. However, because of the shortage of
MPW’s (Male) at Sub-Cefltre level, a scheme
of basic training for MPW (Male) was
initiated during the 7th Plan period. Under
this scheme, the 10th Pass candidates are
selected and trained for one year before they
are inducted into the service.
Female Health Assistant Training
Programme (LHV)
7.3.1 One Female Health Assistant has to
supervise the work of six Sub-Centres in the
rural areas. She provides technical guidance
and supervision to the ANMs who are
working in rural areas. The senior ANMs
are trained for six months to take up, the post
of LHV, which is a promotional post. 44
training schools with an admission capacity
of 2,758 that are functioning in the country.
These training schools are utilised for giving
continuing education for Female Health
Assistants (LHV) besides providing basic
training programme of six months duration.
7.4
•S'
A
7.5.2 The basic training of MPW (Male)
has been initiated by opening 44 such
schools in various States.
Against the
sanctioned strength of 50 schools, out of
which 40 schools are functioning at present.
As these schools were found to be inadequate
to meet the requirements of training of
MPW’s (Male), this training was also
initiated in 36 HFWTCs. Additional staff
was sanctioned for training of MPW’s (Male)
in HFWTCs.
Village Health Guide Scheme
7.4.1 The Village Health Guide Scheme
was initially started as Community Health
Workers Scheme on 2nd October, 1977 in all
States except Tamil Nadu, J&K, Kerala and
Arunachal Pradesh. The Scheme was
renamed as Village Health Guide Scheme in
1981, when it was made 100% Centrally
sponsored scheme under F.W. Programme.
According to the scheme the village
T
t
'I
>
j
I
1
40
i
t
1
■
1.6
Orientation Training of Medical
and Para-Medical Personnel
7 6 1 This is a Centrally sponsored scheme
under the Family Welfare Programme.lt was
started with the objective to train Medical
and Para-Medical Personnel working at PHCs
and Sub-Centres. Each category is placed to
be imparted training in the same institution,
where they had their basic training. The
duration of the training is two weeks.
7.6.2 Pattern of Assistance: The financial
assistance admissible under the scheme is in
the form of 100% non-recurring grant
towards a hostel for 20 trainers alongwith
lecture and demonstration room, kltchen
articles, training equipment and aids. The
recurring grant is admissible on 50:50
sharing basis between the Govt, of India and
the State Governments and the components
covered under this are: rent for hostel (till
the building is constructed), contingency
consumable training material; additional
teaching staff for hostel and class rooms ot
the HFWTCs and stipend for the trainees.
For HFWTCs, which have been augmented
under the scheme of orientation ttaining of
medical and para-medical personnel only
stipend is admissible to trainees. Regarding
UTs as they do not have enough training
facilities available with them, they will seek
the assistance of adjoining States to tram their
personnel.
I
I
J
7.6.3 Progress: The Scheme is in operation
in the States of Andhra Pradesh, Assam,
Bihar, Gujarat, Haryana, Himachal Pradesh,
Jammu and Kashmir, Karnataka, Kerala,
Madhya Pradesh, Maharashtra, Manipur
Meghalaya, Orissa, Punjab, Tamil Nadu, UP
and West Bengal.
7.6.5 During 1993-94, Rs.80 lakh has been
allocated for this Scheme.
7.7
7.7.1 Health and Family Welfare Training
Centres are established in the country with
CV„V1^
•the objective of giving in-service training
health personnel in the rural health
These training centres are set up with 100%
financial assistance from the C-----Centra!
Government. There are 47 HFWTCs in the
country at present.
7.7.2 The category of health personnel
given in-service trainingr at HFWTC and the
as bbelow:period of training is a:
Medical Officer
2 weeks
Health Assistants
(Male & Female)
2 weeks
Health Workers
2 weeks
Block Extension
Educators
2 weeks
Key Trainers
of ANM School
2 weeks
7.7.3 In addition to the above training, the
HFWTCs take up in-service training under
various vertical National Programmes as
well. From 1982, HFWTCs are giving basic
training to MPW ’s (M) also.
7.7.4 Funding Pattern of HFWTCs: The
HFWTCs are funded under 100% Central
assistance from the Family Welfare Budget
The different components which are tundeo
are as shown in Appendix-11
7 6 4 Progress ofexpenditure: The 7th Plan
allocation for the Scheme was Rs. 1,000
lakh. The details of allocation releases made
and anticipated expenditure is as stated
Appendix - I.
7 7 5 The recurring costs of one HFWTC
comes to Rs.9.5 lakh approximately.
41
L
Health and Family Welfare
Training Centres (HFWTCs)
1
■
Appcndix-I
—
-
PROGRESS OF EXPENDITURE
Year
Allocation
1985- 86
1986- 87
1987- 88
1988- 89
1989- 90
1990- 91
1991-92
1992- 93
Nil
50.00
150.00
100.00
50.00
50.00
83.00
80.00
I
Anticipated expenditure
(Rs. in Lakh)
FUNDING PATTERN OF HFWTCs
1
w
Nil
Nil
67.37
43.74
50.00
49.90
78.00
39.96
t-'
Appendix-II
i
Non-recurring
1. Vehicles (one bus, one mini bus and one jeep or two mini
buses and one jeep) and equipments including duplicating
machine, projector, typewriter and furniture.
Rs. 1,36,500.00 (old
expenditure as no training
centre has been sanctioned
after 1975).
2. Construction
Cost of 20,350-20,450
sq.ft, plinth area as
per the blue print of
Government of India.
W
Recurring (per annum)
,
3. Pay & allowances, etc. of the staff (as per pattern).
Rs.8.5 lakh at present
(approx.)
4. Contingencies including purchase of educational materials,
books for library, periodicals,postage, telephone charges,
electricity and water charges, printing and stationery and
other items.
5. Cost of petrol and maintenance of vehicles at the rate of
Rs. 12.000/- and Rs. 9,000/- (for petrol & diesel drive
vehicles respectively).
Rs.6,000.00 (per annum)
Rs.36,000.00 per annum.
(Revised from time to
time).
6. Rent for training centre and hostel for trainees in
case Govt, accommodation is not available.
Rs. 18,000.00 per annum
7. Payment to Guest Faculty
Rs. 1,500.00 per annum
II
1
•w
42
4..-
17
Around
million
are
people
added to the
country’s
population
every year.
>T 4
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Demographic
studies
and
data proces
sing are ex
tremely help
ful in policy
formulation.
k.
i
DEMOGRAPHIC
RESEARCH
AND
EVALUATION
1
;•
Government of India has accorded top
priority to Population Research since
initiation of Plan-era i.e. right from the First
Five-Year Plan. On the recommendations of
Demographic Sub-Committee, appointed by
the Research Programme Committee of
Planning Commission in 1955, the
Demographic Research Centres were set up
in selected Centres to undertake Research on
various Demographic, Social and Economic
Aspect of Population Growth in their
respective regions.
Family Planning
Communication Action Research Centres
were added, later on, to undertake research
studies in the field of Family Planning
Communication to evolve more efficient
educational and action programme for
acceptance of small family norm. Both these
Centres were dovetailed in the year 1978 and
a new nomenclature was given i.e.
Population Research Centres (PRCs) in 197879.
8.1.2 At present, there is a network of 18
PRCs functioning in the country. Of these,
11 are located in Universities, 6 in Non
Government Institutions of high repute and 1
in the State Government. These PRCs can
broadly be categorised under two heads: (i)
‘Fully Developed Centres’; and (ii) ’NotFully Developed Centres’ depending upon
their staffing pattern, i.e. budgetary
allocation and workload. The Government
provides 100% financial assistance to these
Centres in the form of journals and vehicles
and other infrastructural equipments etc. In
addition, training is also imparted to the
officers of PRCs to enhance their research
capabilities.
t
8.1.3 Since their inception, the PRCs have
conducted research on varied topics, such as,
trends in Population Growth, General
Demography, Socio-Economic and
Demographic Correlates, Communication and
Family Welfare - Incentives, Disincentives,
Motivation, Family Planning, etc. These
studies have proved very useful in policy
formation and programme implementation.
The studies conducted by PRCs provide
1
CHAPTER -VII!
43
I
II
valuable information on important aspects,
such as, non-acceptance of Family Planning
Methods, gaps between awareness and
acceptance, levels and trends of fertility,
reasons for discontinuation, misconceptions
about various contraceptive use or shift in
contraceptive acceptance and involvement of
voluntary organisations in Family Planning
Methods. These findings definitely brought
policy implications and changes in the
strategies and programmes of Family
Welfare.
i'
8.1.4 The activities of PRCs are monitored
at regular periodic intervals by the Ministry
of Health and Family Welfare. In order to
co-ordinate the activities of the State, D&E
Cell and PRCs and to ensure meaningful
discussion of their capabilities and available
expertise, Research Coordination Committees
have also been constituted at the State level.
UPS provides guidance and directions on the
methodologies of research, sample design and
even in selecting topics of research, both ot
National and State-specific importance.
8.1.5
During
the
year
1992-93,
78
Research Studies/Papers were completed by
these PRCs, while 108 Studies were m
progress as on 1.4.1993. The achievement
of PRCs is quite commendable as, besides
these studies, they were also involved in the
supervision and on-the-spot checking of the
field work of National Family Health Survey
(NFHS) during the year under review. The
field work of NFHS was conducted under the
USAID Project, "Strengthening of Survey
Research Capabilities of PRCs".
8.2
Field Sample Check of Family
Planning Acceptors
■■
s
4
"1
8.2.1 Sample verification ot Family
Planning acceptors is carried out by State ‘ 11
D&E Cells, Regional Health Offices and
Rational (Central) Evaluation Teams in order
to know the impact of the Family Welfare
Programme in the country and to have a
continuing check on the reliability of the
reported statistics. The findings of these
■f
sample checks are communicated to the
States for further necessary action in the
direction of improving the quality of the
programme.
s
B■i
I
I
■
(
i
i
i
i,
I
44
i
I
I
i;
I NATIONAL COMMITTEE ON F.V
PLANKINO FOR THE ORGANISED SECT
7
91993
The Minister of Health and F.W. Shri B. Shankaranand presiding over the
3rd Meeting of the National Tripartite Committee on Family Welfare Planning
Encouraging response from the people to avail of the Health and Family
Welfare services.
iwimriM
1
J
ORGANISED
SECTOR
AND
VOLUNTARY
ORGANISATIONS
The Family Welfare Programme is sought
to be implemented through the organised
sectors of trade and industry by educating
and motivating the workers employed in the
public and private sectors. NGO and
Voluntary Organisations are also being
increasingly involved to make the acceptance
of the small family norm, a people’s
movement.
9.2
Organised Sector
Realising that the organised sector
9.2.1
is employing over 25 million workforce and
with their dependents they constitute about
14% of the country’s population, it has been
considered necessary to bring this population
fully within the ambit of the family welfare
programme. For this purpose a Tripartite
Committee called Tripartite National
Committee on Family Welfare Planning
consisting of representatives from the
Industry, Trade Union Organisations and the
Government Departments was constituted
under the Chairmanship of the Union
Minister of Health and Family Welfare in
October. 1991. The Committee has held
three meetings, the first on 10th February
1992, the second on 16th November 1992
and the third on 4th November 1993.
1
9.2.2 Asa result of these meetings a number
of important decisions have been taken.
These include setting up of Family Welfare
Cells in the industries; instituting awards for
Electronic Media. Press. Organised Sector
and Voluntary Sector for creating national
awareness on population control; adoption of
slogans on ‘small family norm by industries
in their product advertisements; giving wider
publicity to income tax exemption benefits on
the expenditure incurred by industries on
promotion of Family Welfare Programme;
adoption of specific areas with poor
demographic indicators and low literacy rate
by the industries for intensive work in family
planning and education; sponsoring of TV
spots and film serials on small family norm,
etc.
I'
1
CHAPTER-IX
45
I
9.2.3 Also some Family Welfare Projects
have been undertaken in the unorganised and
semi-organised sectors in different Project
areas in the country with UNFPA assistance.
These ongoing projects relate to (i) The
Working Women in Tamil Nadu; (ii) Planta
tion Workers in West Bengal; (iii) Tribal
Population in Gujarat; (iv) Beedi Workers in
UP, MP, Orissa and West Bengal and (v)
Milk Producers in Gujarat.
Family Welfare for implementing family
welfare programme including MCH and
immunisation services in those
Departments/Public Sector Enterprises. These
include Ministry of Railways, Ministry of
Defence, P&T Department, Border Roads
Dpvplnnmant
T-. i IDevelopment Organisation______
the. Pubhc"
and1 .L
Sector Enterprises like HEC, Ranchi, BHEL,’
Bhopal and Ranipur.
9.2.4 Some Ministries/ Departments/ Public
Sector Enterprises are also being given
budgetary support from the Department of
9.2.5 The budgetary provisions made for
the Family Welfare programmes in the
organised sector for 1992-93 and 1993-94 is
given below
I
R
BUDGETARY PROVISIONS
SI.
No.
B.E.
1992-93
B.E.
1993-94
338.00
212.00
6.90
0.10
5. Ministry of Labour- Population Cell
338.00
212.00
7.30
0.10
2.00
6. ILO/UNFPA F.W.Projects
118.00
118.00
10.00
10.00
692.40
692.64
Ministry/Organisation
1. Ministry of Railways
2. Ministry of Defence
3. P&T Department
!
4. Border Roads Development Organisation
7. Voluntary Organisation in Organised Sector
TOTAL
9.2.6 The performance in family welfare
activities during 1993-94 in respect of
perform
r
ace
in family
2.00
Ministry of Railways and Ministry of
Defence is shown in Table I and Table II. .
TABLE I
welfare
activities
DURING 1993-94
Method
Proportional
Achievement during
April
June
1993-94
1992-93
Sterilisation
4,815
2,693*
IUD
3,045
1,708*
CC users
OP users
*Achievement upto May, 1993
3,965
2,508
2,70.999* 2,69,360
4,549*
4,177
3,54,113
4,919
46
I
(Rs. in lakh)
..jO.
¥
#
i
I
Ji
a
’.V
I
TABLE II
FAMILY WELFARE ACTIVITIES DURING 1993-94
Achievement during
June
April
1993-94
1992-93
Proportional
target during
1993-94
April 1993 to
June,1993
Method
Sterilisation
3,210
3,935
4,621
IUD
3,045
2,790
3,559
CC Users
51.908
45,992
37,171
OP Users
3,078
1,015
2.623
9.2.7 The on going family welfare projects being implemented with UNFPA assistance are
given below.
ONGOING FAMILY WELFARE PROJECTS BEING IMPLEMENTED WITH
UNFPA ASSISTANCE
Grants
Released
upto
Sept. 1993
Name of
Project
F.W. Project for
Working Women in
Tamil Nadu - by WWF,
Madras
5 years
(April’90March’95)
102.00
97.92
2.
F.W-. Project for
Plantation Workers in
West Bengal - by ITA.
5 years
(Feb. ’91Jan. ’96)
168.17
55.50
3.
F.W. Project for Tribal
Population in Gujarat by. RUA, Bardoli.
5 years
(Apr.’91Mar. ’96)
172.35
58.76
4.
F.W. Project
for Milk Producers
(Gujarat) - by Charutar
Arogya Mandal, Vallabh
Vidyanagar.
3 1/2
years
(Jan. ’92Jun.’95)
39.00
22.00
SI.
No.
1.
l
UNFPA
Project
cost
Project
Duration
47
?
I
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S •v
9.2.8 The progress of these projects has
been reviewed by the Tripartite Project
Review Committee headed by Secretary(FW).
9.3 Non-Governmental Organisations
I
9.3.1 The Family Welfare Programme has,
by and large, remained a Government
programme so far. It has now been accepted
that involvement of the non-Governmental
organisations in the programme will give it
the much desired impetus as the voluntary
workers can work in close collaboration with
the people and bring about desired changes in
social and personal attitudes, perceptions and
behaviour more than the staff of the
Government hierarchy. Many steps/initiatives
have been taken in the recent past to
broadbase the involvement of the NonGovernmental Organisations for promotion of
the Family Welfare Programme.
which are under scrutiny/sanction have been
submitted.
Di
9.3.3 Simplification of Procedures: With
'
view to speeding up disposal of NGO
projects and prompt release ot grant, the :
existing procedures tor grant-in-aid have been
liberalised. Also a Nodal Officer in each ®
State/U.T has been identified to deal with the
NGO sector schemes and they have been
sensitised about their role by holding regional |
workshops/ meetings.
|||
9.
et
Pl
th
ft
m
G
o
a:
f<
P
t
9.3.4 Setting up of State Level SCOVA
Committees: States/UTs are being encouraged
to involve themselves fully in the family
welfare programme. For this purpose they
have been asked to set up State level SCOVA <,
Committees to deal with the NGO sector
schemes/ projects. Almost all States have set
up these Committees and have started
clearing projects of the NGOs. Powers to the
extent of Rs. 10 lakh per project have been
delegated to this Committee.
9.3.2 Model Schemes: (i) New NGO
schemes have been formulated and notified in
June/August, 1993 with emphasis on
promotion of small family norm and
population control. These schemes are to be
implemented in weak areas, which have
couple protection rate below 50% or where
Crude Birth Rate is over 35 per thousand or
where other indicators like IMR, MMR,
I CBR, CDR, etc., taken together necessitate
! such supplemental efforts. The financial
assistance under these schemes has been
liberalised for ensuring larger participation of
the NGOs in the programme. Apart from
improving upon the existing level of mother
I and child health, these schemes aim at raising
I the level of couple protection rate to 100 per
i cent. Under one scheme facilities for
I sterilisation beds can also be set up in rural
, areas as well as slums in the cities where
' existing facilities are either distant or are non
\ existent.
9.3.2 (ii)
9.3.5 Setting up of Mother Units: To
increase involvement of NGOs in the family
welfare programme larger organisations
having adequate expertise, capability and
sound financial footing are being involved to
render technical guidance and assistance in
recommending their projects for sanction and ,
subsequently taking up their monitoring and
evaluation. An imprest of Rs.5 lakh has been
sanctioned to these organisations out of which
money will be released to the smaller NGOs
and matching reimbursement claimed by the
mother units from the Government ensuring
that the imprested money does not fall below
Rs.5 lakh at any given time. This imprest is
being enhanced to Rs. 10 lakh. The mother
unit is authorised to extend funding upto 50
organisations.
*w
9.3.6 IPP-Vll Project of World Bank: Out of
the provision under IPP-VII Project an
amount of Rs.24.59 crore has been
earmarked for involvement of the NGOs.
Yearly releases to the States out of this
provision are being made which are to be
Due to wide publicity given to
I! these new schemes through the print media
and by holding regional conferences, a very
encouraging response has been received from
the NGOs.
A
ha
utilised by the State SCOVA Committees.
large number of projects
48
r
s
/
i
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During 1993-94 an allocation of Rs.l crore
has already been made.
9.3.7 Training Schemes for NGOs: For
effective involvement of the NGOs for
promotion of the family welfare programme,
they are required to be trained in project
formulation, financial management, project
monitoring and evaluation. State
Governments have been advised to identify
one organisation in the Government sector
and if necessary another in the NGO sector
fot undertaking such activities. So far 3
projects of voluntary organisations for
training of NGOs have been sanctioned.
9.3.8 Workshops / Seminars /Study Tours of
NGOs: States/UTs have been requested to
hold workshops/ seminars/study tours or
NGOs for sharing experiences and interaction
between the various organisations. A few
States have organised such study tours and
meetings.
9.3.9 Preparation ofa Directory of Voluntary
Organisations: A directory of voluntary
organisations has been prepared through the
Family Planning Association of India. The
directory includes information on the type ot
voluntary organisation, its current activities,
geographical coverage and financial position,
type of health and family welfare activities,
source of assistance, the support it requires
for undertaking community based activities in
the National Family Welfare Programme.
Projects : There is a total budget provision of
Rs.4.90 crore for the NGO sector schemes to
be sanctioned by the Department of Family
Welfare and the mother units during 199394. A list of organisations which have been
sanctioned/released grant-in-aid between Rs. 1
lakh and Rs.5 lakh is placed at AnnexureV.
9.3.11 PVOH-II Scheme: The PVOH-II
Scheme was formulated on 31.8.1987 by
virtue of an agreement signed with USAID
who agreed to fund this project with $ 10
million. The project completion date is upto
31.9.1997. The number of projects to be
funded is 40. The funding pattern is 75:25,
i.e. 75 per cent by the Government and 25
per cent by the NGO.
o
9.3.12 The scheme seeks to reduce
morbidity, mortality and fertility among the
rural and urban poor in the country. The
purpose of the project is to expand and
improve basic and special preventive health,
family planning and nutrition services tor the
poor by strengthening support to the
voluntary sector with special attention to less
served areas and deprived population.
9.3.13 So far 35 projects (29 outreach
service and 6 support service) have been
sanctioned under the scheme. Details of
those organisations which have been given
grants between Rs.l lakh to Rs.5 lakh are
given in Appendix I and those given grants
above Rs.5 lakh are shown in Appendix II.
9.3.10 Budget Provision and Sanctioning of
■
APPENDIX-1
LIST OF ORGANISATION RELEASED GRANT-IN-AID BETWEEN
Rs.1.00 LAKH AND Rs.5.00 LAKHS DURING 1993-94
<
SI. No.
1
amount
NAME OF ORGANISATION
of
PURPOSE FOR WHICH
THE GRANT-IN-AID
WAS UTILISED________ __
3
4
GRANT AID FOR
THE YEAR ‘93-94
________ 2__________
1.
Boroda Citizen Council. Baroda, Gujarat
5,00,000
2.
Pravara Medics! Trust. Uni, Maharashtra
2,37.240
49
For implementation of their
PVOH-U project
Programme on Health and
Family Welfare and
Nutrition Services.
- do -
--•■w
iI
APPENDIX-I (CONTD.)
2
3
4
3.
Jawahar Medical Foundatin, Maharashtra
3,39,527
- do -
4.
K. E. M. Hospital, Pune
3,10,850
- do -
5.
Sewadham Trust, Pune
3,27,716
- do -
6
Sub PVOs by SOSVA, Pune
7
Bhartiya Grameena Mahila Sangh, Indore,MP
- do -
8.
Indian Institute of Youth &. Development
Kalinga, Phulbani, Orissa
- do - do -
9.
Orissa Institute of' Medical Research & Health
Services, Cuttack, Orissa.
-•do -
10.
Jaipur Rural Health & Development Trust,
Jaipur, Rajasthan
- do -
11.
Karunya Rural Community Hospital, Madras,
Tamil Nadu
- do -
12.
Rural Education & Development Society,
Sivagangai, Tamil Nadu
- do -
13.
Janhitkari Chikitsalaya, Kanpur, U. P.
- do -
14.
Kamala Nehru Memorial Hospital, Allahabad
- do -
15.
Guna Unnayan Parishad/Calcutta, XV.B.
- do -
16.
National Institute of Health & Family Welfare
New Delhi. •
- do -
17.
National Federation of Labour Cooperatives
Ltd., New Delhi.
Grant-in-aid to the
Voluntary Organisations to
implement their Project
titled "Pilot Project for
delivery of Family Welfare
and MCH Services among
the yvorkers and familities
of Labour Cooperatives in a
district using Primary
Health Care approach" to
be located in District
Gurgaon, Haryana.
1
i
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9
'3
i
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*
1
A
A I.
_ " _
I
- M i M l*
18.
Jagieevan Balaheena Varga Abhirudhi Sanga,
Cuufcppa, A.P.
4,20,400
For Implementation of their
innovated methods/
Programme for F.W.
19.
Centre for Labour Education and Research,
Bilaspur, MP(for FETM Pro.)
1,40,000
- do. -
20.
Child in Need Institute, Calcutta.
4,87,450
For Implementing Project
on F.W. of the Smaller
PVOs under the Roiling
Fund Scheme.
21.
Centre for Labour Education and Research,
Bilaspur, M.P. (for R.F.S.)
4,46,178
- do -
f
•w
'1
w
50
i
*
Appendix-II
LIST OF ORGANISATION RELEASED GRANT-IN-AID OVER Rs.5 LAKH
DURING 1993-94
Name of the Organisation
Amount of
Grant-in-Aid
for the Year
1993-94
Purpose for which the
Grant-in-Aid was
Utilised
1.
Assam Imdadiya Hospital
Committee, Guwahati, Assam
12,72,300
For implementation of
their PVOH-II Project
Programme on Health,
Family Welfare and
Nutrition Services.
2.
SOSVA, Pune, Maharashtra
10,38,000
- do -
3.
Rural Development Organisation,
Manipur
17,51,000
- do -
4.
’Sarvajanik Parivar Kalyan and Seva
Samiti, Gwalior, MP.
6,42,016
- do -
5.
Naujhil Integrated Rural Project for.
Health and Development, U.P.
10,33,540
- do -
6.
Women in Social Action, West
Bengal
ICCWR, Lucknow
7,61,797
- do -
5,89,450
- do -
SI. No.
■41
7.
I
it
*
51
OU 83
1 /
] C
ano
oocu^/'OM 2 i
v
_z
fr
I
I
I
—Jf
' a
k- ■ a
'
r
II
the Awards for best
The Vice-President, Shri K.R. Narayanan presenting
work in Family Welfare.
Information,
Educa
tion and Communication
Division
organised an exhibi
tion during IITF 93 at
New Delhi.
Ii
I
INFORMATION,
EDUCATION AND
COMMUNICATION
IJ
The IEC Division formulates communi
cation strategy, provide guidelines for
implementation and monitors progress of IEC
activities in the country. The IEC Division
also designs, produces and distributes varied
types of proto-types of media software
throughout the country. In the year under
review, it has provided schemes for
sensitization of opinion leaders and
organising mass campaigns to the community
in the areas with poor ’demographic
indicators.
10.2
New Initiatives and Thrusts
10.2.1 During the year under report, IEC
activities based on communication strategy
for revamping Family Planning in 90-weak
districts/developed last year were intensified.
Greater emphasis was laid on a more
judicious media-mix based on local specific
media forms and need-based inter-personal
communication schemes. More stress was
given at ^rass-root level and the segments not
reached by conventional mass-media channels
for effectively transmitting population related
values and messages. Mobile units/vans
utilising multi-media channels such as audio
visual and enter-educate material through the
electronic media, print material designed for
the neo-l iterate and semi-literates;
exhibitions, inter-personal communication
through para-medical functionaries have been
deployed in remote areas. Greater emphasis
was given to training and development of
training material for Mahila Swasthya Sangh
M'embers and other grass-root level
functionaries. Specific allocation to the
States was made for these activities as also
for area-specific, local, interactive,
innovative IEC activities in selected districts
other than the 90-weak districts.
10.3 IEC Budget
10 3.1 The allocation for IEC activities for
1993-94 is Rs.2,500.00 lakh out of which
Rs 1164.00 lakh have been allocated to the
States/UTs; Rs. 615.00 lakh for Media Units
of the Ministry of I&B and Rs.725.00 lakh
CHAPTER X
t
53
7
professionals for media software production
and other promotional activities by the
voluntary and organised sector. Awards have
been instituted for production of AudioVisual, Software, contribution to Family
Welfare issues by the Press and for voluntary
agencies and organised sector.
have been earmarked for Information,
Education and Communication Division at
headquarters under plan funds. Rs.80.00
lakh have been allocated for the Mass
Mailing Unit of the Ministry under the Non
Plan Budget. The IEC Division regularly
monitors the expenditure being incurred both
by the States/UTs and at the Central level.
i
■
10.4.4 A wards Distributed in July 1993: The
first set of Awards relating to work done in
1992 were distributed by the Vice-President ■S I
of India in an impressive ceremony in
March, 1993, in the presence of the Minister
for Health and Family Welfare, the Deputy
Minister for Health and Family Welfare and w ’■
Shri P.A. Sangama, Vice Chairman of the
Tripartite National Committee. The Awards
were given away for excellence in production
of video films, documentaries, jingles, radio
programmes, songs and best work in the
Voluntary & Organised.Sector respectively.
The Awards for 1993 are to be judged on the
basis of performance from October ’92 to
September ’93.
10.4 Activities at Headquarters
10.4.1 Release of Coin with Family Welfare
Message: A two-rupee coin with an
appropriate family welfare message was
released by the President of India on the
occasion of World Population Day on 11th
July, 1993, designed by the Art Wing of the
IEC Division. The coin depicts a couple
with the girl child and the slogan "CHHOTA
PARIWAR : KHUSHIAN APAAR”.
r
10.4.2
World Population Day: World
Population Day was observed at various
levels, National, State, District, Block and
Village level in every part of the country,
focussing on the need to control population
growth. A two-page special newspaper
supplement was brought out on the occasion,
featuring messages from the President, the
Prime Minister, the Union Minister of Health
and Family Welfare and the Deputy Minister
of Health and Family Welfare. . The
electronic media; radio and television
prominently covered the occasion, numerous
programmes were organised by States, other
agencies, NGOs, the organised sector and the
media units of the Ministry of Inforpiation &
Broadcasting based on the guidelines given
by the Ministry. Various programmes, such
as, public meetings, rallies, cultural
programmes, competitions for students and
youths, health camps, population education
activities, street plays, etc. were organised
jointly by the Department of Health &
Family Welfare, the Organised Sector, NGOs
and Media Organisations.
10.4.5 Involvement of BGVS: The Bharat
Cyan Vigyan Samiti, a voluntary organisation
which has played a very important role in the
promotion of total literacy, is being
associated for the promotion of Family
Welfare by utilising the campaign mode
approach involving the community. A
scheme for supporting activities in 10 Total
Literacy Campaign districts and 10 identified
demographically weak districts has been
approved in July, 1993. The Scheme is
currently under implementation iti the States.
10.4.6 Opinion Leaders Camps: A Scheme
to sensitise Opinion Leaders ’ by holding of
one-day sessions on various aspects of
Family welfare issues has been instituted in
1993-94. Under the Scheme various
categories of Opinion Leaders including
members of Zila Panchayats, Ranches,
private practitioners, teachers, etc. will be
exposed to Family Welfare issues in sessions
to be organised by the States. Funds have
been provided to UP, MP, Rajasthan, Bihar,
Gujarat, Andhra Pradesh, Haryana, Assam
and Orissa under the Scheme.
10.4.3 National Tripartite Awards: Awards
for Best Work in Family Welfare have been
instituted by the Department of Family
Welfare as a step to encourage private
54
I
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*
■ I
I
i
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10 4.7 Deployment of Video Vans: Sixteen
identified districts of UP, MP, Rajasthan and
Bihar in the months of March-April, 1993
and ten districts of MP, Rajasthan, Haryana,
Bihar and UP in June-July, 1993 were
covered by video vans which organised
shows of video-films, distribution of print
material, oral communication programmes
and audio-programmes for a cycle of onemonth each covering around 52 villages.
The software packages consist ot dialect
based featurettes and quickies on prevention
of early marriage, spacing, use of
contraceptive, safe motherhood practices,
immunization, etc. More districts will be
covered during the remaining part of the
year.
10.4.8 Participation in India International
Trade Fair: The 1EC Division of the Depart
ment of Family Welfare participates in the
India International Trade Fair every year by
putting up an exhibition projecting the
population problem, its implications on the
quality of life. Government’s efforts to
control the rate of population growth through
provision of information, education and
communication services and to promote right
age of marriage. Mother and Child Health,
Safe Delivery, use of contraceptives, etc. The
colourful displays are supplemented by inter
active activities such as debate/competition
for school students and youth and women,
live entertainment programmes, street plays,
family planning counselling and distribution
of printed literature. The exhibition is put up
with the help of DAVP of the Ministry of
Information and Broadcasting. The
Department bagged the prize for best display
and dissemination of message for the second
consecutive year in its display in 1993.
I
1
10.4.10 Population Education: Systematic
dissemination of population education both by
formal and non-formal ways, is one of the
most important planks of the revised
communication strategy. In pursuance of the
revised strategy, four projects of Population
Education with UNFPA assistance are
proposed to be operationalised during 199394; three through the Department of
Education, Ministry of Human Resource
Development and one through the Directorate
General of Employment and Training,
Ministry of Labour for integrating population
control messages in various curricula.
10.4.11
During the year 1993-94 the
project-wise status of the various four
projects are as below:10.4.11 (a)
Schools and Non-formal
Education: The Phase HI of this project was
initiated in May, 1993. The main population
education activities in schools and non-formal
education sectors centred around the aims of
integrating population related messages in the
* curricula and text books, training of teachers
and allied functionaries, development of
need-based teaching, learning materials,
dissemination ot information to various
agencies, conducting research and evaluation
studies and popularising the message ot small
family norm among the younger generation
through curricular and co-curricular
activities.
10.4.11 (b): Population Education in Higher
Education - (Phase II) Population Education
in Adult Literacy Programme - Phase II: The
Project documents tor the II Phase of these
two Population Education Projects, viz. in
Higher Education and Adult Literacy
Programme have been developed; approval of
Ministry of Health and Family Welfare has
also been conveyed. The formalities to
obtain approval of UNFPA to make both
these projects operational are being
completed by the Deptt. of Education.
10.4.9 Population Clocks: Five population
clocks have been installed at ISBT, Delhi,
AIIMS inter-section, Nirman Bhawan and
Family Welfare Pavilion, Pragati Maidan,
New Delhi and the Tribune Office,
Chandigarh. These clocks will help to create
an awareness of the national dimensions of
the problem. Two more population clocks
are planned to be installed, one each at
Lucknow and Bangalore.
10.4.11 (c) Introduction of Population
Education as an integral part of Social
Studies curriculum in Vocational Training
55
L
I
Programme. The Project Document for the
II Phase of this Project is in the final stage.
It is anticipated that (this project would be
opertionalised) during 1993-94.
I
keep up the regular schedule of the telecast at
7.30 pm in low power transmission and at
8.45 pm in the National Network. Spots are
also being telecast on Doordarshan Metro
Channel. The population clock telecast in the
morning transmission .is also being recorded
in the Ministry and sent to Doordarshan for
telecast in the morning transmission before
the Hindi News. Special coverage over
Doordarshan and Radio were arranged to
mark World Population Day, Immunization
Day, National events and award giving
ceremonies. Two comic video spots were
specially made on the occasion of World
Population Day.
10.4.12
I.E.C. Training Scheme: Th e
Information, Education and Communication
Training Scheme with the objective of
improving primary health care at the grass
root level and to raise the credibility of
Health Workers in the Community was
launched in the four Hindi speaking States of
UP, MP, Rajasthan and Bihar in November,
1987. The Programme had been supported by
USAID funds till 31 March, 1993. In view
of the benefits derived from the Scheme the
Government has decided to continue with the
Scheme, not only in the four Hindi speaking
States, but to extend it to additional four
States of Orissa, West Bengal, Assam and
Haryana covering a total of 85 districts (68
old and 17 new) during 1993-94. A sum of
Rs. 190 lakh has been allocated to the States
for implementation of the activities under the
Scheme.
i
10.4.13 (a) Haseen Lamhe: An information i
entertainment
based
and
audience- '
participation sponscred programme in 11
regional languages including Hindi is being
broadcast from 29 stations of AIR. The
programme covers topics of family planning
and population issues in an interesting and
absorbing manner. The ten-minute
programme completed one year in September
'93. The duration has now been increased to
15 minutes. The programme evolves
tremendous listener response. It has bagged
a prestigious national prize.
10.4.12 (a) Guidelines for 1993-94 along
with Statewise budget have been issued to the
States. The States have been instructed to
consolidate programme activities under the
Scheme in the old districts (68) and also to
initiate Initial and Regular Training
Programmes in the 17 new districts.
I
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10.5.
Mass Mailing Unit
Editorial Work: Besides
10.5.1 (a)
continuing to bring out the monthly journals,
‘Hamara Ghar’ in Hindi and ‘Centre Calling’
in English, the editorial and art studio
scripted and designed numerous
advertisements focussing popular attention on
new researches like introduction of NoScalpe! Vasectomy and Saheli, the weekly
contraceptive pill. Six single sheeters were
brought out in Hindi and English on Nirodh,
Oral Pill and Copper-T. Two booklets
‘Rising Numbers’ and ‘Choices for Spacing*
and two posters were designed by the Art
Wing. Script of six folders on Nirodh, Oral
Pill and Copper-T were written and given for
printing.
10.4.12 (b) Project personnel were given
learning experience through Orientation
Training Camps in addition to the support
and guidance from Health Workers and
Supervisors during their regular field visits to
the villages. A variety of educational
materials were developed by the States/
HFWTCs for training as well as for use by
health personnel.
10.4.13 In-House Production of A.V.
Materials: A number of audio-visual
programmes were produced during the year
through different agencies.
Doordarshan
continued to be supplied with schedules of
video spots tor telecast during prime time.
A number of new spots have been made to
‘f
10.5.1 (b) Production of Print Material: The
Mass Mailing Unit produced various
56
■I
II
educational, motivational and informational
materials like Hand Bills on Nirodh, Oral
Pills and Copper-T, poster in Hindi"Swastha Maa, Swasth Santan", booklets on
Norplant, model scheme for promotion of
small family norm and population control,
polypathy, promotion of small family norms
through innovative methods, Mini Family
Welfare Centre Scheme, model for assistance
to non-governmental organisation tor spacing
methods, setting up six bedded sterilisation
ward with operation theatre, National AIDS
Control Organisation booklet, cover printing
and binding of Agenda Notes for CCH
Meeting, cover printing and binding of the
Annual Report of CGHS, Agenda and
Proceedings of the Tripartite National
Committee besides printing of two regular
monthly journals ‘Hamara Ghar and Centre
Calling’.
1
10.5.1 (c) Distribution of Materials: The
Distribution Wing of the Mass* Mailing Unit
has mailed over 30 lakh copies of various
educational motivational, video cassettes and
display material throughout the country to
various audience categories of States/UTs,
Government Organisations in the field of
promotion of Family Welfare & MCH
Programmes, including trade union leaders,
voluntary organisations, cooperatives,
organisations under the Ministries of
Defence, Railways, P&T, Family Welfare,
Training Centres, Public Sectors, etc. The
Wing also distributed publicity and
motivational material at various seminars,
conferences, meetings, etc, organised by the
Ministry. The Distribution Wing has an
Address Library of about 6.5 lakh addresses
and efforts continue to broadbase its out
reach by including more addresses of Village
Panchayats and Health Sub-Centres.
10.6
Activities through Media Units of
the Ministry of Information and
Broadcasting
10.6.1 The Media Units of the Ministry of
Information and Broadcasting continued to
education and
provide information,
communication support to the Family
Welfare Programme as per the requirement
and guidelines of the IEC Division. The
focus of their activities was on the promotion
of mother and child health, problem of
population growth, status of women and
small family norm.
10.6.2 Doordarshan: Doordarshan conti
nues to telecast one-minute spots on Family
Welfare issues immediately after the Hindi
Samachar bulletin on the national network
and at 7.30 p.m. on the local channel. In
addition to this population figures are flashed
regularly during the morning transmission.
The display of the population clock is
accompanied with appropriate commentary
about the implications of growing population.
The Doordarshan Kendras provided wide
coverage of the observance of .World
Population Day, 1993. The Kendras telecast
various programmes including panel
discussion, video films, special spot, spot
recordings, interviews and coverage of
important functions. Doordarshan has been
allocated Rs. 20 lakh for 1993-94 for
production of tele-films on behalf of this
Ministry. As per the information available
Doordarshan Kendras telecast 291
programmes and 249 spots during April to
June, 1993.
F
10 6 3 AH India Radio: All India Radio
produces and broadcasts programmes m
different formats like talks, group
discussions, interviews, spot recordings,
features, plays, etc. and broadcasts them tor
different target audience in different
languages and dialects. During the period
from April to July. 1993 AIR statrns
broadcast 27,744 programmes on' family
welfare as per the information available. 1 ne
total duration of these programmes was
The Commercial
1 10 333 minutes.
Broadcasting Service of AIR have been
broadcasting the sponsored programme
"Haseen Lamhe" regularly as well as 3
seconds and 60 seconds spots over the
various channels. The entertainment based
programme is audience interactive and
includes a question answer component on
Family Welfare and MCH. AIR Stations
57
L
i
broadcast special programmes in connection
with the observance of World Population Day
1993. The programmes included messages,
talks, interviews and coverage of important
functions. The radio-sponsored programme
Haseen Lamhe’, which is broadcast over the
Commercial Service of AIR in Hindi and 10
other languages, won the prestigious award
known as the Radio and TV Advertising
Practitioners’ Association of India (RAPA)
Award for 1992.
II
10.6.5 Directorate of Field Publicity: The
theme of Health and Family Welfare is a
priority programme of the Directorate of
Field Publicity. People are educated on small
family norm, population growth,
immunisation, child survival measures, right
age of growth, immunisation, child survival .
measures, right age of marriage, mother and
child care, cleanliness, prevention of drug ■9
addiction, etc. Mass awareness is sought
through film shows, song and drama “
programmes, group discussions and photo
I
exhibitions.
i
10.6.4 Directorate ofAdvertising and Visual
Publicity: The Directorate of Advertising and
Visual Publicity produced a number of
printed material on family welfare based on
requirement projected by the IEC Division.
This includes two posters on small family
norm, two brochures and one single sheeter
on norplant, a booklet on choices for spacing
and a brochure entitled "Rising Numbers”.
DAVP also brought out a set of 26 posters
on family welfare from their own budget for
distribution to field units. Three dialect
based films, "Roshini”, "Swarg Mein Hartal"
and "Barsane Ki Holi" and a number of
video spots were produced by DAVP during
the year. The DAVP has replicated the prize
winning exhibition "Chhota Pariwar, Sukh
Ka - Adhar" developed for IITF ’92 and
supplied the kits to its field units. The field
units of the Directorate organised a number
of exhibitions covering important fairs and
festivals. A prestigious exhibitiion was
organised by the IEC Division and DAVP on
the occasion of the meeting of the Central
Council of Health and Family Welfare in
July, 1993 in New Delhi. A two-page
newspaper supplement on the occasion of the
World Population Day ’93 was designed and
released by DAVP on All India basis.
Newspaper advertisements on other aspects
of Family Welfare such as methods of
Family Planning, No-Scalpel Vasectomy,
Oral Pill Immunisation, etc. are also being
released through DAVP from time to time.
Advertisement on Tripartite National Awards
for Best Family Work, Republic Day
Tableaux, Empanelment of Cartoonist, etc
were also released by DAVP during the year
!
■
10.6.5 (a) Special programmes like baby
•
•o
z4 .i»Lx
shows, seminars, **symposia,
and
debates nn/4
other contests are also being arranged by the
Units to involve women, students and youth.
10.6.5 (b) Important days/weeks like World
Health Day, World Population Day, etc. are
observed by appropriate programmes. A
week-long campaign on the implications of
population explosion was launched by the
field units of the Directorate of Fidld
Publicity on the occasion of the World
Population Day.
10.6.5 (c) Special publicity campaigns are
launched from time to time in 90 ‘Identified
Districts’ of Uttar Pradesh, Madhya Pradesh,
Rajasthan and Bihar.
10.6.5 (d) During the period April ’93 to
Sept. ’93 the Field Publicity Units of the
Directorate of Field Publicity organised
20,031 film shows, 2,560 song & drama
programmes, 839 special programmes,
20,376 oral communication programmes and
11,572 photo exhibitions.
10.6.6 Song and Drama Division : The Song
and Drama Division organised live
entertainment programmes to educate the
masses on Health and Family Welfare,
Population Control and Mother and Child
Health. The idea of small family norm was
publicised through various live performance,
puppet shows, dance drama, folk recitals,
mythological recitals, traditional plays, magic
shows, etc.
\
58
s
t
I
if
10.6.6 (a) The Division has been entrusted
to organise workshops for effective utilisation
of street plays for the promotion of planned
parenthood. A 7-day campaign was organised
by the Division on the occasion of the World
Population Day to highlight the dangers of
population explosion and its harmful effect
on the quality of life. During April-Sept. 93
the Song and Drama Division organised
20,148 programmes.
i
■
10.6.7. Films Division: The Films Division
produces films relating to Health and Family
Welfare and undertakes distribution of prints
to field organisation and cinema houses
throughout the country for exhibition. A
number of films are under production by the
Films Division on various themes including
small mmily norm, spacing, prevention of
early marriage, immunisation, promotion of
condoms for spacing and safe sex. The
Films Division has undertaken production of
featurettes. One such film "Pancha Tantra
has already been produced. The Division has
completed shooting of the other featurettes
"Aahat” and "Tasweer” based on evils of
early marriage. The Division has. also
produced quickies on immunization,
promotion of ORS and home made fluids for
diarrhoea management and promotion of
contraceptives. A few quickies based on
classical ragas have also been produced
whereas a few are under production.
10 6 8 National Film Development
Corporation (NFDC): The films under
production with NFDC are ''Men Pyari
Nimmo", "Shartein Sapnon Ki' and
•Gunghat’. It is expected that production of
these featurettes will be completed during the
financial year.
10.6.9 Press Information Bureau: Press
Information Bureau provides media coverage
to important occasions, events and activities
and policies, programmes of the Ministry of
Health and Family Welfare. PIB organises
projection of H&FW issues through various
media. During the period April to September
’93, PIB provided media coverage to
observance of World Population Day,
meeting of the Central Council of Health and
Family Welfare and other important
meetings.
10.7 Activities in the States/Union
Territories
10.7.1 An integrated IEC strategy with
inter-personal communication with multi
media content was developed. Districts with
indifferent demographic indicators were
identified for special area specific, interactive
value based folk media and inter-personal
communication. Special schemes like Mahila
Swasthya Sanghs, sensitisation of opinion
leaders through organisation of OTCs, joint
training of grass-root level functionaries
training of frontline workers, i.e. BIock
Extension Educators and District Extension
and Media Officers were further strengthened
to effectively carry out IEC activities in the
States/UTs. IEC activities were given a
multi-dimensional and integrated thrust to
increase the outreach and impact of family
welfare messages with the objective of
bringing the gap between awareness and
acceptance.
10.7.1 (a) State IEC annual plans for 199394 were formulated through closer
interactions, keeping in view the dlJferer?tl^
approach. 4-6 weak districts were identified/
selected in each State ^nd funds were
provided for intensive local specific efforts.
10 7 2 Mahila Swasthya Sanghs: Greater
emphasis was laid on inter-personal
communication to encourage community
participation particularly women folk through
establishing Mahila Swasthya Sanghs in Ute
villages having more than 1,000 populatmn
or 200 households in plain areas and 500 or
more population in hilly terrains including
the North-Eastern States. The Auxiliary
Nurse Midwife (ANM) is the member
convener of the Mahila Swasthya Sanghs
(MSSs) which comprises last level
functionaries (like Anganwadi workers
school teachers, gram sevika, trained birth
attendant) and 10 prominent women from the
village community. The ANM organises
59
I
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r
t
I
W
monthly meetings to sensitise them about
family welfare issues. As family welfare
issues are inter-dependent with literacy,
nutrition, status of girl child, etc., this
convergence at the field level is of
importance. The MSS members are expected
to disseminate the knowledge in their
localities. MSSs are being constituted since
1990-91 at village level. A nominal amount
of Rs. 1,200/- per year is allocated for
arranging meetings. So far 42,567 MSSs
have been constituted in the country. 13,2oo
additional MSSs are proposed to be set up
during 1993-94. This women’s group helps
the Female Health Workers (ANMs) to
educate and motivate the community and
obtain support from other women colleagues
working in the village for the welfare of
women and children. It also provides a
forum for discussion and implementation of
family welfare programmes like
Immunisation, Oral Rehydration Therapy
(ORT) Popularisation of Spacing Methods,
Safe Motherhood, etc. A greater rapport with
the rural families will be established for
removal of misgivings and provide help in
generating positive attitude for acceptance of
family welfare programme. T^e MSb
members are given short-term training and
are supplied educational and information
materials and guidance by local level health
workers/BEE/Block Medical Officer. More
than 42 000 Mahila Swasthya Sanghs have
been formed in various States and Union
Territories.
Functionaries: To make the working of the
Mahila Swasthya Sanghs more effective,
performance-oriented, and to reach the
community in a co-ordinated manner with
effective communication skills as well as
knowledge of existing programmes, the
scheme has been further strengthened by
laying emphasis on training as envisaged in
the scheme.
10.7.5 Improvement of Professional Skills:
Training of frontline workers and critical
functionaries of the Department of Women
and Child Development, Nutrition, Rural
Development, Labour and Education, etc.Fl
continued to be organised for better
convergence of activities and to bring about
greater appreciation of each others activities.
Special attention was given to 90-weak
districts by organising joint training of
AN Ms with Anganwadi workers and other
grass-root level female functionaries as well
as holding orientation training camps. More
than 1.16 lakh ANMs and Anganwadi
workers have been trained since 1992-93.
•w
11
1
A five-day course has been
10.7.5 (a)
to
be conducted for District
proposed
Media Officers.
and
The
Extension
underlying idea is to enable these
functionaries; to train Block Extension
communication skill tor
Educators in
i
achieving a better credibility in the field.
Modular training programmes were also
conducted at selected Health and Family
Welfare Training Centres, to orient Block
Extension Educators on priority basis. 1.492
BEEs have been oriented for short-term
training upto 1992-93.
10 7 3 Evaluation of MSS Scheme: Evaluation of Mahila Swasthya Sangh Scheme was
entrusted to Indian Institute of Mass
Communication, New Delhi with WHO
assistance for Rs. 3.00 lakh. The evaluation
was undertaken in Assam, Gujarat,
Karnataka, UP, Punjab and West Bengal.
* The findings are most encouraging. Statewise
I evaluation are also being undertaken by t e
States of Maharashtra, Haryana and
| Rajasthan to focus on the specific issues/
; organisation of MSS.
'
s
10.7.6
Orientation Training Camps:
Orientation training camps were organised
for school teachers, panchayat members and
development functionaries at the SubCentre/PHC and district level for creating a
better appreciation of the population issues
among them and also to ensure their whole
hearted participation in furtherance of the
programmes at various levels.
10.7.4 Training of Mahila Swasthya San^h
Members and other Grass Root Level
10.7.7 Innovative/Local Interact!ve Schemes:
60
-
w
i
w
.I
I
The Scheme was; launched in 4-6 selected
for intensifying IEC
districts in each State
!
are being
Specific
activities
efforts,
in
the
view
areawise
undertaken keeping
■ | talent and innovative
specialised
activities such as Street Plays Burra Katha
Bhajan
Bihu
Folk Dances, Bhvai
Mandalies, Das-Kathia, Dances, Puppetry,
etc.
f
i
61
PERFORMANCE
The performance in respect of the use of
different family planning methods at National
level during the year 1992-93 >n relation to
the targets is summarised in the table giv
Appendix I.
1112 The total number of acceptors of
different family planning melhods e^°
the country during the year 1992-93 as per
provisional performance figures availab e so
far was 26.85 million. Ach>evemen« at
national level in relation to annual targets
methodwise were 80.4% m stenlisation
73.4% in IUD, 90.5% in Conventtonal
Contraceptives and 65.9% m Oral P
during the year 1992-93.
11 2 Performance during 1993-94
(Apr. ’93 to Oct. ’93)
112 1 The performance at National level,
has improved in all the four family planmng
methods (Sterilisation, IUD Insertions
Users and O^P.Users) during the period
under revietf as compared to the levds
achieved in the same period ot last year. The
performance in terms of total family
acceptors went up by 16.0% over th
corresponding levels ot last year. A table at
Appendix II gives performance ngures m
respect of different family planningI methods
during the period April ’93 to October .93
compared to that in the same period last
year.
112 2 Appendix III summarises the position
in regard to family planning achievements
during 1993-94 (upto Oct., 1993) in relatrnn
to the proportionate expected level
achievements for the current year.
Sterilisation Programme
11.3
113 1 Performance during 1992-93: A total
of 4 24 million sterilisation operations
(provisional figures) were performed in th
muntrv during 1992-93. The proportion ot
mbSmy acceptors to total sterilisation was
j
96.5%
113 2 In relation to target achievement at
LVIndia level, the achievement during 199.
CHAPTER-XI
63
I
I93 was 80.4%. Targets were exceeded by
Maharashtra, Punjab, Tamil Nadu, Himachal
Pradesh, Chandigarh, D & N Haveli, Goa,
Daman and Diu, Mizoram and Pondicherry.
11.3.3 Progress during the year 1993-94
(Apr. '93 to Oct. ’93): No targets were fixed
for sterilisations for the year 1993-94. While
formulating method mix for 1993-94, the
States were fully consulted and requested to
indicate the feasible level of achievement on
the basis- of their own assessment of the
expected
demand
for
this procedure
voluntarily. Provisional and incomplete
figures for the year 1993-94 showed that a
total of 1.73 million sterilisation operations
were performed during the period (AprilOct.’93). In relation to the proportionate
expected level's the achievement stood at
74.3% at the national level during the period
under review. Andhra Pradesh, Karnataka,
Kerala, Maharashtra. Punjab, Tamil Nadu,
Tripura, A&N Islands, Chandigarh, Delhi,
Goa, Daman and Diu. Mizoram. Pondicherry
and Ministry of Defence achieved more than
100% of the proportionate expected levels of
achievement.
|
4
11.4
11.5
1
11.5.1 Progress during 1992-93: During
1992-93, a total of 1073.15 million pieces of :®
condoms (including those under commercial 3K
scheme), 153 diaphragms, 14,221 jelly/cream
tubes and 170 foam tablets were distributed.
This works out to 14.91 million C.C. usersenrolled during 1992-93. In relation to.
targets, the achievement at the national level
was 90.5% (89.9% of the targets for C.C. ‘
users was achieved under free distribution ®
scheme and 91.7% under commercial
distribution scheme).
The States/UTs of .• Jg
Gujarat, Punjab, Uttar Pradesh, Himachal.^^.
Pradesh. J&K, Tripura. A&N lslandOH|
!
Arunachal Pradesh. Chandigarh, Delhi, Goa,?
Daman & Diu and Pondicherry exceeded
their targets under the free distribution
scheme.
!
--- .....' ■
.
r
‘
11.5.2----------------------Progress during 1993-94
(April
Oct. ''93): A total of 12.32 million users
(provisional1 figures) ot conventional
contraception were enrolled during the period
Aprii’93 to Oct.'93 of the year 1993-94.
Under the free distribution scheme alone,
10.02 million CC users were enrolled during
the period under report. Achievement at
national level under free distribution was
85.7% of the proportionate expected level ot
achievement. Gujarat. Uttar Pradesh. A&N
Islands. D&N Haveli, Goa. Daman and Diu
and Pondicherry achieved over 100% ot the
proport ionate expected levels of achievement.
I.U.D. Programme
11.4.1 Progress during 1992-93: During
1992-93,- a total of 4.68 million IUD
insertions were done in the country. Ot these
97.3%
were Copper-T. Targets were
exceeded by Meghalaya, D&N Haveli.
Goa, Daman and Diu and Pondicherry. In
relation to targets, the achievement at the
national level was 73.4%
9
Conventional Contraceptives
11.6
Oral Pills
11.6.1 Progress during 1992-93: During
1992-93. a total of 39.26 million oral pill
cycles were distributed to 3.02 million users
of oral pills at the national level. 65.9% of
the annual target was achieved during the
year.
11.4.2 Progress during 1993-94 (Apr. to
Oct. ’93): 2.61 million IUD insertions
(provisional figures) were done during the
year 1993-94 (Apr.-Oct. ’93) at national
level.
In relation to expected levels of
achievement, the achievement at national
level has been 79.2%. Gujarat, Karnataka,
Kerala, Tamil Nadu, Tripura, A&N Islands,
D&N Haveli, Goa, Daman & Diu, Mizoram
and Pondicherry achieved more than 100% of
of
the
proportionate expected
levels
achievement.
11.6.2 Progress during 1993-94 (AprilOct. ’93): During the year 1993-94 (AprilOct’93) a total of 2.57 million users
(provisional figures) of Oral Pills were
enrolled in the country, This achievement
comprises 58.4% of (he proportionate
64
W
.
■■■
f !
i
1
1
I
■I
a
•I
I
■i
1
1
SHARE OF TUBECTOMIES TO
STERILISATION
50----
n
aS
I
40
30
Z 20
fl
10
0
VASECTOMY
TUBECTOMY
i
TOTAL
% STERILISATION TOTAL
1978-79
3.9
10.9
14.8
73.7%
oVASECTOMY
1984-85
5.6
35.3
40.8
68.6%
? tubectomy
I
|
„
m
1989-90 1990-91 1
T
38.5
41.9
91.8%
38.7
41.8
93.8%
I
TOTAL * % STERILISA
i
Ktntn--
expected level of achievement for the period
under review.
11.7
Couples Protected
11.7.1 About 65.81 million couples (43.4
- - cent of the total eligible couples in the
per
reproductive age group 15-44 years) were
effectively protected against conception by
one or the other approved Family Planning
methods as of 31st March 1993. Of these.
30.2 per cent were protected by sterilisation
alone.
11.7.2 The Stat.es/Union Territories of
Gujarat,
Haryana,
Pradesh,
Andhra
Karnataka, Kerala, Maharashtra. Punjab
Tamil Nadu, Himachal Pradesh. A&N
Islands, D&N Haveli, Mizoram and
Pondicherry have protected higher percentage
of couples than the all India percentage (43.4
per cent).
I 1.8 Medical Termination of Pregnancy
(MTP)
11.8.1 In 1992-93. a total of 6.49 lakh
terminations of pregnancy
medical
(provisional figures) were done in the
country.
11.8.2 During 1993-94 (upto June 93),
96116 terminations (figures provisional) were
conducted at national level.
11.8.3 Since inception of the programme in
April, 1972. 8.94 million terminations upto
June, 1993 were effected under MTP Act.
11.9
Maternal and Child Health
Programme
11.9.1 The figures of performance in respect
of immunisation and prophylaxis programme
for the year 1992-93 and 1993-94 (upto
October. 1993) in relation to targets are
summarised in Appendix iV and Appendix V
APPENDIX-1
TARGETS AND PERFORMANCE DURING 1992-93
Methods
,S7.
No.
Targets
1992-93
Achvt.*
1992-93
5.28
4.24
0.15
4.09
80.4
6.38
4.68
73.4
21.05
16.47
10.47
6.00
4.58
2.58
2.00
17.93
14.91
9.41
5.50
3.02
1.58
1.44
85.2
90.5
89.9
91.7
65.9
61.3
72.0
1. Sterilisation
(a) Vasectomy
(b) Tubectomy
2. I.U.D.
3. Other methods(Eq.users)
(a) C.C. Users
i. Free distribution scheme
ii. Commercial distribution scheme
(b) O.P. Users
i. Free distribution scheme
ii. Commercial distribution scheme
26.85
Total Acceptors
Figures Provisional.
** Worked out on the basis of absolute figures.
65
*
Figures in million
Annual
target
of 1992-93.
F
APPENDIXrll
PROPORTIONATE EXPECTED LEVEL OF ACHIEVEMENTS
DURING 1993-94
(April, 1993 to October, 1993)
*
(Figures in million)
I
I
...
Prop. ELA
tfH for
1993-94
(Apr. 93
to Oct. 93
Achvt H
1993-94
(Apr. 93
to Oct. 93
%Achvt. *
of Prop.
ELAUH
3.
4.
5.
1. Sterilisations
2.33
1.73
74.3
2. I.U.D. Insertions
3.30
2.61
79.2
3. Other Methods(Eq.users)
(a) CC Users (Eq.)
i. Under Free distri
22.09
17.69
11.69
14.89
12.32
10.02
67.4
69.6
85.7
6.00**
2.30$
38.3
4.40
2.40
2.57
1.76
58.4
73.3
2.00**
0.81$
40.5
SI.
Methods
No.
1.
2.
bution (Eq.)
ii. Under Commercial
distribution
Schemes (Eq)
(b) O.P. Users (Eq)
i. Under free distri
bution schemes(Eq)
ii. Under Commercial
distribution
scheme (Eq.)
:
’O
•
__
I
I
1
$$
t
$$
f
19.23
Total Acceptors
Figures provisional
Expected level of achievement
ELA
Equivalent
Eq
*
Worked out on the basis of absolute figures
** Annual expected level of achievements
Achievement upto Sept, 1993
$
$$ Based on annual expected level of achievements.
May not tally with the total of free and commercial distribution
@
due to rounding off.
66
4
"I
•S
I
1
A
A'.
I
i
targets
and
achievements
under
Activity'
I
1.
PROGRAMME DURING 1992-93
mch
(Figures in 000’s)
Tetanus Immunisation
for expectant mothers
i.
DPT Immunisation for
children
iii. Polio
iv.
B.C.G.
Measles
vi.
DT Immunisation
for children
vii. T.T. (10 years)
viii. T.T. (16 years)
Prophylaxis against
Nutritional Anaemia
among:
(a) Total women
(b) Children
%Achvt.
I Target
for
1992-93
Achieve
ment*
1992-93
2.
3.
4.
27008
21444
79.4
24290
21907
90.2
24290
22058
90.8
24290
23430
96.5
24290
20830
85.8
17552
12906
73.5#
16054
10448
73.1#
16102
8249
57.5#
27008
24290
16296
13889
60.3#
57.2#
24290
28429
(doses)
66.4#K
Immunisation
A.
1
-iii
appendix
Prophylaxis against
Blindness due to Vit.A deficiency
of
Annual
target
of 199293
I
^,87eS h XZent^'f target was worked out by taking half of the total doses given
' i to the
target
annual
first time initiated continuing and completed dosed beneficiaries as a
~ "of
SZos for
not received.
67 •
««
t
*
APPENDIX-IV
PERFORMANCE UNDER MCH PROGRAMME DURING 1993-94
.
(April,1993 to October,1993)
<
Activity
I .
—--------- -------------------------------- %Achvt.
Ach\n. *
of
Prop.
Prop,
Target for
target
1993-94
’931993-94
(Apr
’93,94(Aprf
(Apr. ’93
Oct. ’93)
93-Oct.
-Oct.
•93)
’93)
!
'ft
Immunisation
A.
1
i.
Tetanus Immunisation
for expectant mothers
16074
9532
59.3
ii.
DPT Immunisation
for children
1
14461
9280
64.2
ill. Polio
14461
9411
65.1
iv.
B.C.G.
14461
10265
71.0
v.
Measles
14461
9435
65.2
vi.
DT Immunisation for
Children+
9269
2967
32.0
vii. T.T. (10 years)*
8325
2551
30.6
viii. T.T. (16 years) +
8347
1692
20.3
B. Prophylaxis against
Nutritional Anaemia among
(Annual
Target)
Total Women +
Children+
27555
24790
6957
Prophylaxis against
Blindness due to
Vit. A deficiency +
24790
10221
(doses)
a.
b.
C.
I
■
I
J
% Achvt.
of
Annual
Target
4724
25.2
19.0
20.6K
+
relate to April
* Figures provisional
©---------• to October.
t -Target and achievement figures
J
K % Achievement of target xyas worked out by taking half of the total doses given to the first time initiated
continuing and completed dosed beneficiaries upto the period under review as the annual target of Vit.
A solution are two dosed beneficiaries.
68
r
I
■^1 i
1
1
appendix
-v
(Figures in Million)
F.P. METHODS
1993-94*
1992-93
% INCREASE
(+)
r
Sterilisations
IUD Insertions
C.C. Users
O.P. Users
1.68
2.12
10.54
2.15
1.73
2.61
12.32
2.57
( + )3.2
( + )23.1
(+)16.9
(+)19.3
TOTAL ACCEPTORS
16.49
19.23
(+)62.5
* Achievement Provisional
69
I
I
Ir
I
•t
—ZiL-IS7" II
W1" •
I
,
, nc IPP are beinq implemented with a
World Bank assisted projects known as IPP are
9
I
total outlay of Rs: 998.02 crore.
it
.1
I
I
I
r.
EXTERNAL
ASSISTANCE FOR
FAMILY WELFARE
AND AREA
DEVELOPMENT
PROJECTS
External Assistance for Family Welfare
Programmes is being received from the
following
UN/Bilateral/International
Organisations.
12 12 U N Organisations: United Nations
Population Fund (UNFPA); United Nations
Children ’s Fund (UNICEF); and World
Health Organisation(WHO).
Organisations:: United
12 1.3
Bilateral Organisations
States Agency for International Development
(USAID); Norwegian Agency for
International Development (NORAD); Danish
International Development Agency
(DANIDA); and Overseas Development
Administration (ODA).
12.1.4 International Organisations: Details
of this assistance are given in the ensuing
paragraphs.
12.2 United Nations Population (UNFPA)
12.2.1 In the current i.e. the fourth phase ot
UNFPA assistance (1991-95) India is
to get US $ 90 million. Out ot this, US $ 70
million will be from UNFPA regular sources
and U S $ 20 million from multi-bilateral
sources. During 1992, UNFPA provided an
amount of US $ 10.13 milhon
Durmg
1993, the expected assistance is Ub * »o./u
million
i
II
CHAPTER -XII
12.2.2 The main programmes tor which
UNFPA assistance is being utilised during
the fourth phase of UNFPA assistance
include Population Education (School, Higher
and Adult Education and Non-Formal
Education), Area Projects in selected districts
of Himachal Pradesh. Maharashtra and
Rajasthan, procurement of raw materials tor
Oral Pills and IUDs etc.. Establishment ot
1 Centres of Excellence for Training in Microsurgical Sterilisation and Recanal isat ion.
Development of a National Centre or
Technological Evaluation ot IUDs and Tubal
Rings; Special Project for Low Acceptance
Areas in Maharashtra; Support to NonGovernmental Organisations/Apex Bodies,
71
i
r
I
Projects for Organised Sector like Income
Generation Scheme for Working Women in
Urban Slums, Beedi Workers, Tribal
Population, etc. and
Outdoor
Communication Activities
under
Information, Education and Communication.
to be provided by UNICEF tor this
During 1992-93, UNICEF
programme.
provided an assistance of Rs. 30.95 crore for
procurement of supplies.
In 1993-94.
UNICEF is likely to provide an assistance of T
about Rs.35.00 crore (US $ 10.93 million)
12.3 United Nations Children’s Fund
(UNICEF)
12.4 World Health Organisation (WHO)
12.3.1 UNICEF provided assistance for the
Universal Immunization Programme during
the Seventh Five Year Plan. It has now to
provide financial assistance for some of the
activities of the Child Survival and Sate
Motherhood (CSSM) programme. For the
period 1991-95, an amount of US $ 107
million (Rs. 278.20 crore approximately) is
1
12.4.1. WHO assistance is received under
WHO regular Country Budget and special feprogrammes for Research, Development and
Training in Human Reproduction. The WHO
Country Budget assistance is received on
biennium basis. During the WHO biennium
1992-93 an amount of US $ 3,238,458 is~^5
likely to be received for Family Welfare k
Projects as per details given at Appendix-I.
appendix
(IN us$)
-i
'7; \
I
THE WHO COUNTRY BUDGET ASSISTANCE
IND/PHC/001 - Organisation of Health Care System based on Primary
Health Care
373,796
IND/MCH/003 - Maternal and Child Health Care
402,560
IND/MCH/004 - Promotion of Family Welfare Services & Research
666,393
IND/MCH/OO5 - FW/PHC - Services in Urban Areas
753,254
IND/EPI/001 - Expanded Programme on Immunisation
484,920
IND/CDD/001 - Control of Diarrhoeal Diseases
1 14.370
IND/ARI/001 -Acute Respiratory Infection
115,090
IND/IEH/002 - Information. Education and Communication.
135.600
Undergoing reallocation
192.475
Total :
3,238.45
j-
w
A
72
1
I
12 4 2 The assistance is being utilised for
supplies and equipments; Group Educational
like Seminars. Meetings,
Activities
Workshops etc; Experience Sharing Study
Tours/Fellowships
abroad, short-term
consultancies and organisation ot various
programmes for medical and para-medical
personnel' in the country and Inionnation,
Education and Communication.
of Family Planning Services by
quality
expanding
“““E
methods and improving the technica
competence of personnel through training and
"Zdation of their skills; and (m) Promot’
ingFamily Planning by broadcast1^
•unong leadership groups and in'-rea^
J’hliA understanding of the benet.ts ot
- Under the WHO special programme
12.4.3.
Research. Development and Research
fur LTraining in Human Reproduction (HRP).
certain project-oriented assistance ^ received
for various institutions involved in the area o
H X RePr«l«ta, A Meo.mta" »
»
Urfe,standing has b«n s,gn«l
4
WHO HRP Programme m lune,
sairenethcning
collaboration with tne
Family Planning.
r 5 4 It is expected that at the end of the
Proiect period, the Total Fertility Rate of
Uitir Pradesh will decline from Mm an
there will be an increase n the Coup
Protection Rate from 357c> to 50;o. H
Project has been launched and is unde
implementation.
“SS&XZ.
support to the programme.
12.5
United States Agency for
JnternationalDevelopment(USAIit)
12 5.1. USAID assistance is being received
mainly for the following schemes;(a)
Private Voluntary Organisations for
Health (PVOH-II) Scheme;
(b)
Innovations in Family
Services Project in U.P.
0 5 2 PVOH-II
Scheme:
The
Planning
Scheme
the country and are engaged m basu and
preventive Health and Nutrit.on MCH and
Family Planning Services. A total amount
VIS S 10 million is to be receiv
USAID under this Project in a period ot 0
, -irs The objectives
cu: '
‘'fofTh,‘
; 1
thePro,ect
Projectare
Post-Partum Programme at Sub-d
lOl^SuMisuSlXel Polt-Partum Centres
cSernment ^ndia.8
During 1991-^
i'CX'TS^tis aiso
being implemented at the Indian Institute
Health Management and Researc
wlth financial askance ot 5 *
allocated by NOKAU.
.
continuing over the period 1990-93.
12.7
Danish International Development
Agency (DANIDA)
12 7 1 ADANIDA assisted Project is being
topi™™®1 » 8 Jis"ic7
12S3 1,nations u . Family Planning
Pectin U.P.: <0 The Project provide or
to Family Planning
•
Arrpss
Services by extending service delivery in the
Puhi c Sector and in the Non-Governmen a
r .
22 96 crore.
expenditure ot
73
“iS
The Project >s up t
Ks.
b„„
reported upto September, l^asjamst
S? in'e-e Of Tamil Nadu tiil August.
1993 against the grant-m-aid i
crore released to the State.
Overseas Development
12.8
Administration (ODA)
»_ 11 Area Development Project
12.8.1 A Phase
in the live
has
in Orissa !•— been taken up
(Dhenkanal, Keonihar.
'
•
i
districts ot Orissa
Sambalpur and Sundergarh)
Mayurbhanj,
assistance ot the ^v^eas
with the
Developm®
The
a total Project cost of Rs. •
Project commenced from 1. ■
i
mq-t is Rs 26.21 crore, in case ot Madras S
ind Rs70.90 crore in case of
■W ■
grant-in-aid of Rs. 27.03 crore and Rs. 22.52^
these cities
crore has been released to t.respectively.
m o 1 (ci IPP-V Pr°ject: ThiS Pr°jeCt B i
„nrerel««l<»
State.
12.9
P9 1 World Bank assisted^ojects”
being implemented i
total outlay
Sh emphasis
iX implied in
-Bis-iSEgs
States
SW?
Expendilure
U.P.
110.54
31.05
42.57
10.87
998 02 crore.
Projects are given below.
M.P.
19 9 1 (a) 1PP-IV Project in West Bengal.
This IT »eci is being implemeniesl mainly m
me tafinima ef
S.a.e »»■ Burd»»
Purulia Birbhum and Bankura at a tu<
•
o r
117 12 crore. The development credit
agreement ’ with the World Bank was
a T)
however, amended in 199° to
he P-aiject.
districts in the State
P^J^- The
State under
under the
continue t... 2^'has
been
Pri’JeChiSelofCRsS
102.88 crore
eXpen
mder inc
11 e Project
P meet unto
upto October,
incurred under
1993.
in Madras and
12.9.1 (b) IPP-V Project
17.63
49.55
IPP-VII Project: The IPP-V11
12.9.1 (d)
Development and
Training, Manpower
Project
is being
Service Delivery
Punjab,
Gujarat,
Punjab
Bihar,
implemented in I
.10
from
2nd
effect
Haryana and J&K with
total cost of Rs. 335.72
November, 1990 at a
is for tive
crore. The period ot the^Projeu
The
years that is upto 1994-95. .•• shares of
-‘3 and the
the different State Governments
September. 1993
expenditure reported upto> •
on next
page.
next page.
us on
under their Projects is
A.P.
74
I
i
reported upto September, 1^Project are as under:
(Rs.in crore)
World Bank
„ -Ma
i
Th Pro ect aims ttt extending the delivery of
Fam 1
Welfare and Primary Health Care |
Services in the slum areas of these c.t^wjh |
emnhasis on Maternal and Child Health, g
lhese backward districts of the Mate y
augmenting the infrastructure tor hedt
Die
1 r rxrv -Tnd training institutions.
of Rs. 32.17
I
Bombay: The. IPP-V Project is being
iniplemented iin the Metropolitan cities of t
November, 1993 to attend the
SA ARC Ministerial Meeting on
Women and Family Health.
(Rs. in crore)
States
Share
Expenditure
Bihar
Gujarat
Haryana
Punjab
J&K
88.18
43.90
42.42
48.66
51.54
8.08 (8/93)
12.96
12.11
12.32
r 11 1 (a) A five-member delegation trom
£ Govi of B.nel»toh. heatol by D .
A K.M. Rafiq.i2.Zamm. tweclor Gen«al.
Oireetoraie of Ifi—f
16.26
15.81
12.9.2 The World Bank has agreed to
provide assistance of SDR 160.90 million
S 214.50 million from
^990-92"to'1994-95 for the Child Survival
and Safe Motherhood (CSSM) Programme
During the year 1992-93, IDA assistance of
Rs. 54.40 crore has been received from the
Bank The assistance expected to be received
during 1993-94 is Rs. 90 crore.
n 9 3 IPP V///.- Project for the urban slums
of Delhi, Calcutta. Bangalore and Hyderabad
was sanctioned in August. 1993 at a cost o
Rs 223.37 crore. The Project will benefit
an estimated population of 73 lakh with the
majority of beneficiaries being women and
children
World Bank has committed an
assistance of SDR 57.7 million (US $
million ) for this Project.
12.9.4 IPP-/X : It is proposed to take up
IPP-1X Project for entire Assam, 10 lagging
districts of Karnataka and 10 desert districts
of Rajasthan with financial assistance of
World Bank. The Project is being “PPra1^
by World Bank in December, 1993 and it is
likely to be sanctioned during next financial
year.
Visit of High-level Delegation to
India
important matters
,eam -isitej
5$
,Xra““eV?'al?;
S^afiear Se«a S.matan »
'programmes and Activities i>™ll
by these Institutions in support it
Family Welfare Programme.
12Jl.1(blAsi«:memfie,o^
visited India during
The team was
programme.
*
•
I
management systems in Inc ia w h
Maharashtra.
12 11 1 (0 A three-member delegation from
12.10 Ministerial/Delegations Abroad
12.10.1 Indian delegations headed by Shri
B. Shankaranand. Health and Family Welfare
Minister, were deputed to :
delegation was to benctlt
- UNFPA and
experience in the execu on o^UNFI
h the
UNDP assisted I at ly
’’"^ffiSaSXMi^eannese
Bali Indonesia in the second week of
November.1993 to attend the NAM
Ministerial/ Senior Officials Meeting
on Population.
SCnT ale field visits to’the State of
team made neK
.
Project m
j
Maharashtra to see UNFI A Area
Nagpur.
Dr. Nafis Sarlik, Executive
12.11.1 (d)
(i)
(ii)
L
Kathmandu,
Nepal.
from
20-23
75
I
....
Director, UNFPA, visited India from 23-26
October, 1993 as a Guest of the Govt, of
India.
I
(vi)
(vii) One Ambulance per block if notW'
already available.
12.12 Social Safety Net
'.7
12.12.1 Under the Social Safety Net (SSN)
Scheme facilities at Health Centres (30,000
population) in 90-demographically poor
performing districts of the country are sought
to be upgraded under World Bank assistance.
Detailed facility surveys conducted have
indicated gaps in essential infrastructure. To
provide facilities for deliveries in aseptic
conditions, bring about reduced maternal
mortality rates and infant mortality rates, the
following facilities are being provided:
I
(i)
-1
12.12.2 The States would be utilising the
assistance for all or any of the facilities listed S’
above. In addition, Rs. I lakh per PHC will
be provided for maintenance of existing S
PHC, simple surgical items, bandages, etc. <
i. >
12.12.3 The scheme is being implemented
the 90-weak districts of States of
Pradesh, Bihar, Rajasthan, Orissa, Haryana, |
Kerala, West Bengal, Gujarat and Madhya
Pradesh from the year 1992-93.
A well-equipped operation theatre
(15’ x 10’).
(iii)
An Observation Ward (15’ x 20’)
having six beds.
(iv)
Two quarters, one for Lady Health
Visitor (LHV) and one for Auxiliary
Nurse Midwife.
(v)
One Generator to ensure continuous
electric supply.
f/
12.12.4 States have selected five PHCs each
for 1992-93 and 1993-94 for upgradation
under the scheme. Rs.45 crore have already
been released to these States in respect of
each year of 1992-93 and 1993-94. Each
PHC will get an amount of Rs. 10 lakh under
the scheme for upgradation of facilities.
Detailed guidelines have been sent to these
States for implementation of the scheme.
The States have undertaken to provide the
services of a lady doctor, a staff nurse and an
ANM in the Primary Health Centre and also
to maintain the facilities created.
(20’ x 20’).
(ii) A labour room-
Provision of running water supply to
u)
OT and Observation Ward.
i
76
1
1
■
autonomous
BODIES AND
SUBORDINATE
ORGANISATIONS
V arious 'autonomous/statutory bodies
located at different levels in the country
provide technical and research support to the
Department of Family Welfare. This Chapter
sums up progress of work in these
organisations during the year under report.
13.2
National Institute of Health and
Family Welfare, New Delhi
13.2.1 NIHFW was established in the year
1977 by the merger of two erstwhile
institutes - National Institute of Health
Administration and Education and National
Institute of Family Planning, lhe Institute is
engaged in different discipl ines: Reproductive
Bio-Medicine, Population Genetics,
Demography and Statistics, Epidemiology,
Medical Care and Hospital Administration
and Communication.
13.2.2 The Institute is pursuing education,
training, research and consultancy activities
in the field of health and family welfare in
the country.
13.2.3 The Institute’s training programmes
have been designed for upgrading human
resource development capacities in the health
sector. Major training programmes have been
in the areas of Hospital Administration, No
Scalpel Vasectomy, Training Programmes tor
Senior Level Administrators, Mother and
Child Health Training Course, (in
collaboration with the Liverpool School of
Tropical Medicine, U.K.) and the Area
Development Project, Orissa.
13.2.4 The Institute ’s District Health
System Research Project in Gwalior is
underway with eighteen research studies on
different aspects of health and family welfare
programmes. Under the project on Population
Simulation three models have been developed
on different dimensions of population growth
and its impact in different sectors. Under the
India Population Projects V-VIA besides
innovative training, Health- Manpower
Development Cells in the concerned eight
States are proposed to be established.
CHAPTER -XIII
77
13.2.5 The Institute is adopting a functional
group approach to provide the forum for
interaction and decision-making among the
faculty.
13.2.6 The educational activities
are
planned to impart basic education and
promote academic excellence in the areas
having a bearing on the health and family
welfare programmes.
The educational
activities comprise a Post-graduate Degree
Course in Community Health Administration
and Ph. D. Programme in various disciplines
of health and family welfare.
13.2.7 M.D. in Community Health
Administration: A three years’ post-graduate
course of M.D. in Community Health
Administration is offered which is affiliated
to the Faculty of Medicine, University of
Delhi, during 1993-94. This course
comprises 23 students, (7 in the third year,
11 in the second year and 5 in the first year).
I
added lor the contact programme. The five ,
regions where the contact programme will be ‘
held are the NIHFW, New Delhi for die
Northern region, SIHFW, Lucknow for the
Central region, SIHFW, Hyderabad for the. '
Southern region, CINI, Calcutta for the7^:
Eastern region, and IIM, Ahmedabad for the
Western region.
I
I!
II
|
13.2.9 (i) Continuing Education in Hospital Management Through Distance Learning: ?.
A one year Post-graduate Certificate Course T ’
in Hospital Management through Distance
Learning is under preparation, which is
expected to be launched in early 1995. The :
professionals^ |
course will be open to medical professional^
working as hospital managers or aspiring to a career in hospital management.
13.2.10 International Course: A 3-month
Course in Health and Population
Management is scheduled to start from
February, 1994, designed for candidates
from developing countries responsible for the
management of health services.
13.2.8 Ph.D. Programme: The faculty
members of the Institute are recognised by
the various Universities as guides for Ph.D.
in different disciplines related to health and
family welfare. Ten Ph.D. students are
engaged in research in the areas of
Population Genetics, Reproductive BioMedicine, Communication and Social
Sciences.
I
' I
I
13.2.11 Training Programmes: The Training
Courses and workshop (both, intra and extra
mural) during the year include 20 regular
training courses, 5 funded courses and 6
workshops, in addition to 5 workshops and
courses organised under the IPP V and VI-A.
13.2.12
Research and Evaluation
Programme: The Health System Research
and Evaluation Studies conducted by the
Institute are of applied nature and generally
based on primary data collected from field.
It is only in the department of Reproductive
Bio-medicine where research connected with
contraceptive development in the laboratory
situation is being conducted.
13.2.9 Distance Learning Programmes:
The Third Course in Distance Learning
started in July 1993 and 300 students were
enrolled. The course curriculum contains 14
management modules. To assist the students
contact programmes of 5 days duration each
are organised at different centres in the
country. The NIHFW also provides library
facilities, video and audio cassettes on
management. The course has a three-tier
system of evaluation comprising self
assessment, internal assessment and terminal
This year, new centres at
evaluation.
Chandigarh, Nagpur and Mysore have been
13.2.12 (i) Research covers Psycho-social
Studies, Health Systems Studies, Population
Genetics and Evaluation Studies of
infrastructure facilities. Some studies focus
on issues like health care delivery system.
78
5
5
I
• r of Supervisory
Strengthening
P^^of Personnel Working in
District Health Care Delivery,
Madhya Pradesh - Phase II.
family welfare as a focal point of interest in
the planning of syllabi of medical colleges in
India, and the nutrition status of lactating
mothers and infants.
xi.
13.2.13 Research and Other Activities in
1993-94:
xii.
i.
iii.
Multi-Media Study of the Duration of
Lactational Amenorrhoea in Relation
of Breast Feed Practices.
xiii.
Development of Health Plan for
District Bulandshahar.
xiv.
A Study of Organisation and
Management of Health Delivery
Svstem in Selected Districts in Six
States of India (WHO-IND-MPN002).
XV.
Study of Fertility, Mortality Pat&rn
and Family Planning Practices
Among the Tribal Population ot
North-Western and Central Northern
Region of India.
Impact of Genetic Disorders on the
Health Profile Among the High Risk
Tribal Groups of Madhya Pradesh.
vi.
A Study of Decidual Prolactin
Secretion and its Role in Male Rats.
vii.
Anti-fertility Effect of Indigenous
Plant Products in Male Rats.
viii.
ix.
J
7.
■
;l
X.
Role of Prolactin in Reproductive
Disorders.
A study of Strengthening Family
Welfare Programme in Organised
Sector.
Population and Health Profile in
India.
A Study of the Logistics and Supply
System of Drugs, Vaccines and
Contraceptives in a District Health
System - District Kamal.
xvi.
Improvement in Quality of Family
Welfare Services in Selected States.
xvii.
Policy
Policy Research
Research on Private Practice
by Government Doctors.
xviii.
Capacity Building for Health Policy
Development in India.
13.2.14 Studies on GnRH Antagonist have
been actively considered for male
contraception.
Assessment of Sperm Steroid Bind ing
Proteins for Regulation of Fertility in
the Human.
13.2.14. (i) Development of Immunodiagnostic Kit: An inexpensive pregnancy test
kit
L. that
J.-.. can be used in hospitals 1S bel"8
developed using
using - heg antibody and gold
developed
chloride conjugate. The efficacy of the kit s
being evaluated.
now being
evaluated. 132 samples with
hundred per cent efficacy have been tested
till date.
Study to determine the Optimum
Population which can be served by
tlie Sub-Centre and its Staff and
requirement of equipments and drugs
thereof (WHO-lND-HSR-OOl).
13 2 15 Projects: District Health Systems
Research Project: District Health Systems
Research Project is being implemented in
Gwalior district of Madhya Pradesh involving
18 research studies.
Combined Administration of
Cynroterone Acetate and a Potent
Androgen as Potential Contraceptive
for Human Males - A Clinical Trial.
13 2 15 ft) National Training Project: India
Population Project V and VI-A. Under Ulis
project, training is being imparted to health
79
-
personnel to enhance capacities for delivering
Mother and Child Health and Family Wei t are
Services.
13.2.15. (ii) Population Simulation Project
11 : The Major Objectives are: (i) develop
and disseminate computer simulation models
to increase the understanding and support for
family welfare programmes;and (ii) develop
presentations based on RAPID model
(demonstrating effects of population growth
on socio-economic development) for four low
performing States (Rajasthan, Bihar, U.P.
and Madhya Pradesh) and the model on CostBenefit Analysis of family planning
■programme.
13.2.16 Information, Education and
Communication Training Scheme in Uttar
Pradesh: The IEC Training Scheme was
operationalised in 17 districts of Uttar
Pradesh from 1988 and the new phase of the
scheme has become operational from April.
1993.
formulation as well as
activities of these Centres.
evaluating the
13; 2.19 Management Consortium: National
Consortium of Institutions in Health and
Family Welfare Management: The goal of the
consortium is to contribute towards
improving health management practices and
processes with a view to achieving national
health goals through collaboration and
cooperation among institutions working in the
field of health and family welfare programme---management.
13.2.19 (i) The consortium meets twice a
year to review the progress of on-going ,
training/research projects and also to decide"^- f
collaboration on new projects.
13.2.20 Specialised Services: The areas in
which consultancy and advisory services are
provided by the Institute include: (i) health
manpower of development; (ii) professionalisation of health managements, including
hospital management and materials
management; (iii) development of referral
services at different levels of health services
infrastructure; (iv) inter-sectoral
coordination; (v) community participation for
health and family welfare adoption, (vi)
computerisation and innovative approaches
for health and family welfare data collection
and analysis; (vii) reproductive health, care
and research on contraception; (viii)
development of epidemiological centres; and
(ix) educational technology.
13.2.17 Private Voluntary Organisation for
Health Project-11: This project is in the
Phase-II stage of implementation since 1990.
13.2.17 (i) The Institute helps to evolve and
standardise methodology for monitoring
various projects funded from PVOH Scheme
against norms laid down for utilisation of
grant.
13.2.18 Centre of Excellence (COE) Project:
The Ministry of Health and Family Welfare
in technical collaboration with Association of
Voluntary Surgical Contraception, New York
launched the “Centre of Excellence” (COE)
Project in 1988 with the purpose of providing
qualify family planning services throughout
the country . While the I phase identified
four such centres, in phase II, twelve more
such centres were established in different
regions to provide quality services in relation
to sterilisation and recanalisation. The
project
Institute has been involved in
13.2.20 (i) Specialised services related to
genetic counselling have been provided by
the Institute.
13.2.20 (ii) 'Fhe Clinic: The clinic of the
Institute is recognised for its work on
diagnosis and management of male and
female infertility. It also provides microsurgical recanalisation operation in post
‘No-scalpel
vasectomy cases. The
Vasectomy’ is being performed in the clinic.
80
Besides, services for maternal and child
health care, immunisation, nutritional
supplementation and family planning are also
provided by the clinic.
13.2.21 (ii) It is also the Regional Resource
Centre for South-East Asia for Primary
Health Care Information with the assistance
of WHO.
13.2.20 (iii) Laboratory Services: Regular
laboratory services (Bio-chemical,
Immunological, Histological and
Radioimmunoassay of Hormones) are
provided to the patients. The Institute also
renders laboratory services for ABO, RH,
MN blood groupings and malarial parasites.
Dial-up-Modum has been
13.2.21 (iii)
established with the help of National
Information System of Science and
Technology (NISSAT). Electronic Mail
Software has been put to use to disseminate
documentation services amongst the network
of Delhi Libraries.
13.2.20
Genetic Epidemiological
13.2.20 (iv)
(iv)
Studies: Department of Population Genetics
in collaboration with Safdarjung Hospital and
G.B. Pant Hospital conducts genetic studies
to provide diagnosis regarding aspects of
congenital gynaecology.
I
13.2.20 (v) Institute's Journal: Health and
Population - Perspectives and Issues: The
Institute publishes the research journal HPPI
twice in a year. It includes articles of
scientific and educational interest in the fields
of health services, administration, family
welfare, including population studies and
other related disciplines.
I
13.2.20 (vi)
Audio-Visual Media: The
Department of Communication provides
media services to various training, research
and other activities of the Institute and
outside organisations. Audio and Video
cassettes have been made for the Distance
Learning Programme.
13.3. Hindustan Latex Limited
13.3.1 Hindustan Latex Limited (HLL) was
incorporated as a Company under the
Ministry of Health and Family Welfare of the
Government of India in March 1966.
13.3.2 HLL is the largest manufacturer of
Condoms in the country. Its two Plants one
near Belgaum in Karnataka and the other at
Thiruvananthapuram in Kerala set up in
collaboration with M/s. Okamoto Industries
annual
Inc. Japan, have a combined
installed capacity of 608 million pieces.
13.3.3 HLL is now a multi product
manufacturer of contraceptives and health
care aids.
13 3 4 Areas of diversification include Latex
Examination Gloves and Hydrocephalus
Shunts.
13 3 5 HLL has added to its range of
contraceptives the Once-a-Week non
steroidal Oral Contraceptive Pill Saheli and
Conoer-T. It has also taken up the
formulation and tabletting of Mala-D/N Oral
Contraceptive Pill.
13.2.21 Computer Activities: Bibliographic
database on computer using CDS/ISIS
Package, for creating Mailing lists and
processing V>f background documents tor
training courses using the computer has been
created.
a
t.
13 3 6 Capital Structure : The issued and
paid up share capital of the Company ts
Rs. 1258.00 lakh. Against this paid up
capital, the Company has generated
Rs. 1239.00 lakh. ITe total capital employed
is Rs.2497 lakh.
13.2.21 (i)
Network Activities: The
s
documentatiop
Centre is linked to
Institute’
Asia-Pacific POPIN with the assistance of
ESCAP.
81
U-
i
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13.3.7 Performance : HLL has consistently
recorded high productivity and profitability,
high capacity utilisation and excellent
industrial relations.
13.3.7. (i) The 1992-93 sales for its various
products are:
619.89 M.pcs.
(a) Condom 9.42 M.pcs.
(b) Latex
Glove
3.00 M tabs.
(c) Saheli
91 Nos.
(d) Ceredrain (Hydrocephalus Shunt)
13.3.7. (ii) The total sales of condoms
include those under the various schemes of
the Govt, of India, Deptt. of Family Welfare,
namely: (1) Free Supply; (2) New
Lubricated; (3) Deluxe; (4) Super Deluxe;
(5) Sawan; (6) Masti; and (7) Bliss and also
domestic sales of HLL’s direct marketing
brands - Moods, Share and Rakshak.
13.3.7. (iii) HLL has been regularly paying
Dividend to the Government of India, for the
past four years. Last year’s dividend was
Rs. 66.01 lakh.
I
1969 and 1977, in line with the latest
technology obtained for its two new Plants
set up in 1985-86 from its collaborators M/s.
Okamoto Industries,
UKamoto
inuuMucd, Inc.,
inv., Japan. The
.nV
modernisation programme commenced in
June 1989 and was completed in three phases
with an outlay of Rs.497 lakh.
'W
Department: The
R and D
13.3.10
Company’s R and D Department has made
significant contributions for improvement of
the quality of the Company’s range of
condoms together with indigenisation of new
materials and other equipments which were
earlier imported. A closer relationship
between the Company and Research Institutes
all over the country such as IIT’s and
Regional Research Laboratories has resulted
thereof.
13.3.11 Quality Assurance'. The Company
lays emphasis on effective quality control at
every manufacturing stage.
13.3.11
(i) The Condoms are tested in
13.3.11 (i)
computerised Electronic Pin-hole Testing
Machine for accuracy. They also undergo
further screening as prescribed under
Schedule ‘R’ of the Drugs and Cosmetic Act.
13.3.12 Marketing and Exports: To meet
the increasing demand for high quality and
newer varieties, the Company markets its
own domestic brands directly.
13.3.8 Technology Transfer:
HLL has
established a sound technological base for the
manufacture of condoms and has made
process improvements over that of its
Japanese collaborators.
1
13.3.12 (i) ’’Moods", a premium brand, was
the first of such brands introduced in the
market on a national scale. The other brands
introduced later were ‘New Share India s
first spermicidal Condom and Rakshak .
13.3.8 (i) The Company now handles trade
enquiries from abroad and within, for setting
up of factories for manufacture of condoms.
HLL has already transferred technology to
M/s. Polar Latex Limited, who have set up a
condom plant at Balasore, Orissa^ with an
capacity of 160 million
annual installed
i
pieces.
HLL took up the social
13 3 12 (ii)
marketing of Mala D Oral Contraceptive Pills J
•
____
in the States ofr- taRajasthan,
Pradesh,
Madhya PrsdpXR,
Nadu
and
Karnataka
from
1
Kerala, Tamil
July, 1993.
13.3.9 Modernisation : HLL has indige
nously modernised its old Plants set up in
13.3.12 (iii) HLL is now establishing a wide
82
■J:
I
network of distributors all ovecthe country to
distribute its commercial brands ot condoms,
surgical and examination gloves, Once-aweek Oral Pill ’’Saheli”, Mala D - and the
"Ceredrain" Hydrocephalus Shunt.
13.3.12 (iv) HLL’s branded condoms and
examination gloves received the 510 K
certification from FDA (Food and Diugs
Administration), USA, which is essentially a
clearance'for marketing these products in the
U.S.
13.3.12 (v) HLL exported its Gloves to
UAE, Uganda, USA, Angola, Kenya,
Mauritius and Oman. The company has also
commenced supply of condoms in the brand
name RESIST to Saudi Arabia, and its
Moods, Share and Rakshak condoms to
Dubai.
13.3.12 (vi) During 1992-93 the total export
earnings amounted to Rs.61.66 lakh.
13.3.12 (vii) Together with t h e
and
____
_____ o
of its
marketing
strengthening
distribution network, HLL plans to market
quality products within the country and
abroad in its own brands. Several products
have been identified including medical and
health care aids.
■
Plant has a production capacity of 30 million
tablets per annum of Saheli. The total project
cost is approximately Rs. 120 lakh.
13.3.13 (iii)
Centchroman Bulk Drug
Project: HLL proposes to set up a
manufacturing plant for this project at
Belgaum. This drug was developed by the
Central Drug Research Institute, Lucknow.
The scaling up process tor manufacture is
being undertaken by M/s. SPIC, Madras.
The estimated project cost is Rs.475 lakh.
13.3.13 (iv) Blood Bag Project: A Blood
Bag manufacturing unit with a capacity of 2
million blood bags per annum is being set up
at Akkulam with technical know-how from
M/s. Sree Chitra Thirunal Institute for
Medical
Sciences and Technology,
Thiruvananthapuram.The Plant is expected to
function by June, 1994. The estimated
project cost is Rs.997.49 lakh.
13.3.13 (v) Hydrocephalus Shunt Project: A
manufacturing unit with an annual capacity of
5,000 pieces is being set up at Akkulam with
the technical know-how from M/s.Sree
Chitra Thirunal Institute for Medical Sciences
and Technology, Thiruvananthapuram. The
estimated project cost is Rs.66.08 lakh. The
Plant is expected to be completed by April,
1994.
13.3.14 Future Projects Planned : Urology
Catheters: This project is envisaged at
Belgaum. Identification of technology is in
progress.
The project cost outlay is
estimated to be around Rs. 1200 lakh and it is
likely to be completed by April, 1995.
13.3.13 Diversification Projects: HLL has
the following five projects on hand:
13.3.13 (i) Copper-T Project: HLL’s Plant
at Akkulam, Thiruvananthapuram, for the
production of Copper-Ts, an intra-utenne
device, has commenced trial production.
Commercial production is expected to
commence shortly.
13.3.14 (i) /.V. Solution Project: This
project is in the initial stage. The estimated
project cost is Rs.2200 lakh. The project is
expected to be completed by May, 1997.
13.3.13 (ii) Centchroman and Mala D/N Tabletting Plant: This plant has been set up
in Belgaum for the formulation ot
Centchroman tablets, in the trade name ot
■Saheli’, and Mala D. The project was
commissioned during October 1993.
The
I
13.3.14 (ii) Injectable Contraceptives: HLL
plans to set up a plant by April, 1998 torJ^e
production of injectable contraceptives. The
estimated project cost is Rs. 1000 lakh.
83
—-I
I
I
13.3.14 (iii) Subdermal Implants: A plant
for the manufacture of Subdermal Implants at
a cost of Rs. 1000 lakh is expected to be
completed by April, 1999.
i!'
13.3.17 Human Resource Development:'
Over Rs. 10 lakh were spent last year fot>ftraining and development of employees*.’’F
Training programmes are broadly classified^
into three categories. Workers Development - Programmes, Supervisory Development
Programme and Executive Development
Programme. Executives were also nominated
to short-term management course at
institutions like IIM, ASCI, etc.
13.3.14 (iv) Medical Appliances: HLL
proposes to take up manufacture of various
medical appliances required for the National
Health care programme.
13.3.14 (v)
Hindustan Latex Research
Centre: HLL plans to set up a National
Centre for excellence in Research for
contraceptives and health care aids. This is
expected to be the nucleus for research work
in the area of evolving innovative products.
13.3.15 Memorandum of Understanding:
Hindustan Latex Limited signed the
Memorandum of Understanding with the
Department of Family Welfare, Govt, of
India, for the financial years from 1991-92
onwards. The performance evaluation of
1991-92 and provisional performance
evaluation for 1992-93 were carried out by
the Department of Public Enterprises, Govt,
of India. The performance evaluation results,
categorised HLL under "VERY GOOD" for
these two consecutive financial years.
13.3.18 Industrial Relations: The Company M
employs 2049 persons at its plant at ?
Thiruvananthapuram and Belgaum. Cordial
employer-employee relations exist since the
past ten years. Long-term wage agreements
have been arrived at through bi-partite
negotiations. The company has a productivity
linked incentive scheme for its employees.
Through a referendum the company brought
down the number of its recognised unions
from 11 to 3, with the full acceptance and
participation of all employees and Unions.
13.3.16 Production Plans 1993-94: For
1993-94 HLL has fixed production targets for
its various products as follows:
13.3.19 Fulfilment of Social Obligations:
Adequate care has been taken for the rural
and peripheral development by the Company.
One of its project is located at Kanagala
Village in Belgaum district, Karnataka State
which is a backward area and a place where
no other industry exists. With the
commissioning of HLL’s unit here, the
economic condition of the area has improved
considerably.
a. Condoms
b. Disposable
Gloves
c. Saheli
(Centchroman
tablets)
d. Copper T
e. Hydro
Cephalus Shunt.
f. Mala DN
1
■
13.3.17 (i) During the period 1993-94, the
company targets the conduct of training
programmes for a minimum number of 320 ?
workers, 70 supervisors and 60 executives
covering all the units.
- 600 m. pcs.
- 24 m. pcs.
18 m. tabs
1 m. pcs.
- 1000 pieces
f-
I
13.3.19 <i) The company strictly ensures the
implementation of the reservation policy of
the Govt, of India. It has in its strength of
2049 employees, 20.20% belonging to SC
and 5.03 % belonging to ST.
16 m. pcs.
13.3.16. (i) These production levels are
estimated to increase the company’s turnover
from 36 crore in 1992-93 to Rs.50.13 crore
for 1993-94.
13.3.19 (ii) HLL has formulated a scheme
for imparting training to 10-15 physically
84
...
handicapped persons tor a period ot one year
at the Nirodh Factory, Thiruvananthapuram
under the company’s Training and
u—
Development Programme.
13.4
Family Welfare Training
and Research Centre
13.4.1 Family Welfare Training and
Research Centre, Bombay is a Central
Training Institute, responsible tor in-service
training in Health and Family Welfare for
States in the Western Region of the country,
which include States of Gujarat, Madhya
Pradesh, Andhra Pradesh, Goa, Daman and
Diu and Dadar and Nagar Haveli.
13 4.2 Training related to Primary Health
Care, Family Welfare and other integrated
National Health Programmes is imparted to
various categories of health professionals ot
State and district level, i.e. District Health
Officers, District Extension and Media
Officers, Key-trainers from Health and
Family Welfare Training Centres of the
above States. The Centre is also conducting
a one year academic course of Diploma in
Health Education for candidates deputed from
all over the country and also for one or two
candidates sponsored by the World Health
Organisation. The course was started in the
year 1987-88.
R.C, Bombay, overseas the implementation
of the l.E.C. Scheme in Madhya Pradesh.
The scheme covered 17 districts ot M.P. in
the year under report. During the year,
F.W.T and R.C., along with State
H.F.W.T.Cs, conducted two initial training
for District/Training and Supervisory Team
members from Bhopal, Ujjain, Dewas
Bilaspur, Durg, Sarguja, Raipur and Raigarh
districts. The faculty also participated in
conducting one day re-orientation workshops
for District Training Teams and P.H.C. start
at 8 district headquarters.
13.5.2 Mid-term Evaluation Of l.E.C.
Training- Mid-Term Evaluation Report was
presented to the Director (Media), Ministry
of Health and Family Welfare, New Delhi in
October 1992.
13 5 3 Printing of "Swasthya Shiksha
During the year, this Centre completed the
task of Hindi adaptation of the W.HAJ.
publication, "Education For Health .
e
task was assigned by the Media Division
Deptt. of Family Welfare, Ministry of
Health and Family Welfare. With the fun s
provided by the Ministry, this Institute got
about 37,000 copies of the book,
"Swasthya Shiksha", printed. These will be
distributed in the Hindi speaking States, as
per the Ministry’s instructions.
13.4.3. Training Programmes are also held
for W.H.O. Fellows deputed through the
Ministry of Health and Family Welfare as
per the needs of the trainees.
13.5.4 Flip Rolls: 2560 Plastic Rolls were
developed during the year. Each Flip Roll
contains 16 health messages. These rolls will
be distributed to IEC districts in Madhya
Pradesh.
13 4 4 During the year 1992-93, training,
education, research and clinic services ot the
Centre were continued in accordance with its
objectives.
Health
13.5.5
Prevention of AIDS:
AIDS
of
Education activities for prevention
A
number
ot
are conducted by the Centre.
•
AIDS
have
been
health education talks on -----given during the year at various organisations
- S.N.D.T. Women’s University, Bombay;
St. Joseph’s High School, Vikhroli, Bombay;
Vanita Vishram School, Bombay; Vidya
Vikasini School, Kandivli, Bombay.
13.5
Information, Education and
Communication (1EC) Training
Scheme
13.5.1
Training Workshops: F.W.T. and
85
I
i
13.6
■■■
a
Delhi. Its objective is to provide State and
National level estimates of fertility, infant
mortality, child mortality, practice of family
planning and maternal and child health care
services and their utilisation. This
information is intended to assist the policy
makers and programme administrators in
formulating the strategies for improving the
family welfare programme in the State.
International
Institute for
Population Sciences, Bombay
13.6.1. Training: The International Institute
for Population Sciences, Bombay, is a
"Deemed University", under the
administrative control of the Ministry of
Health and Family Welfare, for imparting
training, conducting research and providing
consultancy services in the field of
Population Studies'. The Institute conducts
three regular courses of one year duration,
viz. a) The Diploma in Population Studies
(DPS); b) Master of Population Studies
(MPS)’ c) M.Phil Degree programme in
Diploma course in
Population Studies.
Health Education (DHE) is also conducted by
the FWRTC under the auspices of UPS. In
addition to these courses, Ph.D. Programmes
are conducted by the Institute. During the
academic year 1992-93 there were 23
students for the Diploma course in Population
Studies (of which 21 were from countries of
ESCAP region outside India, under the
UNFPA fellowship programmes, and 2 were
sponsored by two States of India); 19 for
M.P.s course (of which 18 are admitted
under Govt, of India and one from Nepal
sponsored by WHO. fellowship); 10 for
M.Phil programme and 36 have registered,
for Ph.D programme (of which 10 Indian
students are registered with Govt, of India
fellowship).
-■*-
13.7.2 The data collection for the NFHS was
done in three phases. By August, 1993 all the
data collection was completed and the
Preliminary Reports have been completed for
all the States. The next phase of NFHS is the
finalisation of State and All India reports for,I W:
which preparations are going on.
4= L
13.7.3 The NFHS is an important
i
component of the project strengthening the
"Survey Research Capabilities of the
Population Research Centres", undertaken by
the Ministry of Health and Family Welfare.
The Institute has been designated as the nodal
agency for the implementation of die Project.
13.7.4 Consultancy Services: During the
year 1992-93, the Institute has provided
consultancy services to various institutions in
India in the field of Population.
13.7.5 Publication: The Institute brings out
a quarterly newsletter about various ongoing
activities of the Institute. During 1992-93,
the Institute published four issues of the UPS
Newsletter. The Institute also brings out a
biennial publication entitled "Dynamics of
Population and Family Welfare". The 7th in
this series has been published consisting of
14 papers from research studies conducted in
1990-91.
13.6.2 Research : The Institute completed 13
Research Projects during 1992-93.
13.6.2 (i) 19 on-going research projects
which were initiated during 1992-93 are in
different stages of completion.
13.6.2 (ii) 14 new research projects were
taken up during the year 1992-93.
13.7.6 Library: The Institute’s Library is
considered to be one of the best libraries in
Population and related topics in this region.
During the year 1992-93, the library added
1117 volumes to its stock, bringing the total
number of volumes to 55, 539. The library
receives 250 journals regularly out of which
13.7 The National Family Health Survey
13.7.1 The National Family Health Survey
(NFHS) is a household sample survey which
covers 24 States and the Union Territory of
K
V
'■S
■
I
..vy,'.
■
86
-4
i
flI
•
c-
150 journals are by way of subscription. In
addition, the library has a total number of
8000 bound periodicals and 12,615 reprints.
1
1fl
13.8
Observance of World Population
Day
The Institute observed World
13.8.1
Population Dayj on July 11, 1993. A
symposium on the
L theme of Population and
Politics was organised at the Institute.
fl
13.9
Association of the Alumni and
Teachers of UPS
13.9.1
An Association of Alumni and
Teachers of UPS has been formed at the
Institute to develop and establish closer
contact and interaction among the alumni and
teachers of the Institute. The first Executive
Committee consisting of 14 members has
been formed with Director of the Institute as
the Ex-officio President.
13.10
Central Drug Research Institute,
Lucknow
Product Development: Centch13.10.1
roman, a new Weekly Contraceptive, was
indigenously developed by the Institute. The
product is now being manufactured and
distributed country-wide.
13.10.4 D'ad Generation: (A) Anti-Implan
tation Activity: 35 new synthetic compounds
and 50 plant extracts including marine flora
and fauna were tested for anti-implantation
activity and of these 92/320 and 93/13
showed interceptive activity in days 1-7 postcoital schedule in rats. Compound 92/238
reported active at 1 mg/kg in days 1-7 postcoital schedule was inactive when given in
the single day schedule on day one postcoitum and hence dropped.
13.10.5. Menstruation Regulating Activity:
32 Plant extracts/ fractions were tested for
early abortificient activity in rat and/or
hamsters and of these plants no.3437 and
3735 showed promising activity.
13.10.6 Local Contraceptive Activity: Over
100 compounds tested tor spermicidal
activity, compounds 93/2 and 93/116 were
found promising.
13.11
13.11.1 (a) Mode of Contraceptive Action:
Studies with compound 85/287 in rat have
suggested that It inhibits protein synthesis m
the uterus and uterine peroxidase activity
during pre and peri implantation periods.
13 11.1 (b) In-Vitro Model Development:
Female: Inhibition of growth of trophoblast
cells in-vitro by certain pregnant derivatives
showed a good correlation with in-vivo
activity of compounds 88/583 and 88/585.
13.10.2
Centchroman (Management of
advanced cancer of breast): 149 cases of
cancer of breast were enrolled at five centres.
Of the 127 evaluated cases, 56% cases
showed positive response. The trial is in
progress.
i
Basic studies in reproductive
biology
13.11.1 (b) (i) Male: A method to isolate
Sertoli cells from immature rats testis and
their in-vitro culture for atleast five days and
to determine lactate and oestradiol secretion
by the cultured cells has been developed.
Screening of agents using this model will be
initiated.
Consap (U)cal Contraceptive
13.10.3
Cream): A total of 224 women volunteers
have been covered for 2265 months of use
with a Pear! Index of 1.67 in the extended
Phase II clinical trials. No side effects have
been observed so tar except tor transitory
vaginai burning in 6 cases. Permission to
initiate Phase III clinical studies is awaited.
Regional Directors Health and
13.11.2
Family Welfare: Department of Family
87
I
Welfare maintains close communication with
the offices of the Regional Director (Health
and Family Welfare) functioning under the
administrative control of the Director General
of Health Services. There-are 17 regional
offices of Health and Family Welfare located
at Bangalore, Ahmedabad, Bhopal,
Bhubaneshwar, Calcutta, Chandigarh,
Hyderabad, Imphal, Jaipur, Jammu,
Srinagar, Lucknow, Patna, Pune, Shimla,
Shillong, Thiruvananthapuram and Madras.
Each of these offices has specific State(s)/
Union Territories attached to them for field
operation covering all the States/ Union
Territories. Regional Directors visit the area
under their jurisdiction and see to the actual
implementation of National Health and
Family Welfare Programmes in the field.
I
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88
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BCG Vaccine Laboratory, Guindy, Madras.
DEPARTMENT
OF HEALTH
III
’-I
1
INTRODUCTION
Shri B. Shankaranand and Shri Paban Singh
Ghatowar are Minister of Health and Family
Welfare and Deputy Minister of Health and
Family Welfare respectively on January 19,
1993. Dr. C. Silvera has assumed charge as
Minister of State on February 18.1994.
2.
The health problems being faced by
us are highly complex and challenging.
While we are still struggling to meet the
health hazards of communicable diseases like
leprosy, TB and malaria, we also have to
now cope with the challenge of post
transitional diseases like cardio-vascular and
cancer. On top of all these, we have to
reckon with the horrendous implications of
The-complexity of the health
AIDS,
problems is further aggravated by wide
spread poverty leading to malnutrition,
unhygienic sanitation, illiteracy and
forces are
‘ > forces
these negative
ignorance:
reinforced by the rate at which our large
population is growing.
3
While the health problems are indeed
complex and daunting, the importance of the
state of health of our people can scarcely be
over-emphasised. As a matter of tact, the
idtimate objective of all socio-economic
development is to bring about a meaningful
and sustained improvement in the well-being
and welfare of the people and there is no
better index of the well being of a people
than the state of their health.
The public expenditure in the health
4
sector both Centre and States put together
has been a little over 1.5% of GDP- Th£
WHO had recommended that public health
care expenditure should gross at least 5% of
GDP if equity and universal coverage are to
be realised. The plan outlay for the central
health sector in 1993-94 is Rs.483.30 crore
which is a marginal increase against the
previous year’s outlay of Rs. 447 crore.
5.
National Aid*
rru^iunniti.
Aid^ Control
^oninn Programme:
Realising the gravity of epidemio- logical
situation of HIV prevailing in the country,
the Government of India has launched a
comprehensive scheme at an estimated cost
89
R7
F
of Rs. 220 to Rs.222.6 crore during the Sth
plan with assistance from the World Bank to
the tune of US $ 84 million and another US
$ 1.5 million from WHO. The World Bank
loan became effective from September, 1992.
6.
With the objective to arrest the
HIV/AIDS infections in the country and to
reduce the future morbidity, mortality and
infection of AIDS, the Ministry of Health
and Family Welfare has set up a National
AIDS Control Organisation as a separate
wing to effectively implement and closely
monitor the various components of the
Programme.
The National AIDS control
the
Programme
envisages
planning,
counselling, implementing and monitoring of
the various activities of the Project, carry out
an intensive public awareness and community
support campaign through mass media and
sustain dissemination of information and
health education about HIV and AIDS,
upgradation of the blood banking capabil ities
in the public sector and expansion of HIV
screening of all blood used for transfusing
and
blood-products
in
the
country,
strengthening of the institutional capabilities
at the State/UT level for monitoring of HIV
and
AIDS
epidemic
planning
and
programming interventions to control such
epidemic and strengthening the clinical
services and case management activities in
STD centres.
I
8.
Blood Safety Programme: A scheme
on prevention of infection and strengthening
of Blood Banking System in the country has
been under implementation since 1989 under
which State Governments were provided
assistance for setting up of testing facilities
including HIV in the Blood Banks,
strengthening and modernisation of State
managed blood .banks and development of
manpower and rational use of blood.
9.
Under the Blood Safety Programme,
it is proposed to upgrade all the 608 State
managed blood banks in the country. During
1992-93, assistance has been given for
modernising 90 blood banks under the World^^B
Bank assisted National AIDS Control^
Programme, while 138 blood banks were
upgraded till March. 1992. The remaining
380 blood banks are proposed to be taken up
for upgradation in a phased manner during
the 8th Plan period. During the year 199394. 100 blood banks are being upgraded. 10
have
been
Training
institutions
operationalised at regional level for training
of Doctors and technicians working in the
blood banks. The rules under the Drugs and
Cosmetics Act have been made more
stringent providing for mandatory testing of
blood for blood transmissible diseases
including HIV and the approval of licence by
the licence approving authorities has been
made compulsory. It also provides that the
whole human blood and components shall
conform to standards as prescribed under the
Indian Pharmacopoeia.
7.
National
Sexually
Transmitted
Disease Control Programme (STD): Recogni
sing STD as one of the major factors for
transmission of HIV infection, the National
STD Control Programme has merged with
the National AIDS Control Programme.
There are 5 Regional STD teaching, training
and research centres at Delhi. Madras.
Nagpur,
Hyderabad
and Calcutta for
undertaking various training programmes.
During the year a number of medical officers
have been trained. It is proposed to take
effective activities to strengthen the clinical
services and case management activities in
STD centres in 97 medical colleges
(including 5 Regional STD Centres) and 275
District level STD clinics.
10.
National
Malaria Eradication
Programme: The organised public health
programme to control malaria was launched
in India in the year 1953. The number of
confirmed malaria cases increased during
1976 which necessitated renewed vigorous
anti-malarial activities and modification in the
existing strategies. With the implementation
of the Modified Plan of Operation (MPO)
which was based on a two-tier stratification,
the total malaria cases decreased from 6.47
million in 1976 to 2.18 million cases in
1984.
However, since then the malaria
situation in the country has remained more or
less static (contained) around two million
90
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1
J
'4
1
cases a year.
The NMEP is a category II Centrally
11.
Sponsored Scheme on 50:50 sharing basis
between the Centre and the State. The
budget provision and estimated expenditure
under the 50% central share which is in the
form of drugs and insecticides during 199394 is to tlie tune of Rs. 11000 lakh.
I
12.
In view of the persistent transmission
12.
of malaria in the seven North-Eastern States
which are almost inhabited by tribal
population, a plan to provide 100% central
assistance tor the control ot malaria is being
worked out. The Urban Malaria Scheme
came into effect in 1971 with the objective to
control malaria by reducing the vector
population in the urban areas through
recurrent Anti-larval measures. The Scheme
was sanctioned in 181 towns distributed in 18
States and 2 Union Territories. It has so far
been implemented in 128 towns.
National Filaria Control Programme:
13.
13.
Filariasis is a major public health problem in
many States of the country and about 396
million people are estimated to be living in
175 known endemic districts of which about
J09 million are in urban areas. The National
Filaria Control Programme which was
launched in 1955, provides for delimitation
of the problem in hitherto unsurveyed areas,
control in urban areas through recurrent antilarval measures and antiparasitic measures.
There are 206 control units and 195 clinics
giving treatment with Diethylcarbamizine to
clinical cases and microfilaria carriers.
s
14.
Kala Azar: Kala Azar is a serious
public health problem in Bihar and Wesl
Bengal. About 30 districts of Bihar and 9
districts of West Bengal are affected by Kala
Azar. The increasing trend ot the disease is
evident from the fact that the total number of
cases which were 17806 with 72 deaths in
1986 rose to a total of 77101 cases with
1419'deaths in 1992. However, this trend
has been arrested in 1993 with total number
of 26752 cases with 439 deaths reported till
July 1993.
15.
Assistance in terms of cash as well as
15.
kind has been provided during the last three
years. In 1992-93, about Rs.20 crore worth
of assistance in kind has been given to Bihar
Material assistance
and West Bengal.
included the insecticides, DDT and the
imported drug Pentamidine Isthionate.
16.
Japanese Eencephalitis: This disease
is caused by a minute virus and manifests as
high fever, convulsions, stiffness of the neck
and coma etc. The death rate due to the
disease is very high and those who survive
do so with various degrees of neurological
complications. Ot late this disease has
become a major public health problem and
has been reported tor 24 States/UTs. As
against 4071 cases with 1530 deaths in 1991,
2432 cases with 888 deaths in 1992, cases
reported till September 1993 are 189 with
126 deaths.
17.
National Programme for Control of
Blindness: The approach under the NPCB
consists of intensive health education tor eye
care through the mass media and extension
education methods; extension of ophthalmic
services in the rural areas through mobile
units and eye camps and establishment ot
permanent infrastructure for eye health care
as an integral part of general health services.
18.
It has been estimated that there is an
annual incidence of 2 million cataract induced
blindness in the country. At the rate of 1.5
million cataract operations annually, we are
adding to the backlog rather than reducing it.
In order to strengthen the Programme and to
reduce the backlog of blindness, it has been
decided to establish District Blindness
Control Societies (DBCSs) under the
Chairmanship of the District Collector. So
far 267 DBCSs have been formed. A sum of
Rs. 6 crore at the rate of Rs. 3 lakh each has
already been released to 200 of these DBCSs
to make them financially and operationally
autonomous. Under the Programme, the
equipments and vehicles are also provided to
District Mobile Units and Primary Health
Centres. The NPCB is being assisted by the
Royal Danish Government. The Phase-H of
the assistance spans the period 1989-96 and
91
so tar a sum of Rs. 3.86 crore has been
reimbursed by the DANIDA to NPCB on
the basis of actual expenditure incurred by
the various State Governments on stipulated
components of NPCB.
19.
The World Bank has been approached
for Rs. 554 crore assistance for an intensive
blindness control programme in the seven
States of Tamil Nadu, Andhra Pradesh,
Maharashtra, M.P., U.P., Rajasthan and
Orissa. One of the strategies of the pro ject is
the formation of District Blindness Control
Societies in all districts of the Project States
and to make them financially and
Dedicated eye
operationally autonomous.
care infrastructure is proposed to be created
and strengthened in the District Hospitals and
selected sub-divisional Hospitals. Medical
colleges are also proposed to be upgraded
with the modern ophthalmic equipment and
provision of special ised training to the faculty
members to perform IOL surgery.
National Iodine Deficiency Disorders
20.
Control Programme: Iodine is one of the
essential elements for human growth and
The spectrum of Iodine
development.
Deficiency Disorders affects each and every
It is
stage of life from foetus to adult.
estimated that in India alone, more than 54.3
million people are suffering from endemic
Goitre and about 8.8 million from different
grades of mental/motor handicaps. The
surveys conducted indicate that out of 235
districts surveyed, IDD is a major public
i health problem in 193 districts. Goitre is not
i restricted only to the Himalayan belt of India
| but also widely prevalent in the plain,
plateau, riverine areas and near the sea coast.
all the District Health Officers in endemic
States for regular monitoring. 23 States/UTs
have set up Iodine Deficiency Disorder
Control
Cells to ensure effective
implementation of the Programme. It has
been proposed to set up the monitoring labs
in the States of Arunachal Pradesh, Assam,
Gujarat, Himachal Pradesh, Karnataka,
Madhya Pradesh, Maharashtra, Sikkim, U.P.
and West Bengal. A tentative allocation of
Rs.75,000/- per lab has been provided for
this purpose.
National Cancer Control Programme:
22.
The Government of India started the Cancer
Control Programme in a limited form during
the year 1975-76 when central assistance at
the rate of Rs.2.5 lakh was provided to
institutions for purchase of Cobalt Therapy
Units for treatment of cancer patients. This
Scheme continued during the 6th and 7th
Plan period with the increase of rate of
assistance to Rs. 12.00 lakh. At the same
time, ten major institutions were recognised
as Regional Cancer Centres which received
financial assistance from the Government.
23.
During the Sth Plan, emphasis has
been laid on prevention, early detection of
cancer and augmentation of treatment
facilities in the country. The new scheme
envisages projects at district level for
preventive health education, early detection
and pain relief measures. Under the scheme,
financial assistance of Rs. 15.00 lakh is
provided to the concerned State Government
for each district project selected under the
scheme with a provision of Rs. 10.00 lakh per
year for each district for the remaining four
years of the project period. During the years
1990-91 to 1992-93. 17 district projects have
been undertaken in Gujarat, Karnataka,
Madhya Pradesh. Kerala, Orissa, Punjab,
Tamil Nadu and West Bengal. Financial
assistance upto Rs. I crore (in phases) is
provided to the State Government for
development of Oncology Wings in the
medical colleges/hospitals and for purchase
of equipments which includes Cobalt Unit.
So far financial assistance has been provided
for development ot Oncology Wings in 16
Medical Colleges/Hospitals in the country.
The achievement of the programme
21.
so far has been that 23 States/UTs have
completely banned the use of salt other than
\ Iodised salt while another 6 States have
banned partially in the endemic areas only.
•. The Chief Ministers of remaining States have
I been requested to urgently issue notification
banning the use of salt other than iodised
salt. Testing kits for on the spot qualitative
i testing have been developed in collaboration
with UNICEF and they were distributed to
•
92
Fi
P’
01
in
h;
s<
2
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e
s
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:
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r
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Financial assistance upto Rs.5.00 lakh is also
provided to the registered voluntary
organisations for the purpose of undertaking
health education and early detection activities
in cancer. So far 15 voluntary organisations
have been provided the assistance under the
scheme.
National Mental Health Programme:
24.
The National Mental Health Programme was
launched by the Ministry with a view to
ensure availability of mental heath care
services for all specially the community at
risk and underprivileged section of the
11 institutions have been'
population.
identified for training of health workers
under the programme. This training will
consist of basic knowledge on mental health
to the Primary Health Care physicians and
para-medical personnel. During 1993-94,
Rs. 18 lakh have been allocated for this
programme.
25.
National Leprosy Eradication
Programme: India ranks foremost among the
countries saddled with the burden of leprosy
Out of 2.7 million cases of
sufferers.
leprosy in the world, 1.3 million are
estimated to be found in India (1993). At the
time of the launching of National Leprosy
Eradication Programme in 1983, the disease
was highly prevalent in the States/UTs of
Tamil Nadu, Andhra Pradesh, Lakshadweep,
Pondicherry, West Bengal, Maharashtra,
Karnataka,
Bihar,
Nagaland, Sikkim,
Andaman & Nicobar. Now the problem of
leprosy has been reduced in many of these
States.
■
1
information indicates that MD1
is well
accepted by the patients, the tolerance is
good and side effects are minimum. There is
marked reduction of over 90% in the
prevalence rate in the 40 districts which have
completed MDT of 5 years or more. MDT
coverage has been expanded to all the 201
endemic districts which includes 135 districts
on vertical pattern and 66 on modified
pattern. During the Sth Plan, it is proposed
to provide MDT coverage to all the districts
with endemicity of 2 to 4.9 per 1000
population on Modified Pattern and MDT
services will also be extended through
primary health care in other low endemic
districts.
27.
A comprehensive proposal for
financial assistance of Rs. 302 crore has been
agreed to by the World Bank in order to
spread MDT in the uncovered areas and to
further intensify efforts for reduction of
Leprosy. World Bank assistance would also
be utilised for strengthening the monitoring
information system and to embark on
deformity care and rehabil itation programme.
28.
National T.B. Control Programme:
Tuberculosis continues to be a major public
health problem in the country with an
estimated 1.5% of the population suffering
from Radiologically active Tuberculosis and
with about 1 /4th of the cases being sputum
positive or infectious. It is estimated that
there are 5 lakh deaths annually on account
of this disease while a similar number of
persons achieve cure.
29.
A joint evaluation of the FB
Programme by the Government of India,
WHO and SIDA revealed that it was
necessary to shift the emphasis from
monitoring, detection and treatment to
monitoring of the number of cases cured, to
bring TB effectively under control. Case
holding and monitoring of cure is beset with
difficulties on account of need to follow-up
patients for a long period of 18 months in the
case of conventional therapy and 6 to 8
months in the case of short course
chemotherapy. Often patients tend to stop
taking drugs when the symptoms of the
26.
The National Leprosy Eradication
Programme was started in 1983 with the
objective to arrest transmission of disease by
The programme
the year 2000 A.D.
provides for the provision of domiciliary
multi-drug treatment coverage in 135 districts
having problem of 5 or more cases per 1000
population and introduction of MDT services
through existing general health care services
in the low endemic districts. Currently about
60% of leprosy patients are getting\ the
Available
benefit of MDT in the country. ?.....
93
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I
disease disappear initially.
30.
In order to reduce the burden of
disease in a medium term perspective it is
estimated that about 10 lakh sputum positive
cases need to be treated and cured each year.
The cost of drugs alone for ensuring such
coverage would amount to Rs. 150 crore per
year. Added to this would be the cost of
strengthening the organisational structure in
the Centre, State and districts for introducing
effective supervised administration of drugs.
Although the central Plan outlay has been
enhanced to a level ot Rs. 35 crore in 199394 from Rs. 28 crore in 1992-93, it is not
considered practicable to avail further
enhanced outlays without external assistance
A project proposal has, therefore, been made
tor obtaining World Bank financial assistance
based on short-term course chemotherapy for
sputum positive cases while the nonintectious cases continues to be on cheaper
conventional therapy.
I
31.
Indian Systems of Medicine: \ lot of
concern has been expressed about over
exploitation of Medicinal Plants as a result of
which rare species are facing extinction.
Ministry took initiative in calling a meeting
which was presided over by Deputy Minister
ot Health wherein Secretary, Environment
and representatives of CSIR and ICMR
A Task Force has been
participated.
constituted tor promotion, development and
appropriate exploitation of medicinal plants
under the Chairmanship
Ministry of Environment.
w
of Secretary,
32.
International Health: Government of
India is assisting the Government of Nepal to
establish the BP Koirala Institute of Medical
Sciences in Dharan.
The Post-graduate
training requirements of Nepalese MBBS
students year-wise and discipline wise has
been worked out. 7 Nepalese students are
being imparted training in Indian institute
in the current year itself.
|
The Department of Health has been
33.
performing the agency role for the Ministry
of External Affairs in connection with the
establishment of Indira Gandhi Memorial
Hospital at Male.
34.
A Protocol was signed with the
Government of Russia on the 16th
September. 1993 at St. Petersburg in which
13 areas were identified for mutual
cooperation.
M. S. Dayal
Secretary’ (Health)
in the Ministry of
New Delhi
Health and Family Welfare
Dated 15-2-1994
Government of India
!
94
*
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I
ORGANISATION
As per the Scheme of allocation of subjects
in the Constitution, the items public health,
sanitation, hospitals anil dispensaries fall m
the State list. Items like population control
and family planning, medical education,
adulteration of food stuffs and other goods,
drugs and poisons, medical profession, vital
statistics including registration of births and
deaths and lunacy and mental deficiency find
a place in the Concurrent List.
1.1.2 The Ministry of Health and Family
Welfare at the Centre is responsible for
implementation of numerous programmes of
National importance like family welfare
primary health care, prevention, control and
eradication of major diseases, etc. which
form the main plank of our development
efforts. The Ministry has several Centrally
Sponsored Schemes which are implemented
through the States. At the same time, it has
also Central Sector Schemes. All these
Schemes aim at fulfilling our National
Commitment to attain the goal of Health for
All by 2000 A.D. in accordance with the
Alma-Ata Declaration of September, 1978 to
which India is also a signatory.
1.1.3 The Ministry of Health and Family
Welfare at the Centre consists of the
Department of Health and Department of
Family Welfare each of which is headed by
a Secretary to the Government of India.
(Organisational Charts of Department of
Family Welfare and Health are at Annexure
I and Annexure II respectively.)
i
1.1.4 The Office of the Directorate General
of Health Services is an attached office of the
Ministry. There are three subordinate offices
located at various places in the country which
function directly under the Ministry (List a
Annexure-IV).
The Ministry is also
administratively concerned wdh 2 V
autonomous/statutory bodies. There aie also
3 Public Sector Undertakings within the
administrative control of the Ministry.
CHAPTER I
95
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1.2
Department of Health
1.4.2 During the year under report, in the
General Duty Medical Officer Sub-cadre, the
following promotions have been effected.
■w
1.2.1 The Department of Health deals with
medical and public health matters including
drugs control and prevention of food
adulteration.
The Department functions
through the Directorate General of Health
Services - an Attached Office (Organisational
Chart at Annexure III). It has 97 Sub
ordinate Offices (List at Annexure V). The
Directorate General of Health Services
renders technical advice on ail medical and
public health matters and in the
implementation and monitoring of various
health schemes.
1.3
Medical Officers promoted
as Senior Medical Officer
(Rs.3000-4500)
8
(«i)
Senior Medical Officer
promoted as Chief Medical
Officer (Rs.3700-5000)
- 58
Officers promoted as Senior
Medical Officers/Chief
Medical Officers in
pursuance of Supreme Court
judgement in the case of
Dr. P.P.C.Rawani and others
55
(iii)
Toning Up of Administration
1.3.1 An efficient administration is the
back-bone of any organisation. The efforts
made during the previous years were
sustained during the year and several steps
were taken in order to ensure that
Government policies and programmes are
implemented not only in time but also
efficiently. Administration has been toned up
by enforcing discipline and accountability.
5
I
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1.4.3 In the Non-Teaching cadre 27
Specialist Grade-II Officers of the Non
Teaching Sub-Cadre were given promotion to
Specialist Grade-I Officers, in the scale of
pay Rs.4500-5700. 31 Specialist Grade II
Officers were placed in the Senior scale
(Rs.3700-5000).
1.4.4 37 Associate Professors have been
placed/designated as professors in the pay
scale of Rs. 4500-5700.
17 Assistant
Professors (Rs. 3000-5000) in the Teaching
Specialist Sub-cadre of the Central Health
Service have been given promotion as
Associate Professors in the pay scale of
Rs.3700-5000.
1.3.2 The Joint Secretary (FA) has been
designated as the Director (Grievances), who
meets the staff of the Ministry personally.
Further, Secretary (Health) himself is
available once every month to hear the
grievances of the employees and to redress
them.
This has gone a long way in
motivating the employees and also in
redressing the grievances in time.
1.4
(i)
1.4.5 In the Public Health Sub-cadre one
Specialist Grade-I Officer was promoted to
Supertime Grade. Two Specialist Grade-II
(Rs.3700-5000) Officers of Public Health
Sub-cadre have been placed in Specialist
Grade-I of Public Health Sub-cadre in the
pay scale of Rs.4500-5700. One Specialist
Grade-II (Rs.3000-5000) Officer of the
Public Health Sub-cadre was placed in the
Senior Scale of Rs.3700-5000 of Public
Health Sub-cadre of the Central Health
Service.
Central Health Service
1.4.1 Central Health Service caters to the
needs of various participating units in
providing medical and health manpower.
The service was restructured in 1982 and
now consists of following four streams;a) General Duty;
b) Non-Teaching;
c) Teaching; and
d) Public Health.
1.4.6 8 Central Health Service Officers had
gone on study leave during the period from
96
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April, 1993 to September, 1993 and -7
Officers have attended training programme
during the year under report.
1 4.7 657 Officers of the Medical Officer
Grade of the Central Health Service have
been confirmed.
1.5
current financial year, it is expected to be
implemented in Karnataka, Maharashtra and
Rajasthan also. CBHI’s computer tacilties are
being strengthened through NIC tor timely
dissemination of information using advanced
analytical tools.
Computerisation
Health Informatics Division (HID)
1.5.1
Informatics
Centre(NlC)
1..
National
the
and
MIS
support to
provides Computer
••
Ministry of Health and Familyi Welfare.
HID
is r"g a
Towards
this,
full-fledged computer centre in the Ministry
The Centre is equipped with a full range o
computer systems, software and manned by
computer professionals for the Sl‘5eesstu
functioning of various projects. The. 48
based mini computer system is operational
with 45 terminals connected to it in aa star
star
network.
International
and
National
Electronic Mail (NICMAIL ) tacdit.es are
available for use by the Ministry through his
centre NICMAIL is being used tor sending
across/receiving information to/from various
district, state, and other NIC centres spread
all over the country. Various computer baser
presentations are prepared by this division to
decision making at the highest level In
addition, complete hardware and software
support is provided for document preparation
for various conferences
held by the
Ministry. Salient features ot some ot the
their progress during the
projects and
year
current
are given below :
I
1.5.2 Health
Family
and
Management Information System.
assisting CBHI in the implementation ot
HM1S ( Ver 2.0) throughout the country.
NIC has already developed the necessary
software which is being implemented m the
district and state level computers.ot NIL
The package extensively uses NICNET r
data transfer and
ot
dissemination
information at the state and central levels.
During this year, the system has been
implemented in Gujarat. Sikkim Tripura and
Andaman and Nicobar Islands. By the end ot
1 5 3 Reimbursement of CGHS Claims.
During the current year, NIC had taken a
turn-key project for the development of
Claims Monitoring and Enquiry System tor
Reimbursement of CGHS claims A reac y
system study had been completed and
software development is in progress.
1 5 4
Computerised On-line Allotment of
Seats and Display System for
MBBS/BDS Courses under 15%
Quota- DGHS had entrusted to NIC the
design development and implementation o
the above system for the 1st and Ilnd round
of allotment of All India Quota ot
MBBS/BDS seats during the academic yea
1993.
i 5 4 (i)
The database of the selected
candidates and colleges with available seats
was maintained in the computer
updated on the selection of the college y
candidate and approval ot the.same _
Selection Committee. On updation ■ ahotment
letters for candidates and various other
reports were generated. As a part ot On-1 me
system, multiple TVs were hooked on to the
‘computer as a part of teletext display so that
the candidates and others available at the
venue can view the allotment process and
availability of seats m various colleges.
1 5 5 MIS on AH 1^'° Post-Partum
Programme:
NIC has designed and
developed the system to monitor and evaluate
the performance of Post-partum sen res
throughout the country. Recently, this system
has been released to the user for data entry
and generation of progress reports.
1 5 6
Inventory
Control
and
Vendor
Analysis System for
Organisation and MSD, Delhi.
been asked to develop and implement the
97
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aforementioned system recently by the
Ministry on a turn-key basis. Accordingly,
NIC is doing the detailed System Analysis as
a part of the System Design.
1.5.7 The following systems developed
over the last few years are regularly being
used by the Ministry :
(a)
Pay Roll Package
(b)
Vehicle
System
(c)
VIP Reference Information System
(d)
‘
............. j Bulletin on
Weekly/Monthly
Morbidity and Mortality of notifiable
diseases.
(e)
MIS on Health and FW Training
Centres
(f)
Budget Monitoring System
(g)
Database on Health Information of
India
Monitoring
Information
1.5.8 Hospital Computerisation: (a) NIC
has completed the project on Computerisation
of Central Admission &. Enquiry Office of
G.B. Pant Hospital, Delhi. Also, it has
implemented the Pay Roll Package for the
staff in the hospital.
I
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1.5.8 (b) NIC has developed and successfully
implemented the software for Drug Abuse
Monitoring System, Pay Roll Package and
Personnel Management Information System
for Doctors at Dr. Ram Manohar Lohia
Hospital, New Delhi.
I
1.5.9
MEDLARS Services: (i) Medical
Literature and Retrieval Systems (Medlars) is
one of the largest medical databases from
National Library of Medicine, Bethesda,
Washington, There are 30 databases,
comprising information on medicine,
dentistry, nursing, health planning,
treatment,
_
cancer, AIDS
population,
chemistry of drugs etc. The Indian Medlars
Centre at NIC is the 17th Centre in the world
which can directly access this vast source of
information through Satellite Communication
of NIC, via Tymnet and Telenet.
. » ’i-
I
-
1.5.9 (ii) In the Medlars family, the largest-^
database is Medline which gives information
on medical publications in addition to dentist
ry and nursing. Medline data tapes are
received monthly and a database has been
created on the computer system located in the
Bibiliographic Informatics Division. This
database is accessible searchable within India
from any institution or library either on
NICNET or through telephone and a modem.
Passwords are given for interactive searching
of Medline from any location in the country.
1.5.9 (iii) In addition to Medline, NIC also
provides information on Cancer, Population
Toxicology and other databases such as
Biological Abstracts, Science Citation Index
etc. NIC also provides fulltest articles from
520 core biomedical journals as contained in
Adonis, a document delivery system on
CDROM.
1.5.10 Training Activities: Large number of
personnel had been sent for various pro
grammes of the Training Division of NIC.
i
98
I
I
...
HEALTH PLANS
I
*
The Plan outlay for 1993-94 was Rs. 483.30
crore; a major portion ot outlay under this
head was used tor the National Programmes
for the control of Communicable and Noncommunicable diseases implemented through
the Centrally Sponsored Schemes. The
1993-94 outlays included allocations tor
National Malaria Eradication Programme
(Rs 110 00 crore), National AIDS Control
Programme. (Rs. 73.00 crore) National
Leprosy Eradication Programme (Rs.35.00
crore), National Programme tor Centro
of Blindness (Rs. 25.00 crore). National
Tuberculosis Control Programme (Rs. 35.00
crore). Along with other disease control
programmes the outlay comes to Rs. 312.24
crore out of a total of Rs. 483.30 crore. An
outlay of Rs. 96.60 crore was assigned to
Medical Education, Training and Research
and ISM and other programmes accounts tor
another Rs. 74.46 crore. The major National
Health Programmes are likely to utilise
allocations budgetted for 1993-94.
2.2
External Assistance
2 2 1
Department ot Health has also put
in considerable efforts at getting enhanced
quantum of funds through external assistance
for major National Health Programmes. The
objective of taking this support is to enable
us to make a more determined impact on the
disease control programmes and reduce the
levels of morbidity and mortality.
I
2.2.2 The Department ot Health has been
engaged in improving the health care services
and access to health, particularly among the
poor and introduce policies which would lead
to effective prioritisation ot programmes and
reduction of disparities that are seen to exist
in the delivery of health services.
a
i
2.3
Conference of the Central Council
of Health and Family Welfare
2.3.1
After an interval ot 4 years, the
CCH&FW was held from 14th to 16th July,
1993. This is an apex decision making body
relating to Health and Family Welfare
CHAPTER II
99
*
programmes and policies. This council is
headed by Union Minister of Hearth and
Family Welfare and consists of State Health
Ministers, eminent individuals in various
fields of Health and Family Welfare as
statutory members and representatives of the
major institutions and organisations
interacting with the Departments of Health
and Family Welfare.
2.3.2 The council reviewed the issues ot
health finances, medical education facilities,
major disease control programmes. Indian
System of Medicine and Homoeopathy, food
adulteration and family welfare programmes.
The council placed emphasis on stepping up
of efforts to improve the provision of health
care services.
I
2.3.3 The Council adopted the following
resolutions:-
»
2.3.3 (i) The Council noted with concern the
declining sex ratio ot females. The influence
of socio-economic status and literacy on
fertility behaviour and infant mortality rates.
The Council resolved that family planning
should not be seen as the concern of one
department or State or Central Government,
but a programme tor which all departments
must participate actively. The council also
noted the various initiatives taken by
Departments ot Health and Family Welfare
for strengthening of Information. Education
and Communication for securing mass
support in respect of family planning.
Involvement
ot
non
Government
organisations tor promoting family planning
and Family Welfare Programmes; the
safety
net
implementation
ot
social
programme in 90 districts. The council
resolved to give high priority to child
survival and sate motherhood programme to
achieve the goal for reduction of infant
mortality rate, maternal mortality rate, child
mortality rate etc.
Schemes
Centrally Sponsored1
purpose they are intended.
i—
for the
2.3.3 (iii) The Council also considered the
draft of National Education Policy in health
sciences and endorsed the policy document in
principle and recommended that a detailed
programme ot action may be developed in a
time him nd schedule.
2.3.3 (iv) TheCCH&FW also discussed and
adopted resolutions on the ongoing National
Health Programmes viz. National Aids
Control Programme. National Malaria
Eradication Programme. National Leprosy
Eradication Programme. National TB Control
Programme. National Programme for Control
of Blindness, National Cancer Control
Programme. Iodine Deficiency Disorders
Control Programme, for strengthening and
effective vigorous implementation ot these
programmes.
The council adopted the
resolution with regard to Indian System of
Medicine and Homeopathy tor strengthening
of Under-graduate colleges, departments of
specialised treatment centres, drug control ot
Indian System of Medicine and development
of medicinal plants etc.
2.3.3 (v) The Council also emphasised the
urgent need for strengthening the machinery
for the proper enforcement of Prevention ot
Food and Adulteration Act and Rules.
2.4
Audit Inspection Report
2.4.1 As per information received upto 15th
September. 1993. from various Accountants
General and Director General of Audit,
Central Revenues, the number of Audit
objections and the number of paras from the
Audit Inspection Reports on the accounts of
Department ot Health and its attached and
subordinate offices outstanding as on
15.9.1993 were as under:Inspection Reports 343
Audit Paras 2162
2.3.3 (ii) The council noted the inadequacy
of existing level of allocation ot funds and
recommended substantial enhancement and
enjoined the States to utilize the funds from
2.4.2 All efforts continue to be made to
settle the outstanding objections and audit
inspection report paragraphs.
1(X)
atfi’
OF PROVISION UNDER REVENUE AND CAPITAL
(PLAN AND NON-PLAN) FOR 1993-94
IN RESPECT OF DEPARTMENT OF HEALTH
DETAILS
(Rs. in Thousands)
DEMAND No.
- Department
of Health
40
- Loans and
Advances to
Govt.
Servants.
30
P
TOTAL
N 0 N- P LAN
N
L A
CAPITAL
REVENUE
CAPITAL
REVENUE
1,06,00
4,68,94,00
2,59,91,00
3,30,60,00
10,60,51,00
99,99
99,99
13,30,00
13,30,00
78 & 79 - Works
Budget
14,36,00
4,68,94,00
I
I
10,74,80,99
REVENUE
CAPITAL
TOTAL
14,36,00
4,83,30,00
PLAN
4,68,94,00
3.31.59,99
2.59,91,00
5.91,50,99
NON-PLAN
2.74,27,00
10.74,80.99
TOTAL
8.00.53,99
■
2.5
3,31,59,99
2,59,91,00
I
ii)
Financial Assistance to Voluntary
Organisations
2 5 1 In order to promote outreach services
in rural and high density urban slum
population of the country, the Government ot
India have been giving financial assistance to
the voluntary organisations tor encouraging
them to set up new hospitals/dispensaries m
rural areas or to expand and improve the
existing hospital facilities.
Financial
assistance is available under the following
grant-in-aid schemes:i)
Scheme for Improvement
Medical Services’,
of
Promotion and Development of
Blood Donation
Voluntary
Programme; and
iii) Special Health Scheme for Rural
Areas.
2 5.2
The maximum ceiling of grant
2.5.2
available under the grants-in-aid scheme is as
follows:of Meili
Metlical Services
i)
Improvement ot
(w.e.f. 1.4.1992) Rs 4.00 lakh
for purchase of hospital
equipments and/or construction
purposes.
101
(Siov-\cro
us
■
V
/*/
I
ii)
Promotion and Development of
Voluntary
Blood Donation
Programme (w.e.f. 29.3.1989)
Non-recurring - Rs. 1.00 lakh for
purchase of mobile van.
Recurring - Rs. 15,000/- in the
first year and Rs. 10,000/- in
subsequent years.
iii) Special Health Scheme for Rural
Areas (w.e.f. 1.4.1992)
2.5.3 Rs. 8.00 lakh for construction of
hospital building, O.T. etc. and Rs. 4.00
lakh for purchase of Hospital equipments.
2.5.4 Grants-in-aid amounting to Rs. 29.14
lakh has been given to 23 voluntary
institutions during the year 1992-93. During
1993-94 (Upto 15th September, 1993), an
amount of Rs. 6.70 lakh has already been
released to 4 voluntary institutions.
2.6
Health Minister’s Discretionary
Grant
2.6.1 Financial assistance to the poor and
indigent patients is given from the Health
Minister’s Discretionary Grant to defray a
part of the expenditure on hospitalisation /
treatment in cases where free medical
facilities are not available. During 1992-93
assistance totalling Rs. 23.57 lakh was given
to 304 individuals. In view of the large
number of requests being received for
assistance, the provision under the Health
Minister’s Discretionary Grant has been
raised from Rs. 15.00 lakh to Rs. 30.00
lakh. The maximum ceiling of grant has also
been raised, from Rs. 10.000/- to Rs.
20,000/- in each case.
I
I
102
i
;
rf' ’ 1
y
i
medical
RELIEF
AND
SUPPLIES
? ;
S'
is
The Centre organises facilities for health
care of its employees and penstoners living, in
the Capital and other major cities thro“e
Central Government Health Scheme a
public hospitals. It rushes relief and supplies
areas hit by natural calamities and
unforeseen disasters. The M.mstry also
assists in investigations tor various crimes
through providing serological and chemica
examination services.
3.2
Central Government Health
Scheme
32 1
The Central Government Hea th
Scheme (CGHS) was introduced onjst July,
1954 as the ‘Contributory Health Scheme in
Delhi, so as to provide c0^Pre^en®,v®
medical care facilities to the Central
Government Employees and members of their
families to replace the cumbersome and
expensive system of reimbursement of
medical expenses. Initially the scheme be^an
with 16 Allopathic Dispensaries covering
about 2.33 lakh pensioners.
3.2.2 Scope of CGHS-. Over the years, the
CGHS has grown, both in coverage an
scope. It has been extended to Bombay,
Madras,
Calcutta, Patna.
Hyderabad,
Bangalore, Pune, Nagpur, Ahmedabad,
Jaipur, Kanpur. Allahabad, Meerut, Lucknow
and Jabalpur. The peripheral towns of
Gurgaon Faridabad and Ghaziabad are
One
PnZled under the CGHS Delh..
Allopathic Dispensary each in Bhub^ef^h
and Ranchi is functioning exclusively for the
As on
Accountant General employees.
313 93 there were 230 Allopatnic
Dispensaries. 17 Polyclinics, 31 Ayurvedic
OiSnsTies/Un™. , M
i
Dispensaries/Units, 8
Dispensaries/Units, 2 Siddha Units and 3
Yoga Centres in these cities, covering .
lakh Central Government Employees and
other entitled persons. All the dispensar.es
work in a single shift with limited aft"
services facilities in functioning (multi sh ft)
Dispensaries.
However, some of he
dispensaries are being run tor 12 hour.
I
CHAPTER HI
103
- ■r.T-.T’1
I
continuously on an experimental basis.
Besides the Central Government
3.2.3
Employees, the other categories of population
availing CGHS facilities include employees
of autonomous organisations, retired Central
Government servants, widows ot Central
Government employees in receipt ot tamily
pension, M.P.s and Ex-M.P.s, Ex
Governors, Ex-Vicb Presidents, retired
Judges of Supreme Court and High Courts,
Freedom Fighters and Members of general
public in 14 specified areas in Delhi. The
Scheme has~ also been extended to the
workers of the Employees State Insurance
Corporation, Kanpur, retired employees of
Indian Council of Agricultural Research
(nonkiptees in Delhi/New Delhi), employees
of Kendriya Vidyalaya Sangathan stationed at
Calcutta, Madras, Bombay, Bangalore,
Hyderabad and Secunderabad, the employees
of statutory canteens in the cities where the
Scheme is functioning, the retired employees
of NIH & FW, New Delhi. CGHS facilities
have also been extended to such ot the
employees of CGHS as are not residing in
covered area.
3.2.3 (i) The Press representatives and the
employees of the Delhi H igh Court have also
been given CGHS facility from March, 1988
and November, 1988 respectively.
iI
i
3.2.4 Facilities and Services under the
CGHS:u The facilities provided under the
Scheme include out-patients care through a
network of Allopathic Dispensaries as well as
Ayurvedic / Homoeopathic / Unani Dispensaries/Units, supply of medicines, laboratory
and X-ray investigations, domiciliary visits,
emergency treatment, ante-natal care,
confinement and post-natal care, advice on
family welfare, specialist consultations and
hospitalisation facilities in Government
Hospitals as well as in private hospitals
recognised under C.G.H.S.
t ■■
.In order to
cost of artificial appliances,
increase the
t number of service institutions as
well as to offer better services to the
C.G.H.S. beneficiaries, all Government |
Hospitals such as Army, Naval, Railways,
E.S.l. and State Government/ Municipal
Hospitals have been recognised under
C.G.H.S. The domiciliary restrictions to
avail of the benefit of the Scheme have been
liberalised in favour of pensioners. The
Central Government pensioners can avail
C.G.H.S. facilities from their nearest
dispensary irrespective of the tact as to
whether they are residing within the
jurisdiction of the Scheme or not.
3.2.6 The orders for one-time payment of
CGHS contribution by pensioners have been
issued. According to these orders, if the
pensioner pays ten-times the CGHS
contribution at a time, he is issued a
permanent whole-lite CGHS card.
3.2.7 New Initiatives'.
In a constant
endeavour to improve the functioning and
facilities of the C.G.H.S.. a number of new
initiatives have been taken.
3.2.7 (i) Expenses incurred on Intra Ocular
Lens (IOL), Hearing Aids and Pacemakers
are reimbursable. In order to expedite
disposal of reimbursement of medical
expenses claims, powers to reimburse the
cost of artificial appliances have been
delegated to the Administrative
Ministries/Departments.
The Addl.
Directors/Deputy Directors of C.G.H.S.
Organisations have been delegated powers to
reimburse the cost ot artiticial appliances to
the pensioners.
3.2.7 (ii) Out-station pensioners have been
allowed to obtain medicines from the
.J
Stores
Mri.....
approved Chemist/Co-operative
through authority slips issued by the
Director for a |period’ specified by the
specialist at a time.
3.2.5 Since November, 1984, the Central
Government pensioners have been made
eligible for reimbursement of cost ot
hospitalisation/specialisedtreatment including
3.2.7 (iii) To facilitate prompt issue of
permission for hospitalisation, CMO incharge have been authorised to accord
104
1
B
I I
♦
I
♦
♦
♦
♦
♦
♦
<
I
I
t
I
♦
I
I
I
t
mV.n ,SE DISrENSARlES/BENEHClAR'rS VSOER VAR.OES « OE
name
DATE OF
STARTING
of the
CITY
allo
2
1
o
La
1. Ahmedabxd
2. Allahib-1^
3. Bangalore
4. Bombay
5. Calcutta
6. Delhi
7. Hyderabad
8. Jabalpur
9. Jaipur
10. Kanpur
11. Lucknow
| |2. Madras
13. Meerut
|4. Nagpur
| 15. P«'na
B 16. Pune
H 17. Bhuhaneshwar
Apr. 1979
Mar. I960
Feb. 1976
Nov. 1963
Aug. 1972
July 1954
Feb. 1976
Oct. 1991
July 1978
July 1972
Mar. 1979
Mar. 1975
July 1971
Oct. 1973
Nov. 1976
July 1978
Aug. 1988
Total
dispensa
RIES
existing
3
•5
7
10
♦28
17
84
♦•14
2
5
9
6
14
6
♦•10
••5
7
IS
230
homoeo
.
ayur
.
4
5
1
1
2
2
I
I
I
4
2
13
1
13
2
.
SYSTE
M-
WISE
(AS
ON
31-
UNANI
SIDDHA
YOGA
TOTAL
POLY
CLINICS
7
8
9
10
6
7
9
13
0
1
1
2
1
4
2
0
1
0
0
2
0
1
1
1
0
34
I
4
2
2
1
1
I
1
1
1
1
2
1
1
31
34
8
2
ff Figures are provisional.
* Including two sub dispensaries.
EXISTING dispensaries
21
118
20
2
7
12
9
17
8
13
7
10
3
1
SYSTEM
3
J
308 ~
17
** Excludi
$ Exclusiv
@ As on 3
WISE (AS ON 31-03-93)
-“tp
Bi
hi
8
nutrition deficiency diseases, breast feeding
etc. during the National Nutrition Week (0107tii Sept. 1993) and World Food Day (16th
Oct. 1993).
3.4.10 The Field Unit of Nutrition Cell has
completed the survey work related to the
study on Infant Feeding Practices among
working and non-working mothers of urban
slums of Delhi/New Delhi.
I
I
I
3.5
Indian Red Cross Society
3.5.1 Ever since its inception in 1920, the
Indian Red Cross Society has done enormous
good work in many fields. The Society is a
national federation with over 650 Red Cross
Branches spread throughout the country at
State/Union Territory, District and Sub
District levels. It is the collectively of the
Headquarters and the Branches inter-woven
together that makes up the Society. The
Branches and the field workers of the Society
always provide a well-knit and well organised
network across the length and breadth of the
country. They inspire, encourage and initiate
at all times all forms of humanitarian
activities so that human sufferings are
minimised, alleviated and even prevented,
thus contributing to the creation of a more
congenial society where the most vulnerable
individuals and communities can live with a
minimum of social and economic security and
human dignity.
3.5.2 The main activities of the Society are
disaster relief, blood collection and
distribution, hospital services, maternity and
child welfare, family welfare, Junior Red
Cross, community services and ambulance
and nursing services.
3.5.4 The Blood Bank situated in the
National Headquarters in Delhi is the largest
Voluntary Blood Bank in the country.
During 1992, about 50,000 units of blood
were collected from voluntary/replacement
donors and after performing all required
tests, infection free whole blood were
supplied free of charge, to needy patients
without any distinction of caste, creed or
status as a gift from the donors.
3.5.5 The Government of India gives grantin-aid to the Indian Red Cross Society tor its
general and blood banking activities. During
the year 1993-94 there is a provision of Rs.
13.00 lakh under non-Plan for this purpose.
3.5.6 The Government of India also makes
annual contribution to the International
Committee of Red Cross. In 1993-94, a sum
of Rs. 3.00 lakh has been provided in the
budget for contribution by the Government of
India.
3.6
St. John Ambulance
3.6.1 St. John Ambulance is a National
Federation of 17 State Centres, 9 Railway
Centres, 3 Union Territory Centres, apart
from about 600 Regional/District/Local
Centres and 25 Brigade Districts with nearly
1,700 Divisions comprising over 35,000
trained personnel. While the Association
Wing has been imparting instructions in First
Aid, Home Nursing and Kinder subjects, the
Brigade Wing consists of uniformed
personnel, who do field duty. First Aid
duties are performed at public functions,
fairs, sports meet, factories, mines and other
places requiring urgent attention for safety
and care in natural and industrial calamities.
3.6.2 During the year 1992, more than 6
lakh of people were trained in First Aid and
The motive of the
allied subjects.
organisation is to serve the sick and injured.
3.5.3 Relief to the victims of floods and
cyclones, earthquake or any other kind of
disaster is the main and foremost activity of
the Society. During the year 1992, the
headquarters of the Society had provided
relief assistance for a gross total value of
about Rs. 2.3 crore both within India and
outside.
3.6.3 During the year 1992-93, the Ministry
of Health and Family Welfare released a sum
of Rs. 50,000/- as annual grant-in-aid to the
109
*
Association. During the current financial
year, i.e., 1993-94, a budget provision of
Rs. ’ 50.000/- has been made tor being
released’ to the Association as annual grant-
in-aid.
3.7
Medical Stores Organisation
3 7 1 The Medical Stores Organisation with
seven Depots at Bombay, Calcutta
Guwahati, Hyderabad. Kamal, Madras and
New Delhi is responsible tor the procurement
and supply of quality medical stores
including equipment to various hospitals^and
dispensaries all over the country at the most
’ economical rates. There are about 1 800
regular indentors who draw their
requirements from these Depots. lhe
Organisation has three Chemical Labqratones
attached to the Medical Stores Depots at
Bombay, Madras and Calcutta tor conducting
the quality control tests.
The Departmentt of Serologist &
3.8.1
Government of
Chemical Examiner to the
t
tn'dia i&U Pioneer Organisation in the country
branches /AT
&ent k^nr>/'nac
of
'orkiflg
advanced serology since its_ inception in
1912. The Administrative Control of the
Qeptt. of Serologist and Chemical Examiner
Calcutta, rests with the Director General of
Health Services and the Ministry of Health
and Family Welfare, Govt, of India.
3.7.2 The Medital Stores Organisation also
caters to the needs of hospitals and
dispensaries' located in rural or sub-urban
areas. It receives supplies from Internationa
agencies like UNICEF, CIDA, WHO,
USAID etc. and distributes them to various
parts of the country. The MSO Procu^
various drugs and other items tor the
implementation ot the Nationa Health
Programme. It arranges relief supplies to the
victims of natural and national calamities.
The Organisation also arrange gift supplies to
foreign countries at the instance of the
Ministry of External Affairs on behalf of the
Govt, of India.
3 7 3 In view of the increased activities and
important role being played by Medical
Stores Organisation, steps tor improvement
in its functioning by way of providing in
house testing facilities in the Depots m
phased
manner
introducing
and
computerisation for inventory control and
financial accounting have been taken. Actum
to provide adequate cold storage facilities in
various Medical Stores Depots is also being
taken.
i
Department of Serologist and
Chemical Examiner, Calcutta
3.8
Chief Objectives
Production and marketing of various
antigen.
diagnostic reagents (VDRL
(V dkl
am.geu
species, specific antisera etc J tor supply
to the Government and Non-Government
institutions all over the country.
1.
To undertake blood group serology and
to offer expert opinion about ditterent
types of medico-legal exhibits/biological
materials sent to this laboratory.
2.
3.
To train laboratory and para-medical
personnel in the various fields of
serology and S.T.D.
4.
To undertake research in
immunodiagnostics and provide facilities
for post-graduate research.
Newer Activities
There have •_.!
been much advancement in
id'anied fields during the last two
serology anc-----■
„„ c. STD/AIDS have been
decades. Furthermore
recognised as
as aa challenging
public h
c’
problem
in
Consequen
ly, the
our
country.
• ’ i in our country
..I’
:*
J
been
organisation
have
activities of the
panded
in
tollowing
tields.the
exi
(a) Providing necessary ^‘PP0^
laboratory services to the Sta
Government run hospitals to
them to organise and expand S
services.
i
I
.
110
(b) Serving as a Reference Centre tor
inter-laboratory evaluation of
VDRL test.
VD Clinics
Hospitals.
(iv)
’ j as Regional STD Training
Serving
and Research Centre.
(c)
to
(vi)
Work has already been initiated to
develop a Regional Blood Group
Reference Centre for Eastern
Region in order to identity
abnormal blood groups and also to
reactions
t------investigate transfusion
etc.
(e)
(vii)
Forensic Serology Section.
V.D.R.L. Antigen Upit.
Antisera Production Unit.
STD Serology Reference Lab.
Regional STD Research <&
Training Centre.
6. Blood Group Reference Centre.
7. Immunology & Biochemistry.
8. Immunochemistry .
9. Training Section.
Some <of
„ the On-going Research
Projects (1992-93):
3.8.2
CO
Microbiological study of
discharge from cases of
leucorrhea and from patients
suffering from urethritis.
00
Study of Chlamydia infections
including serology.
(iii)
Study on HBs antigen in sera
collected from cases attending
Comparison of S.T.S. positivity
with newer serological tests tor
syphilis.
Detection of Ant.cardioliptn
Antibodies (IgM, IgG) and HIV
antibodies in sera from STD and
leprosy patients. ,
Determination of ASO titre and
Creative protein in sera from
patients of rheumatic heart
diseases.
• i of monospecific
(viii) Production
antispecies antisera.
The
Department has the following
The Department
Sections performing specialised jobs. These
are:
1.
2.
3.
4.
5.
Calcutta
—) Carbon
Evaluation of Immutrap
to
substitute
Antigen Test as a s—
VDRL test.
(v)
(d) Engaged in the isolation,
characterisationand standardisation
of different fractions of Human
Immunoglobulins and also their
corresponding monospecific
antisera to be used in the medical
field as diagnostic reagent.
of
Study of Immunological pattern
in cases of myeloma and other
cancer patients.
(ix)
Screening
rare/newer /abnormal
groups.
(x)
3.9
f o r
blood
Hospital Services Consultancy
Corporation (India) Ltd.
HSCC was set up in March, 1983
3.9.1 the
Administrative Control of the
under
nf
Ministry c Health & Family Welfare. It has
3
- j
authorised capital of Rs
comprehensive
Corporation is offering
<
including
technoconsultancy services
• i of detailed
economic survey, .PrePar^tU)IJ>
(architectural and
project report, designing
<.Vctem
engineering), hospital managemen system
hospital administration and bm-med ca
engineering services, planning
planning, project
coordination as
management and coordination
installation, commiss.onmg
supply, installation,
and
c......
maintenance of medical equipments including
back-up services, trammg ot medical and
i.
in
500-Bed Referral, Hospital in
Nagaland (Phase-I). (Cost of
Project - Rs. 210 million).
para-medical personnel including updating of
technical audit of existing hospitals. In brief
HSCC offers total consultancy services
relating to health care delivery and related
fields under the roof.
2. Supply, Installation and
of Medical
Commissioning
Equipment to 340-Bed Kandal
Hospital
at Phnom Penh
Kampuchea (Phase-II).
3.9.2 Capital Structure: The authorised
capital of the Corporation is Rs. 50.00 lakh.
The paid-up capital is Rs. 40.00 lakh divided
into 40,000 equity shares of Rs. 100 each.
3. Comprehensive Design
Consultancy and Planning of
Medical Equipment, recruitment
of medical personnel and
management services for 101- ,
Bed Hospital for Chanda Devi .—^-Charitable Trust, Shillong.
(Cost of Project -Rs. 70 million). 1
The total business of the
3.9.2 (i)
Corporation has been managed without
obtaining any loan/deposits from the
Governments/financial institution or public.
3.9.3 Working Results: The Corporation
has improved its performance in the Tenth
Year of its operation. The total earning of
the Corporation has been Rs. 84.55 lakh
during the year 1992-93 as against Rs. 66.16
lakh in the previous year indicating 27.8%
increase; gross profit has increased from Rs.
18.99 lakh to Rs. 27.09 lakh registering an
increase of Rs. 42.65%.
I
1
4. Master Plan, Detail Planning and
Design. Project Management,
Supply and Installation of
sophisticated medical laboratory
equipment for the National
Institute of Biologicals, at
NOIDA. a joint venture of
OECF (Japan), USAID and
Government of India. (Cost of
Phase-I of Project -Rs. 697
million).
3.9.3 (i) It is also added that as on 31st
March, 1993 the Corporation has paid to the
Government Rs. 48.40 lakh by way of
dividend, Rs. 118.00 lakh as Corporate Tax,
thus totalling Rs. 166.40 lakh as contribution
of the Corporation to the Central Exchequer.
The Corporation has also generated internal
resources to the extent of Rs. 74.54 lakh upto
31st March, 1993.
I
5. Preparation of Detailed Project
Report, Procurement, Installation
and Commissioning (Turn-Key)
of Central Sterile Supply
Department and Laundry at Post
Graduate Instt. of Medical
Education & Research at
Chandigarh. (Project Cost - Rs.
20 million).
3.9.3 (ii) The Corporation has declared and
paid dividend'© 21% on the paid up capital
to its share holders for the year 1992-93
which is the highest till date.
I
I
3.9.4 Major Projects in Hand: Currently
the Corporation is engaged as consultants tor
implementation of the following major
projects.
!
1. Preparation of Final Project
Report. Master Plan, detailed
Design and Engineering Services
including Site Supervision for
112
6.
Preparation of Detailed Project
Report & Design Consultancy
for Expansion Project of Central
Hospital of Eastern Coal Fields
Ltd., Kalla, West Bengal. (Cost
of Project - Rs. 48 million).
7.
Preparation of Detailed Project
Report and Design Consultancy
for the 200-Bed Hospital at
Agartala (Tripura). (Project Cost
- Rs. 125 million).
'fl
8.
11
9.
Preparation of Project Report tor
a 40-Bed Private Hospital in
Asansol, West Bengal.
floods during the monsoon season. Timely
action on the part of the Government averted
major epidemic although normal incidence ot
most diseases were observed.
tin?
Preparation of Detailed Project
Report of the Development I lan
& Schematic Master Plan for the
expansion of existing facilities ot
Institute Rotary Cancer Hospital,
AIDS, New Delhi.
10.
11.
12.
September.
Planning, Design and
Comprehensive Consultancy
Services for the 250-Bed Trauma
Centre of AIIMS at Raj Nagar,
New Delhi. (Project Cost -Rs.
400 million).
Procurement, supply and
installation of laboratory
equipments for upgradation ot
CGHS Laboratories at various
places in the country. (Total
value is approx. Rs. 2.00 crore).
Preparation ot pre-teasibility
report for the Nurul Hasan Post
Graduate Institute of Medical
Sciences and Research Centre at
Kalayani,
West Benga .
(Approx. Cost of Project -Rs.
81.00 crore).
^95 Health service is a very important
part of Nation’s economy. ThK requires
high-tech services also. HSCC, through it
consultancy services is promoting the national
goal of* achieving health for all by t e~yea
2000 AD. Bv exporting expertise, HSCL .
promoting Co-operation, which ,s an integral
part of our foreign and economic policy.
j
3.10
\
I
I
During 1993, a major earthquake
Natural Disasters
,3"
Extensive damage to hfe and
medical assistance to the quake affectwJ
population. The death toll reached 9 485*
The State Government ot Maharashtra
initiated necessary steps. To ^PP'6^1
efforts of the State Government, Mmistry ot
Health, Government ot Ind.a airimed 45
xnecialists medical teams from New Delhi
ah,ng with life saving medicines ^P"
and relief material. Summary ot action taken
by the Dte. G. H. S. is as tollows:-
3 10 2(a) Medical Teams:
15 Medical
Medical College were airlifted immediately
12.00 midnight on 30.9.93.
3.10.2 (b) Medical Store Supplied.
Life Saving Drugs
. 8.00 Tonnes
(Costing approx. Rs.25.00 lakO
X-Ray Films
3 10 2 (c) Technical Assistance to the State
Governments: Public Health
Public Health Team was sent by N-l c u ’
Delhi to study the various probiems tac^
the earthquake displaced Pers‘,ns
gand
Thei
p
temporary shelters.
reco mmendations. were duly forward^ to the
Ministry of Agriculture and- the Sta e
Government of Maharashtra tor
implementation.
3 10 1 The geographical attributes of our
country make it extremely vulnerable to
natural calamities. During 1993, 8 out of
31 States/Union Territories were affected by
3 10 3 Assessment of Psychosomatic Stress
Affected Population:
Population: A Cl]mbin^
on the Affected
team of the
rhe Detence
Defence R
Research
----- - Development
113
!
Organisation and the N.I.C.D. visited the
Earthquake affected areas of Maharashtra to
assess the psychological impact of the
earthquake on quake affected victims. This
team will submit their report shortly after
completion of the assessment.
i)
The existing Contingency Plan was
put in operation. As per Plan, the
drought and flood contingency plan
was circulated to all the States;
ii)
Institutionalization of Health
Management of Various Natural
Disasters
Medical Stores at the Central
Stores at Karnal, Bombay, Madras,
Hyderabad, Calcutta and Guwahati
were kept in readiness;
in)
C.R.I., Kasauli was also
readiness to supply vaccines;
iv)
During the crisis situations
constant contact was maintained
with the respective Directors-o£^=
Health Services to enable -theD.G.H.S to keep an eye on the
progress of relief measures;
v)
The crisis management group of
the Central Government of which
the Director (EMR) is the member, j
met frequently during the crisis '
situations; and
vi)
At the State and District level
preventive and curative measures
were also taken.
3.13
Medical Supplies to the Various
States
3.11
3.11.1 Six institutions located in various
regions of the country have been identified
by die Ministry of Health and Family
Welfare to promote and propagate the
common strategy evolved tor health sector
management of various natural disasters.
These institutions are:-
i)
N.I.C.D. Delhi;
ii)
All India Institute of Hygiene and
Public Health, Calcutta;
iii)
JIPMER, Pondicherry;
Staff
College,
iv)
Administrative
Hyderabad;
v)
National Environmental Engineer
ing Research Institute, Nagpur;
and
vi)
Position of Emergency medical
____
3.13.1
supply on credit payment for the year 199394 (till December, 1993) to different places
in India:
Sardar Patel Institute of Public
Administration, Ahmedabad.
3.11.2 These are institutions of excellence,
each of which has specialised in a particular
I field related to emergencies and disasters.
These institutions meet regularly and
) contribute to evolve a common strategy of
j minimising
___ ___________
the overall _____
,
mortality/morbidity
caused by various natural disasters.
V 3.12
in
SI. Name of the State
No.
1.
2.
3.
4.
5.
Other Preparatory Contingency
Measures by EMR Division
Different measures taken at the
3.12.1
Central level during the year under report
were:
Punjab
Uttar Pradesh
Bihar
West Bengal
Maharashta
(Earthquake Relief)
Value (Rs.)
50,00,000
15,66,931
6,31,200
2,61,200
11,80,685
86,40.016
114
s
I
3.14
Medical Supplies to the Foreign
Countries as Humanitarian
Assistance on Behalf of Ministry
of External Affairs
3 14.1 E.M.R. Division is the focal point
for supplying medical relief to the various
countries by the Ministry of External Affairs
During the year 1993, following relief
supplies were sent:SI.
No.
■>)
ii)
iii)
3.15
Name of the Medical
Relief (Rs.)
Country
Mongolia
Grenada
Belarus
5,25,430.00
4,94,739.00
49,17,139.00
Redressal of Public Grievances
Committee
3.15.1 A Redressal of Public Grievances
Committee is functioning in the Directorate
patients - of the three Central Government
Hospitals namely Safdarjang Hospiul Dr.
RML. Hospital and L.H.M.C. & S K.
The CommUtee
Hospital, New Delhi.
functions under Chairmanship of the Director
General of Health Services.
a i< 2 As per direction of the Committee,
one ' officer in each hospital has been
identified as Grievances Redressal Officer
who is available in the hospitals to public on
fixed time every day.
3.15.3 The complaints relating to medical
care are discussed _and analysed by the
Committee and remedial measures are takem
During 1993, upto 29th December, 18
number of complaints were received. A
of the
Redressal Grievances
meeting of
'
,„; held under the Chairmansh ip
Committee was
of Director General of Health Services on
28.6.1993 and in which 10 cases of
complaints were discussed and decisions
taken.
115
NATIONAL
HEALTH
PROGRAMMES
■ •■s
8
The Centre takes concerted measures to
combat communicable, non-communicable
and other major diseases. For this purpose,
several national health programmes are
directly run by the Ministry which can have
a bearing in the reduction of mortality and
morbidity and also have a salutary■effect on
efforts to improve the quality of life of Ute
common man.
These programmes also
reinforce the delivery of primary, secondary
and tertiary health care throughout the
country. This chapter details the progress
made in the conduct of these programmes
during the period under report.
4.2
National Malaria
Programme
Eradication
4.2.1
The organised Public Health
Programme to control Malaria was launched
in India in the year 1953. Its encouraging
results prompted the Government of India to
switch the strategy from mere control ot me
disease to eradication of the disease m 195o .
The National Malaria Eradication Programme
made spectacular progress till 1965 when
only 0.099 million cases were recorded from
the entire country in that year. But this
success was short lived. In 1976, the
number of confirmed Malaria cases reached
a high of 6.47 million which necessitated
renewed vigorous antimalarial activities and
modification in the existing strategies.
With the implementation of the
4 2.2
Modified Plan of Operation (MPO), which
was based on a two-tier stratification the
total malaria cases decreased from 6.4/
million in 1976 to 2.18 million cases in
1984
However, since then the malaria
situation in the country has remained more or
less static (contained) around two million
cases a year.
4 2.3 Control Strategy: Case detection and
prompt treatment are emphasised so as to
reduce the parasite load in the communi y.
Blood slides are collected through Active> and
Passive Agencies and presumptive treatment
is given.
All positive cases are given
CHAPTER IV
I
117
5
appropriate radical treatment.
4.2.4 Selective and judicious insecticidal
spray is done in areas registering an API of
2 and above in the preceding three years. In
other areas, focul spray and surveillance are
carried out. During 1993-94 about 160
million people were projected for being
covered by spraying.
4.2.5 In urban areas, anti-larval measures
are in the form of recurrent weekly larvicing
with chemicals including Temephos,
Source
Fenthion, MLO, Parisgreen.
reduction as well as other bio-environmental
measures are being applied wherever feasible
to control the breeding of mosquito vectors.
>
4.2.6 Malariogenic stratification to prioritize
endemic areas into high, medium and low
risk areas is being undertaken. This exercise
has been completed first in 12___
Karnataka, and
has been in operation since 1991.
- . During
1993-94, revised strategies based on
stratification have been launched in
Maharashtra, Gujarat and Rajasthan.
4.2.7
E
‘ ' Education to awaken the
Health
community and seek their active involvement
and cooperation -in dealing with disease
control is being undertaken.
4.2.8 Budget'. The NMEP is a category R
Centrally Sponsored Scheme on 50:50 T
sharing basis between the Centre and the
States. The budget provision and estimated
expenditure under the 50% central share
which is in the form of drugs and insecticides
is given below.
4.2.9 Tribal Areas'. In view of the persistent
transmission of malaria, in the seven NorthEastern States which are almost entirely
inhabited by tribal population, a plan to
provide 100% Central assistance for the
control of malaria is being worked out.
^.1
4.2.10 As about 30% of the total malaria
cases and about 50% of the P. falciparum
cases are reported from the tribal areas of the
country, comprising about 44.5 million
population of Andhra Pradesh, Madhya
Pradesh, Gujarat, Maharashtra, Bihar,
Rajasthan and Orissa, a proposal to provide
100% assistance for the control of malaria in
these areas is being initiated for posing to the
World Bank in due course for funding.
4.2.11 Control of Malaria in Urban Areas'.
The Urban Malaria Scheme (UMS) came into
effect in 1971 with the objective to control
malaria by reducing the vector population in
the urban areas through recurrent anti-larval
BUDGET AND EXPENDITURE
Year
Budget Provisions
1985- 86
1986- 87
1987- 88
1988- 89
1989- 90
1990- 91
1991- 92
1992- 93
1993- 94
8868.00
8500.00
8200.00
8300.00
8900.00
8200.00
8960.00(final)
9700.00
11000.00
118
I
Actual Estimated Expenditure
(Bs. in lakh)
8856.91
7815.14
8456.98
8750.00
8862.17
7660.45
8793.04
9800.14
r
I
THOUSAND
_ 0
a £
3000
2000
1000
4000
5000
SQOO
7C00
i
\.f ■ -
to
ow
CD ® ft 148,012
0c s*
o«
i 3g2,398
HI
■
sass ■
Z «
3>
>♦ 8:»|J'2,5C
frl
o
>
c/>
r
iigSiiwS
^
hl
§« I
aS i
2J32.302
> ®
■V
rw ;
wg^O ■• ;ri 2.018.8U&
1WS ''SSa1 2..34.W.
ml
a
i .■
rsn
** o
O)
o
o*
1 ••884,380
□o
01 y®5gl
z
«
•gUji
is. ®
h
p
Sfe 1.732,187
g||| 1,883.284
\ 1.854.830
• c#
□
Pe
2,017.823
Es
■
i
e
2,,^
,,, ^xx;2 &■'-%/.■- ;X,-|;
♦©
M
'Wse K Aw 7-
2,120.472
to
to
N
3D
B
z
□
I
>
■«
measures.
Though the scheme was
sanctioned in 181 towns distributed in 18
States and 2 Union Territories, it has so far
been implemented in 128 towns. About two
lakh cases of Malaria were recorded in 120
towns in 1992. It is observed that 120 towns
from where comparative data was available,
62 showed a decrease while 58 showed an
increase in malaria cases in 1992 as
compared to 1991. The metropolitan cities
of Delhi Calcutta, Bombay and Madras
recorded 12331, 17893, 11879 and 48447
cases of malaria respectively during 1992
compared to 8491, 13354,5334 and 66,937
during 1991.
I
a
Vi
4.3 Kala-Azar
4 3.1 Kala-Azar is a serious public health
problem in Bihar and West Bengal. After its
resurgence in Bihar in the early 70s, the
disease spread from the 4 districts to
adjoining areas. Now about 30 districts of
Bihar and 9 districts of West Bengal are
effected by Kala-Azar. The increasing trend
of the disease is evident from the fact that the
total number of cases which were 17806 with
72 deaths in 1986, rose to a total of 77101
cases with 1419 deaths in 1992. However,
this trend has been arrested in 1993 with a
total number of 26752 cases with 439 deaths
reported till July, 1993.
'■
4.3.2 In view of the growing problem,
planned control measures were initiated to
contain Kala-Azar.
Until 1990-91 the
assistance for the Kala-Azar Control was
being provided by the Govt, of India out of
the National Malaria Eradication Programme
budget provision. However, specific funds to
the tune of Rs. 4.06 crore were made
available during 1990-91 for the control of
Kala-Azar. Since then, the Govt, of India
has considerably enhanced the inputs to Rs.
15.38 crore in 1990-91. During 1992-93,
Rs. 20.00 crore were provided against the
Annual Plan outlay of Rs. 15.00 crore. For
1993-94 a provision of Rs. 20.00 crore has
been approved in the Annual Plan.
Kala-Azar coptrol broadly includes 3 major
activities:
co
Interruption of transmission for
reducing vector population by
undertaking indoor residual
insecticidal spray twice annually;
(ii)
Early diagnosis and complete
treatment ot
of Kala-Azar
i----- ----cases; and
(in)
Health Education for comm
unity awareness.
4 3.4 In view of the financial constraints.
Govt, of India provides the total costs on
medicines and insecticides for Kala-Azar in
Bihar. To ensure optimum utilisation of
available resources, district action plans are
prepared under which exclusive infrastructure
is deployed for the Kala-Azar activities.
Material and equipment with strict
supervision is provided. Monitoring and
concurrent and consecutive evaluation is
regularly carried out.
4.3.5
Assistance Provided by the
Government of India: Assistance in terms of
cash as well as kind has been provided
during the last three years. In 1992-93,
about Rs. 20 crore worth of assistance in
kind has been given to Bihar and West
Bengal. Material assistance included the
insecticides DDT and the imported drug
Pentamidine Isethionate.
4.3.6 In addition, UNICEF assistance of
Rs. 15.95 lakh has been provided in 1990-91
for information, education and
communication activities and orientation of
medical professionals.
4.4 National Filaria Control Programme
4.4.1 Filariasis is a major Public Health
problem in many States of the country and
about 396 million people are estimated to be
living in 175 known endemic districts, of
which about 109 million are in urbAn areas.
4.3.3 Strategy for Control: The strategy tor
119
clinical
including
surveillance of suspected
cases;
4.4.2
The National Filaria Control
Programme was launched in 1955. Under
the Programme the following activities are
undertaken:
(iv)
Studies to identify the high
risk groups hy measuring the
blood level of anti-bodies;
and
(i)
Delimitation of the problem
in hitherto unsurveyed areas;
and
(ii)
Control in urban areas
through recurrent anti-larval
measures and antiparasitic
measures.
(v)
Epidemiological monitoring
of the disease for effective
implementation of prevention
and control strategies.
4.4.3 There are 206 control units and 195
clinics giving treatment with
Diethylcarbamizine to clinical cases and
microfilaria carriers.
4.6
National
Leprosy
Programme
4.5 Japanese Encephalitis
4.‘5.1 The disease is caused by a minute
virus and manifests as high fever,
convultions, confusion, stiffness of the neck
and coma etc. The death rate due to this
disease is very high and those who survive
do so with various degrees of neurological
complications. This disease is spread by
mosquitoes which usually breed in rice fields
and swampy and marshy areas.
4.5.2 Of late this disease has become a
major public health problem and has been
reported from 24 States/UTs. There were a
total of 4071 cases with 1530 deaths reported
in 1991,-2432 cases with 888 deaths in 1992.
In 1993, no serious outbreak of the disease
has been reported till September, with 189
cases and J 26 deaths.
Eradicaton
4.6.1 Problem: India ranks foremost among
the countries saddled with the burden of .1
leprosy sufferers. Out of 2.7 million cases —>
of leprosy in the world 1.3 million are
estimated to be found in India (1993). The
disease is widely spread all over the country. •
The prevalence rate of leprosy exists above 5
per 1000 population in 201 districts out of f
468 districts of the country. About 15% of
the leprosy sufferers are children below 14
years of age. The proportion of infectious
cases varies from 15 to 20% and equal
number of patients suffer from deformities.
At the time of launching ot the National
Leprosy Eradication Programme in 1983 the
disease was highly prevalent in the
States/Union Territories ot Tamil Nadu,
Andhra Pradesh, Lakshadweep, Pondicherry,
West Bengal, Maharashtra, Karnataka, Bihar,
Nagaland, Sikkim. Andaman and Nicobar
Islands. Now the problem of leprosy has
been reduced in many ot these States.
(i)
Care of the patients;
Objectives' The
Programme
4.6.2
Government of India launched National
Leprosy Eradication Programme in 1983 with
the objective to arrest the transmission of the
disease by 2000 AD. It is a 100% Centrally
Sponsored Programme.
(ii)
Development of a safe and
standard indigenous vaccine;
4.6.3
Strategies’. The adopted strategy
under the programme involves:
(iii)
Sentinel
Major
Strategies for Control'.
4.5.3
activities to control Japanese Encephalitis
include:
surveillance
a)
120
Provision of domiciliary multi-drug
r
i
m b
PREVALENCE RATE
2
1
0
< I
4
3
123
ANDHRA PRADESH
ARUNACHAL PRADESH
m
0 51
5.30
BIHAR
0.06
HARYANA
HIMACHAL PRADESH
JAK
0.78
KARNATAKA
0.88
2.42
:.ll
MANIPUR
0.55
MEGHALAYA
0.57
§
MIZORAM
TJ
NAGALAND
!?
£
RAJASTHAN o
§
o
*
3
3
5 Z
1.
•
0.15
0.34
'J
z
I
'i.<»
TRPURA
O
I
0*5
TAMIL NADU
5.08
I
ORISSA
PUNJAB
f
*0 -<
0 r-
0.28
■
Q
SIKKIM
|
UTTAR PRADESH
I
WEST BENGAL
1 *1
F
>
2.87
DAMAN & DIU
o
.16
DIN HAVELI
0.43
3.82
LAKSHADWEEP
PONDICHERRY
2
18
1.4
CHANDIGARH
w
28
|
A a N ISLANDS
DELHI
o 3J i
o 0
o U)
2.24
M
St
»
T rn !
KERALA
MAHARASHTRA
x
-n i
■o r
0.78
©
o
o
0.61
GUJARAT
MADHYA PRADESH
m
0.86
GOA
“I
z
o
1.52
ASSAM
?
8
5
I
2.53
INDIA(2.42)
(0
(0
w
treatment coverage‘in 135 districts
having problem of 5 or more cases
per 1000 population, by specially
trained staff in leprosy:
£
b)
‘Shifting of 66 endemic districts on
Modified MDT pattern to regular
vertical pattern; and
c)
MDT services
Introduction ot
through existing general health care
services in the low endemic districts.
Treatment with combination of drugs
include treatment with 3 drug viz.
Clofazimine
and
kn ampiv in.
Dapsone. Education of the patients
and the community about the
jurabilit} of disease and their socio
economic rehabilitation are other two
key components ot the control
strategy.
4.6.4 Infrastructure: Over the years, a vast
infrastructure ot leprosy workers has been
developed in the country, specially trained
In the
for
providing leprosy services.
endemic rural areas, these services fan- out
from Leprosy Control Units (one for 0.4 to
0.5 million population) while its urban
counterpart called Urban Leprosy Centre
caters to a population of about 30 to 40
thousand. Temporary hospitalization ward
having 20 bed capacity has been established,
at least one in each endemic district to
render hospitalization services. Under the
Programme, 49 Leprosy Training Centres are
engaged in providing training to various
categories of health workers in leprosy.
Following infrastructure exists at the end ot
March, 1993: Leprosy Control Unit-758.
Urban Leprosy Centre-900. Survey Education
and Treatment Centre-6097, Temporary
Hospitalization Ward-291. District Leprosy
Unit-285, Leprosy Training Centre-49.
Reconstructive Surgery Unit-75. Leprosy
Rehabilitation and Promotion Unit-13.
Sample Survey cum Assessment Unit-39.
4.6.5
predominantly established by the State in the
endemic districts.
In the district with
endemicity of less than 5/1000 population,
the general health care provide the services.
However, there are still gaps in the 66
endemic districts due to financial constraints.
To extend the benefit of MDT to over 7
million patients living in these 66 districts.
Government of India sanctioned a modified
MDT approach in these districts trom
January, 1991.
This modified approach
include the involvement of PHC in the
delivery of services to leprosy patients. Now
all these 66 districts are proposed to be
covered on regular vertical pattern ot MD1
scheme, 18 such districts have already been
sanctioned vertical MD1 scheme.
4.6.6 Achievements: Currently about 60%
of leprosy patients are getting the benefit ot
Multi Drug Therapy in the country.
Available information indicates that MD1 is
well accepted by the patients, the tolerance is
good and side effects are minimum. There is
marked reduction of over 90% in the
prevalence rate in the 40 districts which have
completed MDT of 5 years or more. MD1
coverage has been expanded to all the 201
endemic districts which includes 135 districts
on vertical pattern and 66 on modified
pattern.
4 6 7 Target
Achievement in 1992-93-.
During the year 1992-93 against the target of
289600 for new case detection and treatment,
a total of 547686 new cases have been
detected out of which 541078 cases have
been put under treatment.
4.6.8 The target for cases discharged was
573900 during 1992-93 against which
1052823 cases have been discharged.
4.6.9 The objectives of target allocated for
1993-94 consists of 265200 cases tor
detection and treatment and 525300 tor case
discharge. The expenditure of 1992-93 was
Rs.3338 lakh and for 1993-94 the BE
allocated is Rs. 3380 lakh.
Infrastructure thus created has been
121
F-
•■Sr'
-wise performance
year
i
—3 DURING seventh
targets
OF
j ^c Ated below
plan
are
(Figures in Lakh)
Year
Ccise Detection
Achievement
Target
1985-86
1886-87
1987- 88
1988- 89
1989- 90
Total
(7th Plan)
1990- 91
1991- 92
1992-93
1
!
3.82
4.20
4.20
3.90
3.50
19.62
3.69
_
Case Treattnent
Achievement
Target
Case Discharge
Target j Achievement |
4.77
5.08
5.19
4.75
4.67
3.82
4.20
4.20
3.90
3.50
4.56
4.90
4.99
4.65
4.62
3.75
4.30
5.03
5.94
6.55
5.07
5.75
6.01
24.46
4.82
5.13
5.48
19.62
3.69
3.35
2.89
23.72
4.74
5.10
5.41
25.57
8.81
6.12
5.74
27.98
.
9.85
8.26
10.53 ||
6.69
3.35
2.89
"^Turgot allotted for 1993-94 ,s 2.65 lakh cases for detection and
for discharge.
treatment an',d 5.25 lakh cases
National T.B. Control Programme
4.7
A -7 1 Tuberculosis continues to be a major
4.6.10
.6.10 Sth
4
sth Plan:
alHhe
proposed to provide MDT covera^
districts with endemicity
«P
T
wu,ato « »®
5P"““ He* Care in
« eaderare
districts.
of this disease, whi
a a ii World Bank Assistance'. To spread
the MDT coverage to uncovered areas and to
theMD l eoverag
the Government
further intensity the effort.
have sent a comprehensiv p P Bank for financial assistance oR^ 302 cn^
which has been
proposed World Ban
to provide the Upnxy workers
districts.
with about 1/4th o
e
rzz mdt
it s envisaged
separate
endemie
motlerately endemic
t.(ir introducing
-
balanced by an
annually.
District TB Centres have been
established in 390 out ‘^^ogrammlofTB
aio
These are"meant to
country tor su|.
Health
Control in these districts
provide necdSS^e7Pperipheral institutions
Centres and other P P
of
embark
programme.
122
'I
estimated that
Sputum positive cases
MDT -n
The monitoring information sy^tein
\
-
■ ■
-
■y-.r-gf..
TUBERCULOSIS PROBLEM IN
UNINFECTED
82. OX
■
j W«-7 MILL'CNS :
■'
■,
.
•
3.4 MILLIONS
•I
; s
t
¥
■/
5^’
.
INFECTIOUS C
'- - ■
......................................................................................................................................................................................................................................
— <1%
-'
; =
i.
J j
NON-INFECTIO
| 8.3 MILLIONS
1;5% 1
I INFEC
(PULM
36.6%
INFECTED 4 NOT DISEASED
SOURCE:- NATIONAL TUBERCULOSIS INSTITUTE, BANGALORE
F-i
General of Health Services which looks after
the TB Control. This cell has been upgraded
in 1993-94 and is headed now by a Deputy
Director General.
TB training and
demonstration centres have been established
in many States to undertake basic training of
medical and para-medical personnel. The
National TB Institute carries out training of
all district level functionaries.
Bl
4.7.3 Although, around 47,000 beds are
available for treatment of seriously sick TB
patients, the emphasis in TB control,
however, has now been shifted to ambulatory
ueatment; and conventional therapy lasting
about iS months is being gradually replaced
by short vourse chemotherapy, (for the
sputum positive cases) which lasts only 6 to
8 months.
1i '
i
4.7.4 The Conventional Therapy is based on
treatment with INH and Thiacetazone while
short course chemotherapy consists ot an
intensive multi-drug phase involving
Rifampicin, Pyrazinamide, Ethambutol and
INH generally lasting 2 to 3 months followed
by a maintenance phase ot INH/Rifampicin
lasting 4 to 5 months.
While acute
symptoms ot disease generally disappear
within a month of start of multi-drug therapy,
more time is required to achieve a noninfectious or sputum negative status and the
full course of 6 months or so is important
from the point of ensuttog complete cure
with avoidance ot the possibility ot relapse.
i
4.7.5 Anti-TB drugs for free treatment are
being supplied to the TB clinics run by the
State Governments through a Centrally
Sponsored Scheme with 50% ot the cost
being borne by the Central Government and
50% by the States. 100% grants-in-aid is
given for supply of materials, equipments and
drugs for the programme in Union
Territories, as well as in the case of grants to
certain voluntary bodies.
f
i|
I
I
4.7.6
Programme by the Government of India,
WHO and SIDA revealed that it was
necessary to shift emphasis from monitoring,
detection and treatment to monitoring of the
number of cases cured, to bring TB
effectively under control. Case holding and
monitoring of cure is beset with difficulties
on account of need to tollow-up patients tor
a long period of 18 months in the case of
conventional therapy and 6 to 8 mojjths in
the case of short course chemotherapy.
Often patients tend to stop taking drugs when
the symptoms of the disease disappear
initially. This may be on account of work
and social pressures, ignorance or
inability/unwillingness to complete the full
course of treatment. The drugs alone would
cost around Rs. 1500 per patient in case of
short course chemotherapy. Non-availability
of drugs in peripheral health institutions
would also lead to stoppage of treatment. In
other countries of the world emphasis is
being laid on supervision of drug
administration in the 2 month intensive phase
of short course chemotherapy.
4.7.7 In order to reduce the burden of
disease in a medium term perspective it is
estimated that about 10 lakh sputum positive
cases need to be treated and cured each year.
The cost of drugs alone for ensuring such an
coverage would amount to Rs. 150 crore per
year. Added to this would be the cost ot
strengthening the organisational structure in
the Centre, States and Districts for
introducing effective supervised
administration of drugs. Although the central
plan outlay has been enhanced to a level ot
Rs. 35 crore in 1993-94 and is proposed to
be further enhanced to Rs. 50 crore for 199495, it is not considered practicable to avail
further enhanced outlays without external
assistance.
4.7.8 A project proposal has, therefore,
been made for obtaining World Bank
Assistance for TB Control Project based on
short course chemotherapy for sputum
positive cases while the non infectious cases
A Joint evaluation of the TB
(
123
continues to be on cheaper conventional
therapy. Pilot Projects based on this new
strategy are proposed to be implemented in 5
States namely, Bihar, Gujarat, Himachal
Pradesh, Kerala and West Bengal and 6
metropolitan cities, Bombay, Calcutta,
Hyderabad, Madras, Bangalore and Delhi in
order to test and obtain experience with the
proposed new strategy. This is being initially
done with SIDA assistance. It is proposed to
extend coverage of these Pilot Projects after
gaining further experience and building of the
The proposed Pilot
necessary expertise.
Project has been initiated in 3 cities viz.
Gujarat, Delhi and Bombay.
4.7.9 So far the stress in the National T.B.
Control Programme has been on detection
and since this has not helped significantly in
the reduction of the disease, the new project
has, therefore, a revised strategy. However,
during 1992-93, there were 15.39 lakh new
TB cases detected against a‘target ot 17.50
lakh. In the current year (1993-94) about
3.63 lakh cases have been detected against
the annual target ot 18 lakh till July, 1993.
The budget allocation for 1993-94 has been
raised to Rs. 35 crore from Rs. 28 crore in
1992-93. The amount allocated in the budget
is mostly used for the procurement ot drugs.
4.8
I
have, been as follows:
/?.v. in crore.
1991- 92
1992- 93
1993- 94
9.70
20.00
25.00
4.8.3 The infrastructure developed so far
and the targets for the same for the year-*.
1993-94 are as follows:
Target for
1993-94
Regional Institutes
10
of Ophthalmology
National Programme for Control of
Blindness
4.8.1 The National Programme for Control
of Blindness was launched in the year 1976
as a 100% centrally sponsored programme.
The approach under the NPCB, consists of
intensive health education for eye care
through the mass media and extension
education methods: extension ot ophthalmic
services in the rural areas through mobile
units and eye camps and establishment ot
permanent infrastructure tor eye health care
as an integral part of general health services.
4.8.2
Year
Upgradation of
Medical Colleges
60
8
Upgradation of
Distt. Hospitals
402
21
Estt. of DBCS
267
200
Central Mobile
Units
76
Development of
Distt.Mobile Units
162
27
Upgradation of
PHCs
4096
413
4.8.4 The State Governments have to send
proposals in respect of these items.
4.8.5 As a result of the programme the
number of cataract operations has gone up
from a level ot 5.5 lakh cataract operations
in 1981-82 to 1.6 million operations in‘the
year 1992-93. The target for the year 199394 is 24.30 lakh cataract operations.
4.8.6 Voluntary Organisations have played
a very significant role in this programme.
The budgetary allocations tor NPC.B
124
CATARACT PERFORMANCE UNDER N
1981-1993
I
OPERATIONS (Ir
20
15.
15
1 1.34
12.19 12.09 11,96 i i 35
1 0.49
10
8.04
5.5
,i
81-82 82-83 83-84 84-85 85-86 86-87 87-88 88-89 89-90 90-91 91
YEAR
They have been active in providing Eye
Health Eduction, Preventive, Rehabilitative
and Surgical Services for Control of
Blindness.
4.8.11 The purchase of equipment and
vehicles meant for the District Mobile Units
and Primary Health Centres is now being
done centrally and the assignment is also
being done accordingly. 85 vehicles were
procured and distributed centrally for the
various Mobile Eye Care Units in the
country,
Simultaneously the process of
central procurement and distribution of
Ophthalmic Equipment has also been taken
on hand.
4.8.7 The Need to Step up the Programme:
The NPCB-WHO Survey (1986-89) has
shown that there is a backlog of 22 million
blind eyes or 12 million cases of blindness.
Out of this 80.1% is on account of cataract.
4.8.8 It has also been estimated that there is
an annual incidence of 2 million cataract
induced blindness in the country. At the rate
of 1.5 million cataract operations annually we
are adding to the backlog rather than
reducing it. As such the programme needs to
be strengthened considerably if we have to
reduce the backlog of blindness.
4.8.12 Danish Assistance for NPCB: The
National Programme for Control of Blindness
is being assisted by the Royal Danish
Government. The Phase-II of the assistance
spans the period 1989-96. So far a sum of
Rs.3.86 crore has been reimbursed by
DANIDA to NPCB on the basis of actual
expenditure incurred by the various State
Governments on stipulated components of
NPCB. DANIDA had also taken up 5 Pilot
Districts for implementation of NPCB
through the formation of District Blindness
Control Societies in each of three districts.
The performance in cataract surgery has gone
up by 2 to 300% with the formation of
DBCSs in these pilot districts. Encouraged
with this success and on the basis of the
recommendations of the Mid-Term Review
Report DANIDA has now taken up the entire
state of Karnataka for replication of the
model for Control of Blindness developed in
the 5 Pilot Districts.
4.8.9 Steps Taken: It has been decided to
establish District Blindness Control Societies
(DBCSs) under the Chairmanship of the
District Collector. The structure of the
DBCS is:
Chairman
: District Collector
Members
: Chief Medical Officer
: District Ophthalmic Surgeon
: District Education Officer
Nominated members (from NGOs, Private
Sector)
Member Secretary
T
4.8.13 World Bank Project for Control of
Blindness: The World Bank has been
approached for a Rs.550 crore assistance for
a intensive Blindness Control Programme in
the Seven States of Tamil Nadu, Andhra
Pradesh, Maharashtra, Madhya Pradesh,
Uttar Pradesh, Rajasthan and Orissa. As per
the NPCB-WHO Survey (1986-89) these
seven States have the highest prevalence of
blindness after the State of Jammu &
Kashmir. One of the strategies of the Project
is the formation of District Blindness Control
Societies in all districts of the project .States
and to make them financially and
operationally autonomous. Dedicated Eye
Care infrastructure is proposed to be created
: District Blindness
Coordinator
4.8.10 So far, 267 DBCSs have been
formed. A sum of Rs.6 crore @ Rs.3 lakh
each has already been released to 200 of
these DBCSs to make them financially and
operationally autonomous.
The first
Orientation Workshop for District Collectors
was held in Delhi to orient the District
Collectors in the functioning of DBCSs.
Steps have also been initiated to train the
District Blindness Control Coordinators to
enable them to effectively run the DBCSs.
125
>■3'
and strengthened in the District Hospitals and
selected sub-divtsional hospitals. Medical
Colleges are also proposed to be upgraded
with the modern ophthalmic equipment and
provision of specialized training to the faculty
members to ' perform
IOL Surgery.
Ophthalmic Staff is proposed to be trained
under the programme to provide quality Eye
Care Services. The project envisages the
involvement of NGOs and the use of modern
monitoring systems to keep stock of the
performance.
4.9
IDD is a major public health problem in 193
districts. Goitre is not restricted only to the “
Himalayan belt of India but also widely
prevalent in the plain, plateau, reverine areas
and near the sea coast.
4.9.4 Achievements: The achievements
made under the Programme from its
inception to date are as under:(i)
641 private manufacturers have
been licensed by the Salt
Commissioner, out of which nearly
532 units have commenced
production so far;
(ii)
Annual production of iodised salt
has been raised from 5.0 lakh Mt
in 1985-86 to 26.0 lakh Mt in
1991-92 and in 1992-93, the
production was 28.34 lakh Mt.
This is expected to be further
raised to 50.00 lakh MT in near
future;
(iii)
23 States/UTs have completely
banned the use of salt other than
Iodised Salt while another 6 States
have banned partially in the
endemic areas only;
(iv)
Testing Kits tor on the spot
qualitative testing have been
developed in collaboration with
UNICEF and they were distributed
to all the District Health Officers
in endemic State for regular
monitoring;
(v)
23 States/UTs have set up Iodine
Deficiency Disorder Control Cell
to ensure effective implementation
of the Programme;
(vi)
To intensify IDD activities, a
project has been finalised with
UNICEF assistance for intensive
IDD monitoring in 4 States viz.
Uttar Pradesh. Madhya Pradesh,
National Iodine Deficiency
Disorders Control Programme
4.9.1 Iodine is one of the essential elements
for human growth and development. Due to
various factors there has been iodine
depletion of the soil, as a result of which an
average balanced diet and water does not take
care of the total daily iodine requirement of
150 micrograms. Earlier only goitre was
associated with Iodine deficiency. It is now
well established that goitre is only "a tip of
the iceberg" of the manifestations of Iodine
Deficiency Disorders (IDD) . The spectrum
of Iodine Deficiency Disorders affects each
and every stage of life from foetus to adult.
r
J; /'<
i
4.9.2 The National Iodine Deficiency Control
Programme (NIDDCP) is the new name
given to the erstwhile National Goitre
Control Programme. The title has been
changed in view of the wide spectrum of
Iodine Deficiency Disorders like mental and
physical retardation, deaf-mutis, cretinism,
high rate of abortion etc., and the
Government’s commitment to overcome all
other Iodine Deficiency Disorders apart from
Goitre through Universal Iodisation of Salt.
I
”;i"'
4.9.3 Magnitude of the Problem: It is
estimated that in India alone, more than 54.3
million people are suffering from endemic
Goitre and about 8.8 million from different
grades of mental/motor handicaps. Sample
surveys have been conducted by DGHS and
other agencies in 25 States and 4 UTs
throughout the country. The Survey results
Himachal Pradesh and Assam;
indicate that out of 235 districts surveyed.
126
_
(vii)
(viii)
(ix)
■
■
An evaluation of Salt Iodisation
Programme was also carried out in
some districts. The results of
evaluation have shown that the
prevalence of goitre has declined
from 41.2% to 31.8% in Hamirpur
and from 49.53% to 16.9 in
Buldhana;
It has also been proposed to set up
the monitoring labs in the States of
Arunachal Pradesh, Assam,
Himachal Pradesh,
Gujarat, Himachal
Karnataka, Madhya Pradesh,
Maharashtra, Sikkim, U.P. and
West Bengal. A tentative allocation
of Rs. 75,000/- per lab. has been
provided for this purpose;
Information, Education and
4.9.6
To intensify the IEC
Communication:
activities, a communication package by way
of video films, posters/danglers and
Radio/T.V. has been finalised with UNICEF.
4.9.7 VIII Plan Proposals: It is proposed to
strengthen IDD Monitoring and to achieve
the goal of Universal Iodisation of Salt. IDD
monitoring will be carried out at the district
level both through regular checking of
iodised salt as well as urinary iodine
excretion. With this, it is also proposed to
bring down the incidence of IDD to below
10% level by 2000 A.D.
4.9.8 Problems: Surveys in the remaining
districts, ban notification in the remaining
States and setting up of Control Cell in some
States are yet to be completed.
4.10
National Sexually Transmitted
Disease Control Programme
(S.T.D.)
GOI-UNICEF Project 1993-95 has
been approved in 13 selected
endemic States for the extensive
monitoring and IEC activities of
NIDDCP. The activities are to be
strengthened in 106 selected
districts of the 13 States including
North Eastern region;
4.10.1 S.T.D. was introduced as a National
Control Programme during the second Five
Year Plan by the Government of India. The
programme was then primarily a Centrally
Aided Scheme concerned mainly with (i)
establishing S.T.D clinics throughout the
country; (ii) supply of drugs'to the earlier
existing and newly established clinics; and
(iii) conducting orientation training courses in
S.T.D for the inservice medical and para
medical personnel.
After a review of the
4.9.5 Review:
Programme in 1991 the Chief Ministers of
remaining States were advised to urgently
issue Notification banning the sale of salt
other than iodised salt. The State
Governments have been advised to include
iodised salt as a non-compulsory item under
Public Distribution System.
4.10.2 The scheme was converted into a
Centrally Sponsored Scheme during the
fourth five year plan and the Central
Government assistance was limited to (i)
giving grant-in-aid to States for establishing
new S.T.D. clinics and (ii) supplying of
drugs (Benzathine Benzyl Pencillin) to the
S.T.D. clinics.
4.9.5(i) The Salt Commissioner has been
advised to take action to instal iodisation
plants in consuming areas in States/UTs and
to improve packaging of iodised salt to
4.10.3 The scheme was again reviewed and
during sixth and seventh five year plan it was
decided to establish five Regional S.T.D.
Teaching, Training and Research centres at
(x)
5
A National Reference Lab for
monitoring of IDD has been set up
at the Bio-chemistry Division of
National Institute of Communicable
Diseases, Delhi for training both
medical and para-medical
personnel and monitoring salt and
urinary iodine;
Delhi,
prevent iodine losses during transit.
i
127
Madras, Nagpur, Hyderabad and
u
Calcutta.
4.10.4 Recognising S.T.D. as one of the
major factors for transmission of HIV
infection the programme has been merged
w.th the AIDS Control Programme. The
fisting components of the programme viz.
leaching. Training, Research and
Epidemiology, however have been retained
outside the World Bank assisted activities of
the National AIDS Control Programme
Under the National S.T.D. Control
Programme following achievements have
been made:
4-10,4(1) As on July 1993 the Regional
o.l.D. centres have trained as many as 98
medical officers and 112 para-medical
personnel like Laboratory Technicians,
Nurses, Health Educators and Social Workers
etc.
4.10.4(ii)
About 56» medical colleges,
hospitals.
laboratories/public
health
laboratories had participated in the inter
laboratory evaluation programme of VDRL
test being conducted by the Regional STD
Reference laboratory at Madras and
Hyderabad.
4.10.4(iii) The Crash programme for the
training of Medical Officers working in
Primary Health Centres in Tamil Nadu
Andhra Pradesh, Maharashtra, West Bengal
and Delhi at the 5 Regional S.T.D. Training
Centres was launched and under this 274
Medical Officers were trained.
and case management activities in STD
centres in 97 medical colleges (including S
Regional S.T.D. Centres and 275 District
level STD clinics).
4 10.5 Blood Safety Programme-. A Scheme
been under implementation since 1989 under
which State Governments were provided '
assistance for setting up of testing facilities
including HIV in the Blood Banks.
Strengthening and modernisation of State
managed Blood Banks and development of
manpower and rational Use of Blood.
4.10.6 A Programme for the Prevention and
Control of AIDS has been currently under
implementation since 1992. One of the major
components ot this Programme is Blood
Safety and Rational, Use of Blood.
4.10.7
Modernisation of Blood Banks'.
Under this Programme it is proposed to
upgrade all the 608 State managed Blood
Banks in the country with provision of
equipments and recurring assistance of
consumables in a phased manner. During
1992-93 assistance has been given for
modernising 90 Blood Banks under the
World Banks assisted National AIDS Control
Programme, while 138 Blood Banks were
upgraded till March 1992. The remaining
380 Blood Banks are proposed to be taken up
tor upgradation in a phased manner during
the 8th plan period. During the year 1993-94,
100 Blood Banks are being upgraded.
4.10.8 Training and Manpower Develop
ment: 10 Training Institutions have been
operationalised at Regional level for training
of Doctors and Technicians working in the
Blood Banks. Institutional facilities have
already been upgraded. Doctors and
Technicians have been imparted Training in
blood banking technology, through short term
orientation course.
4.10.4(,v) S.T.D. Planning Workshops for
the State Programme Officers of STD, AIDS
and Epidemiologist of various States were
held at Delhi, Madras and Bhubaneshwar.
4.10.4(v ) S.T.D. Treatment Workshop was
held at Delhi on 6-7 July, 1993 to develop
standard treatment guidelines for Sexually
Transmitted Diseases and STD syndrome.
4.10.9 Training modules for training of
various categories of personnel working for
the blood hanks are being prepared and
4.10.4(vi)
The Project seeks to take up
activities to strengthen the clinical services
128
|
modular training will be introduced shortly.
' r''^5
Bi
■
r
4.10.10 Legal Frame Work: Schedule FXIIB provides the necessary legal frame work as
per Drugs and Cosmetics Act. The Rules
have been made more stringent providing for
mandatory testing of blood for blood
transmissible diseases including HIV.
Approval of license by the Central license
approving authorities has been made
compulsory. It also provides that the whole
human blood and components shall conform
to standards as prescribed under the Indian
Pharmacopia.
4.10.11 Promoting Rational Use of Blood’.
It is proposed to establish 30 Component
separation Centres in Blood Banks handling
more than 10,000 units of blood per annum
in phases. Six centres were identified during
1992- 93 and 9 more Centres have been
identified for component laboratory during
1993- 94. The remaining centres shall be
taken during 1994-95.
4.11 National AIDS Control Programme
4.11.1 HIV infection in the country has been
reported from as many as 23 States/UTs and
of these Maharashtra, Tamil Nadu, Manipur
have reported the highest incidence of the
disease. In the Maharashtra and Tamil Nadu,
the pattern of HIV infection is that of SubSaharan type i.e., through sexual
transmission and in the North Eastern State,
the pattern of HIV infection follows the
course similar to South European and
Thailand i.e., through drug abuse.
4.11.2 As per the epidemilogical reports
available as many as 18,98,670 persons have
been screened for HIV of which 13,254 have
been found to be sero-positive as on 30-0993. The sero-positivity rate per 1000 among
the samples screened is 698 and the total
number of full blown AIDS cases reported
from different States is 459. The reported
prevalence of infection represents a fraction
of actual morbidity and this amounts to just
the probial tip of ice-berg of the whole
problem. According to the estimates made.
the number of infected persons by the end of
1990-92 was about 1 million and the total full
blown AIDS cases to be somewhere between
5,000 to 10,000.
4.11.3 Realising the gravity of epidemio
logical situation of HIV prevailing in the
country, the Government of India has
launched a comprehensive scheme at an
estimated cost of Rs.220 to Rs. 222.6 crore
during the Sth Plan with assistance from the
World Bank to the tune of USS 84 million
and another US $ 1.5 million from WHO
The World Bank loan became effective from
21.9.1992.
4.11.4 Ministry of Health & Family Welfare
has set up a National AIDS Control
Organisation as a separate wing to implement
and closely monitor the various components
of the programme as documented in the Staff
Appraisal Report of IDA (World Bank). The
overall objective of the project is to arrest the
HIV/AIDs infections in the country with a
view to reducing the future morbidity,
mortality and infection of AIDS.
4.11.5 The project consists of the following
components:
4.11.5(i) Strengthening Programme Manage
ment Capabilities: National AIDS Control
Organisation is primarily involved in
planning consulting, implementing and
monitoring the various activities under the
project through the AIDS Control Cell at the
State/UT level. The programme is being
implemented as a Centrally Sponsored
Scheme through all the State/Union
Territories who have given letter of
Undertaking to implement the programme.
During 1992-93 grants aggregating Rs. 11.55
crore have been released to the State/UTs.
During 1993-94 first instalment of 25% of
the total grant proposed for the current year
has been released.
4.11.5(ii) Strengthening of IEC : Since
there is no cure for AIDS as of now, the
project seeks to carry out an intensive public
129
r
|
i
awareness and community support campaign
through mass media and sustained
dissemination of information and health
education about HIV and AIDS to all level
and categories of personnel. For launching
media campaign at a large scale through out
the Country, a proposal has been finalised on
the selection of an Advertising Agency.
Limited media campaign has already been
launched with the help of DAVP at an
approximate cost of Rs. 54 lakh.
Clinics.
4.12 National Mental Health Programme
The National Mental Health
4.12.1
Programme was launched during Seventh
Five Year Plan with a view to ensure
availability of Mental Health Care Services
for all specially the Community at risk and
under privileged section of the population.
The basic thtyne was to promote community
participation in the Mental Health Services
development as self help. As per decision
taken at the National Advisory Group, 11
institutions have been identified for training
of health workers under the programme.
This training will consist of basic knowledge
on Mental Health to the Primary Health Care
Physician and Para-medical personnel.
During 1993-94, Rs. 18 lakh have been
allocated for this Programme.
4.11.5 (iii) Prevention of Transmission
Through Blood and Blood Products: The
Project seeks to upgrade the blood banking
capabilities in the Public Sector and
expansion of HIV screening of all blood used
for transfusion and blood-products in the
country. During 1992-93 financial assistance
has been given for modernising 90 blood
banks. During the year 1993-94 another 100
blood banks are being modernised under the
scheme to modernise all the 608 blood banks
in Public Sector.
4.13 National Cancer Control Programme
4.13.1 In India it is estimated that there are
1.5 to 2 million cancer patient at any given
point of time with about 0.6 million new
cases coming every year. The Government of
India started the Cancer Control Programme
in a limited form during the year 1975-76
when Central assistance @ Rs. 2.5 lakh was
provided to institutions for purchase of
Cobalt Therapy Units for treatment of cancer
patients. This scheme continued during the
6th and 7th Plan Period with the increase of
rate of assistance to Rs. 12.00 lakh. At the
same time ten major institutions were
recognised as Regional Cancer Centres which
receive financial assistance from the
Government.
4.11.5 (iv) Strengthening Clinical Manage
ment Capabilities:
The project seeks to
strengthen the institutional capabilities at the
State/UT level for monitoring the
development of HIV and AIDS epidemic and
planning and programming interventions to
control such epidemic. 180 Zonal Blood
Testing Centres (inclusive of 62 Surveillance
Centres) have been set up where blood
testing facilities for HIV are available.
Linkages have been provided throughout the
country. In addition to this, 9 HIV reference
centres have also been set up. An exhaustive
plan has been drawn to train medical officers
down the district and taluk levels in
diagnostic skill and clinical management of
HIV/AIDS Cases. So far about 425 medical
officers have been trained; and
4.13.2 New Schemes' Under National Cancer
Control Programme: During the 8th Plan,
emphasis is on prevention, early detection of
cancer and augmentation of treatment
facilities in the country. The following new
schemes have been initiated starting from the
year 1990-91.
4.11,5(v) Controlling S. T.D.: One of the
predominant mode of transmission of HIV
infection is through sexual contact. The
project seeks to take up activities to
itrengthen the clinical services and case
nanagement activities in STD Centres in 97
nedical colleges and 275 District level STD
4.13.3 Scheme for District Projects: The
scheme envisages projects at district level for
130
♦
5^4
preventive health education, early detection
and pain relief measures. Under the scheme
financial assistance of Rs. 15.00 lakh is
provided to the concerned State Government
for each district project selected under the
scheme with a provision of Rs. 10.00 lakh
per year for each district for the remaining
four years of the project period. The project
is linked with a Regional Cancer Centre or
an institution having reasonably good
facilities for treatment of cancer patients.
During the years 1990-91 to 1992-93, 17
district projects have been undertaken in
Gujarat, Karnataka, Madhya Pradesh, Kerala,
Orissa, Punjab, Tamil Nadu and West
Bengal.
P'
I
I
I
4.13.4 Development of Oncology Wings in
Medical Colleges/Hospitals: This scheme
has been initiated to fill up geographical gaps
in the availability of cancer treatment
facilities in the country. According to the
scheme, financial assistance upto Rs. One
crore (in phases) is provided to the concerned
State Govt, for purchase of equipments which
includes one Cobalt Unit. The civil works
and manpower are to be provided by the
concerned State Govt./Institution. So far
financial assistance has been provided for
development of Oncology Wings in sixteen
medical colleges/hospitals in the country.
4.13.5 Scheme for Financial Assistance to
Voluntary Organisations: Under the scheme,
financial assistance upto Rs. 5.00 lakh is
provided to the registered voluntary
organisations recommended by the State
Government for the purpose of undertaking
health education and early detection activities
in cancer. So far assistance has been
provided to fifteen voluntary organisations
under the scheme.
4.13.6 Utilisation of Funds by the State
Governments: It has been observed that in a
number of cases, there is a long time-gap
between release of the amount by this
Ministry and utilisation of the same by the
concerned State Govt. At times State Govts,
provide the amount or part thereof to the
concerned Medical Colleges/Hospitals after a
considerable time.
This hampers the
effective implementation of the programme.
4.13.7 Government of India intends to
strengthen the Programme further during the
coming years. The schemes for grant-in-aid
to Regional Cancer Centres and for financial
assistance for cobalt therapy units have been
continued. The rate of financial assistance
for cobalt therapy units which was increased
to Rs. 20.00 lakh, has further been increased
to Rs. 50.00 lakh per unit w.e.f. 20th
January, 1993. Other radiotherapy equipmertfs like Brachytherapy and Linear
Accelerator have also been brought under the
ambit of the scheme. A sum of Rs. 19.00
crore was spent on the Programme during the
year 1992-93 as against the total allocation of
Rs. 19.34 crore during the entire seventh five
year plan. A sum of Rs. 20.00 crore has
been earmarked for the National Cancer
Control Programme in the current year.
{
131
F
ifi
H
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W
M
I
PREVENTION OF
ADULTERATION
OF FOOD AND
DRUGS
i
Adulteration of food and drugs can cause
serious damage to human life. This anti
social menace is sought to be countered by
making the legal provisions more stringent
and deterrent, even entailing life
imprisonment for adulterations causing
grevious hurt and danger to human lite. This
malpractice is also being tackled through
effective health education measures. The
drug de-addiction centres are being
strengthened to provide treatment facilities
for the drug abuse problem and drug
dependence disorders.
5.2
Prevention of Food Adulteration
Programme
5.2.1 The Prevention of Food Adulteration
Act, 1954: Food is a basic need for survival.
It is, therefore, imperative to ensure that
whatever we consume is pure and
With this objective, the
wholesome.
Prevention of Food Adulteration Act, was
enacted in 1954. The aims envisaged under
this Act are:
i)
To ensure quality food to the
consumers;
ii)
To protect the Consumers
from fraud and deception;
and
iii)
To encourage
practices.
t
t
fair
trade
5.2.2 The Act, which came into effect from
1st June, 1955, has been amended thrice, in
1964, 1976 and 1986 for plugging the loop
holes and for making the punishments more
stringent and empowering the Consumer and
Voluntary Organisations to take samples.
5.3
Constitutional Status
Enforcement of the Act
and
5.3.1
The subject of Prevention of
Food Adulteration is in the concurrent list
of the Constitution. However, in general,
the enforcement ot the Act is done by the
CHAPTER V
133
-
State / U.T. Governments. The Central
Government primarily plays an advisory role
in its implementation besides carrying out
various statutory functions/duties assigned to
it under the various provisions of the Act.
5.4
Administrative control of Government of
Maharashtra and Council of Industrial and
Scientific Research, Government of India
respectively.
5.6
Main Functions of the Central
Government
5.6.1 There are 78 Food Laboratories
under the Administrative control of State/UT_
Governments and Local Bodies.
5.4.1 The Central Committee for Food
Standards (a statutory committee constituted
by the Central Government under the Act) is
responsible for considering amendments to
various provisions of the Act, Rules and
The Central Government
Standards.
conducts examination for the chemists for
their appointment as Public Analyst under the
Act. It approves the State Prevention of
Food Adulteration Rules under the Act and is
also required to examine and approve the
The Central
labels for infant food.
Government evaluate and monitor the
working of the PFA Act in the States/UTs by
collecting periodical reports and visits and
collects
analytical data from Food
Laboratories for Standardisation purpose. It
also arranges training programmes for
various functionaries under the Act and
creates consumer awareness through
workshops/seminars etc. The Central
Government ensures the quality of food
imported into the country under the Act and
also deals with matters relating to
international agencies namely CODEX/
FAO/WHO.
1
I
5.5
1
I
State Food Laboratories
5.7
Steps Taken
Programme
to
Improve
the
5.7.1 During the year, steps have been1
taken to strengthen the PFA set up. 48
training programmes were conducted by the
Hq. PFA division in collaboration with
various Institutions/Organisations under
which more than 500 different types of
officials/functionaries under the Act were
imparted training, 11 examinations were
conducted in which 225 chemists qualified to
hold the post of Public Analyst under the
Act. Consumer Education Programmes were
organised involving Voluntary Organisations
for exposing them to the Programme of Food
Safety and Quality.
5.7.2 The Centra! Council of Health and
Family Welfare which met in July, 1993
recommended inter-alia that the State
Governments should take appropriate
measures to update and simplify procedures
for licensing, augment enforcement
machinery and laboratory facilities and give
emphasis to sampling and analyses of
commonly used food commodities.
Central Food Laboratories
5.5.1 Four Central Food Laboratories have
been established/specified under the Act,
which work as Appellate Laboratories for the
purpose of samples lifted by Food Inspectors
of States/UTs. and Local Bodies. The two
laboratories viz (i) Food Research and
Standardisation Laboratory, Ghaziabad and
(ii) Central Food Laboratory, Calcutta are
under the Administrative control of the
Directorate General of Health Services and
the other
------ two.
----- , viz. (iii) Central Food
Laboratory, Pune and (iv) Central Food
Laboratory,
Mysore are under the
5.8
Centrally Sponsored Scheme
5.8.1 The Ministry has launched a Central
Sponsored Scheme for providing funds to the
State Governments for purchase of equip
ments for strengthening their Food, Labora
tories, during the Eighth Five Year Plan.
The financial assistance is in the form of a
one time grant. Under this scheme, an
amount of Rs. 151 lakh was given to 17
States/UTs during 1990-93. During the year
1993-94, Central assistance amounting to
I
134
II
I
Rs. 50 lakh was provided to Andaman and
Nicobar Islands, Jammu & Kashmir,
Maharashtra, Pondicherry and Rajasthan.
5.9
Central Drug Standard Control
Organisation
5.9.1 Quality control of imported drugs,
introduction of new drugs, in the country and
framing of the Rules under the Drugs and
Cosmetic Act are some of the important
activities of the Central Drug Standard
Control Organisation (CDSCO). However,
the State Governments are responsible for
issuing licenses for manufacture and
marketing and monitoring the quality of
drugs and cosmetics in the country. The
State Licensing authorities are the
enforcement agency for the Drugs and
Cosmetics Act in their respective States.
-
5.10
Functions of the Central Drug
Standard Control Organisation
5.10.1 The statutory control over the import
of drugs is exercised through the port and
airport offices of the CDSCO located at
Bombay, Nhavashava, Madras, Calcutta,
Cochin and New Delhi. Close co-ordination
is maintained with the State Drug Control
Authorities so as to maintain a uniform
standard of inspection and enforcement ot the
Drug Riles, by the offices located in
Bombay, Madras, Calcutta and Ghaziabad
besides sub-zonal offices at Lucknow and
Patna.
I
5.10.2 Permission for trial of new drugs is
given after due examination of all technical
material and related pharmacological
literature. The clinical trials are evaluated
before granting marketing approval to a new
drug.
under the Drugs and Cosmetics Act and
Government Analyst for 21 States/UTs.
Similar function is carried for 8 States/UTs
by the Central Indian Pharmacopoeia
Laboratory at Ghaziabad and the Biological
Laboratory and Animal House, Madras tests
drug samples drawn from the Southern Zone.
Another Central Drug Laboratory was
inaugurated at Bombay and it will be in a
position to test 5000 samples per year when
fully functional. Regional laboratories are
also being established at Guwahati,
Chandigarh and Hyderabad. They would be
in a position to analyse 3000 samples each
year. Rs. 85 lakh were allotted to Haryana,
Punjab, Kerala, M.P., J&K,Maharashtra,
Karnataka and Tamil Nadu for strengthening
their State Drug Testing Laboratories during
1992-93.
5.10.5 A Statutory Drug Technical Advisory
Board advises the Central and State
Governments on technical matters arising out
of the administration of the Drugs and
Cosmetics Act.
5.10.6 During the period April to
September, 1993, 93 amendments were
issued and 140 monographs were finalised.
In order to provide for a more effective
mechanism to ensure the quality of blood
products, the Central Government has
assumed concurrent licensing powers for
Blood Banks, I.V. Fluids, Sera and Vaccines.
Standards of Condoms have also been revised
as per the specifications of the WHO,
keeping in view its importance in controlling
sexually transmitted diseases and AIDS.
5.10.7 71 additional posts have been
sanctioned for strengthening the CDSCO.
Recruitment action is at hand. This will
enable the CDSCO to have two additional
sub-zonal offices at Ahmedabad and
Hyderabad.
5.10.3 Import of 19 new drugs and 23 new
drug formulations were allowed during the
period April to September, 1993.
5.11
Drug De-addiction Programme
5.11.1 Ministry of Health and Family
Welfare is basically responsible for providing
treatment facilities including preventive
5.10.4 The Central Drugs Laboratory at
Calcutta tests samples of imported drugs and
also functions as the appellate laboratory
1-35
health and after care service in the field of
drug-addiction.
5 11.2 For coordination of functioning of
various
Ministries/Deptts, some high
powered committees have been set-up
including a Cabinet Sub-committee and High
[ evel Committee consisting inter-alia of
Sorne members of Parliament.
5 J 1.3 The Govt, of India have set-up De■iddiction Centres in Central Govt.
Infctitutes/Hospitals at AIIMS, New Delhi,
p G.I., Chandigarh, JIPMER, Pondicherry,
Ijidy Hardinge Medical College and
Hospital, New Delhi and Dr. R.M.L.
Hospital, New Delhi.
5 11.4 In addition, Centres with the
assistance of UNDCP have also been
developed at Deen Dayal Upadhyay Hospital,
|<ew Delhi, AIIMS, KEM Hospital, Bombay
and Institute of Post Graduate Medical
I.ducation and Research, Calcutta.
above Institutes, besides
5.11.5" The;
services also provide
’
treatment
■*
r
providing t
training "of Medical/Para-medical personnel
prepare Health Education Material,
Material, and
'
i
t i i ♦ \ • ill 11 run i 'U \ur\/o'4C
render
Community
Outreach Services.
5.12
1
Steps Initiated to Develop (he
Programme in States
5 12.1 During 1992-93. a new strategy was
I
1
I
developed to strengthen the infrastructural
facilities in the States by way .of providing
them assistance to establish Drug-Deaddiction Centres in the identified Medical
Colleges/District Level Hospitals. A vast
trained manpower of doctors is being
developed who will serve at the peripheral
level after obtaining the training on basic
techniques of de-toxification from the
identified training Institutes.
5.12.2 So far 27 Centres have been
established in various Medical Colleges/Distt.
Level Hospitals. About 500 doctors have
been trained under the Scheme in 20 courses
conducted so far. The training of...para^Smedicals has also been undertaken at some—_L_
Institutes which will be further strengthened.
5.13
Special Measure for North Eastern
States
5.13.1 Keeping in view the acute problem of
drug abuse in North Eastern States,
particularly in Manipur and Nagaland,
additional assistance in terms of equipment,
vehicles and for construction of buildings is
being provided to these States. Special
arrangement have been made to train the
Medical/Para-medical personnel of North
Eastern States.
136
^$4
■
-arst
wi
bi
ii
swi.-
A view of the Central Research Institute, Kasauli.
ȣ
h
i
5
Environ
ment-friendly
in
battery-car
the premises of
National Instt.
of
Mental
Health
and
Neuro Sciences,
Bangalore.
I
Sr
) -T
•*»?*
( )
MEDICAL
EDUCATION,
TRAINING AND
RESEARCH
The Centre has set up regulatory bodies for
monitoring the standards of medical
education, promoting training and research
activities. This being done with a view to
sustaining the production ot medical and
para-medical manpower to meet the
requirements of the health care delivery
system at the Primary, Secondary and
Tertiary levels in the country. This chapter
discusses the status of these activities
conducted by various bodies and institutions.
Medical Council of India
6.2
6.2.1 The Medical Council of India was
established as a statutory body under the
provisions of the Indian Medical Council
Act 1933 which was later repealed by the
Indian Council Act, 1956 with minor
amendments in 1958 (36 of 1958) and 1964
(24 of 1964). A major amendment in IMG
Act was made in 1993 to stop the mushroom
growth of medical colleges/increase of
seats/starting of new courses without prior
approval of the Central Government/Medical
Council of India. The main functions of the
Council are as under:
(')
1
(ii)
(iii)
(iv)
(V)
CHAPTER VI
137
Maintenance ot uniform standards ot
Medical Education both at Under
graduate and Post-graduate levels;
Maintenance of All India Medical
Register;
Reciprocity with foreign countries in
the matter of mutual recognition of
medical qualifications.
Continuing ot Medical Education,and
Provisional/Permanent registration ot
doctors with recognised medical
qualification.
registration ot
additional qualifications and issue ot
Good Standing Certificates tor
doctors going abroad.
I
6.3
Inspections
6.3.1
The Council carried out inspection
of 13 medical colleges for continuance of
recognition of their MBBS Degree as well as
approval of the colleges.
The Council
earned out periodical inspections of 11 post
graduate degree/diploma qualifications of
respective
universities;
16
medical
colleges/institutions were inspected for
approval ot starting of various post-graduate
courses.
The Council carried out 9
inspections of the non-teaching hospital for
recognition of housemenship. The Council
also carried out the inspection for increase of
seats.
6.4
Registrations
6.4.1
The Council has registered 38
doctors with their additional qualifications
under section 26 of the I.M.C. Act, 1956.
JJie Council has issued 369 certificates of
Good Standing to the doctors who desired to
seek registration with the General Medical
Council of U.K. and other Common Wealth
countries.
231
provisional and 326
permanent registration certificates has issued
under section 25(2) and 23 of the I M C
Act, 1956.
6.5
I
!
Continuing
(C.M.E.)
Medical
Education
6.5.1
IIn consultation with the Ministry of
Health and Family Welfare, a C.M.E. Cell
was set up in the Medical Council of India in
December, 1985.
Under the C.M.E.
Scheme, two programmes have been held
upto October, 1993 at different centres and
36 programmes are to be held during the
year 1993-94.
6.5.2 The Council is celebrating its
Diamond Jubilee year from September, 1993
to September, 1994 with activities planned to
implement the needed changes to achieve its
goals. The amount of Rs. 24.60 lakh has
^r,’Vided
tlle HudSel estimates
1993-74 for releasing grant-in-aid to the Council.
6.5.3 The scheme as referred to in the
ndian Medical Council (Amendment) Act
1993 has been notified on 29.9.1993 in the
form of the Establishment of new Medical
Colleges, opening of higher courses of study
and increase of admission capacity in Medical
Colleges regulations, 1993.
6.5.4 The scheme inter-alia provides for
permission ot the State Governments
affiliation of the University concerned"
availability of infrastructure in terms of
adequate buildings, equipments, teaching
staff, hostel facilities, attached hospitals
financial and managerial capability of
institutions for setting up of medical colleges
and expansion thereof.
6.6
Policy Regarding Establishment of
Medical Colleges
6.6.1
At present there are 146 medical
colleges in the country out of which 120 are
recognised by the Medical Council of India
and 26 are unrecognised,
Of the 120
recognised colleges. 98 are in the public
sector and the remaining are run by
trusts/private sectors.
The admission
capacity in the above colleges is about 14000
students per annum.
6.6.2 During the 6th and 7th Five Year
Plans, the policy of the Government has been
. not to open any new medical colleges in the
country as the turnout from present medical
colleges was considered to be sufficient to
meet the needs of the country. This, policy
continued up to 1991 when, it was recognised
that a large number of posts of doctors were
not only lying vacant in rural areas but there
was tremendous interest and pressure for
gaining admission into medical colleges. As
a result,
new colleges were getting
established
even
without
the
basic
infrastructure and facilities. In order to stop
the mushroom-growth of medical colleges,
the President ot India promulgated an
Ordinance on 27th August. 1992 to amend
the Indian Medical Council Act. 1956. The
above Ordinance has since been converted
138
■ i'-
o
into an Act on 2nd April. 1993. The main
provisions of this Act relate to seek the prior
permission of the Central Government before
establishing an institution imparting education
in medical science, increasing the intake of
students or introducing a new or higher
course of study.
6.7
Dental Council of India
6.7.1
The Dental Council of India is a
statutory body set up under the Dentists Act,
1948, with the prime objective of
i ' regulating
--’-o
dental education, the dental profession and its
ethic in the country . For this purpose the
Council Periodically carries out inspections
of the dental institution to ascertain the
standard of the courses and facil ities available
for imparting teaching of dentistry. During
the financial year 1993-94 up to November.
1993, 18 dental colleges in the country were
inspected. A sum of Rs. 19.00 lakh has been
provided as grant-in-aid to the Council in
1993-94.
6.7.2
An ordinance to amend the Dentists
Act, 1948 was promulgated on 27th August.
1992 by incorporating therein provisions for
prior permission of the Central Government
for establishing any new Dental Colleges,
for starting any new or higher courses of
study or training or increase in the admission
capacity in any existing college.
The
Ordinance has now been replaced by the
Dentists (Amendment) Act, 1993 on 2nd
April. 1993.
increase of admission capacity in dental
colleges regulations, 1993.
6.7.5 The scheme inter-alia provides for
permission of the State Governments,
affiliation of the University concerned,
availability of infrastructure in terms of
adequate buildings, equipments, teaching
staff, hostel facilities, attached hospitals,
financial and managerial capability of
institutions tor setting up of dental colleges
and expansion thereof.
6.8
Indian Nursing Council
6.8.1
The Indian Nursing Council is a
statutory body constituted under the Indian
Nursing Council Act, 1947. The Council is
responsible tor regulation and maintenance of
uniform standard of training for Nurses,
Midwives, Auxiliary Nurse-Midwives and
Health Visitors. The Council prescribes the
syllabus and regulations for various nursing
courses.
6.8.2 The inspection of Nursing Schools
and Examination Centres is done to maintain
uniformity and the requisite standards of
Nursing Education in the country. During
the year 1993-94 up to November 1993, 85
institutions were inspected. Work related to
vocationalisation of A.N.M. Course at 104-2
level and the proposal for amendment of
Indian Nursing Council Act, 1947 are
expected to be finalised during 1993-94.
6.7.3 The Council permitted four dental
colleges each to run BDS and MDS Courses
during 1993-94 (up to November, 1993). 18
inspections were conducted during this
period. Fee structure for the payment seats
in dental colleges have been recommended by
Dental Council of India in view of Supreme
Court order.
6.8.3 According to information collected by
the Indian Nursing Council, the total number
of qualified personnel is as follow:
6.7.4 The scheme as referred to the
Dentists (Amendment) Act. 1993 has been
notified on 25.9.1993 in the form of the
' Establishment of new dental colleges.
I opening of higher courses of study and
6.8.4 A provision of Rs.7.50 lakh as grantin-aid from ( entral Govt, had been made
during the year 1993-94 tor providing grantin-aid to the Council, as against the sum of
Rs.7.25 lakh released during 1992-93.
139
Nurses
: 3,40,208
A.N.M.
: 1,50,658
Health Visitors :
17.302
During the year the election tor the ottice ot
the president and vice-president INC was
held Prof. (Mrs.)C. Chandrakanthi became
new president and Smt. B. Bhattacharya
vice-president of the Indian Nursing Council.
6.9
Development of Nursing Services
6.9.1 Training of Nurses: The short term
Courses are conducted to help the teachers in
updating the knowledge in Primary Health
Care with special reference to Health Care
Delivery System. Proposals for conducting
these courses during 1993-94 are being
processed and funds will be released to the
States/UTs for this purpose.
69
6.9.22 Opening of 10 New Schools of
Nursing for SCs/STs: It is proposed to open
10 new schools of Nursing during the 8th
Plan period (1992-97). Project proposals
from States/UTs have been called tor to
provide the financial assistance tor opening
these schools.
i
I
The Council had approved 1661 institutions
in the
country for imparting practical
training to 5787 students. During the year
1993-94, upto Nov., 1993.
18 new
institutions were approved for conducting
diploma course in Pharmacy. An amount of
Rs. 10.55 lakh has been provided in B.E.
1993-94 tor releasing grant-in -aid to the
• -- v
Council.
6.10.3 During the year■ 1993-94, upto
November, 1993, 42 'inspections imparting
diploma and degree courses in Pharmacy
were carried out. The Council withdrew.^
approval of six institutions conducing
D.Pharm. Course and served notice for with
draw of approval of 8 institutions.
6.10.4 The Education Regulation 1991 was
made effective from the academic year
1993-94.
6.11
6.9.3 Nurses Colony: In order to Prov’^
better residential facilities to the Nurses, 500
residential units are proposed to be
constructed. A piece ot land measuring 10
Acres has been allotted for this purpose at
Sriniwaspuri in New Delhi.
All India Entrance Examination for
Admission to MBBS/BDS Courses1993
6.11.1 The Sixth All India Pre-Medical/Pre
Dental Entrance Examination was conducted
by the Central Board of Secondary Education
on 9th May, 1993 in respect ot the,15% seats
in Medieal/Dental Courses at 314 Centres
spread all over the country. The sale ot
bulletin of Information and application forms
6.10 Pharmacy Council of India
was done through 147 branches o Canara
Bank all over the country w.e.t.
6.10.1 The Pharmacy Council of India is a
in addition to the offices ot the Board X
statutory body constituted under the
Madras, Guwahati, Ajmer, Chandigarh an
Pharmacy Act, 1948.
The Council is
1.60,736 candidates were
Allahabad.
responsible for the prescription, regulation
registered out of which 1,37 871 appear^
and maintenance ot minimum educationa
the Examination. The results were declar^
standards for the training of Pharmacists
on 14th July, 1993. 1,558 candidates were
uniformally in the country. It prescribes the
placed in the merit list and 779 in the watting
syllabus, norms for the institutions and
list.
regulations for diploma course in Pharmacy ’
and undertakes the registration ot
6.11.2 In compliance of the directives ot the
Pharmacists.
Supreme Court ot India on 30th April, 1993,
the scheme tor allotment to 15% All India
6.10.2 At present,sthere are 247 institutions
seats was modified. In the year 1993, the
having an admission capacity ot 13930
allotments were made to the successful
students per annum and 52 institutions
candidates, by personal aPP^ance3 from 1st
imparting degree course in pharmacy with
August to 14th August. 1993 &. from 8th
admission capacity of about 2072 per annum.
140
B-
September to 13th September, 1993. The
candidates selected one ot the seats available
as per their merit position and allotments
were made in their presence through
computer and the same were displayed. By
this new process ot allotment all the available
seats were allotted to the candidates, as per
the selection made by them, by mid
September. The whole process ot allotment
and admissions to 15% All India seats was
over by 30th September. 1993. Government
of India spent about Rs.7.00 lakh to meet the
expenses for making allotments by personal
appearance.
-■■I
6.11.3 The Central Board of Secondary
Education met the expenditure on conducting
the Entrance Examination through its own
resources.
6.12
■
All India Entrance Examination for
Admission to 25% Post-Graduate
Seats Conducted by Al I MS, New
Delhi
6.12.1 in compliance; with the directive
of India on 25th
given by Supreme3 Court
C..
September, 1987, A.1.1.M.S. organised and
conducted the sixth All India Entrance
Examination for admission m various Post
Graduate Medical and Dental Courses
_ _____________
on All India basis
(MD/MS/Diploma/MDS)
for^25% of the total seats in recognised
MDS courses under 25% All India P.G.
quota for 1993. The whole allotment and
admission process to these seats was
The
completed by 15th October. 1993.
scheme for allotment to 25% All India P.G.
seats from the year 1994 has also been
modified by the Supreme Court ot India on
22nd April. 1993.
Under this modified
scheme the allotments will be made by
counselling from 1st March to 15th March
through the Computer in presence ot the
candidates. The candidates shall have the
right to select one ot the seats available at
their rank.
6.13
6.13.1 The National Board of Examinations
was initially established as a wing ot the
National Academy of Medical Sciences in
1975 and it became an independent entity m
1982 when the Board was registered as a
society under the Societies Registration Act.
1860.
6.13.2 The Board conducts post-graduate
examinations in medical sciences in 3)
disciplines (28 broad specialities and 11 super
specialities) of modern medicine at the
national level. The Board is thus natronal
level body helping in maintenance ot a high
uniform and standard of post-graduate
medical education and training.
Medical and Dental Colleges.
l
I
National Board of Examinations
6.13.3 The other main objective ot the
Board is the accreditation of various
institutions which provide adequate facilities
for specialist training to candidates. It also
maintains
protessiona
with
liaison
associations concerned with higher medical
education and promotes effective linkages on
a continuing basis among the academic
technical, evaluation, scientific and research
agencies working in the field of medicine and
other allied sciences.
6.12.2 The Entrance Examination was held
at 42 centres in 15 Capital Cities in the
country on 28th February, 1993. The date ot
entrance examination had to be postponed
from 24th January, 1993 on account ()f
disturbances in Bombay and Ahmedabad.
candidates
22 317
in the
appeared
examination
for
admission to
MD/MS/Diploma courses and MDS courses
out of the 26,379 registered. The result was
declared on 11th April. 1993 for enabling the
allotment of seats in 70 Medical and 1 1
Dental Colleges all over India, to the
candidates who qualified in the Entrance
Examination. There were 1866 seats in
MD/MS/Diploma Courses and 46 seats in
6.13.4 The Board awards qualifications
known as Diplomate of the National Board,
in the speciality concerned which is
recognised as e(|uivalent to post-graduate
medical degree. These qualifications are
141
f-
•;O
included in the first schedule to the Indian
Medical Council Act, 1956.
6.13.12 In accordance with the Government
policies to increase the facilities in rural
areas, it is proposed to give -thrust to the
accreditation of 100 bedded hospitals in
various parts of the country.
6.13.5 The examinations of the Board are
conducted twice a year in February and
August in 39 disciplines. 3710 candidates
have
qualified
in
these
prestigious
examinations till July, 1993. The following
are the results of the Board’s examinations
for the year 1992 till July, 1993.
PRIMARY
1
1
6.13.13 It is also proposed to give greater
encouragement to institutions specialising in
Family Medicine, which is of relevance in
the present Primary Health Care approach
based on equity of access and low costs.
FINAL
Appeared
Passed
Appeared
Passed
4575
2713
4231
828
6.14
National Academy
Sciences (India)
of
Medical
6.14.1 The National Academy of Medical
Sciences was
established in 1961 as
registered society with the objective of
promoting the growth of medical sciences. It
recognises talent and merit throughout the
country in the form of election of fellows
and Members of the Academy.
6.13.6 About 120Hospitals/Institutionshave
been accredited by the Board alter inspection
in various specialities.
6.13.7 The Board has created a well stocked
Question Bank in various disciplines.
Research on evaluation methodology has also
been carried out. Several structural reforms
have been introduced in the context of
Theory, Practical, Clinical and Viva-Voce.
6.13.8 The Board has taken steps to generate
a national debate on the need for uniform and
high standards in higher medical education in
the country.
6.13.9 Introduction of Thesis/Dissertation
has Ibeen approved as a compulsory
| requirement iin all subjects for candidates
I who have enrolled for training frc mi January
I 1991 session onwards.
6.14.2 As on 30th September, 1993, the
Academy had on its rolls 6 Hony. Fellows,
609 Fellows and 1113 Members. 28 Fellows
and 49 Members were admitted at the 32nd
Annual Meeting of the Academy held in
Delhi on 2nd
April. 1993.
The Prime
Minister of India, Shri P.V. Narasimha Rao,
was admitted as our Honorary Fellow of the
National Academy on the occasion of the
award giving ceremony. 8 Orations and 6
Awards have been instituted by the Academy
tor which medical scientists were selected
alter proper scrutiny for the year 1992-93.
6.14.3 CME Programme: To keep medical
professionals abreast with current problems
ot the country and update (heir knowledge in
fields for the required delivery of health care
and also help them in preparing for post
graduate examinations of various I universities
and National Board of Examinations, a
programme of Continuing Medical Education
(CME) is being implemented by the
Academy since 1992. as per pattern approved
bv the Government of India.
6.13.10 Training of trainers in order to
construct various types of MCQs and CME
programmes for the trainees of the Board
accredited
institutions
are
being
planned/conducted in various centres in
India.
6.13.11
The Board has also acquired
sufficient expertise in evaluation
and
examination technologies.
142
t-
rssrt
■
6.14.4 During the current year, upto the end
of September, 1993 various associations,
professional bodies and medical colleges have
been sanctioned financial assistance by
NAMS for conducting 23 Seminars /
Workshops etc.
-3
ii
6.14.5 The CME Programme also covers
Human Resource Development by sending
Junior Scientists to Centres of excellence
providing advance methods and techniques.
70
Medical
Scientists/Teachers have
completed training in selected areas at
various specialised centres upto 1992-93.
6.15
All India
Sciences
Institute
of
Medical
6.15.1 The All India Institute of Medical
Sciences, established by an Act of Parliament
in 1956, enjoys the status of an institution of
national importance.
It awards its own
continues to be a
degrees. The AIIMS
leader in the field of medical education,
research and patient-care in keeping with the
objectives of the Act.
6.15.2 The institute was* established to
develop patterns of teaching in under
graduate and post-graduate medical education
in all its branches so as to demonstrate a high
standard of medical education to all medical
colleges and other allied institutions in India;
to bring together at one place educational
facilities of the highest order for the training
of personnel in all important branches of
health activity; and to attain self-sufficiency
in post-graduate medical education.
6.15.3 'Die Institute is fully funded by the
Government ot India. For research purpose,
however, grants are received from various
sources including national and international
agencies. The Institute collects tees from
under-graduate and post -graduate students as
per prescribed schedules. While the major
part ot the services are free for the patients
coming to the AllMS hospitals, certain
categories ot patients are charged tor
treatment/services
rendered to them.
Specialised investigatiuns and sei vices are
143
charged at a subsidized rate.
6.15.4 Medical Education:
6.15.4 (i) Post-graduate Medical Education:
During 1993-94 (Jan.’93 Sc July’93) 100
students (in two sessions, i.e. for the courses
commencing in January, 1993 and July,
1993) were admitted to various post-graduate
courses i.e. M.D., M.S., M.H.A., M.Sc.
and to post-doctoral degrees like the Ph.D.,
M.Ch. and D.M. in various specialities of
medicine, surgery and non-clinical subjects.
Eight candidates belonging to the Scheduled
Castes and 5 belonging to Scheduled Tribes
got admission to the post-graduate courses.
The Institute provides full time post-graduate
and post-doctoral courses in 40 disciplines.
In the year under review 78 post-graduate
students qualified for various degrees. The
guiding principles in post-graduate training is
to train them as teachers, researchers and
above all as competent doctors to manage and
treat the patients independently. Eighty five
candidates from various organisations and
State Governments received short-term
training at the Institute during the year.
6.15.4 (i i) Under-graduate Medical Edu
cation : This year the Institute admitted 50
students to its MBBS course, 14 students to
B.Sc. Nursing (post-certificate) course, 39
students to B.Sc.(Hons.) in Nursing Course,
15 students to B.Sc.(Hons.) Human Biology
Course, 9 Students to B.Sc.(Hons) in
Ophthalmic Techniques, 3 students to
B.Sc.(Hons.) in Medical Technology in
Radiography and 3 students in B.Sc. (Hons.)
in Speech and Hearing.
6.15.4 (ii) (a) The MDBS course is spread
over five-and-a-half years, dividing the period
to one year for preclinical, one-and-a-half
year for para-clinical and two years for
clinical subjects, followed by one year of
internship.
In the curriculum of MBBS,
however, emphasis was laid on the rural and
community service. Paramedical courses like
B Sc.(hons.)
in
Nursing,
Ophthalmic
Techniques.
Medical Technology in
Radiography and Speech and Hearing
I
■ •Institute carry7 out research in
faculty of• the
..... ; to the
health-care
t..~ national
....
areas relevant
needs. The Institute provides a small grant
of about Rs. 12 lakh for research to the
junior members of the faculty. However, a much bigger research fund ot about Rs. 6
crore was received by the faculty from
national and international funding agencies
like Department of Science and Technology.
Indian Council of Medical Research, Council
of Scientific and Industrial Research,
Integrated Child Development Services,
Department of Environment, UNICEF, WHO
etc. The researchers also attract funds from
a number of reputed drug companies. These _
?
funds are received purely on merit ot the
research projects which are approved on
competitive basis. Some ot the frontline
research areas.are: liver diseases; diabetes,
iodine deficiency disorders, rheumatic fever,
AIDS,
malaria,
congenital
glaucoma,
leprosy, typhoid etc.
- and attracted students
continued to be popular
The curricula of these
mn'-’ant scrutiny by the
from other
Qmtinuine Medical Education:
6.15.4 (iii)
cd a numher ot
The Institute
fc,ia and conferences in
workshops, symp- various national and
c()|laboration wtn
year,
during the
international ag>n 1C
various institutions all
Professionals trom
participated in these
. and benefitted with
The members of the
i in
ms
ganised
by
other
CME programmes <’r;
the country.
medical colleges m i
S
I
as s“s'f
( Training for Scheduled Castes
6.15.4 (iv) the Scheduled Tribes (ST)
(SC) and The SC and ST candidates are
,
.-on. i.leration and weightage m
given d
the Government of India
accordance ^ 31! selections.
During the
guidelines in 13
SC/ST candidates were
current year'rhe post-graduate courses; 7 SC
selected for t..- .
. were selected to the
and 4 ST candidate.
SC/ST candidates were
3
MBBS course;
(Hons.) Ophthalmic
admitted to B.Sc.
SC/ST candidates were
Technique; 2
(Hons.) Medical
,,
B.Sc.
to
admitted
in Radiography/course; 1 SC/ST
Technology
Emitted'uf B.Sc. (Hons.) in
candidate was ai— • . course; 1 SC/ST
Hearing
Speech and
admitted to B.Sc. Nursing
candidate was
:: 10 SC/ST candidates
course:
Post-certificate
, B.Sc.(Hons.) Nursing
t()
were admitted
1—
SC/ST candidates were
course, and
(Hons.)
Human Biology
admitted| to B-Sc.l
the year.
('nurse during
i
6.15.7 Community Services: Community
services is an integral part ot the activities of
the Institute. The Comprehensive Rura
Health Services Project at Ballahhgarh and
Urban Health Centre at Malaviyanagar
continue to provide useful service at the
door-steps of the community
Besides.
Department of Obstetrics and Gynaecology
and Dr. R.P.Centre for Ophthalmic Sciences
have been actively involved in various
community health-care activities.
6.15.8 Dr. R.P. Centre for Ophthalmic
Sciences organised 5 major eye camps and in
12 Primary Health Centres eye check‘^
OPDs were held in and around Delhi. 5^0
Intraocular surgery and 3975 refractions were
conducted during the eye camp this year.
, |SS mternational Hole: The Institute
5 5
to provide consultancy services to
continue
countries under the;
several neig
i|ta ncies During 1993aeglT 'ins i u e trained 8 candidates from
various Shouting countries to fidfd ns
hrternational obligations.
AYv'Oo /r: Medical research is a vital
6.15.6
(d the inMitute ’s activities. I he
coinponeiit
144
6.15.9 In its effort to disseminate scientific
knowledge on prevention of disease and
community health education the institute
continues to organise public ketures o
various health problems for the benefit of the
common mass. This programme receives
commendable response both trom the public
and the press.
Accident and Trauma Care Complex under
the aegis of AIIMS has been planned. M/s
Hospital Services Consultancy Corporation of
India Ltd. (HSCC), a Government of India
Undertaking have
been
as
engaged
consultants for this project and the plans for
the same are in progress.
6.15.10 Patient Grc Services-. The patient
load on the AilMS hospitals is ever
increasing. During 1993-94, the rising trend
is obvious.
6.15.11 During 1992-93 the OPDs of the
Main Hospital attended to 1146023 patients
and admitted 54013 patients. A total number
of 75686 surgical procedures
were
conducted. During the period from April to
June (1993) the mainihospital of the Institute
attended to 259764 patients in the OPDs and
admitted 13478 patients.
6.15.17 A sophisticated Nuclear Magnetic
Imaging
facility,
Resonance
(NMRI)
consisting of both the research and diagnostic
models, was commissioned during the year.
The research model was commissioned in
March, 1993 while the diagnostic unit was
commissioned in October. 1993.
6.15.12 During 1992-93 the OPDs and
Clinics of Dr.R.P. Centre for Ophthalmic
Sciences were attended by 147212 patients
and .5002 patients were admitted. A total
number of 6129 surgical procedures were
conducted for various eye ailments. During
the first six months upto September, 1993,
the Centre’s hospital attended to 135855
patients in the OPD and admitted 5002
patients.
-
6.15.18
The Institute has taken up the
expansion work of the Institute Rotary
Cancer Hospital (IRCH). The construction
of the 1st floor of the IRCH building for
establishment of a Surgical Oncology Unit is
in progress.
The Government has also
allocated funds for developing the Bone
Marrow Transplant facility at the IRCH.
During the current year the
6.15.13
Neurosciences Centre and Cardiothoracic
Centre made tremendous progress both in the
quality and quantity of their performance.
During the first six months of the current
year (1.4.1993 to'30.9.1993), the C.N.
Centre conducted 453 heart operations while
the N.S. Centre performed 594 procedures.
The Cardiothoracic Centre attended to 35587
patients while the Neurosciences Centre
attended to 25357 patients in their OPDs
during this period.
6.15.14
The Institute-Rotary Cancer
Hospital attended to 18453 patients in the
OPD and admitted 2940 patients. During
this period 1521 cancer-related surgery were
undertaken.
6.15.15 Budget: The AIIMS is fully funded
by the Government of India. For 1993-94.
the Government has made an allocation ot
Rs. 4725 lakh in Non-Plan and Rs. 2595 lakh
in Plan expenditure.
6.15.16 Innovation: A project to establish an
i
145
6.15.19 The Department of Gastro-Intestinal
Surgery is busy in finalising its plan tor
starting Liver Transplant Programme, for
which Government ha.s already allocated
funds.
The transplant programme will
commence only after the Bill on Organ
Transplantation is passed by the Parliament.
6.16
F’ost-Graduate Institute of Medical
Education and
Research,
Chandigarh
6.16.1 The Post-Graduate Institute of
and
Medical
Research,
Education
Chandigarh, offers courses leading to the
award of degrees of B.Sc. Medical
Medical
Technology,
M.Sc.,
M.Sc.
Technology, D.M.. M..Ch., M.D., M.S..
M.D.S.. Ph.D. etc. As on 31-10-93. a total
of 3371 residents have completed their
training and obtained their Post-graduate
qualifications. On 31-10-93. there were 521
candidates on the rolls of the Institute
pursuing MD/MS. DM/M.Ch.. Ph.D. and
M.Sc. Courses, 16 candidates were on the
rolls for different M.Sc. Medical Technology
Courses, 81 tor B.Sc. Medical Technology
Hypertension. De-addiction from drugs;
diagnosis and treatment of genetic disorders
are also being carried out. Prevention and
treatment of diseases to which the Scheduled
Castes and Scheduled Tribe communities are
(X-Ray Si.
Laboratory),
15 for B.Sc.
(Audiology and Speech Therapy)Courscs and
9 for Operation Theatre Assistant Course.
The College of Nursing affiliated to the
Punjab University, has on its rolls 36
candidates for B.Sc. Nursing (Post basic).
173 B.Sc. Nursing (4 years course) and 20
candidates for B.Sc. Nursing Courses.
I
prone, are being studied by several workers.
The Institute is equally -involved in research
for the
rural and
community related
environment and health problems.
The
Institute has been recognised by the National
AIDS Control Organisation. New Delhi, for
investigative survey of AIDS. Several papers
based on these research findings have been
published in leading scientific journals and
6.16.2 The Nehru Hospital attached to the
Institute has a bed strength of 980. During
the year
1992-93. the registration of
inpatients and outpatients was 32.671 and
8.03.456 respectively.
presented at
national and international
conferences.
Faculty Members have been
invited to deliver prestigious guest orations,
based on their work. The faculty members
have been awarded prestigious research
awards by the Indian Council of Medical
Research. Medical Council of India. New
Delhi, in recognition of their outstanding
achievements of research.
6.16.3 Research work is in progress in
various departments of the Institute.
174
Research Schemes were funded by the
Institute; over 45 by the Indian Council of
Medical Research, New Delhi; 60 by the
Council of Scientific and Industrial Research.
New Delhi; 4 by the Department of Atomic
Energy.
BARC,
Bombay;
4
by
the
Department of Biotechnology, Government of
India, New Delhi; 3 by the National Institute
of Immunology, New Delhi; 2 by the Indo
6.16.5
The Institute has been holding
seminars, symposia and continuing medical
education programmes for updating the
knowledge of the faculty as well as the
Medical Teachers hailing from the Regional
and National Medical Colleges.1
UK Collaboration Programme; 2 by the Indo
US
Collaboration Programme; 1 by the
Indian Council of Social Sciences Research.
New Delhi;
12
by the Science and
Technology Council. U.T.. Chandigajh; 2 by
the Science and Technology Council, Punjab.
Chandigarh; 1 by the Science and Technology
Council, Haryana, Chandigarh; 1 by the
6.16.6 The approved budget estimates for
Non-Plan and Plan for the year 1993-94 are
Rs.2940 lakh and Rs. 1700 lakh respectively.
The Governing Body of the Institute was
Potash and Phosphate Institute of Canada
(Indian Programme). New Delhi. Thus a
total of 310 research schemes are being
carried out by the Members of the Faculty of
the Institute during the year 1993-94.
reconstituted on 15.1.1993.
6.16.4 Basic as well as applied research is
being undertaken at the Institute on several
National
priority
areas;
such
as.
Malnutrition-Vitamin A deficiency. Leprosy,
Amnebiasia. Cancer.
Diarrhoeal Diseases,
Malaria. Filaria. Hepatitis. Family Planning
Anti-fertility
Programme,
Vaccine.
Eradication of Blindness. Rehabilitation of
the Disabled.
Research Programmes on
Rheumatic Heart Disease, Rheumatic Fever.
I
I
l-U)
(i)
A new unit of C.T. Scan has
become operative; at the Nehru
Hospital. P.G.L. Chandigarh;
(ii)
A
new
Sophisticated
Instrumentation Centre has been
established at a cost of Rs. 3 crore
to provide a boost to research
work at this Institute;
(iii)
Computerisation of services at the
Institute is being introduced in
I
expansion of the Emergency Block
are slated to begin within a tew
weeks; and
phases and a large number ot statt
members have been imparted
elementary training in computer
use;
A modern library building has
already been completed which has,
interalia, the tacilities tor central
air-conditioning and computerised
literature research;
^iv)
(v)
The new Audiometry Laboratory
of the Department ofENT is ready
for commissioning;
(vi)
The work on the Dental Centre is
at an advance stage and is
expected to be completed within 4
weeks;
(vii)
r
(XV)
48 Flats for married residents and
32 houses for other categories ot
employees have been completed;
(viii) 60 New beds have started
functioning in the space vacated by
the army authorities;
(ix)
(x)
t."
The Physiotherapy Department has
to a new spacious
moved
accommodation;
The equipmenti to the Central
Sterile ' Supply Department has
be«n augmented,
(xi)
The entire equipment for
laundry has been replaced;
(xii)
and
~ • Air-conditioning Plant
The
Kiant anu
oxygen supply system are
t. - in the
process of being augmented;
the
a
(xiii) Thei construction works of
for
multi-storeyed building
Advance Paediatric Centre has
been started;
I-
(xiv) The construction of the new OPD
Block of the Nehru Hospital and
a
6.17
A Block of Sarai for the attendants
of the patients has been completed
and is being commissioned;
Jawaharlal
Institute of PostGraduate Medical Education and
Research, Pondicherry
6.17.1 Jawaharlal Institute of Post-Graduate
Medical Education and Research, popularly
known as JIPMER. is a Central Government
Institution under the Ministry ot Health and
Family Welfare.
6.17.2 Aims and Objectives: The Institute has
been established with the main objective ot
developing patterns of teaching in Under
graduate and Post-graduate medical education
so as to demonstrate a high standard ot
medical education to all medical colleges and
other allied institutions in India. The broader
objectives of the Institute Hospital are to
extend to the people of Pondicherry and the
neighbouring areas a comprehensive service
in the field of medical care to impart rura
orientation and emphasise the preventive and
promotional aspects of community health and
to integrate family welfare with the general
package of health and nutritional services.
6.17.3 Clinico-Pathological exercises are
held every month to discuss interesting cases
with diagnostic problems. The Medical Care
Review Committee meets every month to
discuss statistics of investigative and clinical
departments with particular emphasis on the
review of medical care rendered to the
patients vis-a-vis death cases.
6 17 4 Installation of Heart Lung Medicine,
Laser Equipment, 2-D Ultra Sound Scanner
& Auto Analyser and the features of the
Hospitals for the patient ^re. One whole
body C.T. Scan and one Cobalt Tele-Therapy
Unit are procured and to he installed.
147
I
6.n
HOSPITAL STATISTICS AT A GLANCE
6.1
Insi
ach
giv
I si Oct. 92
to
5/.vz Moc. 93
1st Apr. 93
to
30th Sep. 93
l.No. of Out-Patients
Attendance
588622
608240
2.Out-Patient daily average
4004
4082
859
859
3.Hospital Bed Strength
16022
4,Total No. of admissions
16051
5.Total No. of discharges
(In-Patients treated)
749
6.Total No. of deaths
96.8%
7.Bed occupancy rate
893
8.Daily Average of
In-Patients
19239
9.Total No. of Operations
10.Total No. of Out-Patients
attendance in Rural
Health Centre. Ramanathapuram. Sadarapet and
Coodapakkam
17846
11.Total No. of Out-Patients
attendance in Urban
Health Centre.
Kurichikuppam
12341
17362
17258
725
97.7%
900
21304
17497
12885
1
148
1.
2,
3
4
5
6
(
I
1
1
Si
fei
fti
M.Ch.(Cardiac-Thoracic &
Vascular Surgery)
M.Sc.(Medical Biochemistry)
B.Sc. (MLT)
B.M.R.Sc.
M.R.O. Training
M.R.T. Training
French Certificate
6.18 Family Welfare
On the Family Weitare
too, Jthe
weitare mu,
6.18.1
u.c
Institute has done excellently well. The
•••achievements of Family Welfare activities are
given below:
1st Oct. 92
to
31st Mar. 93
1st Apr. 93
30th Sept.93
1. Tubectomy 534
2
2. Vasectomy
93
3. l.U.C.D.
4
4. Oral Pill
11 Users
5. Condoms
76
6. M.T.P.
635
3
HI
10
13 Users
73
In addition, emphasis is laid
iaiu on
6.18.2
Education
Re-orientation
and
------EHealth
Additional feature is
Programmes,
of
Natural
Family Planning
promotion (
methods.
5
■
6.18.3 Academic Achievements: The Institute
affiliated to Pondicherry University conducts
both under-graduate and
medical courses viz. MBBS. M.D./M.S. &
Diploma Courses.
The Inst'tut* alst’
conducts Post-Doctoral Courses M.Ch. in
the subjects of Genito-Urinery Surgery and
Cardio Thoracic & Vascular Surgery and
other Para-Medical Courses such as M Si.
(Medical Biochemistry) BScJ,'
B M.R.Sc. etc. Medical Records Officers &
Medical Records Technicians Courses
Diploma and Certificate Courses in French
language are also being conducted in the
Institute. The results of the students in the
various courses have been excellent during
this year also.
6 18 5 Facilities for Scheduled Castes and
Scheduled Tribes: In all the Under-graduate
and Post-graduate Courses conducted by the
Institute, reservations for Scheduled Caste
and Scheduled Tribe candidates as per
standing orders have been strictly to low^
Likewise on the recruitment side also, the
percentage of reservation of posts or
Scheduled Caste and Scheduled Tribe
candidates have been adhered to. There
also a separate book bank for SC/ST students
in the JIPMER Library. The book bank is
very popular among the SC/ST students and
they are given maximum benefit and help
from this bank.
6.18.6 Guest Lectures and Distinguished
Visitors’ As a part of Post-graduate training
programme, eminent Professors in various
specialities visited the Institute and delivered
lectures and also participated in Seminars and
Symposiums which are of high academ.c
value.
6 18 7 Research: Research forms an integral
part of teaching and training. The Institute
has undertaken a number ot research projects
duly approved and financed by the University
Grants Commission and Indian Council of
Medical Research. During the period under
report a number of Research papers have
been published and also presented in the
various Conferences. Seminars etc. by the
faculties.
6 18.8 A comprehensive Health Care Mobile
Clinic Camps were held in 22 villages
catered to by Primary Health Centres adopted
by the Institute under the Re-onentation of
Medical Education Programme.
6.18.4 The total number of students
students on roll
as on 30th September. 1993 are as follows:
M.B.B.S.
Post-graduate M.D./M.S.
Degree/Diploma
M.Ch.(Genito-Uriner surgery
4
17
32
5
2
12
75
375
1X2
4
6.18.9 Specialists from the Departments ot
149
Medicine, Surgery Paediatrics, Dentistry,
ENT
Obstetrics & Gynaecology,
Dermatology and S.T.D. Ophthalmology and
Community Medicine participated in the
camps and provided health care to 8432
patients. Minor Surgery was performed tor
19 cases 79 Dental Extractions were carried
out. In addition to the above, puppet shows
were also arranged in these villages.
6.18.10 Ante-natal coverage and tetanus
toxoid immunisation in the Union Territory
of Pondicherry is very high. During the
Mobile Clinics only such of those mothers
who had not received immunisation or
ante-natal care were examined and given the
appropriate dose ot Tetanus Toxoid.
Re-orientation anu
and training
6 18 11
Re-onentation
programme in the modern educational
technology are routinely arranged for
students and residents.
6 18.12 Library: The Central Library ot the
Institute is well equipped with the latest
books and journals. An amount of Rs. 28 W
lakh has been projected in the Revised
Estimates for 1993-94 for making purchases
of books and journals for Library. It has a
total collection of 28221 books and it
subscribes for 21718 journals at present.
I
6 18 13 Campus: J1PMER has a residential
campus with 8 hostels separately for gents
lady students, resident doctors and nurses. A
new hostel constructed for lady residents was
opened recently to accommodate P.U
Students/Doctors. Quarters of different types
for different categories of staff and a separat
Guest House are also available.
I
6.19
6.19.1 The Lady Hardinge Medical College
& Smt. S.K. Hospital was established in the
year 1916 with the main object of providing
higher education for women, medical care for
women and children and training of women
as Nurses. The Lady Hardmge Med.cal
College, Smt. S.K. Hospital alongwtth
Kalawati Saran Children’s Hospital was taken
over by the Government of India with effect
from 01.02.1978 in pursuance of die
provisions of the LHMC and Hospital
(acquisition) and Wise. Provisions Act, 1977
The Kalawati Saran Children s Hospital was
established in 1956. The two Institutions are
now functioning as Subordinate Offices of the
Directorate General of Health Services.
6 19 2 Lddy Hardint’e Medical College. The
College is affiliated to the University of
Delhi and offers instructions in MBBS an
Post- graduation in various disciplines. I he
College has completed its 75 years of
existence.
6.19.3 For the academic year 1993-94, the
number of students adm'tted for MBBS
Course is 122 (includmg 19 SC and 10 STy
The total number of post-graduate students
and under-graduate students at present on r H
is 163 and 807 respective^ There ars*
SC and 51 ST students on the rojls of the
Institution. For the under-graduate course
foreign students including 'r0^
Commonwealth countries under Gwera.
Cultural Scholarship Scheme and self
financing scheme are also admitted.
6 19 4 School of Nursing: The School of
Nursing run by the Institution Ulfitted
90 students including 6 students f
.
At present total number ot stqdtntl °n
.
260 including students from
countries. Students from Dr.
Lohia Hospital are given ■ practicaljaWnfi
for midwifery. It also
training to the students ot
A
Health School and R.A.K. ColltP
Nursing. New Delhi.
6.18.14 Budget:
(Rs. in lakh)
Plan
Non-Plan
RE 1992-93
BE 1993-94
Rs. 687.90
Rs.1349.72
Rs. 690.00
Rs. 1398.00
Lady Harding Medical College
and Smt. S.K. Hospital, New Delhi
150
0
I
'§)• I
B
(v)
Patient Care, Teaching Under
graduates and Post-graduate
Students, Research and Extra
Curricular Activities.
Police (Autopsies):PostMortem facilities for the
Zones which have been
allocated to this Hospital.
(vi)
24 hours emergency with
surgical facilities2
(vii)
l.C.U.:h modern intensive
care unit is functioning under
the Department o f
Anaesthesia, with all
and
required facilities
attached laboratory.
6.20
1
Foreign dignitaries.
6.19.5 The Hospital provides 750 hours of
practical training to the students of college of
Pharmacy.
6.20.1 The total bed strength of Smt. S.K.
Hospital, at present is 836. The Kalavati
Saran Children’s Hospital has a bed strength
of 380 including 25 beds in emergency and
intensive care. This Hospital has a full
fledged department of Physical Medicine and
Rehabilitation for imparting curative,
preventive and rehabilitate services to
handicapped patients.
(viii I
Drug Dc-Addiction Unit .This
unit transferred
from
Safdarjung Hospital on
18.01.1989
is having
sanctioned strength ot 30
beds. Now it is functioning
with 20 beds. This unit is
designated centre, set up by
the Govt, of India for early
detection and treatment of all
types of addictions and is
open to males and females
with both indoorand outdoor
facilities.
(ix)
One accident &: emergency
unit created in 1991. has
been providing excellent
services.
6.20.2 These two hospitals, alongwith
additional beds for clinical units in Medical,
Surgical and Ortho Surgery at Dr. RML
Hospital (having 70, 60 and 20 beds
respectively) provide training to students on
female, male and child patients. Modern
equipments to meet the requirement ot time
is being installed in various departments of
the Hospital with a view to make it a fully
equipped hospital.
6.20.3 Special Services Given in the Hospital:
The Institution provides following round the
clock special services in addition to the
routine patient care and Laboratory Services.
(i)
E.C.G.
('•)
X-Ray Service in S.K.H. &
The 24 hrs. Biochemistry.
Laboratory commissioned in
is
the Nev/ Building
functioning properly.
(x)
K.S.C.H.
(iii)
Laboratory Service :
Blood Bank
Haematology
Biochemistry
(iv)
Embalming of Dead
Bodies.This Hospital
provides embalming service
for practically th* whole of
Delhi, especially for VIP and
(Xi)
<xli)
The Nursing Home,, which
was renamed in 11991 is
functioning properly.
Ultrasonograph has been
installed In the labour room.
Antirabies and ,Diabetic
clinic started with available
resources.
131
&OV-|CrO
O Id-6 83
I ■
...
f-
(xiii)
(xiv)
(xv)
(xvi)
Laboratories o! the Ho'.pital
have been upgraded with
installation
of latest
electionic equipments i.e.
LI ISA.
Auto
Analyser.
Echocardiogram Tread Mill
etc
College auditi'rium is being
national
&
used for
international conferences to
update medical information
among professionals.
un
3. Indoor
Admissions
I
3
28666
3,61.860
1.52.193
a. New
h. Old
2.35.135
1.26.725
74.180
78.013
152
I
Tr
M;
9,037
Ot
M
D(
Te
10,522
Minor
3.961
6,561
5. Deliveries
9,028
6. Abortion
1.343
7. N T Ps
1.31 1
8. Sterili
sations
1.771
9. I.C.D.
1.058
lO.Nirodb
3.15.303
Vi
6.'
in’
an
to
tn
St
6.
Wi
K
H
Bi
D
6.
1.557
u
is
c;
b
P
12.T.T. Immunisations
K.S. C.H.
2. O.P.D.
Attendance
22.100
a. Patients
h. New Borns
1 I .Oral
Pills
6.20.5 Medical Aid was provided io rhe
patients in SSK Hospital and K.S. C. Hospital
as under:
1. Casualty
17967
Attendance
(144 MLC Cases)
B.
Major
Expansion of infrastructure
in Deptt. of Radiology is
done to provide more
rad iod iagnost ic equipments.
9
.31,137
4. Operations
(Indoor)
6.20.4 Performance: The Institution is
actively involved in Government Health
Service and has played an active role in
implementing the National
Health
Programmes of the Govt, of India, for the
people of Delhi and its adjoining areas.
1
2
1
Additional operation theatre
for MTP. sterilisation and
caesarian operations is added
to improve family welfare
programme.
S.S.K
K.S.C.H.
S.S.K
6J
im
on
1st Dose
I Ind Dose
5.383
2.717
1 3 Total No. ot
X-rays done
43.775
22.663
14.Total No. ot
Special X-rays
15.240
done
3.774
15.1 lira sound
investigations
done
2.990
(
6.20.6
This Institution has undertaken
immunisation coverage through LIP and EPI
programmes.
w.LC.'.O
Immunological laboratory
6.20.10
established in 1986 is carrying the research
work on:
1.
2.
3.
4.
The total number vaccinated is as
under:
B.C.G.
Mantoux
Triple Antigen(DPT)
Oral Polio
Measles
Double Antigen(DT)
Tetanus Toxoid
Vitamin A
I
4,779
6,778
10,117
11.719
2.428
878
151
4,009
The College and1 Hospitals are
6.20.7
therapy
imparting training in oiccupational
.
and physiotherapy to students of the Institute
fTthe Physically Handicapped. Similarly
training is being provided to the Pharmacy
Students and to Dieticians.
6.20.8 3,55,375 and 1,32.588 investigations
were performed in Smt. S.K. Hospital and
K.S.C.H. in Cytology, Chemical Pathology,
Haematology, Surgical Pathology. Clinical
Biochemistry, Pathology and Microbiology
Departments during the year 1993 (upto
September. 1993).
6.20.99 Blood Bank'. 4,163 units of blood
and 5,608 units of blood were
were collected
t
issued in 1993. Voluntary blood donation
___ oirganised by this Institution.
camps were
Wood collected was used tor the needy
patients.
6.20.9 (i) The college is a:
a.
WHO collaborating centre for
training:
1n
reference
and
disease
1from
streptococcal
September.
1989 ICMR Advanced
___
Centre Laboratory for Studies in
streptococcal diseases.
h.
Advanced centre tor research on
Rheumatic and Rheumatic Heart
Diseases.
■
Shigellosis
Toxoplasmosis
Herpes
E. Coli
Conferences:
6.20.11
organised/attended:
Conferences
Workshops
Lectures/Papers
Seminars
Camps
Symposia
6.21
This
Institution
12
8
9
15
10
3
Mahatma Gandhi Institute
Medical Sciences, Sewagram
of
The Institute was set up m
6.21.1
commemoration
ot
Mahatma
Gandhi
Centenary Celebrations in 1969. It has at
present an annual admission capacity ot 64
students. It is the first and only medica
college in the country to be located in a rural
surrounding and exposes the students to the
health problems of the rural areas.
I he
Institute has a teaching hospital, Kasturba
Hospital being the only hospital, to be started
by Gandhiii. Father of the Nation, with 501
beds with excellent diagnostic and curative
facilities and has adequate base for under
graduate and post-graduate training and
research. The Institute is administered by the
Kasturba Health Society registered under the
Societies Registration Act, 1860.
6.21.2 The Institute has developed various
innovative programmes such as Extended
Internship Training Programmes, a General
Out-Patients Department (which is like a
PHC in the teaching hospital with reterral
facilities). Health Insurance Schemes, etc. to
give exposure to the students regarding health
and the related problems ot rural areas.
Students and faculty wear Khadi, attend
prayers every Friday and emphasis is on
153
character building, simple living and dignity
of labour. Students and faculty come from
all over India.
F
6.21.3 According to the pattern of financial
assistance, the annual expenditure ot the
Institute is shared amongst the Government
of India, Government of Maharashtra and the
Kasturba Health Society in the proportion of
50:25:25. The Central Government released
grant-in-aid Rs.250 lakh to the Society tor
the maintenance of the Medical College
during 1992-93. During 1993-94 Rs 125
lakh have been allotted to the Institute for the
first two quarters of the year.
1
F
%
All India Institute of Hygiene and
Public Health, Calcutta
6.22
i
i
6.22.1 All India Institute of Hygiene &.
Public Health, Calcutta, one of the pioneer
Institutes in the field of Public Health in the
country, was established on December, 30.
1932 with the following aims and objectives
I
!
1
i)
To develop manpower in the field ot
Public Health in the country by
post-graduate training
providing
facilities;
di
6.
6.22.4 The Institute has a well-qualified and
highly experienced teaching faculty. At
there
academic
present,
are
eleven
departments in the Institute each headed by a
Professor or an Associate Professor.
6.
C
in
hi
tc
st
R
al
6.22.5 Manpower Development: During the
year, the Institute conducted one Doctoral
Degree Course, two Master’s Degree
Courses, seven Diploma Courses, onef^
Certificate
Course and man
orientation/refresher training programmes.
The teaching and training programmes
undertaken by the Institute are aimed towards
development of manpower in the field of
Public health and provide facilities for
various disciplines, e.g. medical doctors,
epidemiologists, microbiologists, nurses,
nutritionalists, dieticians, health educationist,
health
statisticians, veterinarians,
demographers, social scientists, etc. During
the year 1992-93, 42 students were registered
in Masters and Degree Courses, 149 in
Diploma Courses and 496 in Short- Courses
for training.
6
6
Ii
I
c.
tl
6
5
u
o
o
(:
I
(
6.22.6
Research: A large number of
research projects are in operation during the
year. These schemes have been funded by
the Central and State Governments and also
by the National and International agencies.
The on-going projects concern important
environmental and
areas of health,
occupational hazards and nutritional status of
children and tribal women.
ii) To conduct research relating to
various health problems and diseases
in the country; and
iii) To undertake operational research to
develop methods for optimum
utilisation of health resources and
application of the findings tor
protection and promotion of health
care services.
i
i
C
K
6.22.7
Services: The Institute provides
regular service to the people through its
urban and rural health centres. In addition,
the Institute provides technical
consultative services to various state
Governments, industries and organisations
throughout the country.
6.22.2 Since its inception, the Institute has
been engaged in post-graduate teaching and
research in various disciplines ot health and
related sciences to fulfil the above objectives.
J
A
administrative assistance is provided by an
Additional Director and an Administrative
Officer, who are supported by four office
superintendents and ministerial staff.
6.22.3 Institutional Set up: The Institute is
headed by a Director who looks after all
research and academic
administrative,
organisation
management of the
i
6.22.8 The Institute has been engaged as one
of the vaccinating Centres for yellow fever.
154
I
•A
4
....
L
•
■■
About 400 persons have been vaccinated
during 1992-93.
Ve
fee
6.23
id
\t
The Rural Health Unit
Training Centre, Singur
and
6.23.1 The Rural Health Unit & Training
Centre (RHU&TC), Singur , one of the oldest
in India, was established in 1939 with the
help of Rockefeller Foundation with a view
to provide a model tor comprehensive health
service to the rural population.
The
RHU&TC at Singur covered a population of
about 82 thousand in July, 1993.
ic
a
le
d
e
e
k
6.24
Urban Health Centre, Chetla
6.24.1 The urban practice field area ot the
Institute was established on 30th December,
1955. It covers an area of 3.9 sq. km. and
caters to an estimated population ot more
than one lakh.
6.24.2
Technical and Consultancy
Services:Technical and consultative services
to various State Governments, Industries and
other organisations were provided by several
other departments of the Institute.
6.24.3 Centres of Research and Studies: The
Institute is recognised as a Regional Centre
(Eastern and North Eastern Zone) for setting
up laboratories under National Drinking
Water Mission, Department of Rural
Development, Government of India. It also
continues to act as a WHO collaborating
centre for water supply and sanitation.
6.24.4 The Institute is acting as Regional
Surveillance Centre for Viral Hepatitis in
North Eastern States. The Department ot
Microbiology and Epidemiology are jointly
responsible for surveillance ot Viral
Hepatitis. Further, the Institute has also been
earmarked as Regional Surveillance Centre
for Japanese Encephalitis in North Eastern
States.
6.24.5
t
A WHO Collaborating Centre for
Disaster Preparedness has been set up in the
Department of Preventive and Social
Medicine of the Institute in March, 1993
under the auspices of WHO. This is the only
centre of its kind established in the
South(East) Asian Region.
6.24.6 The AIDS Surveillance Centre of the
Institute will be actively engaged in
identification and study ot the AIDS prone
segments of the population and in collection
of valuable information on various socio
economic aspects of their lives and attitudes.
A difficult task of surveying the red-light
areas of Calcutta has been undertaken and
much headway has already been made in this
matter.
6.24.7 Planning for Future Development of
the Institute'. For expanding activities ot the
Institute in future, there is an urgent need for
a new campus as the present campus does not
provide much scope tor expansion tor adding
several new departments and Courses Oi
Social and Public Health. In order to meet
this long felt need a plot of land has already
been acquired in the Salt Lake City, Calcutta.
Action has been initiated for developing the
architectural plan ot the building to be
constructed.
6.25
Central Leprosy Teaching and
Research Institute, Chengalpattu
6.25.1 This Institute is functioning as an
apex Centre for training of leprosy staff in
the'country. It was takeji over by GOI in
1974 with the objective to provide training to
leprosy staff, referral services to the leprosy
patients and to conduct operational field
research in leprosy.
The Institute has
separate wings of epidemiology, clinical
medicine, orthopaedic and reconstructive
surgery,
micro-biology laboratory,
monitoring and evaluation and administration.
The Institute has 31 Group ’A’ level posts
sanctioned and bed capacity ot 125 patients.
The'Institute is fully equipped with modern
operation theatre. The following categories
of NLEP staff are being provided training:
District Leprosy Officers, Medical Officers,
155
Su.gcn.s,
Surgeons Non-Medical Supervisors. Lab.
Technicians, Physio-technicians and Smear
Technicians.
l
6.25.2 The Progress in respect of training,
services to the patients referred and field
research has been very good The budget
estimates for the year 1993-94 is Rs 29 lakh
(Plan) and Rs. 111.25 lakh (Non-Plan).
6.26
Regional Leprosy Training and
Research Institute, Raipur,
Madhya Pradesh
6 26.1 The Institute was established in the
year 1979 with the objective to provide
training to leprosy staff, services to referred
leprosy patients and to conduct operationa
field research. The Institute has 75 hospitals
bed capacity, OPD facilities and field area
covering 1.56 lakh population. There are 11
sanctioned posts of Group A faculty m he
Institute The Institute has been conducting
training of following categones of leprosy
staff-Para-Medical Workers. Non-Medma
Supervisors, Lab. Technicians and Medical
Officers. The achievement of the Institute in
training of staff, providing services to the
patients and field research has been good
The Institute has hostel facility <
accommodate 30 trainees at a time
I he
Institute has a separate department of Public
Health, Bacteriology and Surgery.
i
I
I
i
lying vacant. New training and hostel block
has recently been added. The categories of
leprosy staff being trained at this Institute are
as under:
6 27 2 Metlical Officers, Non-Medical
Supervisors, Para Medical Workers,
Laboratory Technicians. The achievement of
the Institute in providing training and referral
services has been satisfactory. The other
operational field research components require
improvement.
6 '>7 3 The budget estimate for the year
]993.94 is Rs. 1.15 lakh (Plan) and Rs.
24.20 lakh (Non-Plan).
Regional Leprosy Training and
Research Institute, Gouripur,
Bankura, West Bengal
6 28.1 This institute was established in the
year 1984 with the objective of providing
'training to leprosy staff, referral services to
leprosy patients and operational field research
in leprosy. After negotiations in the late 70 s
Government. of India and Government of
West Bengal has signed an agreement in
December. 1983 to set up this Institute by
handing over the building and hostel to the
Central Government by the Ma
Government. The handing over the budding
and the land has not been completed I he
State Government and the employees
continue to occupy the premises^
lhe
Institute at present has a hospital with 50 bed
6 26 2 The Budget estimates for the year
capacity for admission of patients and it a .
,993.94 is Rs. 20.5 lakh (Plan) and Rs.
provides OPD services. One lakh tie d area
32.00 lakh (Non-Plan).
population has been adopted
demonstration of field work to the tramecS.
Regional Leprosy Training and
6.27
The hostel accommodation is very lim
Research Institute, Aska, Ganjam,
accommodate eight trainees at a time Ju <
Orissa
13 sanctioned Group ’A’ faculty posts. 4 a t
vacant.
The Institute is providing training <
6.27.1 This Institute was established in 1977
the Para-Medical Workers. Non-Medcal
with the objective of providing training to
Supervisors and Laboratory
leprosy staff, referral services to leprosy
Special training courses tor Medical
patients and operational field research in
are also arranged occasionally.
leprosy.
The training faculty ' posts
6 ^8 2 The budget estimate toi the year
sanctioned consist of a Director, a CMO.
,993.94 is Rs. 41.30 lakh (Plan and nil
Surgeon, a Pathologist, a Senior Mec c.I
officer and a General Duty Medical Ottlcer.
under Non-Plan)
The posts of Surgeon and Patho.ogist are
6.28
156
6.2<
6.21
of
194
Mil
a
Un
gr<
Nu
ad1
ed
an
6.
C(
C<
M
P<
N
K
O'
s<
6
h
[
F
(
6.29
Raj Kumari Amrit Kaur College of
Nursing, New Delhi
6 29 1 The Raj Kumari Amrit Kaur College
of Nursing New Delhi was established in
1946 as a subordinate organisation ot
Ministry of Health and Family Welfare, it is
a teaching institution and affiliated to
University of Delhi. It conducts under
graduate and post-graduate courses in
Nursing. Besides, the College also provides
advisory and consultative services on nursing
education matters to States, Union Territories
and to some of the developing countnes too.
and other related health organisations.
6 29.7 The Rajkumari Amrit Kaur College
of Nursing has a Sub-Centre at Chhawla
Village, about 35 Kins, away trom the
college which serves a population ot about
12 000 and is also used as a Rural field
Teaching Centre for training nursing students
of all the programmes offered by the R. A.K.
College.
2 2?.2 The College conducts a 4 Year
6.29.2
Course in B.Sc.(Hons.) Nursing; a 2 - Year
Course in Master of Nursing; l-Year lost
Master ’s Course in M. Phil in Nursing; a
Post Certificate Programme (Diploma in
Nursing Education and Administration ) ot
10 months duration and Short-term Courses
of continuing Education tor Nurses in
service.
6 29 3 One Nursing faculty from Rajkumari
Amrit Kaur College of Nursing has also got
herself registered with the University ot
Delhi for undergoing Ph.D. Nprsmg
Programme w.e.f. February. 1992.
6 29 4 During the year 1993-94 the college
admitted 47 students in B.Sc.(Hons ) m
Nursing, 16 in Master of Nursing. 40 in
Diploma in Nursing Education and
Administration; and 2 (1 in Full-time) and (I
in Part-time) in M.Phil Nursing.
6.29.5 Being a subordinate organisation of
the Government of India the whole financial
funding in running of its establishment rests
with the Government. The Budget provision
for 1993-94 for the college is. Rs.30 lakh in
Plan side Rs. 106.00 lakh in Non-Plan side.
6 29 8 The Centre also receives students
from all over India for training in Rural
Health Services. Regular clinics, health
education programmes, short courses in
First-Aid Home Nursing. Dais Training etc.
are also conducted by the Nursing Faculty
posted at the above Centre. The students and
staff stay at the Centre round the year to
fulfil the health and educational requirements
of population and students.
6.30
Rural Health Training Centre,
Na.jafgarh
The Rural Health Training Centre.
is a subordinate office under the
Directorate General of Health Services which
renders services, viz., (i) Primary Health
Care; (ii) Training; and (m) Conducts Field
Studies.
6.30.1
Under the primary health care
6.30.2
_
like
services immunisation, maternity and
child health, family welfare, emergency
services, malaria control services, etc. are
provided to the community through indoor
and out-patient departments and through
domiciliary visits.
These services are
provided through the three Primary Health
Centres at Palam. Ujwa and Najatgarh. (The
Primary Health Centre at Palam along with
its four Sub-centres continues to he under the
technical control of Lady Hardinge Medical
College. New Delhi).
6.30.3 In addition, the community is uN"
educated for family welfare activities,
immunization and other health programmes.
Education is provided through film shows,
baby shows, exhibitions, discussions anu
6.29.6 The College is designated as a WHO
collaborating Centre for Nursing
Development and works in collaboration with
Institutions, of Higher Education in Nursing
157
Ig
I
seminar and other entertainment programmes.
6.30.4 Training : During the year 1993-94
six weeks training was given to 211 medical
interns of Lady Hardinge Medical College
and Safdarjung Hospital under Re-orientation
of Medical Education Scheme. Four weeks
and two weeks training courses were
conducted for Nurses under General Nursing
and Public Health Nursing Scheme and
training was imparted to students tor ANM
In all 336 Nurses were trained
Courses.
under these schemes.
432 trainees were
trained under Community Health Nursing.
40 Female Multipurpose Health Workers
were also trained at ANM Training School.
12 candidates were trained under the scheme
for promotional course from ANM to LH
(4 weeks).
£
The admission capacity tor this course is 20
Twenty candidates
in each session.
are enrolled at present in the July, 1993
session.
6 315 Auxiliary Nurse-cum-Midwife course
under 10+2 vocational scheme: This course
is affiliated to Central Board of Secondary
Education. All the sixteen students ot class
XI of this course were promoted to class XII
while one student left the training. Eighteen
students of class XII appeared in the
examination conducted by C.B.S.E. out ot
which five passed, nine tailed and tour
students got compartment in English.
Seventeen candidates were admitted to class
XI (Vocational Course) this year.
6 30 5 Field Studies : Four field studies
were conducted during the year 1993-94 Six
teams from abroad and one team each from
J.N.U. C.H.E.B., Lady Irwin College. New
Delhi, visited the RHTC. Najatgarh. during
the year 1993-94.
6.31 Lady Reading Health School, Delhi
■’ r Health School is
Lady Read^ig
6.31.1
the pioneering
considered as onee ' of
<
its
for training of
of
kind
institutions and first < ■.
aims al
The
School
Health Visitors.
providing training facilities to various
tTnuning personnel and also
caters M.C.H. Services through the attached
Ram Chand Lohia Infant Welfare Centre.
I
6.31.2 The Institution is imparting the
following courses at present:
6 313 Diploma in Public Health Nursing:
This course is of 10 months duration with a
total admission capacity ot 40 students.
Students are having their field
6.31.6
experience■ in health centres in different
hospitals and institutions in Delhi.
6.31.7
The Ram Chand Lohia Infant
Welfare Centre attached to this institution
served a two-fold purpose viz. proving
M C H. and Family Welfare Services
including domiciliary mid-wifery services and
immunisation to a popidation of over 45 000
and training to the students ot this institution.
6 318 This institution conducts health
education programme for the community m
the M C H Centre as well as in the area
the form of exhibition role play, group
discussion, puppet shows etc. spec.a^ Adult
Literacy Drive. World Population Day and
Breast Feeding Day were celebrated w th n
the Ram Chand Loh.a Centre as well a m
the community. Exhibition and Health Educ
ation were the most important events of the
programme. Baby-shows held tor the chdd
ren of the community
community and prizes were
awarded.
6 31 4 Certificate course for Health Workers
(Female) under Multi-purpose Workers
Scheme: This course is of six months
duration. Students are admitted twice a year.
6.31.9 The Institution assists in the
programme of other agencies also. Public
Health Nursing students from Cakut a.
158
H'
G
S
n
6
F
y
6
(
c
I
(
Health Visitors from New Delhi. F.B.
Centre Orientation Group of students from
S.T.D. Centre. Safdarjung Hospital. New
Delhi are among them.
6.31.10 Total budget for the institution and
Family Welfare Staff is Rs.29.50.000 to this
year.
National Institute of Communicable
Diseases,Delhi
6.32
Objectives: The Institute was
66.32.1
32 1
established in July 1963 by expanding and re
organising the activities of the erstwhde
Malaria Institute of India with the following
objectives:
i)
To undertake basic and applied
research on all aspects ot
Communicable Diseases.
ii) To provide guidelines in the planning
of epidemiological Services
organising field investigations of
communicable Diseases out-bieak
and suggest control measures.
iii) To organise training programmes at
National and International level for
raising trained man-power tor
programme management and
augmentation of research.
Filaria Research & Training Centres each at
Calicut (Kerala), Rajahmundry (Andhra
Pradesh) and Varanasi (Uttar Pradesh).
6.32.3 Training Courses: The Institute has
been rendering pioneering services in the
development of trained man-power in respect
of various communicable diseases and control
measures thereof by way of organizing
various courses viz. Malaria, Malaria
Entomology, Vector Biology and Control
Epidemiology, Diarrhoeal Diseases, AIDS,
Expanded Programme of Immunization etc.
These courses attract national and
international participants. Scientists in these
fields are brought together to get acquainted
with the recent development by organizing
workshop and seminars funded by WHO,
UNICEF as well aS National Government.
6.32.4 Some of the important trainings
conducted by the Institute during the period
under report are field epidemiology training
course. International training course in field
epidemiology, training course on vector
biology and control and a short term course
in Medical Entomology.
’
Some
6.32.5 Epidemiological Investigations.
carried
of the significant investigations carr*. out
during 1993-94 were:
Investigation of outbreak of
Gastroenteritis in Andhra Pradesh,
Karnataka, Haryana and Delhi
Municipal Area;
i)
6.32.2 Organisation: The above mentioned
objectives of the Institute are being achieved
by carrying out activities through seven
divisions namely,
Bio-Chemistry.
Epidemiology, Helminthology, Medical
Entomology and Vector Control
Microbiology, Training and Malanology and
Zoonosis. Besides the Institute has eight
field stations in different parts of the country
viz. South India Branch. Coonoor (T.N.).
Malaria Research Field Station Jagdalpui
(Madhva Pradesh). Kala-Azar Unit. Patna
(Bihar), Field Practice Unit.
Alwar(Rajasthan), Plague Surveillance Unit.
(Bangalore, Karnataka) and three Regional
ii)
Investigation of the recent report on
BCG associated adenitis in All India
Institute of Medical Sciences, New
Delhij
iii) Assessment report on the prevalence
of Communicable Diseases with
particular reference to J.E. m
Gorakhpur Division of U.P.; and
iv) Epidemiological investigation of
Handigudu disease in Karnataka - A
case study.
159
t-
r
1
6 32.6 Applied Research: The Institute
conducted some significant research projects
on outbreak of Cholera due to \ .Choleral
non 01 in parts of Karnataka. U.P., Andhra
Pradesh and Delhi on efficacy of DPV and
measles vaccines in Bombay and Bhopal and
on epidemiology of poliomyelitis in Delhi
during the period under report. The Institute
has also been carrying out studies and
surveys on Malaria, Dengue, Kala-azar, J.E.
and measures to control these diseases.
6.33
laboratory manuals, to other institutions were
supplied by this Division.
6 33 3 Molaria Research: Action has been
initiated in June, 1993 by this Division to
develop a District Microplan for control of
Malaria in Distt. Shahjanhanpur, U.P.
Similarly, studies have also been initiated on
the impact ot pattern of eco-system on
malaria situation in low lying areas of
Sikkim.
Guinea Worm Eradication
Programme
6 33.1 Being the nodal agency for GWEP in
India, the Division of Helminthology, NICD
Delhi Plans, Coordinators, guides and
evaluates the programme in the country. The
implementation of the programme is carried
out by the Guineaworm endemic states
namely Andhra Pradesh, Gujrat, Karnataka,
Madhya Pradesh, Maharashtra and Rajasthan.
In 1992 the programme has achievedi 97%
reduction in the annual incidence ot GW
cases from 39792 in 1984 (start of GWEP) to
1081. Similarly a 90% reduction in the
number of guineaworm affected villages from
12,840 in 1984 to 1244 in 1992 has been
achieved.
6.33.2 Microbiology. Microbiology division
is a composite unit consisting of section on
Virology, Bacteriology, Mycology and
Quality Control of vaccines. This division
conducted referral diagnostic services tor
various communicable diseases such as
AIDS, viral hepatitis, poliomyelitis, Measles
and other enteroviruses, the RDKCH
complex, meningitis, Acute Respirator
infections, cholera and gastroenteritis and
fungal infections Kits and
diagnostic
reagents to other surveillance centres under
the AIDS and Hepatitis programmes
teaching materials/Technical literature/
6.33.4 Zoonosis: Currently studies are being
carried out on following Zoonosis diseases;
Salmonellosis, Toxoplasmosis, Arboviruses
and Leptospirosis, Brucellosis, Hydatidosis,
Plague, Rabies and Visceral.
6.34 Central Research Institute, Kasauli
6 34 1 Central Research Institute, Kasauli is
a'pioneer Institute for the production and
quality control of immunobiologicals, vaccine
related research, teaching and for >mP?rt'n8
training to trainees from not only India but
also South and South-East Asian countries.
?
for
reatment/management of dog bite and snake
bite cases and acts as a consultancy centre fo
Hydrophobia cases, referred from various
parts of Northern India.
6 34.3 Production of Immunobiologicals:
Last
production targets ot immunobiologicals
including EPI vaccines entrusted to it by the
The targe *
Government of India.
various immunobiologicals and their actual
supply figures for the year 1992-93 and
19933-94 are given on next page.
160
ere
TARGETS FOR VARIOUS
IMMUNOBIOLOGICALS AND THEIR ACTUAL SUPPLY
FIGURES FOR THE YEAR 1992-93 AND 1993-94
ieen
I to
of
.P.
Ion
■on
of
Name of
the Product
]993-94
1992-93
Targets
Supply Figures
Targets
Supply Figures
Triple Vaccine
240 Lakh doses
2,22,44,390 doses
240 Lakh doses
53,71,680 doses
i L.T. Vaccine
200 Lakh doses
1,77,33,740 doses
200 Lakh doses
50,06,840 doses
T.T. Vaccine
270 Lakh doses
2,94,11,160 doses
270 Lakh doses
92,13,220 doses
T.A. Bivalent
12 Lakh doses
16,49,300 doses
12 Lakh doses
6,86,130 doses
T.A. Children
10 Lakh doses
5,30,340 doses
10 Lakh doses
1,74,930 doses
Imm u nobiologica Is
'I
- ;ng
12,880 doses
99,680 doses
A.K.D. Bivalent
Cholera Vaccine
50 Lakh doses
45,41,100 doses
50 Lakh doses
20,75.010 doses
A.R.V. (Human)
60 Lakh ml.
62,91,785 ml.
60 Lakh ml.
35,56,725 ml.
J.E. Vaccine
20 Lakh doses
24,570 doses
20 Lakh doses
12,57,465 doses
Yellow Fever Vaccine
0.25 Lakh doses|
32,002 doses
0.25 Lakh doses
21,1 19 doses
CAVS (Liquid/dry)
6 Lakh ml.
2,60,570 ml.
7 Lakh ml.
1,08,000 ml.
A.R. Serum
0.7 Lakh ml.
91,230 ml.
0.70 Lakh ml.
47,890 ml.
T.A.T.S. 1500 1U
125 Mega Unit
2,165 Vials
125 Mega Unit
1,228 Vials
T.A.T.S. 10,000 IU
125 Mega Unit
4,148 Vials
125 Mega Unit
1,792 Vials
D.A.T.S. 10,000 IU
125 Mega Unit
2,571 Vials
125 Mega Unit
2,088 Vials
Normal Horse Serum
1 Lakh ml.
23,720 ml.
I Lakh ml.
6,100 ml.
Diagnostic Reagents
3 Lakh ml.
2,51.800 ml.
3 Lakh ml.
1.32,235 ml.
* Supply Figures upto 31st October, 1993.
161
F
h
t
I
6.35
Quality Control of
Inununohiologicals
6 35 1
The
erstwhile Biological
Standardisation and Quality Control Division
which had been monitoring the quahty of
immunobiologicals (produced by CRl and
other Institutes) was split into two
independent divisions in April, 1 w.
National Salmonella anil Escherichia Centre,
final identification of these organisms is done
and also Diagnostic Reagents and Antisera
are prepared and supplied to the indentors.
6 35 5 There are several ongoing vaccine
related research projects. Of these the major
project is. "Production of Rabies Tissu
Culture Vaccine in VERO Cell Line .
1. Quality control Division ot CRl
2. Central Drugs Laboratory.
Scrutiny of production/quality control
6 35.6 Teaching and Training Activites: The
Institute is conducting regular courses of
B Sc M Sc. and Ph.D. Microbiology tn
accordance with statutes/regulations of
Himachal Pradesh University. In addition it
conducts group educational activities in the
form of regular refresher programmes tor
medical veterinary and scientists working in
different institutions in India and
neighbouring countries.
protocols.
6.36 Pasteur Institute of India, Coonoor
Quality' Control Division
This Division has been entrusted with:
7‘ I Quality Control
(a) Final
Immunobiologicals.
(b)
Tests on
(c) Updating the instruction leaflets and
lables
of immunobiologicals
produced at the Institute.
(d) Survellance of good manufacturing
pratices in various production units
of the Instiute.
Central Dru^s Laboratory: This
6.35.2
Laboratory was set up with an aim to keep
strict vigilance and to .ensure the quality ot
immunobiologicals in concordance with the
Drugs and Cosmetics Act. 1940. produced by
various manufacturing units in India and
those imported in the country. It r^veive! '
these
samples
from
onuo
Drugs
Authorities throughout the country It wi
continue this activity till National InstL ot
Biologicals. NOIDA. becomes tunctional.
6.35.3
To maintain uniformity in the
production of immunobiologicals in the
country. National Reference Standards are
standardized
and supplied
prepared.
periodically to the various manufacturing
institutions.
6.35.4 Research and Development:
6 36 I
The Pasteur Institute of India,
Coonoor is engaged in conducting research m
Rabies. Influenza and other respiratory virus
infections etc. and in the production ot liteanti-rabies and DTP group of
of
saving
Vaccines.
Anri-ruhics Vaccine: The annual
6.36.2
m
productu of anti-rabies vaccine undertaken
:by, t.._
the institute out of its own resources is
a/ound ..48.0 lakh ml. The institute has
supplied during 1992-93. 43.13 lakh ml. <4
anti-rabies vaccine for treatment ot human
patients and 3.23 lakh ml. tor the treatment
of animals. During 1993-94 (upto Aug. -).
the institute has supplied 22.99 lakhs ml. o
anti-rabies vaccine to various States and
the WHO for supplies to Nepal,
institute has also taken up the pdot pri^u
for production of Tissue Culture Anti-rabies
Xdnewith the he!p of WHO/1 NDP A.T
.
The relevant studies in this regard h
completed and this vaccine will be made
available for human pre-exposure and P exposure treatment in our country shortly.
dried
Six consecutive batches ot freeze
Tissue Culture Rabies vaccine tor human u.e
At the
162
Ct
s.
tt
s
p
u
I
have already been tested by the quality
control unit ot CRI, Kasauli and declared as
satisfactory. This vaccine has also been
tested in the institute itself and found
The D.C.I. has given
satisfactory.
permission to release this vaccine tor human
use.
re>
me
era
s.
ine
Ijor
ssu
6.36.3 DTP Group of Vaccines: The institute
has been producing DTP group of vaccines
for the National Expanded Programme ot
Immunisation with 100% grant-in-aid from
the Govt, of India and supplying these
vaccines to various States.
Details of vaccines supplied to
6 36 4
various States for EPI during the last three
years are as under:
FOR EPl
DETAILS OF VACCINES SUPPLIED TO VARIOUS STATES
PROGRAMME. . . u 4
(Figures in lakh doses)
ihe
jof
in
jof
) it
the
tor
tin
hd
Vaccine
7997-92
7992-95
1993-94
(upto
30.09.93)
DPT
DT
'FT
150.40
86.09
9.70
167.60
71.20
117.40
56.35
45.11
33.93
_________ L—___
6.36.5 New Activities: (a) Testing of Oral
Polio Vaccine and measles Vaccine: The
institute has established the quality control
division within the institute for testing oral
polio vaccine and measles vaccine.
f
f
)
he
t
6.36.5(b) Estab
Establishment
I ishment of
oj WHO
Collaborating Centre for Rabies: The
institute has also been designated by the
WHO as a "WHO Collaborating Centre tor
Training in Rabies vaccine production and
control for a further period of 4 years upto
1995.
countries of Nepal and Bhutan. It conducts
Post-Graduate courses in Psychiatry. Clinical
Psychology. Psychiatric Social Work and
Psychiatric Nursing, leading to the
qualifications of M.D..
DpMPsychological Medicine. M.Phil in Clinical
Psychology and Psychiatric social work,
Ph.D in Clinical Psychology and DPN in
Psychiatric Nursing.
In addition, being
situated in a major tribal area of the country,
it meets the needs of tribal people ot this
region.
6.37.2 The Institute has five fold activities:
namely:
6.36.5fd Recognition for Ph.D. Programme
hy Bharathiar University: The institute is
provisionally affiliated to the Bharathiar
University for conducting Ph.D. Programme.
6.37
(i)
Central Institute of Psychiatry,
Ranchi
(ii)
6.37.1 The Central Institute of Psychiatry
set up in 1918 is directly under the control ot
the Directorate General ot Health Services
and Ministry of Health and Family Welfare.
New Delhi and serves the needs ot people
from all over India and the two neighbouring
163
To provide diagnostic, therapeutic
and rehabilitation services to the
mentally ill both at primary health
care and institutional level;
To provide Post-Graduate
psychiatric training in the field ot
Psychiatry and allied fields like
Clinical Psychology. Psychiatric
Social Work and Psychiatric
Nursing-
research
To conduct
behavioural sciences,
(iv)
To extend mental health services
to the rural tribal area; and
(v)
To impart training in behavioural
sciences to the medical and para
medical personnel from other
organisations.
f
Institute: The figures tor out-patient and
inpatient services for the period from 1st
April, 1993 to 30th September, 1993:
in
(iii)
(a) Out-patient Attendance:
6.37.3 The hospital provides the full range
of psychiatric facilities to patients of all age
groups. In addition to the 643 inpatient
beds, it has family therapy units functioning
in the cottages outside the hospital.
Psychiatric Services
6.37.5 (i) Community Psychiatry'. Services in
the community at two centres-one in a West
Bokaro industrial area and the other at public
sector Coalfield Hospital, were started m
1988 are continuing. Besides, consultancy
psychiatric service at a voluntary organisation
day care centre (Deepshikha) tor mentally
handicapped in Ranchi City is provided.
6.37.5 (ii) Rural Mental Health Clinic: In
keeping with the National Mental Health
Programme policy of providing minimum
mental health care to all and specially
vulnerable and underprivileged sections ot
the populations, a clinic is run in a rural area
40 km away from the Institute, once a week.
Besides providing psychiatric services to the
patients, the visit to this clinic is utilised to
disseminate mental health knowledge to PHC
doctors, MPHW Village Health Guides and
Community leaders.
6.37.5
(iii)
Psychiatric Services at
New
Old
Total
Adult
C.G.C.
1908
184
6027
462
7935
646
Total
2092
6489
8581
6
ai
c;
d
6
P
P
h
h
(b) In-patient Sendees:
6.37.4 It has a well equipped Occupational
Therapy Department which imparts training
in occupational skills to the patients in areas
like carpentry, weaving, painting, cane work,
tailoring etc.
Recreational activities like
games, films and social events. Religious
instructions and services in the different
faiths are parts of regular treatment.
6.37.5
ol
m
si
Total Admission :
Total discharge :
926
902
e
c
s
6.37.6 Various research projects have been
taken up during the year.
6.37.7 The budget provision for Central
Institute of Psychiatry, Ranchi is Rs. 1.40
Crore for Plan and Rs. 2.76 Crore tor Non
Plan for the year 1993-94.
»
(
6.37.8
The
The Institute has celebrated its
6.37.8
Diamond Jubilee this year in May, 1993.
6.38
National Institute of Mental
Health and Neuro-sciences,
Bangalore
6.38.1 The National Institute of Mental
Health and Neuro-Sciences (NIMH ANS) was
established in December, 1974 as an
autonomous Institution registered under the
Societies Registration Act. This institute is a
joint enterprise of Central Government and
the Government of Karnataka.
6 38 2 NIMHANS serves the mentally and
ill person8
neurologically
g^er^
manpower and conducts research in the tieiu
ot mental health and neuro-sciences.
K
endeavours to take the developments in the
laboratory vo the community.
6.38.3 Hospital Services: A total number of
tor treatment
53,966 patients were screened for
[he
!
164
__-
I
of psychiatrically, neurologically and
neurosurgically ill patients. There has been
significant increase in registrations and
follow ups.
6.38.10 Budget: The Budget provision for
NIMHANS for the year 1993-94 are as
follows:
Plan
Non-Plan
6.38.4 Academic Activities: The Institute is
affiliated to the Bangalore University and 77
candidates were awarded Ph.D., M.Phil
degrees and diplomas during the year.
Research: Research has been a
6.38.5
priority area in the Institute. During the
period under report 14 Research projects
have been completed and 12 new projects
have been taken up in the Institute.
6.38.6 Epidemiology of Head Injuries: To
establish the incidence, cause, nature and
outcome of head injuries, an epidemiological
study was undertaken in NIMHANS. About
2,897 head injury patients were interviewed
by trained investigators from 7 major
hospitals of the city during the period
September, 1991 to February 1992.
I
Ifc
i
I
I
I
k
I
I
I
F.
6.38.7 Study for re-introduction of helmets
and organising Seminars, Symposium and
Workshops: The Institute has conducted the
study for re-introduction of helmets
compulsorily with effect from 1st October,
1993 in Karnataka and has also organised
several Seminars, symposium and workshops
during the period under report.
Total
- Rs.550.00 lakh
- Rs.900.00 lakh
Rs. 1450.00 Lakh
6.38.11 The Plan as well as Non-Plan
expenditure is shared by the Central
Government and the Government ot
Karanataka. 75% of the Plan expenditure is
borne by the Central and the Government of
Karnataka bears the balance 25%. Similarly
45% of Non-Plan expenditure is borne by the
Central Government and 55% by the
Government of Karnataka.
6.39
All India Institute of Speech and
Hearing, Mysore
6.39.1 The All India Institute of Speech and
Hearing was established in the year 1965 and
was registered as an autonomous body in the
year 1966.
6.39.2 The important objectives of the
Institute as enshrined in the Memorandum
and Articles of Association are:
6.39.2 (i) Training : To provide and assist in
imparting general professional and technical
education and training in speech and hearing
for graduate, post-graduate and doctoral
degree (Speech & Hearing) courses of
Mysore University.
6.38.8 Networking of CD-ROM(CDNET):
The proposal for networking of CD-ROM
through novel LAN with 10 accessed
terminals has been accepted by NIMH ANS.
The database to be installed are ENBA-SEPsychiatry,EMBASE-Neurosciences,PsyLIT
and citation index neuro-sciences. This is
considered to be a fulfledged bibliographical
as well as full text database for
bibliographical literature search service.
6.39.2 (ii) Research : To provide and assist
in
making available facilities and
encouragement to research in Speech &.
Hearing their disorders and the concerned
diseases of the Ear, Nose and Throat.
6.38.9 Battery-operated vehicles: With the
approval of the Finance Committee two
battery
operated vehicles have been
introduced in NIMHANS for carrying out the
activities of laundry, kitchen, drugs, stores,
hospital necessary stores etc.
6.39.2 (iii) Clinical Services : To provide
and assist in providing clinical and surgical
services for those with speech and hearing
handicapped and ear, nose and throat
diseases.
165
IL-
t
Medical
disorders.
6.40
During the year 1993-94. the
6.39.3
following activities have been undertaken.
Indian Council -of
Research
r 40 1
The Indian Council of Med'ca'
given training
in using the computers instaneu
departments.
i
■ Rs. 55.00 lakh
■ r s . 75.00 lakh
Plan
Non-Plan
r ao 7 (iv'l Public Education : To educate
SEX arsons
!XpXs
.s«
i
6.40 2
'“TTsX“ » Sg earned o».
strengthened. Sttuhe i
important
on sibling spectes cmple
io
vectors, on methods ot personal.P
repellents, ma aria
fauna and
‘
ie
seroepidemiology, anophlme
immunological studies.
• IX
6.40.3 To overcome the
of insecuddal
conducive to
certain ecological
resistance in
■ fe
mosquito br<edinL'. .llternttive strategies
P.falciparum malaria, a
were
like bio-environmental
tesled
evolved. These strateg £ « b g
hy
under the Science & Techm gy
S,TS”hySXBRVS’X.M a. rhe
Delh, at 12 ddter^nratg .insecticides are no
country. In h.s r gy
.n special
used at an
circumstances only.
sophisticated e(lulPm^nt-
Madsen OB 822.
OS.
Thereafter T"'.'1' T^'‘Snmark. K.9
,2 Xr'^Sl*« ste
Institute.
, on 1
(iin
cXrativ.
Collaborative
Pr,,j('ct.^
XS'OTET
the Institution/ orgamsatn n.
Y
SPA'b*’D«P«
NCERT, New
Delhi, uepu.
Govt, of India etc.
6 39.3 (iv) Construction Activities . Plans
^gHtSSSXki^rogress:
6-40.4
S
F/"J^“r’SRKc'>
n(ariasis controj P^a^^.h
m
filariasis ^problem
Kerala Ct’nt'Xring the technology to the
assured by 'ran^rrl Avector control a
X”«’»O"“”'s“er,”w
Ministry of Welfare, Government
6.40.5
6.39.5 Grants from Government of India
At RMRC. Bhubaneshwar, efforts
166
..
lai
11
h
d
:S
have been made tor developmentt of an
immunodiagnostic assay mei■thod for detection
in asymptomatic
of filarial
infection
microfilaria carriers.
Research
Enterovirus
Centre (ERC),
Bombay, and CME, Vellore intensihcatmn of
vaccination activities, resulted
resulted m steady
decline in the incidence <of paralytic
poliomyelitis.
The VCRC, Pondicherry is
6 40 6
undertaking field trials on the biologica
control of mosquitoes using B. spheric us
which is a highly specific larv.cide tor certain
mosquitoes especially Culex ciuinquefasaatus
in polluted breeding habitats.
6 40 13 An effective surveillance system has
been ’ established
which incorporates
monitoring of vector density and
evidence of virus activity m sentinel am al.
at
ICMR’s Centre
for Research m Medical
at ICMR’s
Centre for
Entomology (CRME). Madura!.
6 40 7 Leishmaniasis: For effective control
of kala-azar, the council 's "t!l,s'ng
research capabilities tor ett.cienl case
detection, e^rly diagnosis and pnimpt
A strategy has been tested for
6.40.14;
kii combining water management
c.
vector control
of neem coated urea. Results have
with use
methods
suggested that combining the two met.. ''- ‘
would be preferable.
treatment of the patients of k a-azan
Studies are being undertaken on a term e
drugs like ketokonazole and alternate
therapies for management ot cases ot
kala-azar. The role of administermg gamma
interferon in patients who do not respond t
pentavalent antimony is also being evaluated.
\
i
s
6 40.8 Studies are on going to assess the
effect of conventional antileishmamal drugs
on immunological profile and to understand
the pathogenesis of the disease and rde t
calcium ions in defense mechamsm of
t
J
macrophages.
j
I
6 40 9
Viral Diseases: Epidemiological,
virological,
molecular
and
biological
immunological studies on various v.ra
diseases viz. hepatitis. Japanese encepnal U
(JE) dengue fever, measles, rubella and
National Institute of Virology (N1V). Pune.
*
r
I
Th
r.
IW
■ id
an
A)f
lis
tie
la
Outbreaks of JE and dengue in
6.40.10
neighbouring districts were investigated.
Diagnostic tests are being deve’oped for- non
non B hepatitis. Primers and probes
A
have also been synthesised tor the detection
of HCV by polymerise chain reaction.
6 40 11 ELISA kits for the detection ot
rotaviruses, JE and hepatitis A have been
prepared at the NIV. Pune.
Tuberculosis is a common
6.40.15
infection in
HIV infected
pathogenic
■' ; have
follow-up
persons. Long term tollow-up studies
mu
been initiated in subjects with HIV infection
tu.
for evidence of developmentt of
c. tuberculosis,
infection in
of
HIV
and also for development c.
tuberculosis patients.
To spearhead India’s research
6.40.16
National AIDS
efforts on HIV/A1DS )a was established in
Research Institute (NAR1) ’
!992 by the Council ih Pune. The
October 1
undertaking
Institute would
be
would be
HIV
infection.
multidisciplinary studies on
6 40 17 The preparation for AIDS Vaccine
Evaluation (PAVE) project is a collabori {t^
programme involving NARl. Pune and <
Hopkins School of Medicine Ba tunore
USA characterization ot the HIV via. ( ■)
!,„Jivaccines
situation will be undertaken.
Tuberculosis: The Council has
6.40.18
lol;
I studies to evolve
undertaken operational
•
j
suitable
for application in
methodologies t Programme
to
'Tuberculosis
National
efficiency.
it
and
its
improve
strengthen
Case finding and case holding are two
important components for improving the
■
Towards this objective,
different strategies to !.
6.40.12 In studies conducted at the ICMR’s
167
F
are being tried.
6.40.19
Feasibility of using split-dose
double drug combination administered on
alternate days during an initial intensive
phase of two to three month appears to be
promising. However, long-term follow-up is
necessary; to confirm their efficacy. Studies
are underway to standardise diagnostic
criteria and to study the feasibility of short
course chemotherapy in cutaneous
tuberculosis.
6.40.20 Epidemiological studies to evaluate
the annual risk of infection as a tool tor
monitoring the time-trends of Jhe disease are
being carried out. A methodology for the
surveillance of tuberculosis is being
developed.
Leprosy: The main thrust of
6.40.21
research in leprosy is to reduce the infection
load in the community by introducing
effective Multi Drug Therapy (MDT), and
testing appropriate vaccines against leprosy.
The efficacy of different MDT regimens has
been established.
Presently a WHO
sponsored field trial - of loxacin in
paucibacillary leprosy is being undertaken.
Two comparative leprosy vaccine trials
against leprosy were launched under the aegis
of ICMR to determine the protective efficacy
if any, of the available candidate vaccines.
In the first trial a comparative evaluation of
ICRC and BCG vaccines is being undertaken
by Cancer Research Institute, Bombay in the
State of Maharashtra. Another trial using
ICRC, M.w. (developed by National Institute
of Immunology, New Delhi), killed M.leprae
with BCG (WHO), BCG and normal saline
has been launched in the State of Tamil Nadu
by CJIL Field Unit, Avadi. A combination
of multidrug therapy with immunotherapy
M.w. is also showing promising results.
due to non watery diarrhoea, where ORS
would have a limited role in management of
dehydration. Dependence on ORS only,
therefore, seems inadequate.
A phage typing scheme for
6.40.23
V.eholerae 01 biotype ElTor has been
developed at NICED, Calcutta by which
1000 strains could be clustered into 27 types,
giving a cent percent typability.
6.40.24 With the objective of developing an
effective immunogen, N-acetyl-Dglucosamine specific hemagglutinin (HA) adhesin - from V. cholerae 01 was isolated
and purified for the first time in India.
6.40.25 With a view to develop a better
vaccine for typhoid a study was carried out
to isolate and purify porins from the outer
membrane of Salmonella typhi.
6.40.26 Health Services Research: Study
conducted on strengthening of health
education services evolved a system of
implementing the health education
programme through the existing health
infrastructure. The survey gave an insight
into population characteristics, knowledge,
attitude and practices related to health and
communication methods.
6.40.27 Studies have been carried out by the
Regional Medical Research Centre for
Tribals, Jabalpur on socio-cultural, and
demographic aspects, health seeking
behaviour, status of women and economic
aspects of health care in view to have an
indepth understanding of specially primitive
tribes in different parts of MP.
6.40.28 Contraception and Reproductive
Biology: Council’s research efforts - in
contraception include a judicious mixture of
basic, clinical and operational research aimed
to meet the needs of the women today and
during the 21 st century.
6.40.22 Diarrhoeal Diseases: In recent years
through studies conducted at National
Institute of Cholera and Enteric Diseases
(NICED). Calcutta it has become evident
that more than 50% of diarrhoea cases are
6.40.29 During the year, studies exploring
the potential of the use of inhibin tor fertility
regulation both in males as well as females
168
*
I
• 6).40.34 Feasibility of developing a nonsurgical reversible method of male
contraception using the injection of polymer
styrene maleic anhydride (SMA) into the
6.40.30 Under the Task Force Programme
lumen of the vas deferens has been initiated.
on Immunodiagnostics, kits were developed
Studies in rodents and rhesus monkeys have
for reproductive hormones - peptides and
shown intravasal injection of SMA provides
steroid.
a safe, effective and reversible method of
contraception. A Phase I clinical trial on
6.40.31 The Task Force on product
human suggests that the method is safe and is
development is focusing its attention on
A
not associated with major side effects. A
indigenisation of CuT 200 IUD production
Phase II clinical trial is being planned.
with the help of industry. The Council and
IPCL, Baroda are exploring the possibility of
C. '.2.25 Maternal and Child Health: In the
6.40.35
substituting presently imported raw material
< MCH the Council had undertaken
field of
used for the production of CuT 200B
operational
research studies on improving
components with the materials available
quality and coverage ot MCH care within the
within India.
existing health care infrastructure.
and tamoxefen on a male contraception were
undertaken.
It
6.40.32 Council’s Clinical trials have
shown that Norplant is a safe and effective
contraceptive pre-programme logistic study
with norplant II in A, B, C post-partum
centres showed that efficacy and local side
effects were similar to those seen in the
Phase III clinical trials.
However, the
removal rates for menstrual irregularities
were higher indicating that there is a need for
strengthening counselling services prior to
Norplant insertion in these centres. It was
also noted that these women were not
followed up according to the schedule
suggesting that there is a need to improve
provision for follow up care services in these
centres.
J
6.40.33 The Council initiated a clinical
trial to find out a suitable dose of RU486 and
prostaglandins for non-surgical MTP in
Indian women. The results show that use ot
RU486 200mg. followed by 5 mg. of 9methylene PGE2 vaginal gel is as effective as
RU486 600 mg followed by 3 or 5 mg. of 9mathylene PGE2 gel for termination of
pregnancies within 28 days of missed period.
The success rate was 94.5% and 89.6% in
women with 7-14 days and 15-28 days of
missed menstrual period respectively. There
were no serious side effects, immediate and
delayed complications were very few and
could readily be tackled.
6.40.36 An intervention study to improve
quality and coverage ot MCH/FP services is
currently ongoing in 31 HRRCs. Interim
analysis of 2 year data has shown that by
training, improvement ot MIS and guidance
in implementation of programme, the existing
infrastructure at PHCs can be catalysed for
substantial improvement both in coverage and
quality of MCH/FP care provided at the
primary health centre. The Council has also
carried out studies on use of at risk approach
for providing appropriate care tailored to
meet the needs of women and children.
6.40.37 Psycho-social research studies
aimed at improved community participation
in providing care for women and children
through innovative intervention strategies are
underway. An attempt is also being made to
improve the pregnancy outcome through the
provision of pre-natal screening and genetic
counselling services at the district hospitals.
A study has been initiated in 31
6.40.38
6.40.38
centres to develop a database to study trends
in some selected indicators of maternal health
through compilation ot routinely collected
hospital information.
6.40.39 Nutrition: Research efforts of the
Council in nutrition and allied areas include
studies on maternal and child nutrition, body
169
F
yr' '
surveillance of food contaminants reveaieu
high level of contamination ot DDT and
HCH residues in vobine milk and human
breast milk, arsenic, cadmium and lead in
infant formula and leaty vegetables, and
aflatoxin B in groundnut and maize sample.
composition and energy metabolism, diet
related diseases like diabetes and cancer, and
nutrition interventions. Studies to identity
food toxins and food contaminants and
adulterants are also underway.
tl
6.40.40 Evaluation of the mid day meal
programme showed that the supply ot meals
was satisfactory only in 64% ot the schools.
Inadequate food supplies, poor storage and
transport facilities were some ot the identified
bottlenecks.
I
6 40.43 Chemoprevention is relatively a
new area of cancer research. Epidemiological
data show that diets rich in antioxidant
nutrients reduce the risk of several cancers.
'An intervention trial was undertaken to
evaluate the impact of micronutrient
supplementation (Vitamin A, riboflavin, zinc
and selenium) on oral precancerous lesions in
the high risk group ot reverse smokers.
Besides the clinical response, the oral
epithelial cells showed a significant reduction
in DNA adducts and micronuclei ot the
supplemented group,
lesions in the
confirming the beneficial impact of
macronutrients. This approach in high risk
population can modify precancerous
significantly and may thus reduce the
incidence of oral cancers.
I
6.40.44
A
multicentric
study
(
I
1
6.40.46 A collaborative project of NIOH
and NCRP on occupational cancer has
revealed a significantly high risk of lymphatic
and haematopoietic cancer among painters
and construction workers, elevated risk ot
lung cancer among textile workers, welders
metal and wood workers and increased risk
of bladder and skin cancer among agricultural
labourers.
6.40.42 In view of increasing use ot palm
oil ■ in India, the possible effects ot its
prolonged consumption were investigated in
human volunteers. The studies showed that
palm oil had no adverse effects on lipid
profile or platelet function and can be safely
used as a cooking medium.
I
c
6 40 45 Oncology: The initiation of the
National Cancer Registry Programme
(NCRP) in 1981-82. has helped in providing
data-base on cancer occurrence in the
country. The data generated by hospital
cancer registries show that among males,
cancers of the oral cavity, pharynx
Oesophagus, lung, larynx, leukaemia_
lymphoma were common whereas in females
the common sites were cervix uteri, breast,
oral cavity and oesophagus. Case control
study on oesophageal cancer at Bangalore
reported dose response to beedi smoking and
tobacco chewing among males.
6.40.41 Feasibility studies have shown that
linking vitamin A distribution with measles
vaccine-could provide an additional dose ot
the vitamin to infants between 9-12 months.
However DPT/polio booster coverage is
low in majority of the states and unless
special efforts are made to improve this,
linking the two programmes may not have
any advantage.
1
t
on
6.40.47 A feasibility study for prevention
and early detection of cervical cancer has
shown that after appropriate twirnng the
auxiliary nurse midwives (ANMs), yi lag
health guides, anganwadi workers, intern,
and medical officers of PHCs detected
precancerous and cancerous lesions of the
uterine cervix, by means ot chmeal
downstaging for all married women and by
Pap smear screening ot women abo
years and those symptomatic even below 35
years of age.
6.40.48 A study is ongoing at AI1MS on
immunological parameters relevant to
diagnosis in HPV infected individuals and
cervical cancer cases.
6.40.49
The prevalence of reproductive
170
. J
I
I
■
I
tract infections (RTIs) were studied in women
attending gynaecology OPD. Preliminary
observations indicate that 85% women had
one or more RTIs and 65% women were
positive for multiple infections ot lower
genitalia.
6 40 50 Studies are ongoing at IRCH. New
Delhi and PGIMER. Chandigarh tor
estimation of cost of management ot tobacco
related cancers, coronary heart d|sease
(CHD) and chronic obstructive lung diseases
(COLD).
interventions and has shown consequen
iimprovement in the subjective well being of
iyoung women. The collaborative study of
narcotic drugs and psychotropic substances
has provided data on the pattern of drug
abuse, profile of drug abusers and has also
evaluated the existing treatment modalities.
A drug abuse monitoring system has been
developed and tested. Studies at the ICMR •
Centre for Advanced Research on Health and
Behaviour Madurai have shown that health
education to the HIV infected for prevention
of transmissive behaviour is feasible to
modest extent in a clinical setting.
6 40 51
During the year analysis of food
carcinogenic/mutagemc
substances for carcinogenic/nwtagenic
chemicals was carried out. The studies show
that turmeric, mustard and onion are strong
antimutagens, pan masala is mutagenic.
Unconventional oils and tned food substances
were non-mutagenic. Studies showed th.
iron deficiency predisposes to gastromtestmal
cancers The nitrosamine levels showed high
contents in beer, sauces and ketchups, dry
fish, salted lime and lemon pickles.
6.40.52
;
Cardiovascular
Assessment of the prevalence and risk tacto
profile of coronary heart disease ami ng.
both rural and urban populations reveal^
that about 30% of men and a slightly hi her
proportion of women do not have any
identifiable coronary risk factor
them
The proportion of persons who
SeJ .he PXe«e ..f all .he h.ur kn.»»
■
risk fae-lors was very low. The preva ear <
risk factors showed an increase with age
The Council has initiated a network ot
Centres for Preventive Cardiology.
5
6 40 55
Geriatrics: A workshop on the
Public Health Implications of Ageing m India
was convened by the Council in collaboration
with the London School of Hygiene and
Tropical Medicine. London and the All India
Institute of Medical Sciences. New Delhi.
The Workshop provided a forum tor
obtaining knowledge related to demographic
profile, morbidity pattern, utilisat.on of
existing health services and the role ofn< n
governmental organisations (NGO) tor the
care of the elderly.
Environmental and Occupational
6.40.56
At the National Institute ot
Health:
Health (NIOH), Ahmedabad,
Occupational
of studies have been on the
the major thrust
and Occupational health
Environmental
problems of under serviced working groups.
A study of individuals exposed to
its
hexachlorocyclohexane
during
manufacture showed need to
regular
biological monitoring in exposed worker^
Indigenously designed hearing Pri'^ 1 (
to evaluate comfort.
me suiuj j
comfort grading for the hearing pro ec i
devices A computer model based on data
Indian population has been deve oped to
simulater range of movement of body joint..
Sreofm^softhebody segments, human
postures and motions, and biomechanical
6 40.53
OphthalmicSciences: A Centre tor
Advance Research on Ocular Infections as
been initiated at the Guru Nanak Eye Ce"
New Delhi. Steps have been initia ed to the
establishment of an ln’erna‘u’na'C^ t?r
diology Laboratory at Dr. R.P. Centr
Ophthalmic Sciences, New Delhi.
analysis of postures.
A poison Information Centre has
6 40 57
6.40.57
been started M NIOH to provide mformat.on
Mental Health: During the year
6 40 54
the project on Indicators of Mental Health
evolved and tested strategies tor psychosocial
171
i?
I
the toxicity of industrial and household
chemicals and drugs to the community on
demand including a telephonic answering
service.
6.40.58 In occupational health care
delivery to rural workers through PHC, the
major health problems observed among
agricultural workers included respiratory
morbidity, pesticide toxicity and accidents.
In case of non-agricultural workers, the
major morbidity was due to respiratory
problems.
6.40.59 The Environmental Carcinogen
Unit, is continuing the carcinogenicity studies
of chemicals. Toxkity screening system
using fish larvae and microbial genotoxicity
assay system are being developed and
standardised.
6.40.60 Pathology: Studies have been
undertaken on pigment cell biology,
pathology of tropical diseases, gynaecological
and STD pathology, renal diseases, tumour
biology, and trace element analysis in
biological tissues.
6.40.61
Studies on patients with melanotic
lesions, viz., melanomas, pigmented basal
cell carcinomas, seborrhoeic keratosis and
repigmenting vitiligo, to
assess the
melanotrophin dependence of proliferating
melanocytes, showed that melanocytes are
hormone dependent cells, their proliferation
depending on ACTH binding.
1
6.40.62
were
Differentiating patterns
studied in primitive neuroectodermal tumours
(PNET) including intracranial medullobl
astomas, pinealoblastoma, retinoblastomas,
soft tissue neuroblastomas and neuroectoderman tumours. The central PNET from
the posterior fossa shows patterns resembling
early cerebellar differentiation.
Areas of
glial differentiation were observed in tumours
from older age groups.
The peripheral
tumours show neuroblastoma composed
entirely of primitive cells and neuroec
todermal tumours showing a biphasic pattern
including both neuroblastic and primitive
SL
ectoderman cells.
6.40.63
Correlation of steroid hormones
(estrogen and progesterone receptors) status
with clinical and histological prognostic
factors and survival and been studied in
patients of breast cancer, to assess their role
in differentiation of tumour cells, metastatic
potential and disease free and total survival.
6.40.6)4
Role of serum prostate specific
antigen (PSA) in early diagnosis and follow
up of patients of prostatic cancer has been
evaluated.
Serum PSA had been found
significant in detecting early cancer and
metastasis and for following up the patieht;T572Z'■
6.40.65 Studies to assess behaviour of
biologically important
elements in
mycobacterial infections i.e. leprosy and
cutaneous tuberculosis, revealed that dermal
granulomas and inflammatory cells in
different forms of leprosy are poor in copper,
zinc and calcium while they show higher
levels of magnesium, phosphorus, sulphur
and potassium.
Haematology:
6.40.66
Research
was
continued in various disciplines such as
autoimmune disorders, sickle cell disease,
haemophilia, acute
t h a I a s s a e in i a.
and population
I
lymphoblastic leukaemia
genetics.
6.40.67
A total of 2504 subjects of
suspected autoimmune collagen vascular
for various
disorders were screened tor
diagnostic parameters such as anti-nuclear
factor antidouble stranded DNA (anti-ds
DNA), anti-single stranded DNA. antirihonucleoprotein and anti-Smith antigen. Ot
these, 127 patients completely satisfying the
1982 revised ARA criteria for the diagnosis
of systemic lupus erythem.atosus (SEE) were
investigated for the presence of idiotypes
(Id), anti-ds DNA and anti-idiotypes. The
study has indicated that the idiotype and anti
idiotype network has a immuno regulatory
role. A higher incidence of anti-idiotypes
was seen intreated SEE patients in remission
whereas no anti-idiotypes were seen in severe
172
6/
Vi
wi
ex
as
Pc
siid
V
b(
cc
6
Ii
e—
d
s
6
i<
i
I
<
I
SLE patients.
i
6.40.68
A project has been initiated at
Valsad (Gujarat) and Nagpur (Maharashtra)
with a view to study the variability in clinical
expression of sickle cell disease and its
association with various genetic factors.
Population screening has been done and
homozygous
individuals,
sickle
cell
identified. The lower levels of HbS found at
Valsad suggest that alpha thalassaemia would
region as
be more prevalent in Valsad
compared to Nagpur.
6.40.69
The Council’s Institute of
Immunohaematology
at Bombay
has
established a facility for the prena:al
diagnosis of thalassaemia in the first and
second trimesters of pregnancy.
■-
Population
screening
for
6.40.70
identification of the Bombay (Oh) phenotype
is ongoing in the Sindhudrug district of
Maharashtra.
Venoms: In view of high mortality
6.40.71
and morbidity due to snake bites, the Council
identified different research areas in this topic
and constituted a Task Force in 1989.
J
1
Results of a study being carried at
6.40.72
Jadavpur University, Calcutta indicate that
crude' venom of the saw viper -Echis
carinatus causes significant release of
histamine and serotonin from peritoneal mast
cells of rat and acetylcholine from small
intestine of guineapig in a dose dependent
manner. Antiserum raised against whole
serum in rabbit was found to be
immunologically potent. It protected mice
against haemorrhagic activity of venom and
provided 16-fold protection.
6.40.74
Traditional medicine research/The
its multidisciplinary
ICMR
continued
centrally coordinated. Task Force strategy,
following disease-oriented approach in the
scientific evaluation of selected time
honoured traditional remedies/tcchniques in 6
refractory disease conditions identified by the
Council viz., Kshaarasootra technique for
anal fistula, and indigenous remedies for
viral hepatitis, bronchial asthma, diabetes
mellitus, urolithiasis and filariasis. The new
strategy involves simultaneous research using
advanced chemical, pharmacological and
toxicological studies, along with precise
quality control and standardisation studies on
each drug selected.
6.40.75
The Kshaarasootra technique
which was proved through multicentric
clinical trials to be a safe, acceptable and cost
effective alternative to surgery tor patients of
anal fistula, is now being subjected to quality
control and standardisation of its individual
ingredients as well the tinished product. The
manufacturing process is also being
standardised. A Monograph on these aspects
is under preparation for possible
incorporation in the Indian pharmacopoeia.
6.40.76
In studies on hepatoprotective
plants, picroliv, a standardised glycoside
mixture derived from Picrorhiza kurroa, has
shown highly significant hepatoprotective
anti-viral
and
action coupled
with
immunomodulater activities in vivo and in
vitro experimental models. This has been
cleared for phase II clinical trials by the
Drugs Controller of India. Tolerance studies
on this compound in human beings, have
been initiated at two centres as a prelude to
undertake Phase II clinical trials.
6.40.77
During the year, multicentric
double blind clinical trials have been initiated
at 4 centres on another promising
hepatoprotective plant Phyllanthus amarus, in
patients of chronic viral hepatitis.
6.40.73
A study to evaluate plants effective
in snake bites is progress at University of
Calcutta, it has identified three common
indian plants viz., Pluchea indica, Vitex
negundo and Emblica officinalis of which.
Pluchea indica seems to be the most potent.
Further studies are in progress.
Significant leads in experimental
6.40.78
animal models have been obtained at the
Advanced Centre at CDR1 on a tew other
173
j:
plants including other Phyllanthus species.
I
r
6.40.79 Multicentric clinical trials on
higher dose of Vijaysar (Pterocarpus
marsupium) in patients of diabetes mellitus
are in progress. The concept of undertaking
clinical trials on a flexible dose schedule has
been introduced. Advanced studies including
insulin tolerance and plasma insulin assay in
diabetic patients are proposed at one centre
(i.e. Sita Ram Bhartiya Institute for Science
and Research, New Delhi).
I
6.40.80 In bronchial asthma multicentric
clinical trials are in progress on the
Ayurvedic plant Shireesha (Albizzia lebbeck).
fn urolithiasis and filariasis animal studies
have yielded encouraging leads, which are
being pursued.
6.41
I
Publication, Information
Communication
and
Various activities in the area of
biomedical information and communication
were continued during the year through the
print, visual as well as the audio-visual
media. Apart from efforts for dissemination
of biomedical information to the common
man, biomedical bibliographic information
services to medical and non-medical
scientists, as well as activities relating to
scientometric studies and management
information systems received due attention.
6.41.1
The Indian Journal of Medical
6.41.2
Research continued to be published into two
independent sections A & B (started on an
experimental basis) during 1992. It has been
decided to merge both the sections from
The monthly in-house
January, 1994.
periodical of the Council viz., the ICMR
Bulletin continued to disseminate scientific
information on biomedical research carried
out under the aegis of the ICMR. A tew
special issues of the Bulletin with articles on
ageing, HIV infection, etc. were brought out
during the year. The Hindi Publication Unit
of the Council brought out the H indi version
of the Council’s Annual Report (Varshik
Prativedan) *as well as the Bulletin (ICMR
Patrika).
Updation/revision of the first
volume of the encyclopaedic- Monograph of
Medicinal plant of India is in progress,
through computerization of the enormous
literature now available on the plants
included in this volume (i.e. those with
botanical names from alphabets A to G).
6.41.3
Scientific lectures were organised
in collaboration with the Council’s Institute
of Pathology, New Delhi, in connection with
the National Science Day celebrations in
February, 1993. The Audiovisual Unit has
undertaken videofilming on Japanese
encephalitis,
Kshaarasootra (Ayurvedic
medicated thread for management of anal
fistula) and highlights of the activities of the
malaria Research Centre. Five other shorter
programme on different aspects of malaria
have been completed during the year. In the
area of Health Education, the Unit has
produced a 12 minutes video programme on
malaria targeted to schoolgoing children.
6.41.4
Under scientometric studies, the
major areas taken up included preliminary
analysis of global malaria research,
publication analysis of ICMR extamuial
research for the period 1988-92 and
designing a database on Indian biomedical
Work also was continued in
journals.
updating the ICMR intramural publication
and citation databases.
6.41.5
The 1CMR-NIC Centre on
Biomedical Information, currently provided
bibliographic information services from over
40 databases of MEDLARS. USA, to users
throughout India. The Centre also provides
access through E-Mail to databases at NLM
such as GENBANK (Gene sequence), EMBL
(DNA sequence), SWISSPORT, PIR,
KABATPRO (Protein sequence) and other
sequence databases. In 1993 three new
databases were added in addition to the back
AIDSL1NE,
files of MEDLINE. These are AIDSLINE,
AIDSTRIALS, AIDSDRUGS AND
MEDLINE BACK85.
V.P. Chest Institute, University
6.42
of Delhi
The Institute is financed by this
6.42.1
Ministry and is administered by a Governing
174
turnover in various tissues of experimental
animals; trials in bronchial asthma using
indigenous drugs; establishment of norms for
lung functions and exercise responses in
The Institute conducts applied and
6.42.2
Indians;
variability of flow volume
basic research in chest diseases and allied
parameters
in normal
individuals,
It provides diagnostic and
specialities.
clinicophysiological relationships in diffuse
consultation services in chest diseases. It
interstitial lung diseases; techniques ot
provides specialised laboratory and clinical
aerosol delivery aetiological significance ot
diagnostic services in cases with problematic
fungal, pollen and insect allergens, serum
lung diseases referred to the Institute from all
profiles
in acute
immunoglobulin
over India.
exacerbations ot asthma and their correlations
with viral infections such as influenza,
studies on chronic obstructive pulmonary
Training: The Institute conducts
6.42.3
disease (COPD)
including pulmonary
several post-graduate courses ot Delhi
and role ot
sleep,
functions
during
University viz. DTCD/MD (Tub. & Resp.
corticosteroids
in
management;
comparative
diseases)/M.D. in non-clinical subjects viz.
in school
studies
pulmonary
functions
of
Pharmacology,
Medical
Bio-chemistry.
children
in
and
Leh
(as
part
of a High
Delhi
Physiology and Microbiology, Besides Ph.D.
Attitude
research
Physiology
programme),
students in a number ot biomedical and
epidemiology of Farmer’s Lung Disease in.
clinical subjects receive their training.
prevalence
ot
north-western India;
influenzae
in
respiratory
tract
haemophilus
Students were enrolled tor the
6.42.4
using
rapid
micromethods
infections.
various post-graduate courses relating to
standardised
VPCI
itself;
at
the
isolation and
medical
Bio-chemistry, Physiology.
characterisation
ot
trom gram
R-plasmids
Pharmacology, Tuberculosis and Respiratory
negative bacilli, with a view to identify those
Diseases, Microbiology, and Ph.D.
plasmids coding for antibiotic resistance;
development ot a simple, sensitive
immunoassay for pneumadin ( a .new
Patient care: During the calender
6.42.5
decapeptide which appears to be involved in
year 4904 new and 22884 old cases attended
water and electrolyte metabolism disturbances
the Clinical Research Centre. Ot these 18
in lung diseases); effect of acclimatisation on
were admitted in the indoor wards tor special
psychomotor performance ot aviators; role ot
investigation and treatment.
ultrasonography in the diagnosis ot chest
diseases as compared to conventiona
The
Institute
6.42.6
Publication:
radiography; identification of 29 newer
continued to publish the quarterly periodical
inhalant allergens; and immunochemical
"The Indian Journal of Chest Diseases and
quantification of airborne inhalant allergens
Allied Sciences" which has a wide national
in the Delhi area. The DST sponsored
and international circulation.
Centre for the Study of Visceral Mechanisms
undertook studies on the influence ot anti
6.42.7
Research: Studies on diverse
tuberculous treatment on ECG in pulmonary
aspects of respiratory diseases/conditions
tuberculosis, apart from' other physiological
were conducted, involving clinical as well
investigations.
biochemical physiological immunological,
Body constituted by the Executive Council.
University of Delhi.
US
ns
|th
ed
le
th
in
as
>e
ic
al
ic
rr
k
microbiological,
pharmacological and
Examples ot
radiological investigations.
these studies are:-
6.42.9
The VPCI received grants tor
conducting research projects from agencies
such as ICMR. DST and UGC. 25 research
papers authored by faculty and staff of the
VPCI were published in scientific journals
Effects of protein malnutritioni on
6.42.8
choline
phosphoinositide and phosphatidyl c....
175
!
Bureau.
It is mainly responsible for
producing printed health education and
for
publicity material
various health
programmes.
during the period under report
A provision of Rs. 200.00 lakh has
6.42.10
been made in the Budget Estimates 1993-94
under head "Non-PI an".
6.43
Central
Bureau
Health
6.43.6
Journals : Dissemination of health
education information and to interpret the
plans and achievements of the Ministry is
done by the Division through its monthly
journals. SWASTH HIND (English) and
AROGYA SANDESH (Hindi). They cover
varied issues relating to health education,
public
health.
health
programmes,
behavioural research, book reviews.
Education
6.43.1
The year 1993 has been a period
of significant achievements for the Central
Health Education Bureau. The Central Health
Education Bureau set up in 1956. has been
striving to achieve the goal of developing and
promoting health education in the country.
■I
'l
I
(
(
t
6.43.7
The special numbers brought out
were: Anti-leprosy Day. World Health Day,
No-Tobacco Day. World Environment and
Health Day. Health Progress Nutrition and
Health. World AIDS Day.
Two other
publications brought out regularly are DGHS
Chronicle (English Quarterly) and Swasthya
Siksha Samachar (Hindi Quarterly). These
journals highlight the activities of DGHS.
6.43.2
CHEB. being a wing of the
Directorate General of Health Services,
continued to provide support to the Ministry
in implementing the official policies and
programmes of health education in the
country. To achieve the above mentioned
objectives. CHEB has six technical divisions
with Administrative Section to provide
administrative support. These are:
(i) Training; (ii) Media, including
Editorial
and Exhibition Sections; (iii) School Health
Edu- cation; (iv) Health Education Services
(v) Research and Evaluation; and (vi) Urban
Field Study and Demonstration Centre.
6.43.8
Besides. 8 publications were also
brought out. Campaign material on World
No-Tobacco Day and World Health Day
were also brought out.
6.43.3
The highlights of the activities
carried out by CHEB during 1993-94 are:
6.43.9
Future
Fifty
new
Plans:
publications which are under various stages
of preparation are to be brought out during
the year.
6.43.4
Training Division: The courses
conducted by this Division of the Bureau are
(i) Two year diploma in health education;(ii)
In-service training, two month certificate in
health education, two month media personnel
course , four week social sciences research
method, four week key trainers course, two
week faculty of HFWTC medical, five-day
district level medical officers course and fiveday certificate in health education for doctors
of ISM course and (iii) Orientation training 103 national students were given orientation
training in health education.
6.43.10
The Exhibition and Audio Visual
Sections of the Division organised 15
exhibitions
on different areas of health
subjects. 5 video spots on different health
subjects were prepared.
The section
maintained close liaison with voluntary
institutions and various media units of the
Ministry of I &. B. The audio-visual services
of the Bureau were utilised tor health
education of the people and in training
programmes.
Media Division Including Edirorial"
6.43.5
and Exhibition Division: The Editorial
Section is one of the primary sections of the
6.43.11
Research and Evaluation Division:
The following are the ongoing Projects/
Studies undertaken by the Research and
Evaluation Division:
176
!
r
NOTIFIED CASES AND DEATHS OF CHOLERA IN INDIA
50
43.285
# CASES SOEATHS
40
• 30
I :
1 1
21.955
S 20
1
7
14.
12.947
17
10
5,25.
801
T
0
3.704
2.320
I—
1960
!
7.088
5.813
1965
1970
1975
0.309
0.154
0.087
0.15
1980
1985
1990
1991
SOURCE : HEALTH INFORMATION OF INDIA
■
6.43. ll(i)
Study on Cultural and
Cordelates of Tribal Health: The focus of the
study, inter-alia, is to study preventive and
curative behaviour of tribal people; and
extent of health education activities carried
out by various health workers in tribal areas.
It has been carried out in four States viz.
Maharashtra, Gujarat, Andhra Pradesh and
Orissa. As many as 58 villages and 1642
households are covered in the study.
Study on status of
6.43.11 (ii)
Implementation of Health Education in
Schools. The objective is to assess the extent
to which health education is being transacted
in schools. Study tools have been prepared.
6.43.11(iii)
Study on People’s
understanding of selected National Health
Programmes, The study tools have been
prepared.
6.43.12 School Health Education Division:
The School Health Education Division works
as a technical resource with the Ministry of
Education, NCERT and Directorate of Adult
Education. It works in close collaboration
with all these agencies and also with State
Health and Education Departments and
Universities in the country for strengthening
health education programme for formal and
non-formal education.
Services.
It collects, analyses and
disseminates the information on Health
Conditions in the country, covering all
aspects of health, namely, health status,
health resources, utilisation of the health
facilities etc. It also conducts the training
programme for various categories ot
statistical personnel dealing with health and
medical fields and arranges training for
overseas fellows in the country on health
statistics. The Bureau is actively engaged in
the Monitoring and Evaluation of strategy ot
Health for all by 2000 A.D. in India.
6.44.2
Epidemic Intelligence:
The
obligations under the International Health
Regulations are being observed.
The
morbidity and mortality figures in respect of
internationally quarantinable
diseases
including Cholera are received by C.B.H.I.
every week from all States/Union Territories
as well as from all major sea-ports and
Based on the figures, Weekly
airports.
Epidemiological Reports are prepared and
sent to WHO every week.
Surveillance on principal
6.44.3
Communicable Diseases other than those
covered under the international health
regulations is also being maintained,
Monthly reports on these diseases are being
received from States/Union Territories every
month in the prescribed proforma. This
alongwith reports on other diseases like
Malaria, Leprosy and Blindness are published
in the monthly Health Statistical Bulletin.
6.43.13 The Division collaborates with
NCERT and CBSE for strengthening health
education in schools. Also, a centre for
promotion of health related vocation studies
has been established by the Ministry of
Health & Family Welfare at CHEB and the
work relating to the Inter-Ministry
Committee set up develop modalities for
starting health-related vocational courses was
taken over by the Division.
Health
6.44.4
Training Programmes:
The
training on Vital and Health Statistics is
conducted at two centres i.e. Model Vital and
Health Statistics Unit, Nagpur and Regional
Health Statistics Training Centre.
Chandigarh. During 1992-93, a total ot 17
candidates in General &. Health Statisticsand
18 candidates in Medical coding were trained
in these two centres.
' 1
The Central Bureau of Health
^^44.!
Intelligence (CBHI) is the Health Intelligence
Wing of the Directorate General of Health
6.44.5
Training Courses for Medical
Record Officers (one year duration) and for
Medical Record Technicians (Six months
duration) are being conducted at Training
6.44
Central Bureau
Intelligence
of
177
I
centres for Medical Records, Satdarjung
Hospital.
Delhi
and JIPMER.
New
Pondicherry. During 1992-93 a total of 8
and 21 candidates were trained in the courses
for Medical Record Officers and medical
Record Technicians respectively at these two
centres.
6.44.6
Field Studies: Six field survey
units established and located in the ottices ot
the Regional Director (H&FW) at Patna.
Bangalore, Bhubaneshwar, Jaipur, Lucknow
and Bhopal are carrying out various field
studies in Health related matters. The field
survey units at Bangalore. Bhubaneshwar and
Patna which were established in 1981 have
carried out 40 studies and those at Bhopal.
Jaipur and Lucknow established in 1986 have
conducted 72 studies, making c total ot 112
studies by all six field survey units.
National Medical Library
6.45
National Medical Library has been
6.45.1
functioning under the administrative control
of the Directorate General of Health
Services. It is housed in its own building on
the Mahatma Gandhi Marg, Ansari Nagar,
New Delhi. It continues to discharge its
mandate for providing information services to
meet requirements in the field of Health,
Medical and related sciences for the users
throughout the country.
6.44.7
Health Management Information
System: In pursuance of the National Health
Policy for establishment of ctticient and
effective management information system in
the Health and Family Welfare sector in the
country, a computer compatible Health
management information system has been
developed and designed in collaboration with
the participating States. National Informatics
Centre and World Health Organisation.
6.44,8
Me.ctingsIC o nfcre n c c s: A
conference of State Bureaus of Health
Intelligence/ Equivalent Statistical cells was
held on 27-28 September. 1993 in Delhi.
Twelve States participated in the conference.
This will be followed by a second conference
which is to be attended by the rest of the
States/UTs.
(i)
It has a collection of over 2.65
lakh publications with addition of
2.500 publications annually. It
receives 2.061 current journals.
(ii)
Photocopies are provided to the
users on paid orders. 1,70,635
pages
of photocopies were
to
5.750
supplied
requests
including 437 sent to South-East
Asian countries. Photocopies ot
42.950 pages were supplied to
officers in the D.G.H.S. and the
Ministry.
Forty-five requests
were received from National
Library of Medicine. Bethesda,
U.S.A'.
(iii)
750 MEDLARS (CD-ROM)
search requests were processed
during April-October. 1993 and
printouts of citations/ abstracts on
requested topics were supplied to
applicants throughout the country.
(iv)
Compilation and circulation of
Documentation Bulletins like (i)
Highlights from. Current Health
Literature and (ii) AIDSDOCDocumentation on AIDS were
continued using the computer
facility available at NML. Data
for "Index to Indian Medical
periodicals" and "Catalogue ot the
Library" are also being input for
storage and retrieval.
6.45.2
Librarv was consulted by 58.(M)0
Publications: CBH1 brings out
6.44.9
many publications at varying period icy.
These are Health Information ot India.
Monthly Health Statistical Bulletin. Directory
of Hospitals in India. Medical Education in
India, Para-Medical Training in India and
Health Graphics of India etc.
178
iir“
*
of Indian nationality who are pursuing their
studies in Post MBBS/B.D.S/M.Sc./Ph.D. in
certain selected specialities and super
specialities in which adequate trained
personnel are not available in the country.
The subject/specialities are reviewed from
time to time on the basis of shortage keeping
in view the availability of manpower in the
relevant areas/fields. The existing rate of
scholarshipJbrPost-MBBS/BDS/M.Sc./Ph.D
is Rs. 850/- per month and that for post
Doctoral courses is Rs. 1000/- per month.
The tenure of P.G. Scholarship is two years
whereas for post doctoral courses the
duration is three years.
visitors; they referred 3.8O.OOO publications.
8,760 publications were loaned to individual
members and 3,060 were supplied on interlibrary loan. 15,500 Reference Queries were
answered.
National Medical
6.45.3
Training:
Library has organised workshops/training
programmes in the field of Health Sciences
Library and Information Services in various
regions of the country as a part of Group
Education Activity Component of the
HELLIS Network in India. Training course
at Grant Medical College, Bombay in May.
1993, a workshop at NIMH ANS, Banglore in
June, 1993 and a 5-week Orientation course
in Medical Librarianship at National Medical
Library in August-September. 1993 were
conducted.
Out of the total Scholarship
6.46.2
awarded annually. 15% and 7.5% of
Scholarships are reserved for candidates
belonging to SC/ST respectively. In case the
requisite number of candidates belonging to
the SC/ST communities are not available, the
Scholarships are awardetl to other eligible
candidates from general quota.
6.45.4
Branch Library at Nirman Bhavan
continued to provide reading material to stall
and officers in Nirman Bhavan.
D.G.H.S. Scholarship Scheme
6.46
Under the D.G.H.S. Scholarship
Scheme scholarships are awarded to students
The year-wise selection of the
6.46.3
candidates is indicated below:-
6.46.1
YEAR-VV1SE SELECTION OE THE CANDIDATES
Year
No.of Scholarships
pr»>posed lo be
awarded
No.of Scholarships
actually awarded
No.of bene filled
SC
1979- 80
1980- 81
1981- 82
1982- 83
1983- 84
1984- 85
1985- 86
1M86-87
1Q87-88
1988-89
1*489-90
IM90-91
|*49|-92
19*42-93
120
120
120
120
120
110
100
KM)
100
I 13
124
120
120
120
120
120
96
63
4
7
3
I
6
2
2
I
2
4
10
6
8
6
90
I 10
|(K)
1(8)
1(8)
113
124
120
I2<)
86
179
No. of beneftlled
ST
I
3
I
I
4
I
I
*
However, scholarship amount is
6.46.4
released on receipt of the response from
candidates.
6.46.5 , The selection of the award of
scholarship for the year 1993-94 is being
made.
6.47
1
The North Eastern Indira
Gandhi Regional Institute of
Health and Medical Sciences,
Shillong
The North Eastern Indira Gandhi
6.47.1
Regional Institute of Health and Medical
-• •••
-* -■-)
Sciences, Shillong
was set
_up under the
of
Resolution
the Group of Ministers,
Government of India in their Meeting held on
16.12.1982 and the approval of the Central
Government. Its objective is to provide
advanced and specialised health care to the
people of the North-Eastern Region including
Sikkim and to serve as a regional referral
service centre; to promote a programme of
health manpower development and training in
identified fields of super-specialisations.
6.47.2
The Central Government realising
the • difficulties being encountered in
implementing the Project Report prepared by
Dr. N.S. Deodhar, entrusted the task of
reviewing and suitability suggesting views tor
revising the Project Report to Dr S.D
Sharma, the then Additional Director General
of Health Services with a view to ensure that
part of the project is implemented early,
taking into account the facilities already
available in the North-East Region,
particularly Shillong.
6,47.4
After consideration of Dr.
Sharma’s Project Report, the Additional
Secretary(Health) undertook a visit to
Shillong and held discussions with Chief’
Minister of Meghalaya among others to
finalise the proposal for the establishment of
the Institute.
The proposal for
implementation of the Project is under
consideration of the Ministry.
National Institute of Biologicals
6.48
6.48.1
National Institute of Biologicals
has been established by the Government of
India to fulfil the need for a high standard of
quality control of biologicals in India. The
prime objective of the Institute will be to
develop and lay down standards for quality
control testing procedure for biologicals and
• immunobiological products being produced
indigenously as well as imported in India.
6.48.2
The Institute has been set up as an
autonomous organisation, registered under
the Societies Registration Act, 1860, under
the control of--the Ministry of Health &
Family Welfare. The total outlay ot the
project is Rs. 69.74 crores spread over a
period of 8 years falling in Sth and 9th Plans.
The project will be funded by the
Government of India, OECF, Japan, and the
USAID. The share of the donor agencies
and the Government of India will be as
fol lows:Govt, of India
OECF, Japan
USAID
: Rs. 24.25 crore
: Rs.37.17 crore
: Rs. 8.32 crore
Total
: Rs.69.74 crore
6 48.3
A
A plot of land measuring 74’^°
sq. mtrs. in the Institutional Area (Phase II),
NOIDA. has been acquired for setting up
the Institute.
A Site Office has been
constructed and the boundary wall is undti
Master Plan tor
construction.
e
construction of Administrative Block, Guest
House, Hostel and Cafeteria has been
prepared and submitted to NOIDA authorities
for approval.
Dr. Sharma in his report submitted
6.47.3
on 5.1.1993 recommended tor the
development of the Institute in two Phases,
namely, Phase-I as a short-term proposal tor
setting up of an Institute with limited
facilities, Phase-II being a
long-term
proposal, implementation of which should
start alongwith Phase-I and would consist ot
provision of facilities at the permanent site
tor the Institute.
180
i
Pending completion of the
6.48.4
construction of the building complex at
NOIDA, NIB has proposed to start the
scientific programme in an Interim facility in
the accommodation leased out in a suitable
building. Six laboratories are proposed to be
set up in this accommodation.
The
renovation work has been scheduled from
May, 1994 and the laboratories are expected
to be ready by March. 1995.
A detailed Institutional
6.48.5
Development Plan for the project has been
prepared for implementation.
1
6.49
i
BCG Vaccine
Guindy, Madras
Laboratory,
BCG Vaccine Laboratory, Madras
6.49.1
a subordinate office under the Directorate
General of Health Services was set up in
1948 with the assistance of the WHO and the
UNICEF to manufacture and supply BCG
vaccine and Tuberculin PPD to the States and
Union Territories. The supply of FD BCG
Vaccine to States and Union Territories are
done under Universal Immunization
Programme as per allocations fixed by the
Government of India. The biologicals are
also supplied to Medical Institutions and
private medical practitioners on payment.
This is the only Laboratory in India engaged
in production of FD BCG Vaccine and
Tuberculin PPD.
for 1993-94 to meet the requirements of UIP
in India. Out of this, the production target
for this laboratory is 350 lakh doses. Upto
the end of September, 1993, a total of 119.27
lakh doses have been produced by this
laboratory. Upto 30.9.93, 330.34 lakh doses
were supplied which includes imported
vaccine as well.
The biologicals produced and
6.49.4
supplied during the period April, 1993 to
September, 1993 are as under:
Production
Supply
119.27
lakh
doses
330.34
lakh
doses
RT-23
8991
vials
7653
vials
2-TL)
157
vials
88
vials
FD BCG
Vaccine
(20 dose
per ampoule)
TUBERCULIN
PPD
1-TU
6.49.5
Post - Graduate students from
Madras University doing M.Sc and M.D.
Microbiology and nurses are being trained in
this laboratory.
The requirement of vaccine
6.49.2
increased rapidly owing to introduction of
EPI and subsequently UIP. To increase the
installed capacity and to meet the additional
requirement, expansion programme for this
laboratory was included in the VII Five Year
Plan with the total outlay of Rs.l crore. The
UNICEF supplied the imported equipments
and spares costing about Rs.2 crore. For this
expansion as well as for installation of the
machineries some construction of new
buildings/laboratories and modification of the
existing laboratory were done.
6.49.6
Future plan of action: The
expansion of the BCG Vaccine Laboratory
was included in the Seventh Five Year Plan
with an outlay of Rs.l crore which excludes
the imported machinery costing about Rs.2
crore procured through the UNICEF. After
complete installation of all these machines the
installed capacity will be 400 lakh.doses.
6.49.7
A proposal for opening a Unit tor
preparation of diluent for the BCG Vaccine
has been included in the VIII Five Year Plan
with an outlay of Rs. 198.81
lakh.
Administrative approval/expendituresanction
for Rs.3.61,54,000A has been accorded for
Target for supply of 503.85 lakh
6.49.3
doses of BCG Vaccine has been determined
181
I
attend various courses at the National TB
Institute, Bangalore. The institute has also
been recognised as a WHO collaborating
centre.
The Vth International Training
Course at NT1 was held in January 1993.
The institute is also engaged in important
epidemiological, sociological.. bacteriological
and operational research connected with the
TB control programme and provides suitable
technical guidance to the distt. TB centres so
that their performance can further improve.
The institute is also given responsibility of
monitoring the distt. TB programme of the
country. Quarterly reports are received by
the institute which are scrutinised and
comments are given to the State Governments
to take necessary corrective action, whenever
necessary. The institute also brings out
annual report on monitoring of the
programme.
setting up the production Unit at Madras in
order to achieve self sufficiency in
production of BCG Vaccine.
!
6.50
National Tuberculosis Institute.
Bangalore
The National
Tuberculosis
6.50.1
Institute, Bangalore was established in the
year 1959 by the Government of India with
the assistance of WHO &- UNICEF to evolve
nationally applicable methods of TB Control
and Training key personnel for TB Control
Programme.
About 5300 personnel of
different categories have been trained in 68
courses held in the Institute, so far. Apart
from training of distt. TB teams, it also
undertakes refresher courses for district TB
and reorientations/
centre personnel
training/seminars for senior health
administrators and professors of Medical
Trainees from abroad also
Colleges *etc.
f
6.50.2
The financial outlays are as under:
FINANCIAL OUTLAYS
(Rs. in thousands)
Plan
Non-Plan
6.51
Actuals
1992-93
BE
1993-94
994.2
9,378
97,50
10.00
All India Institute of Physical
Medicine and Rehabilitation,
Bombay
The All India Institute of Physical
6.51.1
Medicine and Rehabilitation, Bombay has
been functioning in the field of Rehabilitation
Medicine over the past 39 years. The
Institute is a pioneer Institute in the whole of
South-Asia with facilities for Mescal
Rehabilitation services (with 40 bedded
hospital, Operation Theatre tor
Reconstructive Surgery facilities for
Pathology and X-Ray investigations etc.)
which cover Rehabilitation Nursing,
Physiotherapy, Occupational Therapy.
Medical Social Work, Vocational Guidance.
Evaluation, Adjustment and Training and
11.34
1,10.27
BE
1994-95
16.90
1.27.25
supply of Prosthetic and Orthotic appliances.
The Institute has a Research Society. The
Institute undertakes training at Graduate and
Post-Graduate level and research in
Rehabilitation Medicine. Over the past few
years the Institute has been trying to reach
the disabled population scattered all over
rural areas in general and the areas where
Scheduled Caste and Scheduled Tribe
population is concentrated in particular
through camp approach. These camps are
conducted in collaboration with voluntary and
Semi-Government or local organisations.
The Departments providing
6.51.2
services to the handicapped are: (i) Medical
Rehabilitatum (with 40 bedded hospital,
Operation theatres Pathology and X-Ray
182
!
RE
1993-94
Investigation operation theatres etc.); (ii)
Rehabilitation Nursing; (iii) Physiotherapy;
(iv) Occupational therapy; (v) Speech
therapy; (vi) Prosthetic and Orthotics (with
Prosthetic Workshop); (vii) Vocational
Guidance, Evaluation, Adjustment and
(with vocational
training
Training
workshop); (viii) Medical social work; (ix)
Research;and (x) Administration.
This Institute runs Under-graduate
6.51.3
and Post-graduate Diploma and B.Sc and
M.Sc Degree courses in Rehabilitation for
MS/MD,
M.B.B.S., Homoeopathic,
Ayurvedic and Unani Doctors Physiotherapy
and Occupational Therapy and several post
graduate diploma courses in various aspects
of rehabilitation.
6.51.4
During the period under report
about 18,000 new cases and 6640 old patients
were treated through social clinics and 25000
patients attended in out patient department for
various ailments. A total of 922 operations
were performed in the Institute.
6.51.5
During the year 1993-94, a budget
provision of Rs. 122.40 lakh under Non-Plan
and Rs.75.00 lakh under Plan has been made
for the Institute.
183
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Prime Minister Shri P.V. Narasimha Rao inaugurated the session of
Mahotsava of Ayurved Mahasammelan at Nagpur oni 25th December, 1993. The
of Indian Systems of Medicine was
issue of strengthening and development
<
discussed.
I
I
L
I
f.
INDIAN
SYSTEMS OF
MEDICINE AND
HOMOEOPATHY
The National Health Policy ot 1983
envisages the necessity to initiate organised
measures to enable each of the Systems ot
Indian Medicine that is Ayurveda, Siddha,
Unani, as well as Homoeopathy to develop in
accordance with its genius. The^policy
proposes for planned efforts to find an
appropriate role and place for these ditterent
systems in the overall health care delivery
system in the country.
7.1.2 People of our country have faith in
the traditional systems, the services provided
are generally cheaper and available in small
towns and rural areas, and the remedies are
known to be generally free from side-effects.
Further, India has a large resource of about
4 lakh practitioners of ISM and 1.5 lakh
practitioners of Homoeopathy, whose
services need to be fully utilised. There are
about 220 ISM and Health Colleges
producing about 9000 graduates in Indian
.^vRtftms including diploma holders in
Systems
Homoeopathy every year.
7.1.3 Ayurved based on Athervaved, was
developed more than 3,000 years ago by
sages like Agnivesh and Sushruta. There is
mention of about 15,000 drugs in the
classical texts, of these 1,500 drugs
mentioned in about 50 Classical Texts are
presently in wide use.
7.1.4 ‘Siddhars’ seem to have contributed
towards development ot Siddha Medical
System. The literature is basically in Tamil
and this System is practised in the Tamil
speaking areas in India, as well as in
countries like Sri Lanka, Malaysia and
Burma. Its origin is also attributed to the
great sage Agasthya.
7.1.5 The Unani System of Medicine had
its origin in Greece. It was extensively
adapted and developed by the Arabs after
assimilating medical knowledge from India
and Persia. It has developed strong roots in
India. In view of its many similarities with
the Ayurvedic System the two are practised
side by side by Vaidyas and Hakims.
CHAPTER VII
185
r
f
I
7.1.6 The basic concept in all the three
systems related to maintaining a balance in
the body between different elements or
humors of hich the body is functioning. Any
disturbance in the balance leads to disease
and the therapy lies in restoring the balance
through use of medicines ot natural origin
based on herbs and minerals.
7.1.7 Non-drug therapies like Yoga and
Naturopathy which are being practised in the
country as a way of living for maintenance ot
health have also been included under Indian
Systems of Medicine.
7.1.8 Homoeopathy had its origin from
Germany and is practised in India for nearly
150 years.
7.2
Institutional Development
7.2.1 Before independence these systems
were left, to develop on their own with
practically no Governmental support. Indian
Systems of Medicine were generally practised
on the basis of learning through family
traditions, although few colleges had come up
in the late 19th Century or in the earlier part
of 20th Century. Thus, there was practically
no regulation regarding the practice and
educational standards. Persons went to such
physicians on the basis ot faith in their skill,
knowledge and integrity. The ability to
diagnose and cure a disease was considered
to be a quality having spiritual dimensions.
7.2.2 After
independence. institutions
paralleling those existing in Allopathy were
formed in order to develop these systems.
These include the Central Council of Indian
Medicine and the Central Council for
Homoeopathy to register practitioners in
these systems and to lay down minimum
standards for education. The Central Council
for Research in Ayurveda and Siddha, the
Central Council for Research in Unam
Medicine, the Central Council for Research
in Homoeopathy and the National Institute
for Ayurveda at Jaipur and the National
Institute of Homoeopathy at Calcutta, were
also set up as apex bodies for research and
teaching. In order to formulate standards for
drugs, Pharmacopoeial Committees tor each
of these systems were set up and supported
by laboratories like the Pharmacopoeial
Laboratory for Indian Medicine and the
Homoeopathic Pharmacopoeial Laboratory,
both being located at Ghaziabad. A recent
innovation is the setting up of Rashtriya
Ayurveda Vidyapeeth which is to utilise the
Guru Shishya Parampara as the basis ot its
functioning involving close personal rapport
between the teacher and the taught, in
contrast to the impersonal relationship in
modern institutions.
1.3
7.4
I
Central Council of Indian Medicine
7 4 1 The Central Council ot Indian
Medicine is a Statutory Body const,tu ^
under the provisions ot Indian Mechune
Central Council Act. 1970 (IMCC Act,
1970). The first Council was nominated o>
the Government of India in ^Tl- The
Council was reconstituted in 1984 vide
Government of India notification in Gazette
of India, Extraordinary, Part-II, Section III,
Sub-section II dated 7.5.84 and elections tor
further reconstitution of the Council are in
progress and are likely to be completed by
the end of this year.
7.4. l(i) On the advice of Central Council,
the Central Government notified the inclusion
of BAMS of Amravati University m the
Second Schedule to the IMCC Act 1970
during the year 1992-93.
Besides 5
Ayurvedic qualifications, 3 Unam and 3
186
I
Educational
Professional
7 3.1 There are two Central Councils, viz
(i) Central Council of Indian Medicine
(CCIM) and (ii) Central Council or
Homoeopathy (CCH). which are responsible
for laying down and mamtaimng uniform
standards of education and regulate the
professional practices of the practitioners in
the field of Indian Systems of Medicine and
H omoeopathy, respective! y.
I
I
I
Regulation of
and
Standards
Practices
|r'
-•
Siddha qualifications were recommended by
Central Council of Indian Medicine for
inclusion in 2nd Schedule of the IMCC Act
are being examined by the Ministry.
The Central Register of
7.4.1 (ii)
Practitioners of Indian Systems of Medicine
registered with the Boards of Andhra
Pradesh, Assam, Delhi, Haryana, Himachal
Pradesh, Jammu and Kashmir, Karnataka,
Orissa, Punjab, Tamil Nadu and West Bengal
on the basis of recognised medical
qualifications have been published in the
Gazette of India. And for the remaining
States the register was sent for publication in
the Gazette of India.
7.4. l(iii) The budget estimate of the Council
for the year 1993-94 approved by the
Ministry is Rs. 191 lakh under Non-Plan and
Rs. 20 lakh under Plan. The Plan provision
is being utilised for conducting CCIM
elections.
7.5
Central Council of Homoeopathy
maintain Central Registrar of Homoeopathy
and matters connected therewith.
7.5.2 During the year under report, the
Central Council has sent its recommendations
to Government of India for the inclusion of
following medical qualifications in
Homoeopathy in the Second Schedule to the
Homoeopathy Central Council Act, 1973:7.5.3 For maintenance of Central Register,
the list of Registered Practitioners of States
of West Bengal, Andhra Pradesh, Punjab is
being prepared for the first supplement
thereto. Work to prepare Corrigendum in
respect of Central Register of Homoeopathy
is in progress.
7.5.3(i) The Central Council has registered
130 Practitioners possessing recognised
qualification in Part-I of Central Register.
7.5.4 The Central Council has finalised
amendments to the following Regulations and
has sent the same to all the States/UT
Governments for their comments, if any:
7.5.1 The Central Council of Homoeopathy
is a corporate body established under the
provision of Homoeopathy Central Council
Act, 1973 to maintain uniform standards of
medical education in Homoeopathy and
Course)
1.
Homoeopathy (Degree
Regulations, 1983.
2.
Homoeopathy (Minimum Standard of
Education) Regulation, 1983.
MEDICAL QUALIFICATIONS IN HOMOEOPATHY IN THE SECONDr SCHEDULE
TO THE HOMOEOPATHY CENTRAL COUNCIL Ati,
Madurai Kamaraj University, Madurai
B.H.M.S. from August, 1992 onwards
S.P. University
B H.M.S. from 1991 to 1993
B.H.M.S. Graded from 1987 onwards
Degree
Rajasthan Board of Homoeopathy
System of Medicine
D.H.M.S. (as per from 1988 onwards C.C.H.
Regulations)
Board of Homoeopathic Systems of
Medicine, Assam
D.H.M.S. from 1983 to June, 1987
Andhra University
M.B.S.(H) during 1984 Spl. Qualifying
Examination
Bihar University
B.H.M.S.
187
Ito.;-.
7.5.4(i) The Central Council also finalised
the amendments to Homoeopathy Central
Council (Inspectors and Visitors)'
And finalised the
Regulations, 1982.
Homoeopathy (Remunerations a nd
Allowances) Regulations and sent it to
Central Government for approval.
7.5.5 The budget allocatidn for the Central
Council for 1993-94 is as under:Plan
Non-Plan
I
Rs. 10.00 lakh
Rs.22.00 lakh
Rashtriya Ayurveda Vidyapeeth
7.6
7.6.1 The Rashtriya Ayurveda Vidyapeeth,
an Autonomous Bodv was registered on 11th
February, 1988 as' a Society under the
Societies Registration Act, 1916.
7.6.l(i)
The main objectives of this
Vidyapeeth is to promote and preserve the
knowledge of Ayurveda. Persons possessing
Post-graduate qualification in Ayurveda or
Graduates with three years teaching/
research/professional experience are inducted
for training for 2 years on traditional lines.
7.6.2 During the year 1993, 3 Governing
Body meetings were held.
7.6.2 (i)
Following actions were taken
during 1992-93:(1)
Five Gurus were appointed.
(2)
Out of 25 students selected for the
course 17 are taking training at
present.
7.C.3 A two-day seminar on Kidney
7.6.3
Disorders was held on 29th and 30th March,
1993. Hon’ble Union Minister for Health
and Family Welfare, Shri B. Shankaranand
inaugurated the Seminar and Hon ble Shri
Paban Singh Ghatowar, Deputy Minister tor
Health and Family Welfare had addressee.! the
Valedictory Session on 30h March, 1993.
1
About 500 eminent Ayurvedic Experts from
various parts of the country had participated
in this Seminar and some of them had
presented their papers on the subject.
7.6.3(1) Fellowship Certificates were also
awarded to the eminent personalities in
Ayurveda.
7.6.4 Rs.20 lakh have been provided in the
. Budget Estimates for 1993-94.
1.1
7.7.1 The four National Institutes viz. (i)
National Institute of Ayurveda at Jaipur; (ii)
National Institute of Homoeopathy at
Calcutta; (iii) National Institute of Unani
Medicine at Bangalore; and (iv) National
Institute of Naturopathy at Pune, were set up
under the Ministry of Health and Family
Welfare as autonomous organisatipns.
7.7.2
7.7.2 National Institute of Ayurveda,
Jaipur: The National Institute of Ayurveda,
Jaipur was established during the year 1976
by the Government of India in collaboration
with Government of Rajasthan at Jaipur as an
apex Institute of Ayurveda in the country to
develop high standards of teaching, training
and research in all aspects of Ayurvedic
System of Medicine with a scientific
approach. It also provides facilities tor
Ph.D. in Ayurveda and is affiliated with the
University of Rajasthan.
7.7.2(i) Teaching: During the year under
report, 253 students were studying in Under
graduate course of " Ayurvedacharya
(B.A.M.S) in the Institute.
7.7.2(ii) Hospital Services: The Institute is
maintaining two hospitals, namely Madhav
Vilas Hospital in the campus and Seth Suraj
Mai Bombaywala Hospital alongwith a
separate maternity and child welfare centre
with a total bed strength of 200. Both these
hospitals have IPD and OPD facilities. The
Institute also organised four medical aid
camps under the Centrally Sponsored Scheme
to provide medical aid in SC and S
188
I
National Institutes
predominant areas including all economically
backward areas of Rajasthan.
7.7.2(iii)
During 1992-93, a sum of
Rs. 169.84 lakh was made available to the
Institute under Non-Plan and Rs. 185.09 lakh
under Plan from the Government ot India.
Rs. 13.68 lakh were provided from the
Government of Rajasthan and Rs. 15.34 lakh
were received from the Institute’s sources.
J
7.7.3 During the year 1992-93 construction
works to the tune of Rs. 157.59 lakh were
done which include Bhatti Unit, Girls and
Nursing Hostel and maintenance of old
building.
During the year 1993-94 an
amount of Rs. 130 lakh Under-Plan is being
deposited with the State P.W.D. to carry out
the construction works of Girls and Nursing
Hostels and Rs. 17 lakh under Non-Plan for
maintenance.
7.7.4 Financial Position: The budget
allocation for the Institute during 1993-94 is
as under:
Plan
Non-Plan
7.8
National
Medicine
Rs. 190.00 lakh
Rs.225.00 lakh
Institute
of
Unani
The National Institute of Unani
7:8.1
Medicine, Bangalore, an autonomous
organisation ot this Ministry was established
in collaboration with Government of
Karnataka. It has been registered under the
Karnataka Societies Registration Act, 1960.
The control and management of the Institute
vests with the Governing Body, which
consists of seventeen members with the
Union Minister for Health and Family
Welfare, as President and the Minister tor
Health and Family Welfare, Government of
Karnataka as Vice-President. The term ot
the Office of Non-Official Members of the
Governing Body is three years.
7.8.l(i) 55 acres and 2 guntas of land have
been given free of cost by the Government ot
Karnataka in Srigandadhakavalu village on
Bangalore-Magadi Road for construction ot
the Building of the Institute. The State
Government of Karnataka would be sharing
l/3rd of the recurring and non-recurring
expenditure ot the Institute and also
construction cost, while 2/3rd would be met
by the Ministry of Health and Family
Welfare, Government of India. Plan and
Estimate of the proposed building ot the
Institute have been prepared and shall be
placed before the Governing Body for
approval.
7.8.1(ii) The main objective of the Institute
is to produce graduates and post-graduates in
Unani System of Medicines.
7.8.1(iii) Budget provision of Rs. 100.00 lakh
for the Institute for the year 1993-94 has
been made under Plan.
7.9
National Institute of Naturopathy,
Pune
7.7.1
7.9.1 The National Institute of
Naturopathy, Pune was registered under
Registration Act, 1960 with the object ot
promotion of Naturopathy and to encourage
research in all aspects concerning human
personality, cure of chronic ailments,
prevention ot diseases and development ot
human personality for achieving good health.
7.9.1 (i)
The National Institute of
Naturopathy (NINJ organised 3 seminars in
Naturopathy treatment, one each at Trichur
(Kerata), Bangalore and Aurangabad. These
seminars were ot the nature ot patients
consultancy-cum-seminar. One Treatmentcum-Demonstration Camp was conducted by
the Institute at Aurangabad in collaboration
with Kakatiya Nature Care Hospital. The
Institute has also been conducting awareness
courses of 15 days duration of Naturopathy at
Yashwant Palace, Chanakyapuri, New Delhi.
So far 7 such courses have been conducted
There has been good
by the Institute.
response from a number ot administrative
training institutes in the country to include
lectures in Naturopathy in their training
programmes. To cope up with the increasing
189
Plan
Non-Plan
7.11
: Rs. 149.20 lakh.
: Rs. 50.55 lakh.
Scheme for Raising Standards of
ISM & H Colleges (V.G.)
7.11.1 In 1992-93 attention has been
focussed on upgradation of standards in
existing 220 ISM&H Colleges run either by
State Governments or by grantee institutions.
It has been recognised that the quality of
under-graduate education will be critical in
determining the quality of services provided
by ISM&H practitioners not only in terms of
patient care but also for building up a cadre
of research workers. A number of ISM&H
colleges lack facilities in terms of equipment,
class rooms, space, hostel building,
pharmacy, herbal garden and attached out
patient services/beds which would be
considered essential for proper training of
ISM&H graduates.
7.11.2 During 1992-93, 14 colleges were
provided assistance to the tune of about Rs.
106 lakh. The outlay of assistance to such
colleges is increased from Rs. 106 lakh in
1992-93 to Rs. 280 lakh in 1993-94.
7.11.3 Under this scheme, the Ministry
proposes to provide assistance to 10 to 12
Colleges for upgradation of various facilities
during the year 1993-94, covering an amount
of Rs. 2.80 crore.
7.12
Scheme for Reorientation Training
Programme for Teachers,
Physicians, Research Workers and
Drug Inspectors in ISM and H
7.12.1 As a part of continuing medical
education, required to update the knowledge
of Teachers, Physicians, Research Workers
and Drug Inspectors with regard to the latest
developments in the field of ISM, this
scheme for reorientation training has been
taken up during the VUIth Plan Period as a
cent percent centrally sponsored scheme.
During the year 1992-93, 22 Training
Courses were taken up in 6 ISM&H Colleges
at a cost of Rs.3.08 lakh. In addition, a
Seminar on Rasa Sastra was also held at
B.H.U.
7.12.2 For the year 1993-94 requests have
been received from about 18 colleges for
conducting such Courses. An amount of
about Rs. 16 lakh was approved for release
by the Screening Committee.
7.13
Post-graduate Centres and
Departments
7.13.1 Besides other Post-graduate Centres
and Departments, the National Institute of
Ayurveda, Jaipur, the Gujarat Ayurveda
University, Jamnagar and the Banaras Hindu
University, Varanasi have full-fledged Post
graduate facilities in Ayurveda.
7.14
Institute for Post-graduate
Training and Research, Gujarat
Ayurveda University, Jamnagar
7.14.1 Institute of Post-graduate Training
and Research at Gujarat Ayurveda
University, Jamnagar is a pioneer Institute in
the field of Ayurvedic Post-graduate
Education. In the last year 32 students
passed their M.D.(Ay.) Course. While in
the current year already 27 students have
successfully completed their Post-graduate
Course in June, 1993. A budget provision of
Rs. 130 lakh and Rs. 145 lakh has been
made for the year 1993-94 under Plan and
Non-Plan Schemes respectively.
7.14.2 The other major activity of the
Institute is to facilitate the research work
leading to Ph.D. degree in Ayurveda. This
course was introduced in 1978 and 22 were
awarded Ph.D. degree. A research project in
collaboration with Rajkot Cancer Hospital,
Rajkot, is also in progress.
7.14.3 In the previous year, the research
works on 32 M.D. (Ay.) and one Ph.D. level
projects were completed and in the year
1993-94, the research work on 35 M.D.
(Ay.) and 8 Ph.D. thesis projects are in
progress. In addition, the work on 3 projects
undertaken by the faculty members is also
being continued.
191
7.14.4 Last year 1,09,019 patients (both old
and new) were given Ayurvedic relief at
O.P.D. level and 1652 patients were admitted
in the 150 bedded Hospital attached to the
Institute for the specialised treatment. In
addition, 826 Panchakarma therapies were
given to provide relief to the chronic
patients.
7.14.5 Last year Re-orientation Courses of
14 days duration for Ayurvedic physicians
In these courses, 69
were conducted.
Ayurveda physicians and teachers were
trained in Panchakarma and Kshara Sutra
treatment. It is planned to hold 6 Re
orientation Courses in Panchakarma and
Kshara Sutra of two weeks duration during
the year 1993-94.
7.14.6 A Three-month Shor-t-term
Foreigners Training Course in Ayurveda was
conducted in 1992-93 in which 6 foreign
doctors had participated. The next course is
being organised during November/December.
1993.
7.14.7 The Institute is a collaborative centre
of W.H.O. Under this scheme, the Ayurveda
Graduates of the neighbouring countries
sponsored by WHO are trained in the recent
advances made in the field of Ayurveda
treatment. Last year 3 Ayurveda graduates
of Sri Lanka were benefitted by the
programme and this year upto September,
1993 one foreign Ayurvedic graduate has
already completed his training.
7.14.8 Facilities for Post-graduate Course in
Siddha is available at Govt. Siddha Medical
College, Palayamkottai, Tamil Nadu and for
Unani at Hyderabad and in Aligarh Muslim
University.
7.15
for upgradation of Departments for PostGraduate Training and Research during the
financial year 1990-91. Both recurring and
non-recurring grant in aid is given under the
scheme. The scheme has been conceived as
an incentive to Homoeopathy Colleges to
attain the prescribed minimum standards for
starting the P.G. course in Homoeopathy.
During the Financial year 1992-93, Rs. 45.00
lakh were provided to 4 institutions and
during the Financial Year 1993-94, there
exists a Budget Provision of Rs. 50.00 lakh
(Plan) for the Scheme.
7.16
and
7.16.1 Four Pharmacopoeial Committees are
working for preparing official formularies/
pharmacopoeias to maintain uniform
standards in preparation of drugs of
Ayurveda, Unani, Siddha and Homoeopathy
and to prescribe working standards for single
drugs as well as compound formulations
including tests for identifying purity and
quality of the drugs.
7.17
Ayurvedic
Pharmacopoeia
Committee
7.17.1 The Ayurvedic Pharmacopoeia
Committee had published Ayurvedic
Formulary of India in 2 parts and Ayurvedic
Pharmacopoeia Part-I containing standardsof
80 monographs on single drugs (plant origin)
so far. The II part of Ayurvedic Formulary
of India has been trans.lated from Hindi to
English and is being sept for publication.
7.17.2 18 draft monographs on single drugs
and 32 compound formulations for inclusion
in Ayurvedic Pharmacopoeia,and Formulary
have been drafted during the year.
Scheme relating to Upgradation of
Departments in Homoeopathy
Colleges for Post-graduate Training
and Research including Pattern of
Assistance thereunder
7.17.3 The main Ayurvedic Pharmacopoeia
Committee met on 28th and 29th September,
1992 and approved 34 formulations for
inclusion in the Hird Part ot Ayurvedic
Formulary of India.
7.15.1 The Scheme has been formulated
purely as a Central Scheme for providing
financial assistance to Homoeopathy Colleges
192
I
Pharmacopoeial Standards
Drug Testing Facilities
7.17.4 The Sub-Committee for Identification
of Single Drugs met on 3rd and 4th March.
1993 and reviewed 143 single Drugs of Plant
Origin appearing in the Ayurvedic Formulary
of India Part-I (English Version). These will
be placed before main Ayurvedic
Pharmacopoeia Committee for final approval.
7.17.5 DrugStandardisationSub-Committee
met on 26.11.93 and certain guidelines have
been made .for preparation of the standard
compound Ayurvedic formulations.
I
7.17.6 The Working Group of Ayurvedic
•Pharmacopoeia Committee met twice during
the year and finalised 20 draft monographs
on single drugs. These will be placed-before
the main committee of Ayurvedic
Pharmacopoeia Committee for final approval.
7.17.7 The budget provision of Ayurvedic
Pharmacopoeia Committee made during the
year in Plan is Rs. 10.00 lakh and in Non
Plan is Rs. 15.00 lakh.
7.18
Siddha Pharmacopoeia Committee
7.18.1 The work on II Part National Siddha
Formulary Tamil Version is in progress.
Already 60 formulations were approved by
the Siddha Pharmacopoeia Committee.
Another 40 formulations will be added and
then this will be sent for publication.
7.18.2 More than 300 single drugs of plant
origin were identified in the First Part of
Siddha Formulary. Monographs are to be
prepared for all these drugs. 60 Monographs
were prepared; out of which 20 were
approved by the Siddha Pharmacopoeia
Committee. The remaining will be placed
before Siddha Pharmacopoeia Committee for
approval in the ensuing meeting.
published.
7.19.2 0 part of National Formulary of
Unani Medicine (English Version) containing
202, compound formulations is ready for
printing.
7.19.3 The work on the III part of National
Formulary of Unani Medicine (English
Version) is in progress and 65 compound
formulations have been approved by Unani
Pharmacopoeia Committee for inclusion in III
Part of National Formulary of Unani
Medicine. The work on further formulation
is in progress.
7.19.4 45 monographs on single Unani
drugs is ready for printing.
7.19.5 The work on the First Part of
National Formulary of Unani Medicine
(Hindi Version) is in progress.
7.19.6 The work on 55 monographs on
single drugs is also in progress.
7.19.7 The expenditure is met from A.P.C.
budget.
7.20
Pharmacopoeia
7.20.1 The 55th and 56th meetings of the
Homoeopathic Pharmacopoeia Committee
were held on the 6th January, 1993 and 23rd
March, 1993 respectively in New Delhi. The
Committee besides considering important
business, considered 68 finished product
standards and approved 64 of them. The
Committee also approved another 23
monographs (13 for Homoeopathic
Pharmacopoeia of India, 7 for code and 3 for
consolidated edition).
7.18.3 The expenditure is met from A.P.C.
budget.
7.19
H om oeopathic
Commit tee
7.20.2 The Sth meeting of the Working
Group of Homoeopathic Pharmacopoeia
Committee held in New Delhi on 19th
February, 1993 considered 24 monographs
and approved 16 of them. These were
further approved by the main committee in
Unani Pharmacopoeia Committee
7.19.1 First Part of National Formulary of
Unani Medicine (Urdu Version) containing
its meeting held on 23rd March, 1993.
441 compound formulations has already been
l‘K
t
7.20.3 The Vlth
Volume of the
Homoeopathic Pharmacopoeia of India
consisting of 263 monographs has since been
published.
7.20.4 A budget provision of Rs. 7.00 lakh
under Non-Plan during 1993-94 has been
made for Homoeopathic- Pharmacopoeia
Committee.
7.21
Drugs Control Cell (ISM)
7.21.1 The Drugs and Cosmetics Act 1940
was amended in 1964 (effective from
8.12.69) and Chapter IV-A was added in this
Act providing for licensing and for exerting
partial control on the manufacture ot
Ayurvedic, Unani and Siddha drugs tor sale
in the market. Some of the provisions of this
Act were further amended in 1982 in which
definitions of misbranded/adulterated and
spurious drugs of Indian System ot Medicine
etc. were given and penalty prescribed.
7.21.2 In order to advise the Central and
State Governments in matters relating to
Indian System of Medicines two Statutory
Bodies i.e. Ayurvedic, Siddha, Unani Drugs
Technical Advisory Board and Ayurveda,
Siddha, Unani Drugs Consultative Committee
have been set up under the provisions of the
Act.
7.21.3 The Drug Control Cell for Indian
System of Medicine in the Ministry was set
up in May, 1992 to assist the Drugs
Controller (I) in matters relating to Indian
System of Medicines and to look after the
work of the above Committees.
7.21.4 The meeting of the reconstituted
Ayurvedic, Siddha and Unani Drugs
Technical Advisory Board was held in
December, 92. Draft bye-laws of reconsti
tuted Ayurvedic, Siddha and Unani Drugs
Technical Advisory Board were finalised and
approved by the Board.
limiting the alcohol contents and packing size"
of Mrit Sanjivini Sura and Mahadrakshasava
was published on 2.12.92.
7.21.6 Notification of Government of India
banning the use of tobacco in drugs of Indian
System of Medicines has been ratified by
Ayurvedic, Siddha, Unani Drugs Technical
Advisory Board in Dec. 1992. Similarly
Draft Notification issued abolishing the loan
licensing system in Indian System of
Medicines has also been approved by
Ayurvedic, Siddha, Unani Drugs Technical
Advisory Board in Dec. 1992.
7.21.7 The Ayurvedic, Siddha, Unani Drugs
Technical Advisory Board at its meeting held
in Dec. 1992 considered the book Rasatantra
Sara Va Siddha Prayog Samgrah included in
the first Schedule of Drugs and Cosmetics
Act. 1940 and decided that the part of the
book should be specified in the First
Schedule as "Rasatantra Sara Va Siddha
Prayoga Samgrah- Part I". Accordingly a
draft has been sent for notification in the
Gazette.
7.21.8 The Ayurvedic Pharmacopoeia of
India Part-1, Vol.I containing 80 monographs
on single drugs of vegetable origin has been
published and it is proposed to give this book
a legal status by incorporating it in the rules
of Drugs &. Cosmetics Act during this year.
7.21.9 Regional Drugs Testing Laboratories
are proposed to be set up for testing Indian
System of Medicines Drugs under Central
Council for Research in Ayurveda and
/Siddha and Central Council for Research in
Unani Medicine possibly by utilising their
available infrastructure.
7.22
Pharmacopoeial Laboratory
Indian Medicine, Ghaziabad
for
7.22.1 The laboratory was established in the
year 1970 as a standard - setting-cum-drugtesting laboratory for Indian Medicine
including Ayurveda, Unani and Siddha
System at the national level. Indian Systems
of Medicine (ISM) are covered under the
7.21.5 The final Notification GSR No.904
(E) limiting the packing size of Karpur-Asva,
Ahiphana Asava, Mrig Madasava and
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purview of Drugs and Cosmetics Act, 1940.
The worked out standards, in the form of
monographs are published by the Ministry of
Health and Family Welfare in Ayurvedic,
Unani and Siddha Pharmacopoeia of India.
The first volume of Ayurvedic
Pharmacopoeia of India - Part I containing 80
monographs on single drugs has already been
published. The work on the second part of
Ayurvedic Pharmacopoeia is in progress.
7.22.2 During the year, the laboratory has
worked out standards on 20 single drugs and
25 compound formulations, which have been
submitted to the Ministry for finalisation by
the Ayurvedic Pharmacopoeia Committee
(APC). Pharmacopoeial work on single
drugs of Unani medicine rs under process for
placing before the Unani Pharmacopoeia
Committee.
7.22.3 Laboratory has preserved more than
2000 standard specimens of crude drugs in
the Museum procured from different sources
and by conducting collection tours in
different regions of country.
7.22.4 An Advisory Committee for
Pharmacopoeial Laboratory for Indian
Medicine comprising of Prof. A.N.
Namjoshi, Bombay, Dr. S.K. Mishra, Delhi
and Miss S. Satakopan, Madras as Members,
has been constituted and two'meetings of this
Committee were held at Ghaziabad and
Bombay during the year.
7.22.5 Budget for the year 1993-94 in
thousands
Plan
Non-Plan
7.23
19500
1700
Pharmacopoeia
Homoeopathic
Laboratory, Ghaziabad
7.23.1 Homoeopathic Pharmacopoeia
Laboratory, Ghaziabad, is a high technology
based standard setting-cum-drug testing
laboratory for homoeopathic medicines at
National Level. Homoeopathic medicines are.
covered under the purview of Drugs and
Cosmetics Act, 1940. Worked out standards
are released by the Ministry of Health &
Family Welfare in the form of Homoeopathic
Pharmacopoeia of India (HPL). Six volumes
consisting of standards for 706 drugs and 150
finished products have been published.
Homoeopathic Pharmacopoeia of India is
included in the Second Schedule of Drugs
and Cosmetics Act, 1940. In addition to
above, standards of over 500 allied items and
limit for alcohol contents of commonly used
homoeopathic medicines have also been
published.
The laboratory has released
recommendatory standards for 200 raw
materials and commonly used finished
products.
7.23.2 During the year, the laboratory
completed fixation of standards for 29 basic
drugs against a target of 25 and 20 finished
product Standards against a target of 25.
Drug testing of 211 survey samples against a
It undertook testing of
target of 100.
samples referred by different States and
Government Agencies.
The laboratory
maintains medicinal plants garden where rare
and exotic medicinal plants are cultivated and
preserved. A seed and germ plasm bank of
rare and exotic plants is also functioning.
7.23.3 Budget: A provision of Rs. 65.00
lakh under Plan and Rs. 16.50 lakh under
Non-Plan has been made during 1993-94.
7.24
Apex Bodies for Research
7.24.1 The four research councils, Viz. (i)
Central Council for Research in Ayurveda
and Siddha (CCRAS); (ii) Central Council
for Research in Unani Medicine (CCRUM);
(iii) Central Council for Research in
Homoeopathy (CCRH); and (iv) Central
Council for Research in Yoga and
Naturopathy (CCRYN); continued to initiate,
aid, guide, develop and coordinate scientific
research in different aspects of the respective
system both fundamental and allied. These
Councils are the apex bodies for research in
the concerned systems of medicine and are
fully financed by the Government of India.
195
7.25.3 During the execution of this
programme, medical aid to about 2.5 lakh of
patients through
Out door Patient
Departments and about 2000 patients at In
door Patient Departments functioning at
different Institutes/C'entres/Units of the
Council have been providex.1.
7.24.3 The Council carries out its functions
through a net work of 85 Research InstitutesCentres functioning under its direct control
and through a number of Units/Enquiries
located in Universities, Ayurveda/Siddha and
Modern Medical Colleges, etc.
7.25.4 Health Cure Research Programme:
Health Care Research Programme carried out
by the Council include Service Oriented
and
Surveillance
Screening
Survey
Health Care
Programme,
Community
Research Programme and Tribal Health Care
Research Programme. During the.^riod^.
under report a population of about 75^000
individuals pertaining to 80 villages including
30 tribal pockets have been covered under
this programme and incidental medical aid
provided to more than 30.000 patients.
7.25
i
Clinical Research Programme
7.25.1 Clinical Conditions continued to be
studied in Ayurveda during the reporting
include Amavata (rheumatoid
period
(hemiplegia).
arthritis),
Paksvadha
(Sopondilytis).
Pangu
Grivastambha
(paraplegia).
Kampavata
(parkinson s
disease), Gridhrasi (sciatica) Saisviyavata
(poliomyetities), Amlapitta (hyperacidity).
Parinamasula(duodenal ulcer), Annadravasula
(gastric ulcer), Pravahika (dysentery).
Grahani Roga (malabsorption syndrome),
Kamala (Jaundice), Bhagandar (Fistula-inano), Tamaka swasa (bronchial asthama),
Swetapradara ( leucorrhea). raktapradara
(metrorrhagia),
Madhumeha
(diabetes
mellitus),
Kriccha
(dysuria),
Mutra
Vyanbalvaishamya (hypertension), Hridroga
(ischaemic heart disease), Slipada (tilariasis),
Visamajwara (malaria). Kitibha (psoriasis),
Pama (seabies) Vicarcika (oozing eczema)
and Arbudaviseseh (Cancer).
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7.24.2 The Central Council tor Research in
Ayurveda and Siddha an autonomous bod\
under Ministry of Health & Family Weltare,
Government of India is an apex body in India
for
the
coordination,
formulation.
development and promotion ot research on
scientific lines in Ayurveda and Siddha.
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7.25.5 Drug Research Programme: The
Drug Research Programme consists of
Medico-botanical Survey. Cultivation of
Medicinal Plants, inter-disciplinary research
programmes likePharmacognostic, Chemical,
Pharmacological and Toxicological studies
besides Drug Standardisation Studies.
Pharmacognostical Studies ot 7 drugs,
Chemical
15 drugs and
studies of
Pharmacological and Toxicological studies of
25 drugs used in Ayurveda and Siddha
System of Medicine have been carried out
during the reporting period. The Council is
also maintaining a Musk Deer Breeding Farm
at Mehrori in Kumaon Hills and there are 25
animals in this farm.
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7.25.6 Drug standardisation research studies
of about 80 single drugs, detailed
standardisation studies of 15 formulations
have been carried out besides laying
preliminary analytical standards for
25
formulations used in Ayurveda and Siddha
System of Medicine.
7.25.2 Clinical conditions under Siddha
System of Medicine continued to be studied
during the reporting period
include
Valliguanmam (peptic ulcer), Putrunoi
(Cancer), Manjal Kamali (infectivehepatitis),
sandhivatha soolai (rheumatoid arthritis).
Kalanjaga padai
(psoriasis). Vellainoi
(leucorrhea) Gunmam (intestinal disorders).
Vellupunoi
Venkuttam
(anaemia),
(leucoderma), Neerazivu (diabetes mellitus).
Oothalnoi (obesity) and Karappannoi (skin
diseases).
I
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7.25.7 Literary Research Programme: In the
field of revival and publication ot ancient
literature printing work of Astanga Sangraha
- Part-1 has been completed during the
196
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icpoiliug period. The 1 uuncil is briiiging
om "Journal of Resea: h in Ayurveda and
’.iddha . "Bulletinoi Mcdico-Fthno-Botan
Research", ‘ Bullcini ot Indian Institute oi
History of Medicine" besides the N’ev. .
letter'.
7.25.8 Family Welfare Rcseuix 7/ /7-oscreening and
gramme:
Clinical
Pharmacological
siudies of the oral
contraceptive agents are being carried out
under this programme. About 250 new cases
were studied besides old cases carried
forward from the previous year for clinical
evaluation of oral contraceptive agents like
AYUSH-AC IV, K capsule, Pippalyadi
Yoga. Neem Oil and Vandhyavari (Vicoa
indica). Pharmacological studies on seven
drugs have been carried out.
7.25.9 Budget: The budget allocation for the
year 1993-94 is as under:
Plan
Non-Plan
Family Welfare
7.26
Rs.345.00 lakh
Rs.597.00 lakh
Rs. 17.50 lakh
Central Council for Research in
Unani Medicine
7.26.1 The Central Council for Research in
Unani Medicine continued its multiiaceted
research activities in the field of clinical
research, drug research, literary research and
survey and cultivation of medicinal plants,
besides the Family Welfare Research
Programme. These activities were continued
through a network of 30 institutions/units.
.26.3 lJuring the period under report the
llowing iinportata research activities are
being continued.
.'6.4 'The pro'ect on scientific interpreta:on of theory of Akhlu: (Humors and
; .‘mperaments). .A project on establishing
i..c eff icacy of cupping scientifically in cases
of Rheumatoid Arthrit is has also been studied
and yielded promising iesults.
7.26.5 A pilot project tm Amraz-e-Qalb
Hapercholesterolaemia). The drugs under
trial showed significant effect in normalizing
the cholesterol and tryglyceride levels.
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7.26.5 (0 l ijihci siudies are in progress.
7.26.6 General OPD Programmes: To
provide free medical treatment for common
ailments through Unani Kit medicines to the
patients attending the OPD’s of the
Insiitutes/l mils so as to select cases of
research problems undcT study, continued at
14 Centres of the Council.
During the
reporting period a tolai o4' 55425 cases of
common ailments were attended at different
centres.
7.26.7 Ihr Mobile i:< search Programme:
To meet the medical needs to common people
specially, the Scinch h- Castes, Schedule
Tribes and other under privileged sections of
the population in the rural areas and urban
slums the Council continued its activities
through 15 mobile units attached to different
institutes and units. During the reporting
period a total of 30540 cases of common
ailments were attended at different centres of
the Council.
7.26.8 School Health Programme: 1050
School Children were screened and 640
children found suffering from various
ailments were treated with Unani Kit
Medicines.
7.26.2 Clinical Research Programme: 'The
Clinical and therapeutic ’studies were
continued on some common and chronic
ailments with special emphasis on the
diseases having National priority.
The
Council achieved promising results of clinical
trials in the field of Bars (Vitiligo), lltehsb-eTajaweef-e-Anf (sinusitis). 11 tehsb-e-Kabid
(Infective hepatitis). Nar-e-Farsi (Eczema)
and Wajaul Mafasil (Rheumatoid Arthritis).
Standardisation
Research
7.26.9 Drux
Standardisation
work
on 10
Pro^raninic:
single drugs and’ 38 compound formulations
have been under taken during the reporting
197
■
period. Besides standardisation of 10 drugs
of mineral origin and method of processing
of eight compound formulations was also
under taken.
7.26.10 Survey and Cultivation of Medi
cinal Plants Programme: During the surveys
of different areas a total of 360 plants
specimens were collected. Seventy eight
folk-lore claims for various ailments were
also collected from different tribal pockets.
7.26.11 240 Kg. of Aat^ilal and about 100
kg. of other 18 Medicinal Plant products was
produced form the Central Herb Garden.
i
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Literary1 Research Programme:
7.26.12
Translation, editing and compilation of rare
Unani books/manuscripts were continued.
Compilation of a booklet on Yarquan
(Jaundice) was completed during the period
under report.
Family Welfare Research
7.26.13
Programme: Clinical screening of four oral
Unani contraceptives were continued.
During the reporting period 90 new cases
were registered whereas 95 old cases
continued from previous year bringing a total
of 185 cases studied during the reporting
period.
7.26.14 Budget: The budget allocation for
the Council for the year 1993-94 is as
follows:
Plan
Non-Plan
Family Welfare
7.27
100 lakh
210 lakh
4.5 lakh
an autonomous organisation under the
Ministry of Health and Family Welfare.
7.27.2 It has during the years, established a
network of 51 Institutes/Units located in the
various parts of the country. The Council
continued its research activities in the field of
Clinical Research (including Tribal and
Epidemics), Clinical Verification, Drug
Proving, Drug Research and Standardisation
including Survey and Collection of Medicinal
Plants, Literary Research and Documentation
(including publications).
7.27.3 Clinical Research studies have been
divided into two parts viz. Disease related
and Drug related. Thirtyseven (37) Clinical ' :
Research Projects are in progress at six
research institutes, thirteen Clinical Research
Units, one Clinical Research Unit (Tribal),
Sambalpur
(Orissa) and one Drugs
The project
Standardisation Unit.
’’Evaluation of -Homoeopathic Drugs in
Asymptomatic HIV Infection" is being
studied in cooperation with Indian Council of
Medical Research (ICMR) and is being
undertaken at Regional Research Institute,
Bombay and Clinical Research
Unit,’
Madras.
7.27.4 Clinical Research in Epidemics: The
treatment-cum-Research stud ies undertaken in
the epidemic of Kala Azar at Muzaffarpur
from March, 1991, has been concluded in
May, 1993, due to decline in the number of
cases. A total number of 159 cases were
studied. They were prescribed homoeopathic
medicines on the basis of the totality of
symptoms and have shown good response.
7.27.5 Belladonna 200 (single dose) has
been distributed as preventive for
Encephalitis to 23,217 persons in the villages
of remote areas under the Pipraich Primary
Health Centre of District Gorakhpur, U.P.
where repeated out breaks have been reported
earlier.
Central Council for Research in
Homoeopathy
7.27.1 The Central Council for Research in
Homoeopathy is a premier organisation in the
country engaged in systematic and scientific
research in the field of Homoeopathy and
was constituted, on' the 30th March, 1978 as
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7.27.6 Clinical Research in Tribal Areas:
The Council has 22 Tribal Units in the
different trial pockets of India. These units
198
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have been assigned the Drug Related Clinical
Research Projects on the diseases found
prevalent in the tribal pockets.
7.27.7 Clinical Verifications Research:
Clinical Verification of the pathogenesis in
respect of 64 lesser known drugs (including
20 drugs proved by the Council) is being
continued in (7) Institutes and units under the
aegis of the Council. The symptoms of
various drugs verified in large number of
patients are picked up to indicate reliable
indications of the drug, thus fulfilling the
long felt need of confirming the scanty and
scattered symptom-complexes of the lesser
known drugs.
7.27.8 Drwg Proving Research Programme:
Drug Proving Research Programme is of
continuous nature and is being undertaken at
5 Institutes/Units of die Council. So far 37
drugs have been proved by the Council. The
data of 4 drugs alongwith clinically verified
symptoms has been published in the form of
Monographs and of 20 drugs in the quarterly
Bulletin of the Council.
Revision of Kent’s Repertory, the work on
Chapters Mind, Ears and Respiratory has
been completed and on chapter Nose and
Generalities, and on chapter Mind under the
project Additions to Kent’s Repertory from
Boger Boenninghausen ’s Repertory is in
progress. The booklet on chapter Eye will
be published in the year 1993-94, from time
to time.
The Council continued the
7.27.13
publication of two periodicals viz. Quarterly
Bulletin and CCRH News. Vol. 15 of die
Quarterly Bulletin and CCRH News No.20
will be published.
7.27.14 The manuscript of the monographs
"Aegle Folia and Aegla Marmelos" have
been finalised for printing.
7.27.15 Budget: The Budget Allocation for
the Council for the year 1993-94 is as under:
Plan
Non-Plan
7.27.9 The proving of 2 drugs has been
completed and of one drug is in progress
during the period under report. The proving
of two more new drugs will be taken up in
the year 1993-94.
7.28
Central Council for Research in
Yoga and Naturopathy
7.28.1 The Central Council for Research in
Yoga and Naturopathy, New Delhi is a
Society registered under the Societies
Registration Act of 1860 with the object of
providing assistance for conducting research
in Yoga & Naturopathy. The Council has
also undertaken the aspect of education and
training.
7.27.10 Drug Research Studies: The Drug
Research Studies include drug standardisation
(quality control). Survey and Collection of
Medicinal Plants and advance research
studies for potency estimation of
homoeopathic potencies.
Literary Research Programme:
7.27.11
Under die Literary Research Programme"Review and Revision of Kent’s Repertory,
in relation to odier works", compilation of
homoeopathic therapeutics on rheumatic and
other disorders of the joints and additions to
Kent’s Repertory from Boger
Boenninghausen’s Repertory are being
carried out.
7.27.12
Rs.135.00 lakh
Rs. 135.00 lakh
7.28.2 The major activities of this Council
are presently limited to giving grants-in-aid
to voluntary Yoga and Nature Cure
institutions and for running nature cure
training programmes. The activities of the
Council were reviewed and it has now been
decided that the Council will take up new
projects of setting up of propagation-cumtreatment centres. Patient Care centres and
training courses. The Council proposed to
Under the project, Review and
199
set tip six propagation-cum-treatment centres
(3 each in Yoga & Naturopathy), 20 patient
care centres (10 each in Yaga &
Naturopathy) and 1 training course in Yoga
and
Naturopathy besides conducting
Seminars, Workshops and publication of
books.
para-military forces of SSB Group Centres of
Delhi and Himachal Pradesh who were im
parted yoga training.
for
7.29.4 The results of the study of regular
yoga practices on subjective experimental
feelings revealed that the regular yoga
practises tended to be less aggressive,
anxious, depressed, nonchalant, sceptical,
startled, egoistic but reached higher on the
scores of concentration, social behaviour.
Study of determining the effectiveness of
yoga on asthmatic patients revealed that yoga
tends to alleviate the symptoms of Bronchor
constriction, Hyper-ventilation - hyperapnea,
irritability, panic-fear sand fatigue—etc.
showing thereby the beneficial effect of yoga
in scientific terminology.
7.29.1 Central Research Institute for Yoga
was established in 1976 with the main
objective of conducting clinical, fundamental
and literary research and to promote yoga
with wider understanding, acceptance and
application.
7.29.5 The Institute proposes to complete 20
short-term research projects during the
current year. During April to September,
1993, 36 indoor patients were treated for 30
days’(Hospital with 10 bedded capacity) and
out of them 32 had shown remarkable
improvement.
7.28.3 The Budget Allocation of the Council
for the financial year 1993-94 is as under:
Plan
Non-Plan
7.29
Rs. 30.00 lakh
Rs. 8.50 lakh
Central Research
Yoga (CRIY)
Institute
7.29.2 During 1993-94 (upto September.
1993), the Institute has got published/
communicated 9 research papers on various
subjects of yoga. The collaborative work
with Maulana Azad Medical College. New
Delhi on diabetes mellitus and essential
hypertension is in progress and data collected
so far seems to elucidate the action of yoga
on cellular metabolism.
7.29.3 The Institute proposes to conduct a
study on ‘Evaluation of Normative pattern ot
Biochemical. Haematological and Cardiovas
cular variables in Physically Active Indian
Population’. This study will involve yoga
training to a large group of security force
personnels and assessment of yoga training
on cardiovascular risk factors. A great deal
of emphasis has been given to probe into the
arena of subjective experimental fields as a
result of administration of an integrated set ot
specific yogic technology in varieties ol ex
periential situations involving patients as well
as yoga aspirants, besides those jawans ot
7.29.6 Over 560 outdoor patients suffering
from diabetes, hypertension, spondylitis,
arthritis and various disorders had attended
O.P.D. and were given yoga treatment.
Total number of sadhaks who attended yoga
classes was 2206 and total attendance was
17781.
7.29.7 The Institute also provided yoga
training to 99 SSB personnels of all ranks at
Dharampur, Solan, Himachal Pradesh, 40
SSB personnels at Ghitorni Centre, Delhi and
300 Jawans of Group Centre, SSB, Sapri,
Distt. Kangra. Himachal Pradesh.
7.29.8
During the year 1993-94, the
following budget provisions have been made
by the Ministry of Health & Family Welfare.
Plan
Non-Plan
200
10.00 lakh
34.50 lakh
I
7.30
Jawaharlal
Nehru Bhartiya
Chikitsa Avum Homoeopathy
Amisandhan Bhavan, Janak Puri,
New Delhi
7.30.1 This building is coming up in the
Institutional Area, Janak Puri. New Delhi, to
house the Headquarters’ of the following
research councils:1.
Central Council for Research
in Ayurveda and Siddha
(CCRA&S);
Central Council for Research
in
Unani Medicine
(CCRUM);
3.
Central Council for Research
in Homoeopathy (CCRH);
4.
Central
Council
Homoeopathy (CCH);
5.
Central Council for Research
in Yoga and Naturopathy
(CCRY&N); and
6.
Central Council for Indian
Medicine (CCIM).
for
7.31
Development of Medicinal Plants
7.31,1 The increasing shortage of certain
Medicinal Plant/Trees which provide raw
material for preparation of ISM and
Homoeopathy drugs has become a cause ot
concern. The Ministry of Health and Family
Welfare have initiated certain steps to
augment the availability of this raw material.
7.31.2 A Cell was set up in the Ministry to
look into various aspects related to
development of Medicinal Plants which are
specifically required for preparation of drugs
of ISM and Homoeopathy. The activities ot
this Cell include coordination with concerned
Departments/Organisations for the
development of Medicinal Plants.
The
attempt is to encourage cultivation and
growth of Medicinal Plants under various
government departments like Agriculture,
Environment and Forests, Rural Development
etc.
7.31.3 An inter-departmental meeting was
organised on April, 7, 1993 under the
Chairmanship of Shri Paban Singh Ghatowar,
Dy. Minister for Health and Family Welfare
to discuss inter-departmental/institutional
arrangements and other related aspects tor
ensuring the better availability of raw
material for medicines of plant origin.
7.30.2 This building is located in an area of
2.09 acres and has a covered area of 115582
sq. feet (7 floors including basement). The
cost of the land acquired for the construction
of this building was Rs. 6.27 lakh. The
foundation stone of this building was laid by
the then Vice-President, Dr. Shankar Dayal
Sharma, who is now the President of India.
7.31.4 As recommended in the above stated
meeting, steps have been initiated tor the
following:
7.30.3 The work of construction of this
building is being looked by the Director,
Central Council for Research in Ayurveda
and Siddha, New Delhi. So far Rs. 545.08
lakh have been spent on the construction of
the building which is almost completed.
During 1993-94, there is a budget provision
of Rs. 100 lakh against which Rs. 16.47 lakh
have been utilised till September, 1993.
201
CO
Setting up of an InterDepartmental
Committee
under the Chairmanship of
Ministry of
Secretary,
Environment and Forests;
(ii)
Setting up of herbal gardens
in ISM & Homoeopathy
leaching institutions;
(iii)
Projection of demand of raw
herbs for pharmaceutical
industry in consultation with
drug control authorities;
!
(iv)
Proper involvement of
States/UTs in this direction;
and
(v)
Conservation, cultivation and
development ot identified
Medicinal Plants by
concerned departments under
regular
their
programmes/activities.
7 31.5 "Central Scheme for Development
and Cultivation of Medicinal
initiated by this Ministry in the year 1990-91,
was further expanded. During the year
1992-93, Rs. 55 lakh were provided as finan
cial assistance to 10 institutions. There is a
provision of Rs. 100.00 lakli for this scheme
in the current year and it is proposed to
cover more institutions by providing central
assistance for the purpose.
7.32.
Indian Medicines Pharmaceutical
Corporation Ltd., Mohan, Distt.
Almora, Uttar Pradesh
7 32 1
Indian Medicines Pharmaceutical
Corporation Limited, Mohan, Distt. Almora,
Uttar Pradesh is a Public Sector Undertaking
of the Ministry having their Registered Office
and Factory at Mohan, Distt. Almora (a
Valley in Kumaon Hills). This Public Sector
Enterprise was established in July, 1978 and
started its commercial production in June,
1983. The Authorised Share Capital is
Rs. 100 lakh and paid up Share Capital is
Rs. 79.40 lakh. Participation in the Equity
Capital of the Corporation is in the ratio of
51:49 between the Government ot India and
the Government of Uttar Pradesh through
Kumaon Mandal Vikas Nigam Ltd., Naimtal.
7 32.2 The Corporation is engaged in
manufacture and supply of pure, genuine and
authentic Ayurvedic & Unani medicines.
7.32.3 The Corporation’s profit in 1991-92
after Tax provision is Rs. 4.73 lakh. D^ri^
1992-93 the production and sale ot tne
Corporation were Rs. 98.36 lakh and Rs 144
lakh respectively (tentative).
Up o
September, 1993 the production and sale ot
the Corporation are Rs. 37.11 lakh and R..
41.61 lakh respectively.
202
t.
c-
FACILITIES FOR
SCHEDULED
CASTES AND
SCHEDULED
TRIBES UNDER
SPECIAL
COMPONENT
PLAN FOR
SCHEDULED
CASTES AND
TRIBAL
SUB-PLAN
t
The Scheduled Castes and Scheduled Tribes
constitute 16.48% and 8.08% respectively of
the total population of the Country as per
1991 Census. The constitution provides for
a comprehensive frame work for the socio
economic development of Scheduled Castes
and Scheduled Tribes. Article 46 of the
Constitution requires the State (both Central
and State Govts.) to promote with special
care the educational and economic interests
of the weaker sections and in particular of
Scheduled Castes and Schedule Tribes and to
protect them from social injustice and all
forms of exploitation.
8.1.2 A broad Strategy was evolved for
Welfare and Development of Scheduled
Castes and Scheduled Tribes and the concept
of Tribal Sub-Plan and Special Component
Plan for Scheduled Castes were adopted
during V Plan and VI Plan respectively
which have* continued during VI, VII and
VIII Five Year Plans and have been the main
instrument for all round development and
welfare of Scheduled Tribes and Scheduled
Castes respectively.
8.1.3 The National Health Policy (1983)
envisages according high priority to provide
health services to those residing in the tribal,
hilly and backward areas as well as to
endemic diseases affected population and
vulnerable sections of the society.
8.1.4 In order to remove the inbalance and
provide better Health Care and Family
Welfare Services to Scheduled
Castes/Scheduled Tribes, the population
coverage norms of establishment of rural
infrastructure have been relaxed.
8.1.5 Accordingly, the Strategy adopted for
meeting the health care needs of Scheduled
Tribes and Scheduled Castes envisages the
provision of preventive, promotive and
curative services through a net work of
Primary Health Centres, Sub-Centres,
Community Health Centres, Rural
Dispensaries and at villages level through
Health Guides and trained Dais supported by
CHAPTER VIII
203
L
implementation of programme for the control
oi communicable diseases, undertaking of
research in diseases of which Scheduled
Tribcs/Scheduled Castes are generally prone.
The mobile dispensaries and camps organised
wherever feasible, are catering to their needs
at their door-steps.
8.2
relaxation of Norms
8.2.1
Primary Health Centres and Sub
Centres: Keeping in view the far flung areas,
forest land, hills and remote villages where
• he most of triha'
habitations are
concentrated, the population coverage norms
have been relaxed to one Primary Health
Centre for every 20,000 population and one
Sub-Centre for every 3,000 population in
hilly/tribal areas as against one PHC for
30,000 population and one Sub-Centre for
5,000 population in general rural areas. The
States have been advised to set up at least
1.6% of the Sub-Centres in SCs Basties or
villages having 20% or more Scheduled
Castes population and 7.5% of their annual
targets in Tribal areas.
8.2.2 The State Govt, have been advised to
give further relaxation for setting up SubCentre/Primary Health Centre in the case of
tribal hartilets and Scheduled Castes Basties
which are 5 Kins, away from the available
Health and Family Welfare delivery point.
Needs
8.2.3
Under the Minimum
19678 Sub-Centres 3169
Programme,
Primary Health Centres and 352 Community
Health Centres have been established in tribal
areas besides 1012 Allopathic Dispensaries,
Similarly 16572 Sub-Centres, 5917 Primary
Health Centres and 363 Community Health
Centres have been established in SCs
Basties/villages having 20% or more
Scheduled Castes population besides 558
Allopathic Hospitals/Dispensaries
anaseptic deliveries to reduce maternal and
infant mortality rate in rural/tri ba! areas. A
delivery kit is provided to them after
completion of training. They are paid Rs.
3/- per delivery to replenish the kit, Majority
of the dais trained belong tc> SC/ST
community.
8.2.5 Revised guidelines for training ot Dais
have been issued to States. Training will be
conducted for 6 working days and a per diem
of Rs. 40/- will be paid to each Dai tor 7
days besides Travelling Allowance. Training
will be conducted in batches ot' 5-6 at health
facility having 50-60 deliveries/month.
Reporting fee of Rs. 10/- is being paid per
delivery.
8.3
8.3.1 Opening o/
Hank for Scheduled
Castes A Scheduled Tribes: Book Bank for
Scheduled Caste & Scheduled I ribe Students
have been set up in Central Institutions like
P G 1 M E R , Ch a n d i g a r h , JI PM E R ,
Pondicherry, A.1.1.M.S., New Delhi, Lady
Hardinge Medical College. New Delhi etc.
8.3.2 Project on Health Care for Primitive
Tribal Group (PTG): Among 258 Scheduled
Tribe communities, 74 groups have been
recognised as PTGs due to (i) their persuing
pre-agricultural level of technology; (ii)
having low literacy rate; and (iii) suffering
from diminishing population or stagnant
population growth.
8.3.3 As per the recommendation of the
Working Group on Development and Welfare
of Scheduled Tribes, the Ministry of Welfare
has formulated a Scheme "Health Care for
Primitive Tribal Groups (PTGs)" and
emphasised to incorporate it in the States
Annual Plans during VIII Five Year Plan.
The Scheme with guidelines has been sent to
all the concerned States/UTs to prepare and
send to the Planning Commission for its
approval to be incorporated in their State
Plans.
8.2.4 The Central Government is providing
100% Central assistance to States/lJ'fs to
train dais (Traditional Birth Attendants) to
improve their skill and to ascertain the sate
204
I
Schemes exc’usively for Scheduled
C a s t ex /Sc h edi i I ed Tr i h es
PRIMARY HE V TH ( ARE ( EMTI S iN TRIHAL AREA
n <\
Sdh-( ent res
i! State/UT
|-------------1
I. Andhra Pradesh
2. Assam
3. Bihar
4. Gujarat
5. Himachal Pradesh
6. Karnataka
7. Kerala
8. Madhya Pradesh
i 9. Maharashtra
! 0. Manipur
i| li./.Orissa
! I'/.Rajasthan
|i B Jikkim
|| 14,Tamil Nadu
|
|
j
:
1 15.Tripura
j 16.1’ttar Pradesh^
i".West Bengal
18. A&N Islands
19. Daman & Diu
20. Arunachal Pradesn
21 .Meghalaya*
22. Mizoram
23. Nagaland*
24. D&N Haveli *
25. Lakshadweep
Total
Note
R
P
9
3
915
804
3522
2005
>
66
2115
421
5393
1662
22 I
23'Hi
1336
10
70
200
1381
712
30
17
190
447
OH *
44:
1824
163?
97
1850
268
1(,(H
i
I
I
4
I
71.48
5
137 |
489
294
10
317
64
807
265
51.79
81.40
146.96
87.47
63.65
91.95
96.45
| 100.00
)
M85 I
|
i 158.57
I 122.50
1376 IJ 99.64
17
58.57
28
98.33
82.35
14
124.21
I 52.57
1 1 1
- I
418
34
17
314
; 100.00
50.96
100.00
82.35
24600
19228
78.16
200 |
1
12
30
219
107
4
24
67
55
63
5
9
3684
PHCs : Primaiv He; hh f’culjcx.
CHCs : Community Health Centres.
: Required as per relaxed norms ol estatMishmeni.
R
P
: In position.
%
: Percentage in position <>l the required
(Fi
. Ined'ides Hilly Sab P;a:i Area
PrimatA' Health. Care S'-niecs.
. f’rcJ.'ininanrly tr.lxi! inh.ihited State1. H
figures are pr<- •;, iI.
205
1 16
7
208
183
15
307
59
633
265
121 I
b5. Ab
64.57
69.91
i 190.00
_jr
q"
R
349
162
3
13
22
189
91
3
32
45
55
65
5
7
7
|
84.67
8
1
10 I:
61.16
42.54
19
62.24
27
150.00
96.84
_J29
92.18
96
72.30
49
100.00
5 !
100.00
98.59
24 •
81.00
300.00
n
108.33
5 !
73.33
1 I
86.30
20
85.05
1
75.00
50.00
6
133.33
3
67.16
4
100.00
25 I
I
103.17
100.00
350.00
79.72
2937 ______
3
1
!
J
22J1
I
8.4
Research and Other Programmes/
Schemes
8.4.1
Funds are provided by Central
Government to Central Institute viz. ICMR,
AIIMS etc. for conducting the research on
typical health problems ot Primitive Tribes,
other Ttibal Groups and Scheduled Castes to
which they are generally prone.
8.5
Indian Council of Medical Research
8.5.1 Indian Council of Medical Research
carries out research on the health problems ot
STs., diseases to which tribal people are
prone etc. 5 Regional Medical Research
Centres in the country, one each at Jabalpur
(M.P.), Bhubaneshwar (Orissa), Jodhpur
(Rajasthan), Dibrugarh (Assam) and Port
Blair (A and N Islands) have been established
for the purpose.
8.6
VVHO/ICAR Sponsored
Research Studies
8.6.1 The following four research studies on
tribal population sponsored by WHO/ICAR
have been carried out by Prof. Indira
Chakravarty, Principal Investigator and
Director ' Professor, Department of
Biochemistry & Nutrition, All India Institute
of Hygiene and Public Health, Calcutta.
8.6.1 (i) Impact of Nutrition and Health
Education, on the Nutritional and Health
Status of Lodhas of West Bengal.
8.6.1 (ii) Impact of Sanitation and Clean
Water Supply on the Nutritional and Health
Status of some Tribals of West Bengal.
8.6.1 (iii) "Environmental Impact Assess
ment" effect on certain specific pesticides on
Tribal Population of Varied Nutritional
Status.
8.6.1 (iv) A Comparative Biochemical and
Nutritional Study on Malnutrition and Child
Mortality in ' certain Urban (Pavement
Dwellers) and Tribal (Lodha, Mahali, Kora,
Santhal and Munda) Areas.
8.7
Indian Systems of Medicine and
Homoeopathy
35.1 The Central Council for Research in
8.7.1
Homoeopathy, Ayurveda and Siddha and
Unani Medicines are providing medicines,
incidental curative services, besides
conducting research on diseases which are
most prominent amongst tribal population,
their
living conditions and propagate
knowledge of oral hygiene, prevention of
diseases and uses of common medicinal
plants available in the area.
8.8
Centrally Sponsored Schemes
Implemented by States/UTs
Under the Centrally Sponsored
8.8.1
Schemes of Malaria and Leprosy Eradication,
Filaria, Kala-Azar, Japanese Encephalitis,
T.B. and Blindness Control, provisions are
made for Tribal Sub-Plan and Special
Component Plan tor Scheduled Castes
separately every year in order to ensure that
these services are available to Scheduled
Castes/Scheduled Tribes population.
8.9
Financial Implications
8 9.1 A provision of Rs. 34.68 crore has
been made for Tribal Sub-Plan and Rs. 21.92
crore for Special Component Plan for the
Welfare & Development of Scheduled Tribes
& Scheduled Castes during the year 1993-94
in the Central Health Sector.
8.10
Scheduled Castes and Scheduled
Tribes Cell
8. JO. 1 The Scheduled Castes and Scheduled
Tribes Cell in the Ministry continued to look
after the service-interests of the Scheduled
Caste/Scheduled Tribe employees during
1993. This Cell assists the Liaison Officer in
the Ministry in discharge of his duties in
respect of matters relating to representation
of Scheduled Castes and Scheduled Tribes in
services ini establishments under this
It circulated various
Ministry.
instructions/orders received from the
Department of Personnel and Training to the
206
1
■
=
I
peripheral units of the Ministry for their
guidance and necessary compliance. It also
collected various types of statistical data on
the representation of Scheduled Castes and
Scheduled Tribes from the subordinate
offices of this Ministry as required by the
Department of Personnel and Training and
the Commissioner for Scheduled Castes and
Scheduled Tribes. The Cell scrutinises cases
where case for de-reservation of posts are
mo veil. Advice is also rendered regarding
reservation procedures and maintenance ot
rosters, to various sections and offices of the
Ministry. Complaints/represen-tations from
various associations and individuals regarding
non-observation of the reservation policy and
discrimination practices on grounds of social
origin are dealt with in this Cell, thus
keeping a close watch to ensure justice and
equality to the Scheduled Caste and
Scheduled Tribe employees.
8.10.4
Parliamentary Committee on the
Welfare of Scheduled Castes and Scheduled
Tribes, Reservation for
employment of
Scheduled Castes and Scheduled Tribes in
Central Medical Institutes
and Colleges
including reservations in admissions tor
Scheduled Castes and Scheduled Tribes
therein called information on Medical
Institutions under this Ministry, which has
been collected from the following Colleges/
Institutions and sent to Lok Sabha Secretariat
for placement before the Committee.
i)
Central
Ranchi;
Institute
8.10.3 A Special Recruitment Drive was
launched during the year 1993 to remove the
backlog vacancies reserved for SCs and STs.
Special recruitment efforts were made during
this drive to fill up the backlog vacancies in
respect of the institutions/organisations under
This Cell
control of this Ministry.
coordinates the recruitment efforts of the
subordinate offices under control of this
Ministry. Sincere efforts have been made to
liquidate the backlog of SC & ST vacancies
within a definite time frame.
Psychiatry.
Pondicherry;
ii)
8.10.2 During 1993, inspection of rosters
was carried out in respect of local
subordinate offices under control of the
Ministry. The defects and procedural lapses
thereof were brought to the notice of the
officials. The salient aspects of the scheme
of reservation were brought home. The
practical difficulties in implementation ot
reservation orders and maintenance of rosters
were clarified. Suggestions were made to
streamline the maintenance of rosters in these
Institutes.
of
iii)
All India Institute of Hygiene &
Public Health. Calcutta;
iv)
Lady Hardinge Medical College &.
Smt. S.K. Hospital, New Delhi;
v)
All India
Medicine
Bombay;
vi)
Post Graduate Institute of Medical
Education & Research, Chandigarh;
vii)
Mahatma Gandhi Institute of Medical
Sciences, Wardha;
viii)
National Institute of Mental Health
& Neuro Sciences, Bangalore; and
ix)
.All India Institute
Sciences, New Delhi.
Institute of Physical
and
Rehabilitation,
of
Medical
8.10.5 The total number of employees and
representation of SCs & STs in (i) the
Central Health Service Cadre (the cadre
controlled by the Ministry), and (ii) the
Ministry, its attached and subordinate offices
is detailed below:
207
REPRESENTATION OI SCs & STs AMONGST OTHERS ON I.!.1993
Name of Cadre
Total
Employees
1
ST
SC
i) Ceaitral Health Service
(Group ’A’ posts)
4,074
523
205
ii) Ministry, its attached
and subordinate
offices
29.862
9,786
1,736
!
I
208
1
USE OF HINDI IN
OFFICIAL WORK
The Ministry of Health and Family Welfare
is actively involved in promoting the use of
Hindi, the official language in office work.
9.1.2 A full Hedged Hindi Division is
functioning in the Ministry to supervise
proper implementation of the official
language policy in the Ministry and its.
attached and subordinate offices, autonomous
bodies, statutory organisations and public
sector undertakings etc.
9.2
Hindi Teaching Scheme
9.2.1 In the Ministry of Health and Family
Welfare 96% officers/employees have
acquired a working knowledge in Hindi and
this Ministry has been notified under rule
10(4) of the OL Rules 1976. Efforts are
being made to impart Hindi Training to
remaining employees. Training of
Stenographers/ Typists in Hindi
Stenography/Hindi Typewriting is being
emphasized.
•i
9.3
Implementation
of Official
Language Act, Rules made there
under and the Annual Programme
9.3.1
Implementation of the Annual
Programme interalia is reviewed/monitored in
the meetings of Official Language Implemen
tation Committee and various inter personal
contact programmes organised by the
Director(OL)/Asstt. Director(OL). Sustained
efforts are being made to achieve the targets
fixed by the Department of Official Language
in the Annual Programme for the year 199394. Almost the entire work relating to group
'D' employees is being done in Hindi. In
compliance of section 3(3) of the Official
Language Act, all administrative and other
reports are being prepared bilingually i.e. in
Hindi and English.
9.3.2 During the year 1992-93 out of 23283
letters, 5359 letters were sent in Hindi to
region ‘A’ & ‘B’. Concerted efforts are
being made for increasing the use of Hindi in
the communications originally sent to region
CHAPTER IX
209
I
‘A’ &
Inspections of 22 Sections in the
Ministry was conducted by Director (OL)
and Asstt. Director (OL) and the standard
drafts used in the respective sections have
been provided in bilingual version.
|
9.3.3 During the year 2 subordinate offices
were notified under rule 10(4). In all 69
offices under the Ministry have been notified
so far.
9.3.4 To assess the use of Hindi in the
various offices under the Ministry, inspection
is a continuing process. Inspection of 13
offices has been carried out and inspection of
15 more offices is likely to be conducted
shortly.
9.4
Hindi Week
9.4.1
Hindi week was organised in the
Ministry from 13.09.1993 to 17.09.1993.
Employees were encouraged to do their work
in Hindi during the week. Various
competitions were organised in which a
number of employees/officers participated
and cash prizes were awarded to the winners.
Hindi day/Hindi week was also organised in
institutions under the Ministry.
9.4.2 A Hindi workshop was organised in
the Ministry for the employees having
working knowledge in Hindi from 6th to 9th
July, 1993. Two more sessions of the Hindi
workshop are proposed to be organised
during the year.
9.5
9.5.1 At present 63 Devnagari typewriters
are available in the Ministry including
electric/electronic typewriters. Steps are
being taken to increase the number of
Devnagari typewriters.
9.5.2 In the interest of better functioning of
the Division efforts have been made/are
being made to equip the Division with
electronic equipments. Computers are also
being provided to the Hindi Division.
9.6
Incentive Scheme
9.6.1 With a view to promoting the use of
Hindi in noting and drafting in official work,
the cash award scheme continued to operate
duringAhe year under report
9.7
Promoting Writing of Books on
Medicul and Health Subjects
9.7.1 A scheme for encouraging the authors
of (i) books translated into Hindi from
foreign language (Excepting English);(ii)
hooks translated from English and Indian
Languages into Hindi and (iii) original books
in Hindi on various Medical and Health
subjects is being run by the Ministry of
Health and Family Welfare with attractive
awards.
210
L
Mechanical Aids
INTERNATIONAL
COOPERATION
FOR HEALTH AND
FAMILY WELFARE
Various International Organisations and the
United Nations Agencies particularly WHO.
continued to provide significant technical and
material assistance for many Health and
family Wei tare Programmes in the country:
the status in this behalf is discussed in this
Chapter.
10.2
World Hen It h Orgnnisution
10.2.1
The World Health Organisation
(WHO) is the main UN Agency collaborating
with this country in promoting and
developing health care facilities. As a
founder member. India makes regular annual
contribution to WHO.
—
10.2.2 The WHO provides assistance to
Member States on biennium basis through the
following services:-
r
(i)
Supplies and Equipments;
(ii)
Training/Fellowships/Study Tours:
and
(iii)
Short-term Group Education
Activities (Seminars / Workshops /
Meetings / Conferences / Studies
etc.).
10.2.3 The assistance from WHO is mainly
used as seed money to generate health
development activities and fill vital gaps in
the National Health Programmes. During the
biennium 1992-93, the assistance from WHO
was US $ 13.76 million and it was used for
as many as 45 projects. By the end of
November, 1993 this assistance was obligated
to the extent of 85% and 15% ot it was in
the pipeline, which was expected to be
obligated by end of December. 1993.
10.3
Japanese Assistance
10.3.1 A programme for Medical Research
and Education in the Sanjay Gandhi PostGraduate Institute of Medical Sciences,
Lucknow, is being implemented with
Japanese assistance. The assistance has been
■
CHAPTER X
211
given in the form of equipment and service
of Japanese experts to SGPGI, Lucknow.
10.4
I
Overseas Development Assistance
(U.K.)
Overseas Development
(ODA)
U.K., is giving
Administration
Papillomavirus
....
..
Human,
assistance for
Infection and Cervical Cancer project, a
collaborative project between Institute of
Cytology and Preventive Oncology, New
Delhi and St. Mary’s College of Medical
School of London, at an estimated cost of £
263,210 during a period of three years;
Haemoglobinopathy Control Project;
collaboration between B.J.Wadia Hospita ,
Bombay and University College Hospital
London, involving an estimated cost of L
435,200 during a three years period;
Rotavirus Infection Research Project,
between the two collaborating institutions viz.
National Institute of Cholera ‘and Entei ic
Diseases, Calcutta and East Birmingham
Hospital, U.K. at an estimated cost of £
89,658; Chlamydial Laboratory Project a
collaborative activity between Dr. R.P..
Centre for Ophthalmology, All India Institute
of Medical Sciences, New Delhi and Institute
of Ophthalmology, London at an estimated
cost of £ 494,293 for 3 years 1993-94 to
1995-96; Andhra Pradesh School Health
Project at an estimated cost of 8 million
Viral Hapatitis Project, at an estimated
amount of £ 324,778 arfl a Research Project
on Characterisatitfh of Genes and Gene
Products of Mycobacterium Leprae Identified
Using Sera from Leprosy Patients, a
collaborative Programme between All India
Institute of Medical Sciences, New Delhi and
National Institute for Medical Research, The
Ridgeway Hill, London for a period of three
years.
10.4.1
10.5
The
-t has been signed for financial
agreement
assistance of $ 85 million over a period of
six years to provide M.D.l. (Multi Diug
Therapy) in the Districts where prevalence
rate of'leprosy is two or more per thousand
population; financial assistance involving
about $ 513 million for a period of seven
years starting from 1993-94 is under advance
amsideration for the National Blindness
Control Programme and a proposal tor
development of secondary level Hospitals tn
Andhra Pradesh at a cost ot about Rs. 417
crore has been posed tor World Bank
assistance.
10.6
Danish International Development
Agency (DANIDA)
DANIDA has been providing
10.6.1
financial assistance in helping to develop
service structure required tor Nat10^
Blindness Control Programme. The total
assistance received during the seamc phase
of the project is Rs. 22.245 crore. DANIDA
is providing financial assistance in the form
of orant-in-aid for MDT activities under the
National Leprosy Eradication Programme.
An amount of Rs. 3.5 crore have been
received from DANIDA upto December,
1992.
10.7
Swedish International Development
Agency (SIDA)
SIDA is providing financial
10 7 1
•issistance to the National Leprosy
Eradication Programme since 1978 mvoItang
24 million Swedish Kronar. SIDA is also
assisting the National T.B. Control
Programme since 1979. At present the
Third Agreement for the period from 199094 for an amount of US $ 7.095,706 ts under
implementation.
10.8.
World Bank
The
10.5.1
The World Bank is providing
assistance for a comprehensive project tor
preventioni and control of HIV infection
(AIDS). The project has commenced with
•
‘an
World Bank Assistance of $ 84 million.
Norwegian Aid for International
Development (NORAD)
10.8.1 A three year agreement (1990-91 to
1993-94) was signed with NORAD for
receiving financial grant not exceeding NOK
activities.
10 million to support MDT
h'
212
10.9
Cultural Exchange Programme
10.9.1 Three delegations from the Govt, of
Hungary, Mangolia and Seychelles visitedIndia under Cultural Exchange Programme
during this year.
10.10
Indo-Russian Agreement
10.10.1 A protocol on cooperation between
India and the Russian Federation in Medical
Sciences and Public Health was signed on
16th September, 1993 covering a period upto
31st December, 1994.
This protocol
envisages cooperation on various subjects
relating to Health and also provides for
exchange of Specialists from both the sides.
10.11
■
Port/Airport Health Organisation
10.11.1 Arrangement for Health clearance
and Quarantine administration at the eight
major ports and five International Airports in
the country are made by the Central
Government under the Indian Port Health
Rules, 1955 and Aircraft (PH) Rules, 1954
which are based on the International Health
Regulation 1969. In addition, a new Port
Health Office has been commissioned at
Jawaharlal Nehru Port, situated at New
Bombay at Halida Port. The objective of
these Port and Airport Health Organisations
is to prevent spread of communicable
diseases, prevention of entry of Yellow Fever
into the country through passengers coming
from or transmitting through notified
endemic countries. Arrangements also exist
for health clearance of aircraft at Amritsar
Raja Sansi Airport, Hyderabad, Trivandrum
and Dabolim Airports. Similar arrangements
are also made as and when necessary at
Lucknow,
Varanasi.
Gaya,
Nagpur,
Ahmedabad, Agra, Pune, Bangalore and
Andaman & Nicobar Island. Arrangements
exist for health clearance of ships at various
minor ports and special arrangements
regarding health clearance of ships arriving at
Tuticorin Port and Bangalore are also made
with the help of State Government skiff.
10.11.2 Deratting exemption certificates are
being issued by all the eight International
Ports in India viz. Bombay, Calcutta,
Cochin, Kandla. Madras, Mandapam Camp,
Marmagoa and Visakhapatnam. Deralting
work is being carried out at Bombay.
Calcutta. Madras and Cochin Ports.
10.11.3 Health checks have been established
since 1976 at Attari in respect of* India
Pakistan Rail and Road Traffic.
10.11.4 No Vaccination Certificate, other
than against Yellow Fever is required for
entry into India.
10.12
Fellowship
10.12.1 The Ministry of Health and Family
Welfare receives foreign assistance in the
form of fellowships from World Health
Organisation; Commonwealth Scholarship
Commission. London; Overseas Development
Administration, British Council Division,
U.K. and other countries involved in the
Colombo Plan. In addition, Japan, Thailand,
Australia, Singapore and Bangladesh etc
also offer fellowship/training opportunities to
our medical and para-medical personnel in
their countries. Such assistance plays an
important role in meeting training needs of
our health personnel under various public
health programmes and in exposing them to
new technological developments taking place
around the World. During the biennium
139
1992-93 this Ministry nominated
candidates for WHO fellowships. In 1993. 2
candidates have been selected by the
Commonwealth Scholarship Commission for
Commonwealth Senior Medical Fellowship
and 22 candidates for Commonwealth
Medical Fellowship. During this year, under
Colombo Plan Fellowship Programme, 9
persons were nominated for training in Japan,
5 for AIDS training in UK, 23 officers for
attending Maternal and Child Health Course
under Colombo Plan Fellowship at the
Liverpool School of Tropical Medicine, U.K.
4 persons from National Institute of Health
and Family Welfare visited Liverpool School
of Tropical Medicine for MCH training
course. Under the Miscellaneous Fellowship
213
I
offers received from time to time during this
year, 2 persons were nominated for training
in Indonesia, 5 for Thailand and 1 for
Croatia.
10.12.2 Since January, 1993, 193 WHO
fellows from various countries visited India
for attending training courses in various
health institutions in this country. Apart
from this, 54 foreigners visited India under
various Health Programmes.
10.12.3 Since January, 1993, 94 medical
personnel participated in International Conferences/Seminars/Symposia/Training Prog
ramme abroad. This offered an opportunity
to Indian medical experts to acquaint them
selves with the latest developments in the
field of medicine and surgery in other coun
tries of the world and to exchange views with
their counterparts. In addition, 800 young
doctors were granted No Objection Certifi
cates this year to pursue higher studies in
various medical fields in USA.
i
214
t-
ANNEXURES
I
annexure
-iv
SUBORDINATE OFFICES OF THE MINISTRY OF HEALTH AND FAMILY WELFARE
I
1.
Director,
FWTRC, 332, S.V.P. Road,
Bombay-400 004.
2.
Director,
Homoeopathic Pharmacopoeia
Laboratory, Central Govt.
Offices Complex
No.l, Kamla Nehru Nagar,
Ghaziabad-201 002.
3.
Director,
Pharmacopoeia Laboratory tor
Indian Medicine,
Central Govt. Offices Complex,
Kamla Nehru Nagar,
Ghaziabad-201 002.
l
217
I
I
LIST OF SUBORDINATE OFFICES OF DIRECTORATE GENERAL OF HEALTH
SERVICES
1.
I
2.
3,
1
I
4.
5.
!
6.
11
Port Health Officer,
port Health Organisation,
Pattan Swasthya Bhavan,
7, Mandil Road,
Behind Taj Mahal Hotel,
Bombay-400039.
port Health Officer,
Port Health Organisation,
Marine House, Hastings,
Calcutta-700 022.
Port Health Officer,
Port Health Organisation,
Willingdon Island,
Cochin-682 033.
Port Health Officer,
Port Health Organisation.
Rajaji Road, Madras-600 001.
Port Health Officer,
Port Health Organisation,
Kandla, P.O. Kandla Port (Kutch)
330 210.
Port Health Officer,
Port Health Organisation,
Marmagoa, Goa-403 803.
Airport Health Officer,
Airport Health Organisation,
Dum-Dum, Calcutta Airport,
Calcutta-700 052.
12.
Airport Health Officer,
Airport Health Organisation,
Delhi Airport, Palam,
New Delhi-110 010.
13.
Airport and Border Quarantine
Health Officer,
150, Ranjit Avenue, Amritsar.
14.
Airport Health Officer,
Airport Health Organisation,
Tiruchirapalli Airport,
Tiruchirapalli-620 007.
15.
D.A.D.G (MS),
Govt. Medical Store Depot,
Bombay-400 008.
16.
D.A.D.G. (MS),
Govt. Medical Store Depot,
9, Clyde Rev: P.O. Hastings,
Calcutta-700 022.
17.
D.A.D.G. (MS),
Post Box No.8,
Govt. Medical Store Depot,
Karnal-132 001 (Haryana).
18.
D.A.D.G. (MS),
Govt. Medical Store Depot,
No.37, Naval Hospital Road,
Madras-600 003.
7.
Port Health Officer,
Port Health Organisation,
Vifihakhapatnam-531 001.
8.
Port Health Organisation,
Mandapam Camp P.O., Remand
Distt. (T.N.) 623519
9.
Airport Health Officer,
Airport Health Organisation,
Sahar, Bombay-400 099.
19.
D.A.D.G. (MS),
Govt. Medical Store Depot,
Hyderabad.
10.
Airport Health Officer,
Airport Health Organisation,
Madras -600 001.
20.
D.A.D.G. (MS),
Govt. Medical Store Depot
Post Box No. 84, Guwahati-781
218
I
1 1.
21.
D.A.D.G. (Store).
Medical Stores Sub-Depot,
Qutab Enclave,
New Delhi.
22.
Dy. Drugs Controller (I),
Central Drugs Standard Control
Organisation (West Zone),
C.G.H.S. Dispensary Building,
1st Floor, Antop Hill,
Bombay-400 037.
23.
24.
I
Nagar (Central Govt. Enclave),
Hapur Road,
Ghaziabad-200 102.
Dy. Drugs Controller (I),
(East Zone) CDSCO, C.G.O.
Building, Nizam Place (West),
234/4, Lower Circular Road,
Calcutta-700 020.
Dy. Drugs Controller (I),
Drugs Inspector Trg. Scheme,
C.G.H.S. Dispensary Building,
1st Floor, Antop Hill,
Bombay-400 037.
Central Drugs Standard Control
Organisation, Custom House,
Cochin-682 003.
31.
Director,
Central Drugs Lab..
3, Ryd Street, Calcutta.
32.
Director,
Central Indian Pharmacopoeia Lab,
Raj Nagar, Ghaziabad-201 002.
33.
Director, Biological Laboratory
House Campus, G.H.S.D.,37, Mivti
Hospital, Madras-600 003.
34.
Asstt. Drugs Controller®,
Nava-Sheva, SHEVA, P.O.
Uran, Distt.RAIGAD-400 707.
25.
Asstt. Drugs Controller(I),
New Custom House,
Ballard Estate, Fort,
Bombay-400 038.
35.
Asstt. Drugs Controller^),
Indira Gandhi International
Airport, Air Cargo Terminal,
New Delhi.
26.
Asstt. Drugs Controller(I),
Custom House,
15/1, Starand Road,
Calcutta-700 001.
36.
Director,
Central Drugs Laboratory,
ESIS Hospital Building,
Wagle Industrial Estate,
(4th Floor) Jhans.Bombay.
27.
Asstt. Drugs Controller(l),
Room No.66, 2nd Floor,
Custom House,
Madras-600 001.
37.
28.
Dy. Drugs Controller(l),
Central Drugs Standard Control
Organisation, South Zone,
4, Azeez Mull, 7th St.,
Thousand Lights,
Madras-600 006.
Asstt. Drugs Controller (I),
Sub-Zonal Office,
Health and F.W.,C-2, B-80,
Mahanagar,
Lucknow-6.
38.
Asstt. Drugs Controller (I),
Sub-Zonal Office, C/o Regional
Director, Health & F.W., Danara
House, Salimpur, Ahara,
Behind RBI,
Patna.
39.
Director, JIPMER,
Dhanvantari Nagar,
Pondicherry-605 006.
J
29.
Dy. Drugs Controller®,
Central Drugs Standard Control
Organisation, North Zone,
Sagmen Wing ’A’, 1st Floor,
C.G.O. Building, Kamla Nehru
219
L
30.
40.
Principal,
Lady Hardinge Medical College ani
Smt. S.K. Hospital,
New Delhi.
41.
Medical Supdt.,
Kalawati Saran Children Hospital,
New Delhi.
42.
Superintendent,
Lady Reading Health School,
Bara Hindu Rao,
Delhi-110 006.
43.
Principal,
Rajkumari Amrit Kaur College of
Nursing, Lajpat Nagar,
New Delhi-110 049.
44.
Med. Supdt.
Dr. Ram Manohar Lohia Hospital,
New Delhi-110 001.
46.
Director,
M.I.I.P.M.R. Haji Aii Park.
Clerk Road, Mahalaxmi,
Bombay-400 034.
47.
Serologist & Chemical Examiner
to the Govt, of India,
3, Lyd Street, Calcutta-700 016.
48.
Director and Medical Supdt.,
Central Institute of Psychiatry,
P.O.Kanke,
Ranchi-834 006 (Bihar).
49.
Central Food Lab.,
3, Kyd Street,
Calcutta-700 016.
50.
Food Research & Standard Lab.
Navyug Market, Ghaziabad.
51.
Director, C.R.I.
Kasauli-17 205 (HP).
52.
Director, BCG Vaccine Lab.,
Guindy, Madras-600 032.
54.
Director, NMEP,
22, Sham Nath Marg,
Delhi-1 10 054.
56.
57.
220
I
Director. N1CD,
22, Sham Nath Marg,
Delhi- 1 10 054.
55.
Med. Supdt.,
Safdarjung Hospital,
New Delhi- 110 016,
45.
53.
Director,
AIIH
PH,
1 10, Chittaranjan Avenue,
Calcutta.
R.H.T.C. Najafgarh,
New Delhi.
Director,
C.L.T.R.l.
Tirumani, ChengaIpattu-603 001
Tamil Nadu.
58.
Director,
Regional Lep. Trg. &. Research
Institute, Aska,
Distt. Ganjam (Orissa).
59.
Director,
R.L.T.R.L,
Lalpur. P.B.No.112. Raipur.
60.
Director,
Reg. Lep. Trg. and Research
Institute, Gouripur,
Distt. Bankura,
West Bengal.
61.
Director,
62.
Model Vital and Health Statistics
Unit, Civil Corporation Office
Building, Civil Lane,
Nagpur-1.
63.
Dy. Director (Central Zone),
CGHS, Delhi. 5th Floor C-Wing,
Nirman Bhavan, New Delhi.
64.
Dy. Director,
CGHS. United India Building.
Sir Firoz Shah Mehta Road, Fort.
Bombay.
National Tuberculosis Instt.,
No.8, Ballary Road, Bangalore.
65.
Dy. Director,
CGHS, 38, Bhavani Nagar,
Meerut City.
66.
Dv. Director,
CGHS, 117/617, Pandu Nagar,
Kanpur.
67.
Dy. Director,
CGHS, Q.No.l, Type-III,
Double Storey. CPWD,
Central Govt. Colony, Civil Lines,
Nagpur-440 002.
68.
Dy. Director, CGHS.
9-A, Rana Pratap Marg,
Lucknow-226 001.
79.
Dy. Director, CGHS,
Office of the Accountant General,
P.O. Hannu, Ranchi, (Bihar).
80.
Dy. Director, CGHS,
A.G. Colony Unit.4.
Bhubaneshwar-751 001.
81.
Regional Director.
Regional Office for Health and FW,
48/8, Hindustan Park,
Calcutta-700 029.
82.
Regional Director.
Regional Office for Health and FW.
Danara House, Salimpur Ahara.
(Behind RBI), Patna-3.
83.
Regional Director.
Regional Office for Health and FW,
C-2, B-80. Mahanagar,
Lucknow.
Dy. Director, CGHS,
8, Explanade East, 4th Floor.
Calcutta.
70.
Dy. Director, CGHS,
C.I.T. Colony. 1st Cross Street,
Mylapore, Madras-600 004.
71.
Dy. Director,CGHS.
Indu Bhavan,
Gandhi Nagar. Boring Road,
Patna-800 001.
72.
Dy. Director, CGHS,
1-7/154-155, Bakaram.
Hyderabad-500 048.
84.
73.
Dy. Director, CGHS,
Ganesha Towers, 2nd Floor,
III Infantry Road,
Bangalore-560 001.
Regional Director,
Regional Office for Health and FW.
Kothi No.3281. Sector-21-D,
Chandigarh.
85.
Regional Director,
Regional Office for Health and FW,
A. 11/256/B. 1, New Airport,
Prakash Nagar,
Hyderabad.
86.
Regional Director.
Regional Office for Health and FW,
Anand Estate. Industrial Estate
Corner, Bapunagar.
Ahmedabad-380 024.
87.
Regional Director,
Regional Office for Health and FW,
25. Ramanathan Street.
T. Nagar.
Madras-600 017.
74.
I!
78.
69.
!
I
Dy. Director, CGHS,
232, Napiar Town,
Near Russel Chowk,
Jabalpur (M.P)
Dy. Director, CGHS,
7, Liddle Road, George Town,
Allahabad. (UP)
I
77.
Dy. Director, CGHS,
Hotel Radha Krishna,
Near Railway Station.
Jaipur-202 006.
75.
Dy. Director, CGHS,
Swasthya Sadan. Mukund Nagar.
2nd Floor. Pune.
76.
Dy. Director. CGHS.
Shalimar Cooperative Housing
Society, Near Embassy Market.
Ashram Road.
Ahmedabad-380 009.
221
88.
Regional Dircc("i.
Regional Office f<n Health and FW,
Ripon Hospital Compound,
Shimla-171 001.
93.
Regional Director.
Regional Office tor Health and I W.
Sangrill a I ripock Road.
Imphal-79:- 001
89.
Regional Director.
Regional Office for Health and FW,
F-711. Prem Nagar (New Plot).
Jammu Tawi
94.
Regional Director.
Regional Office for Health and
FW.76
131/16, Maharana Pratap Nagar,
Bhopal -462 001.
90.
Regional Director,
Regional Office tor Health and F\V,
140, Saheed Nagar.
Bhubaneshwar-751 007.
95.
91.
Regional Director,
Regional Office for Health and FW.
34/2, Parvati Darpan Building,
1st Floor, Shankar Nagar-H.
Pune-411 009.
Regional Director.
Regional Office for Health and FW,
101, Sree Sanidhi Railway Parallel
Road.
Kumar Park West,
Bangalore-560 020.
96.
Regional Director.
Regional Office for Health and FW,
K-10, Durga Das Path.
Malviya Marg. Jaipur
97.
Regional Director.
Regional Office for Health and FW.
Felli-Velle. Lumsohpoh.
Shillong-793 014.7
92.
Regional Director,
Regional Office for Health and FW.
Navanesthan Building.
TC.27/1460(i) Statue Road.
Chirakulam Lane.
Thiruvananthapurain.
222
annexure
v/
DEPARTMENT OE FAMILY WELFARE
List otTnstituuons/Voluntary Organisation which received Grant in-aid from Department
of Family Welfare for Rs. 1.00 lakh to Rs. 5.00 lakh during the year 1993-94. (as on 31.12.1993)
S.No.
1
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13..
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
Amount
Name of the Institutions
3
2
Rural Education and Development Society
Institute of Economic Growth
Women in Social Action, Midnapur
Bombay Cityzen Council, Baroda
Lucknow University. Lucknow
Bhartiya Gramin Mahila Sangh. Indore
Karunalaya Rural Community Hospital. T.Nadu
Orrisa Institute of Medical Research and
Health Service. Cuttack. Orissa.
Institute of Social & Economic Change.
Bangalore.
Women in Social Action, Jhargaon
K.E.M. Hospital, Pune
Kamla Nehru Memorial Hospital. Allahabad
Ghokhley Institute of Politics ami
Economics, Pune
Parivar Medical Trust, Ahmed Nagar
Jan Hitkari Ch-ikitsalaya, Kanpur
National Federation of Labour Cooperation
Ltd., New Delhi.
Indian Institute of Youth and Development
Phulwari
Sewadham Trust. Pune
Jawahar Medical Foundation, Dhule.
Maharashtra
Population Research Centre, Sukhadia
University. Udaipur. Rajasthan
Jaipur Rural Health Development Trust.
Jaipur
J.B. Balheenararga Abhivrudhi Sangh.Cuddaph
Apna-laya, Bombay
National Institute of Motivational
Development. Bombay
Central Council for Research in Unani
Medicine. New Delhi.
Principal, Health and F.W. Centre. Hyderabad
Principal, Health and F.W. Centre. Guwahati
Principal, Health and F.W. Centre. Hazari
Bagh.
223
4.16,268
4.03,000
2.78.000
5.00.000
1,57,000
5.00.000
2.00,000
2.48,000
2.42.000
4,83.797
3.10,850
3.41,672
2.07.000
2.37,240
2.40,500
2.71,401
2.40.000
3.27,716
3,39,527
3.00.000
2.80,000
4.20.400
1,96.800
1.56.200
1.50,000
2.00,000
2.00,000
5.00.000
1
29
30
31
32
33
34
35
36.
37.
38.
39.
40.
41.
42.
3
2
Principal, Health and F.W. Centre,Ahmedabad
Principal, Health and F.W. Centre,Rohtak
Principal, Health and F.W. Centre,Trivandrum
Principal, Health and F.W. Centre.Bangalore
Principal, Health and F.W, Centre. Cutlack
Principal, Health and F.W. Centre, Calcutta
Principal, Health and F.W. Centre. Girhtwt
t
(T.N.)
j
Population Research Centre, Lucknovv
Shri Gopal Shiksha and Samaj Sewa Samiti.
Morena
Centre for Research Rural and Industrial
Development, Chandigarh
Dr. Ambedkar Dalita Varga Abbivirdhi
Sangham, Cudapa.
Voluntary Health Association of Tripura
Gauhati University, Guwahati
Shri Shanti Niketan Shiksha Prachar
Samiti, Morena
22 4
2,00,000
2,00,000
2,00,000
2,00,000
2,00,000
2,00,000
2,00,000
3,96,000
1,21,150
2,15,700
3,21.250
2,00,000
1,58,750
2,47.500
I
ANNF.XURE - VII
DEPARTMENT OF HEALTH
List of Institutions/Voluntary Organisations which received Grant-in-aid from Department ot
Health from Rs. 1.00 lakh to Rs. 5.00 lakh during the year 1993-94 (as on 31-12-1993)
SI. No.
Name of the Institutiofi/Voluntary Organisation
Station
4
I
I
j
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
/Vnount
National Institute ot Naturopathy
Medical Council ot India
Pharmacy Council ot India
Patel Charitable Trust
Lady Hardinge & Medical
J.H.'C.
Indian Nursing Council
Indian Nursing Council
Marwari Relief Society
Hindu Mission Hospital
Hind Kusht Nivaran Sangh
Hind Kusht Nivaran Sangh
Sri Ayurved Mahavidyalaya
Nav Jagrat Manav Samaj
Indian Council for Medical
Phildelphia Leprosy Hospital
Netaji Subhash General Maternity Hospital
Khairabad Eye Hospital
Cancer Detection Society
District Blindness Control
Leprosy Mission Hospital
Jahangir Memorial Charitable
Bharat Sevashram
Rajendra Leprosy Research
Gandhi Memorial Leprosy
Gandhi Memorial Leprosy
SPSM, Madhupur
Kasturba Health Society
Nithish Bharatiya Chikstya
Cancer Relief Society
Anand Medical Foundation
Provincialate Society ot Sisters
Bharat Sevasram AIDS Prevention Society
Galaxy Club
Bankura Leprosy Hospital
Lions Eye Bank
I.N.C. '
____________
225
J
Pune
Nev.' Delhi
New Delhi
Gujarat
New Delhi
Kanpur
New Delhi
New Delhi
Calcutta
N' ailras
C; leutta
Calcutta
Nagpur
Jamshedpur
New Delhi
Andhra(Salur)
West Bengal
Kanpui
New Delhi
Karnataka
Vizianagaram
Allahabad
Bihar
Patna
Karnataka
Wardha
Bihar
New Delhi
Muzaffer
Nagpur
Pune
Quilon
Bihar
Guwahali
Imphal
Bankura
Bijapur
New Delhi
5.00.000
4.40.000
2.50.000
3.00.000
2.95.760
1.00.000
1.25.000
2.5O.OOO
2.00.000
1.71.067
1.17.901
1.17.442
5.00.000
1,47.478
1.57.500
2.04.120
1.00.000
1.00.000
5.00.000
4.00.000
3.18.620
2.57,235
2.57.235
2.08.012
1.33.245
1.76.985
1.91.085
1.66.000
1.00.000
1.00.000
2,00.000
1.98.350
2.18.962
1.55.760
1.15.900
2.40.'855
2.00.000
1.87.000
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4683.pdf
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