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Strengthening of Family Welfare
and
Maternal and Child Health Services
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India Population Project-IX Proposal
Final Version Approved by GOI and IDA
9
Department of Health and Family Welfare.
Karnataka
June 1994
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Foreword
*
Hie Department of Health and f amily welfare Gosemment of Karnataka, had at
the meeting held tn Washington in the first week of May 1994, requested the inclusion
of civil wmks in the three districts
Belgaum, Bijapur and Gulbarga in IPP IX, at an
additional costi of Rs. 133 '503 million The Ministry of Health and family Welfare.
Government of India and the Internationa^ Deveiopjncnt. Agency have reviewed the
request and agreed to fund additionaTRs ?0 million . thus raising the total funding to
Rs I 147 50 million against the total base cost of Rs 1220 922 million
Illis document updates the final IPP IX Proposal dated March 1904
incorporating the proposals for the three districts
Belgaum. Bijapur and Gulbarga in
the appropriate sections
Hie (iovcnimcnt of Karnataka would like to place on record its appreciation of
the understanding and support received from the officials of the Ministry of Health and
Family Welfare. Government of India and the Leader and members of Appraisal Mission
and officials of the International Development Agency.
I he present volume incorporates all the documents submitted subsequent to the
I inal Revision of the Project Proposal and replaces the previous versions of the project
proposal
Gautam Basu IAS
Secretary, Government of Karnataka
Department of Health A. Family Welfare
Bangalore
June 27. IW
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Contents
Page
Executive Summary
I. Introduction
1 1 India Population Projects
1.1.1 India Population Project -. I
1.1.2 India Population Project - III
1.1.3 Lacunae in Implementation
1.2 Profile of Karnataka
12 1 Population and Growth
12 2 Literacy
12 3 Scheduled Caste and Tribal Population
1.2 4 CBR. IMR and TER
12 5 Health Facilities
1.2 6 Achievement: FW and MCH
12 7 Fertility
1.3 KAP of Family Planning in Karnataka
1.3.1 Awareness and Knowledge of FP Methods
1.3.2 (Jsership of FP by Method
1.3.3 Usership by Age of Wife
1.3.4 Usership by Living Children
I 3.5 Exposure to Mass Media
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2 The IPP-IX Project
2.1 Action Plan of MoHEW
2.2. Project Proposal
2.2.1 Need for the Project
2.2.2 Project Goals
2.2.3 Area to be Covered by the Project
2.2.4 Rapid Appraisal of Needs
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3. Programme Linkage with Community at Local Level
15
4. Strengthening of FW and MCH Services
4.1 Strengthening of Health Centre
4.1.1 Buildings
4.1.2 Buildings for PHCs
4.1.3 Rehabilitation of Existing Centres
4.1.4 Handling Solid Waste
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4 15 Furniture and Equipment
4.1.6 Improving Productivity of Paramedical Staff
4.1.7 Link Workers
4.1.8 Development of CHCs into FRUs
4.1.9 Maintenance of Buildings
4.1.10 Budget for Strengthening Delivery of Services
5 Improving the Quality of Services
5.1 Training
5.1.1 Existing Training Facilities
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5 111 HFWTCs
5.1.1.2 Multipurpose Worker (Male) Training Schools
5.1.1.3 ANM Training Schools
5.1.1.4 LHV Promotional Training Schools for ANMs
5.1.1.5 CGN Training Centres
5.1.1.6 Health Inspector Training Centres
5.1 2 Manpower Projections
5 1.3 Adequacy of Pre Service and Pre Promotion Training
32
Schools
33
5 1.4 Staffing of Training Centre and Schools
33
5.1.4.1 HFWTCs
34
5.1.4.2 ANM Training Centres
34
5.1.4.3 Health Inspector Training Centres
34
5.1.5 In service Training of BHEs and Paramedical Staff
36
5.1.6 Proposed Training Programme
37
5.1.7 Training Centres For Jr. Health Assistants
40
5.1.8. Role of HFWTCs
41
5.1.8.1 Upgrading Infrastructure of HFWTCs
42
5.1.8.2 Phasing of Expenditure on HFWTCs
5.1.9 Training for TBAs, Anganwadi Workers, Community
42
Leaders and Others
43
5.2 Buildings for ANM schools
43
5.3 State Institute for Health and Family Welfare (SIHFW)
46
5.3.1 Training Load of 1HFW
46
5.3.2 Phasing of Expenditure on IHFW
47
5.4 Budget for Improving Quality of Services
Ill
Page
6 IEC Activity
6 1 IEC Wing in Karnataka
6 2 Communication Needs
6.3 IEC Objectives and Sti negy
6 4 Equipment for IEC
6 5 IEC Materials
6.6 Mahila Swasthya Sanghas
6.7 Staff
6 8 IEC Programme for the First Year
6 9 Budget for IEC
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7 Ib-oject Management
7 I. Apex Authority
7.2 Engineering Wing
7 3 MIES
7 3 1 Present Status
7.3.2 Proposed Information system
7.3.3 Staffing for MIES
7.3 4 Capital Equipment for MIES
7.3 5 Stationary and Office Supplies
7.3.6 Computer Systems for Special Applications
7 3.7 Selection of Vendors and Consultants
7.3.8 Budget for MIES
7.4 Evaluation Studies
7.5 Flow of Funds
7.6 Budget for Project Management
8. Innovative Schemes
8.1 Sub-Centre Health Advisory Committee
8.2 Involvement of PVOs and PMPs
8.3 Special Programme for Tribal Areas.
8.4 involvement of Industrial Houses in IEC
8.5 Non-Formal Education for Girls and Young Women
8.6 Clubs for Newly Married Couples
8.7 Community Incentives
8.8 Marketing of Nirodh
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8 9 Monitoring of Innovative Schemes
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9. Tribal Population of Karnataka
9 1 Scheduled Tribes of Karnataka
9.2 Tribal Development in Karnataka
9.3 Ethnographic Survey of Scheduled Tribes of Karnataka
9.4 Socio-Economic and Demographic Studies of Tribes in
Karnataka
9.5 Beneficiary and Communication Needs Assessment
Studies
9.6 Proposed Studies
10. Project Costs
10.1 Project Cost by Activity
10.2 Expenditure by Category
10.3 Phasing and Costing of Activities
10.4 Project Sustainability
References
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Annexures
1. Plan of Sub-Centres Building
2. Plan of Residential Quarters for MOs
3. List of Villages Selectedfor First Year construction of
Sub-Centres
4. District Map: Mandya
5. Taluk MAP: Nagamangala
6. Village MAP
7. Status of Buildings for PHCs in Karnataka
8. Plan For PHC Building
9. Furniture and Equipment for Sub-Centres
10. Equipment for ANM Kits
11. Plan of District Training Centre
12. Furniture and Equipment for District Training Centre
13. Plan of Building for HFWTC Mysore
14. Plan of Building for ANM Training School
15. Plan of Building for S1HFW
16 Furniture and Equipment for HFWTCs
17. Furniture and Equipment for SIHFW
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Executive Summary
1.
Project Objectives
The specific objective of the project is to implement a programme
grain able at village level to reduce CBR, IMR and MMR and increase CPR to reach the
national target for the year 2000.
The strategy to be adopted for achieving the objectives is to
1. Involve the community in promoting and delivery of family welfare services.
2. Strengthen delivery of services by providing
equipment kits and supplies to TBAs, Sub-centres and PHCs,
b make ANMs at sub-centres mobile by providing loans for purchase of two
wheelers,
c. buildings for sub-centres with provision of residential accommodation for ANMs,
d. buildings for PHCs, and
residential quarters for medical officers.
3 Improve the quality of services by providing training to personnel* official and| non
official at various levels including TBAs, community leaders and voluntary agencies.
4. Strengthen monitoring and evaluation by developing and installing MIES from district
to state level.
Area to be Covered by the Project
While coii^ruetion of buildings for sub-centres, PHCs and residential quarters for
medical officers will be confined to selected thirteen districts, other activities such as
Training, IEC and MIES will be carried out in all the districts of the state.
The districts selected for construction of buildings for sub-centres, PHCs and
residential quarters for medical officers are the eight districts not covered by IPP-1 and
IPP-111 namely, Bellary, Chikmagalur, Dakshin Kannad, Hassan, Kodagu, Mandya,
Mysore, and Uttar Kannad. In addition, Shimoga and Chitradurga districts covered under
IPP-I and Belgaum, Bijapur and Gulbaiga covered under IPP--III are also included.
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3.
Civil Works
3.1.
Buildings for Sub-Centres
There are 2076 sub-centres widiout buildings in the thirteen districts. It is
proposed to construct buildings for fifty percent of sub-centres (Le. 1039 sub-centres) in
thirteen selected districts. Each new sub-centre building will have an examination room,
and a muhi-purpose hall that can serve as a waiting room or meeting room as well as
office area for Jr. Health Assistants(ANM). Besides it will have residential quarters for
ANN. The total area will be 64 sq. m. and is estimated to cost Rs. 230,000 per unit.
The selection of sub-centres for construction of new buildings will be based on the
following criteria:
1. Accessibility to nearest PHC (distance and transport facility).
2. Low level of immunization of children.
3.
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Low level of contraception.
Availability of unencumbered site of 225 sq.m within the middle of the village,
flic site should be well drained
Environmental conditions around the site.
3.2.
Buildings for PI ICs
Out of the 12^7 PHCs sanctioned and operating in the state 983 PUCs have their
own buildings or buildings are under construction. Out of the 314 PI ICs without
buildings, 218 are in the project districts in which civil works arc contemplated It is
proposed to construct buildings for 94 PHCs at an estimated cost of Rs. 780,000 for each
PHC building
3.3.
Residential Quarters for MOs
Residential quarters for medical officers will be constructed at locations where
suitable residential accommodation is not available and the doctors have been living in
settlement other than that in which the PHC is located. If residential accommodation is
provided in the premises of PHC or nearby the availability of doctor is ensured. In all 271
residential quarters are planned to be built in the thirteen districts. The area of each
quarters will be 70.6 sq.m, and estimated to cost Rs. 300,000.
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3.4. Buildings for Training Establishments
3.4.1 Buildings for ANM Training Schools
ANM Training Centres in the districts of Bellary, Dakshin Kannad, Hassan,
Kodagu, Mandya, Mysore and Uttar Kannad have no buildings. Each of these will be
provided with a building with hostel facility for 48 students at a cost of 3.00jnilliQrL
3.4.2 LHV Promotional Training Schools for ANMs
Out of the four LHV Promotional training schools two Training Schools at
Belgaum and Mangalore will be closed down as there is excess capacity. The schools in
these cities have no buildings. A building is under construction for the Training School at
Gulbarga while the one in Bangalore has no building. A building with an area of 575 sq.m,
will be constructed for the Training School including hostel facility for 30 students at
Bangalore at a cost of Rs. 1.60 million.
3.4.3 District Training Centres
It is proposed to construct one training school in each district to provide in-service
training to paramedical staff. Each centre will have hostel facility for 30 trainees and will
cost Rs. 1.60 million
3.4.4 Health and Family Welfare Training Centres
The Health and Family Welfare Training Centre (HFWTC) at Mandya located in
communicable Diseases Investigation and Training Centre is proposed to be shifted to
Mysore. A Building with an area of 1365 Sq.m will be constructed at a cost of Rs. 5.187
million. Quarters for Principal and Medical Lecturer will also be. built at a cost of Rs.
0.722 million
The JIFWTC at Ramanagaram will be expanded by constructing additional lecture
halls and other facilities .a a cost of Rs. 0.456 million.
1
3.4.5 Institute of Health and Family Welfare
It is proposed to set up an apex institute at Bangalore to design training courses
for all categories of staff and conduct training courses for the faculty of all training centres
currently run or proposed to be run by the Department of Health and Family welfare. The
institute will also take up evaluation of programmes undertaken by the Department and
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suggest actions to remove deficiencies or improve performance. At a later stage, the
institute will offer diploma course in selected subjects for which substantial number are
deputed to institutes outside the State for training. An office building at a Cost of Rs. 1.90
million will be constructed at the campus of Leprosy Hospital at Magadi Road, Bangalore
where a training centre building with hostel facility for 32 senior officers has been
constructed under IPP—III....
3.5
Rehabilitation of Existing Health Centres
It is estimated that 48 CHCs, 327 PHCs and 2212 Sub-centres in the thirteen
districts covered by the project need repairs to structure, replacement of electrical wiring
and fittings, repair of toilets, provision of continuous water supply. A provision of Rs.
43.919 million has been made in the Project Cost.
The State Government has to undertake at its cost rehabilitation of health centres
in the remaining seven districts. It has also to provide for regular maintenance of all health
centre buildings
3.6. Upgrading CHCs into FRUs
A survey of facilities available at CHCs is being carried out to identify centres
which can be upgraded as first level referral units (FRUs) at minimal cost. The criteria for
selection of Cl ICs will be:
1. The centre is already functioning as a referral hospital,
2. Specialists like surgeons, obstreticians & Gynaecologists and Paediatricians have
already been sanctioned,
3. Availability of major operation theatre, and
4. Marginal inputs will are required to make them function as FRUs
Hie average cost of developing each FRU is estimated at Rs^O.350 million.
4.
Strengthening Delivery of Services
Apart from construction of buildings for sub-centres and renovating existing health
centres other steps are proposed for strengthening of delivery of health and family welfare
services.
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4.1
Furniture and Equipment
Sub-centres which are being provided new buildings will be given full complement
of equipment and furniture For other sub-centres, missing furniture and equipment will be
replaced A provision of Rs. 97.005 million has been made for this purpose
4.2. Improving Productivity of Paramedical Staff
Qne-third of the ANMs who do not have midwifery kits will be provided with
equipment kit at a cost of Rs. 6 0 million In order to save the time of paramedical staff in
travelling, loan will be given for purchase of vehicle of their choice out of four types A
revolving fund of Rs. 105 million is proposed for this purpose
4.3
Link Workers
It is proposed to set up Health Advisory Committees (HAC) for each sub-centre to
orient delivery of services to the needs of the community. Apart from the health officials
two persons from each village served by the sub-cent(c will be nominated to the
committee by the Chairmen, of the respective (kam Panchayats. At least one nominated
member from each village will be a female.
The IIAC will select a voluntary worker from each village to act as a link between
the sub-centre and the beneficiaries The voluntary workers will be paid j)crformanQp
based incentives A provision of Rs. 87 99g million has been made for payment of
incentives io link workers
4.3 Delivery Kits
To ensure safe and elean delivery. Trained Birth Attendants (daisjin each village
will be provided disposable delivery kits free of cost A provision of Rs. 13.295 million has
been made for meeting the cost of these kits.
5.
In-Service framing of Staff
A study Population Centre, Bangalore revealed that there are serious gaps in the
knowledge, skills and practices of personnel in regard to family planning, maternal and
child health, nutrition, immunization, control of communicable diseases, environmental
sanitation, vital statistics and health education. It was indicated that there is an urgent need
for retraining of all paramedical staff The Training Needs Assessment of paramedical staff
initiated by the Project Proposal Team indicated that the situation did not seem to have
materially changed.
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The training programme proposed under IPP-1X Project is aimed at
1.
2.
3.
4.
5.
updating knowledge, skills and practices of all health functionaries for effective
delivery of Health FW and MCH services,
developing communication skills to effectively carry out IEC activity in the
community,
making health functionaries awareof theirjob ^^on^bilili<|s as providers of primary
health care,
maintaining information on performance at their level and providing feed back, and
developing knowledge and skills to act as trainers at their level.
All health functionaries will be provided in-service training initially for two weeks
and a refresher course of two week duration after three years.
fhe training modules and their duration for different categories of staff were
planned on the basis of training needs survey, discussions with Joint Directors, DHOs and
Principal and staff of HFWTC.
Hie Joint Director (H.E.& T) will be responsible for conducting in-service training
courses for medical and paramedical staff and pre-service training to ANMs and
MPW(M). It is proposed to establish a training centre for Junior Health Assistanlsjn each
of the 19 districts (Bangalore urban and rural districts will have together one district
training centre). Nearly 15.000 Junior Health Assistants (Male & Female) will be trained
at the district training centres.
Training courses for Medical Officers, Block Health Educators and Senior Health y
Assistants Male and Female will be provided at HFWTCs. 'Hie Junior Health Assistants
Male and Female will be trained in their respective districts. Around 7000 Medical
Officers, Block Health Educators and Senior Health Assistants (Male & Female) will be
trained at the five HFWTCs. Besides providing continuing education to medical officers
and supervisory staff, the HFWTCs will have the responsibility of providing pre-service
training to Jr. Health Assistant Male and Sr. Health Inspectors which are full time courses,
each of one year duration.
It is proposed to set up A State Institute for Health and Family Welfare to
1. design training courses for all categories of staff,
or
2. conduct training courses for the faculty of all training centres currently run
i
proposed to be run by the Department of Health and Family welfare,
3. Conduct nianagement training programmes for superintendents of hospitals and senior
doctors,
4. undertake
programmes of the Directorate of Health and Family welfare,
including those under 1PP-IX, jind suggest actions to remove deficiencies or improve
perfonnance. and
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5.
offer diploma courses in DPH, DPHE and DPHN with affiliation to Bangalore
University
Experts in different subjects with considerable teaching experience will be engaged
to review existing materials prepared for CSSM/UIP and design the courses modules and
lesson plans and coordinate their activities. The experts will be selected from HFWTCs,
N1MHANS. Medical Colleges, Nursing Schools, Management Institutes, Institutes of
Mass Communication, NIC and leading consultants The training
The total cost of
development of course material for trainees is estimated at I 635 million Rupees.
Que...-day orientation courses to 52,000 persons, — TBAs, anganwadi workers,
selected members of gram panchayats. voluntary workers and school teachers will be
conducted at the PHCs at a cost of Rs 16 624 million during the project period
6
1EC
Hie Information Communication and Education activity is being strengthened by
providing equipment and additional manpower at the Directorate Interpersonal
communication supplemented by audio-visual media will be the main modes of
communication.
The objectives for the II-C programme arc
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•
•
•
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To promote higher age at marriage among boys and girls.
To promote spacing methods among young couples with one child or none
To promote terminal methods at younger age than hitherto.
To achieve hundred percent ante natal registration.
To educate and motivate the community to accept referral services under CSSM
programme.
To motivate women with unwanted pregnancy to avail of MTP service.
To involve and encourage the participation of the community, PVOs and NGOs in the
Family Welfare programme
The Paramedical staff will be relied on to provide interpersonal communication as
they are, according to 80 percent of respondents interviewed for communication needs
survey, providing MCH and FP services through house to house visits. Apart from
conducting training programme to improve the communication skills of the paramedical
staff, inter personal communication kit will be made available to each ANM. The kit
would consist of items such as flash cards, flip charts, slide viewer, and other educational
aids. A quarterly news letter for internal circulation to paramedical staff will be brought
out. This news letter will give information on other IEC activities planned for the coming
quarter, suggestions for improvement received from paramedical staff and the names of
those who have done outstanding work.
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It is proposed to provide one each of video projector with VCP, TV/VCR, Slide
< projector, overhead projector and a long bodied jeep to each district. TV/VCKs will be
provided to Ninety five selected CHCs will be provided with TV/VCRs and 800 Mahila
Swariiya Sanghas will be given radio cum cassette player. A sum of Rs. 18 367 million has
been provided for equipment and vehicles..
The IEC materials, whether for field exhibition by the district staff or Doordarshan
and AIR, will be designed in consultation with senior district officials such as DHO.
DHEO so that the communication materials reflect the socio-cuhural ethos of different
regions of the state It is proposed to invoke experts in the field of mass communication
from public and private sector institutions for development of messages and their
scheduling based on the results of communication needs study Folk artists will be
supported to develop audio-visual programmes An outlay of Rs. 37 46 million is
proposed for development of IEC materials
IEC materials whether they be audio-visual films, slide shows, posters, folders or
wall papers have to be pre tested to assess their effectiveness in conveying intended
messages to the target population A provision of Rs I 056 million is made for pre-testing
of IEC materials.
Apart from telecasting TV serials and FW films on Doordarshan, they will be
exhibited by the district staff by hiring video vans This will be tried out on an
experimental basis in five districts during the first year and if found effective it will be
extended to another five districts in the second vear and remaining districts in the third
year A sum of Rs. 41.5 million has been provided for hiring of video vans and buying time
on AIR and Doordarshan.
It is proposed to form Mahila Swasthya Sanghas (MSSs) and utilize them as a
channel for communication to supplement the efforts through mass media and
interpersonal communication. It is planned to train the members of MSSs at PHCs and
undertake, with their help, programmes such as well baby shows, women and children's
day celebration, motivation of eligible couples etc. As it is difficult to manage and sustain
the MSSs on a large scale,, it is proposed to pilot MSSs on a limited scale and evaluate the
programme and extend it only if the results are satisfactory.
The IEC Staff at the Directorate will be augmented to manage the increased IEC
activity.
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Project Management
7.
The apex body for management of IPP-IX is the Project Governing Board (PGB)
consisting of the Chief Secretary, and Secretaries for Finance, Health and Family Welfare,
Director Health and Family Welfare Services, Additional Director (FW & MCH), and
Additional Director (Projects) of Karnataka and Representative of Government of India.
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A Steering Committee consisting of the Secretaries of Health and Family Welfare
and Finance. Director Health and Family Welfare Services, Additional Director (FW &
MCH), and Additional Director (Projects) will carry <<ut such functions as are assigned by
the Project Governing Board and shall furnish reports from time to time to the Board for
ratification of actions taken
The Additional Director (Projects) will be responsible for implementation of
IPP-IX A post of Jt Director (Area Projects) is created to assist the Additional Director
(Projects) in coordinating activities of various departments / agencies.
An Engineering wing is being set up to plan and coordinate construction,
renovation and maintenance activities with State and Zilla Parishad PWDs.
A comprehensive management information system will be implemented Computer
systems will be installed at the offices of District Health Officer and at the Directorate
Computer systems will also be provided to Engineering, IEC and Training wings for
specialized applications in their respective areas
A sum of Rs. 9.826 million is provided for equipment and vehicles and Rs 3 60
million towards consultancy services for project management.
Innovative Schemes
A number of innovative schemes are contemplated. 'Hie most important being:
•
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Participation of community through Health Advisory Committee at Sub-centre
level
Involvement of PVOs and PMPs in promotion and/or delivery of services
Provide ANM training to Tribal Girls and post them to new sub-centres in tribal
villages
Involvement of industrial houses in IEC activity
Providing non-formal education for girls and young women
Promoting clubs for newly married couples
Offer community incentives for reaching MCH targets
Marketing of condoms through public distribution system
Project Duration and Cost
The Duration of the project is seven years. The Breakup of base cost of the Project
by activity is Presented in Table 8.1
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Fable 8 I Breakup of Project Cost by Activity
Million
___ Rs
700 843
119 591
820.434
91 675
80 915
172.590
58 008
44.209
102.217
13 575
36 120
49 695
75.886
940087
280.835
1220.922
Activity
Strengthening Delivery of Health
acilities
Improving Quality of Health Facilities
I EC
Administration & MBS
Innovative Schemes
I olal
Capital
Revenue
Total
Capital
Revenue
Total
Capital
Revenue
Total
Capital
Revenue
Total
Capital
Capital
Revenue
Total
Percent
of Total
57 40
9 80
67.20
7 51
6 63
14 14
4.75
3 62
____ 8_37
1 11
2 96
4 07
6 22
77.00
23 00
100 00
Fable 8 2 presents the phasing of expenditure by year between 1993-2000.
Fable 8.2 Phasing of Expenditure
Million Rupees
9 3-94
Total capital expenditure
Total revenue expenditure
Total Project cost__________
Physical contingency______
Price contingency_________
Project cost with Contingency
94-95 95-96
96-97
97-98
49337
51834
57 696
280 835
68 584
75 444
1220 922
2 154
80 273
35 326
264 554
112 924
1565 749
48 082
230 746
15 460
2 863
14 741
24 369
40 553*
49,936
61.914
34.767
r828
27 319
241 047
355 5)8 307 978
308 1 19
142 433
97 731
15 721
17 877
T ota)
942 087
104 803
20 414
32 348
’
?90
596
240
165
210 585
21 124
99-00
17 748
182 664
270 182
98-89
16 750
55 465
207 817
189 461
The Government of India and the International Development Agency have
approved a Base Cost of Rs. 1147.5 million at the negotiations held in Washington during
May 1994.
Chapter 1
Introduction
India Population Projects
11
Karnataka has benefited from the India Population Projects — IPP-1 and
IPP-III. which together covered seventy percent of the population of the state. While
the overall objectives of both the projects focused around health and family welfare,
there were some differences in the emphasis on service components.
1.1 1
India Population Project - I
IPP 1 was supported by Ministry of Health and Family Welfare (MoHFW),
Government of India, with assistance from the International Development Association
(IDA) and the Swedish International Development Authority (SIDA). Hie project was
implemented during the period April 1973 - March 1980 in the six districts of
Bangalore Revenue Division
Bangalore Urban, Bangalore Rural, Chitradurga.
Kolar, Shimoga and Tumkur. The project area had as per 1991 census a population of
15.1 million comprising 33.6 percent of the population of the state.
•
•
•
•
•
I
•
•
Hie project aimed at
expansion of health infrastructure,
linking the provision of family planning services with a supplementary nutrition
programme.
creation of population centre to evaluate performance on a continual basis and
to design and operate MIES and evaluate performance, and
provision of technical assistance.
IPP - 1 (Karnataka) consisted of the following wings:
construction or engineering wing to take care of the construction of building
and other physical facilities;
implementation wing for recruitment and appointment of staff, provision of
supplies and equipment and supplementary nutrition; and
population centre for conducting research studies and monitoring and
evaluation of the project.
The activities of all the three wings were coordinated by a Project Coordinator.
'Hie responsibility for implementation of the project was entrusted to the Project
Governing Board (PGB) chaired by the Minister for Health and Family Planning,
Government of Karnataka. A steering committee with the Secretary, Health as
Chairman was formed to assist the PGB and to carry out such functions as were
assigned to it by the PGB and furnish reports to the PGB for ratification of actions
taken.
2
1
I
2
The institutions contracted to provide services were: (I) Administrative Staff
College. Hyderabad for consultancy in management information, technical report
preparation and training; (2) National Institute of Nutrition, Hyderabad for assistance
in the implementation, monitoring and evaluation of supplementary feeding
programme; and (3) Central Food Technological Research Institute to manufacture
and supply energy food for the supplementary feeding programme
Sixty-five ‘"major" buildings, 694 sub-centres and 97 additional buildings were
constructed under IPP-I. Of these buildings, 784 were provided with safe drinking
water and 4 17 with compound walls. As many as 1 11 four wheeled vehicles were
provided and equipment and furniture worth Rs 12 million was purchased and put in
place
112
i
India Population Project - III
IPP III was implemented during 1984 1992. with support from the Ministry of
Health and Family Welfare and the IDA, in Belgaum, Bijapur and Dharwad districts of
Belgaum Revenue Division and Bidar Gulbarga and Raichur districts of (rulbarga
Revenue Division These six project districts had a population of 16 2 million in I99|
and accounted for 35.9 percent of the state population.
lhe objective of the project was the attainment of goals of population policy of
India namely, to reduce fertility, and lower infant, child and maternal mortality lhe
goals were sought to be achieved by
* #
* J.
•
•
•
•
•
generating demand for services,
augmenting staff and facilities,
improving professional and technical skills,
improving management, and
involving community, voluntary organizations, other government departments and
local bodies in the family welfare programme.
Hie components of IPP-III were formulated on the basis of experience gained
from IPP-I. The supplementary feeding programme for pregnant women in the last
trimester, nursing mothers during the first six months of lactation and toddlers aged 6
to 24 months which formed part of IPP-I was not included in IPP-III. On the other
hand IEC and population education components were introduced for the first time in
IPP-III to generate demand for family welfare services.
The total cost of IPP-III was Rs. 713.1 million and its break up by the four
major components is presented in Table 1.1.2.1.
>
►
I
3
Table 1.1 2.1 Break up of Expenditure on IPP-IH
Act ivity_________________
Service delivery__________
IEC & population education
Research & evaluation
Project management
Percent
83.0
6.4
____19
7.7
Under IPP-lll, as many as 2.344 buildings of different types were constructed
and 83 PHC’s were repaired or provided with extensions Safe drinking water was
provided to 720 buildings and compound walls were constructed for 654 buildings
One hundred and fifty four-wheeled vehicles and 512 motor cycles were provided
Equipment and furniture worth Rs 26 million was purchased and supplied to difTerent
hospitals The managerial and professional skills of many medical, paramedical and
non-medical personnel have been improved through well organized training
programmes
1PP III had a construction wing, an implementation wing and an IEC wing
Population education activity was entrusted to State Council of Education Research
and Training of the Department of Education. Government of Karnataka. Ehc research
and evaluation activities were assigned to the Population Centre in Bangalore.
IPP-Hl (Karnataka) also had a Project Governing Board (PGB) with the Chief
Secretary as the Chairman and a Steering Committee with the Secretary Health as
Chairman.
1.1.3 Lacunae in Implementation
w
■’1^1
F',>: ’
K.
Ill-
Delay in implementation has been one of the problems experienced in
implementing both IPP- I and IPP III resulting in prolonging the duration of the
projects from five years to seven years or more. The start of the project is delayed due
to delays in deputing personnel from other government departments and appointing
new staff
Delay in construction of buildings has been a serious problem. This has arisen
due to handing over responsibility of const ruction to Public Works Department, Land
Army Corporation and Karnataka Construction Corporation which have their own
priorities and independent construction programmes besides being under staffed. In
Kerala all the buildings under IPP—III could be constructed without delay because the
Directorate of Health and Family welfare Services has its own construction wing which
undertook the construction activity.
Delay due to lack of clarity in project management at difTerent levels has been
another serious problem. The objective of having the Secretaries of Finance and
Planning Departments on the Project Governing Board was to create a single window
for all approvals needed for project implementation. In spite of this understanding.
Project coordinators were required to obtain sanctions from Finance and Planning
4 )
■1
4
Departments for activities approved by the board Thus, the Project Governing
Boards, which were expected to cut down delays, became one more tier in the
sanctioning process
Delays due to conflicts between officers in-charge of IPP project and those
in-charge of ongoing schemes have also occurred India Population Programmes arc
supposed to be implemented as part of ongoing family welfare programmes However,
the Project coordinator who implements India Population Projects does not report to
the Additional Director (FW & MCH) who is responsible for ongoing MCH and family
welfare programmes leading to conflicts between them. In IPP-III, an India Population
Project District Health Officer was appointed to implement project activities while the
regular District Health Officer was looking after ongoing MCH and family welfare
programmes This resulted not only in unhealthy competition but also conflicts
between the two officers.
12
Profile of Karnataka
1 2 I
Population and Growth
Hie population of Karnataka, as per 199 J census was 44.98 million and
accounted for 5 3 1 percent of the population of the country lite annual compound
growth rate has declined from 2.38 percent in the decade 1971 81 to 1.90 in the
decade 1981 91 While the decline in growth rate was substantial in IPP I and
“Other" districts it was marginal in IPP III districts.
'fhe urban population was 30.9 1 percent of the state population in 1991
The sex ratio has declined from 963 in 1981 to 961 in 1991 The decline has
occurred in Bangalore Rural, Bellary, Bidar, Bijapur, Dharwad, Gulbarga, Kolar,
Raichur and Tumkur districts.
Table 1.2.1.1 Population, Percent Urban, Sex Ratio and Growth Rate
Year
IPP-1
>■
W'
r
Population
(in thousands)
Urban %
n-
Sex Ratio
Growth %
IPP-I1I
Project
Other
Districts
All
Districts
16,163
13,689
44,977
23.8
25.4
968
960
2.08
2.05
21.2
24.5
980
987
2.24
28.9
30.9
963
961
2.38
1.93
Project
Districts
Districts
1991
15,125
1981
1991
1981
1991
1981
1991
38.6
42.8
940
939
2.91
2.12
1.60
<
5
F
1 2.2 Literacy
The literacy among females aged seven and over increased from 2 0 percent in
1981 to 37 3 percent in 1991 During the same period the literacy among males aged
seven and over increased from 48 0 to 56 4 percent The six districts covered under
IPP-III had in 1991. the lowest literacy level among males and females as compared to
IPP - 1 and other districts
Table 1.2.2.1 Percent Literate among Males and Females Aged 7 & Over
Year
Males
females
1981
199]
1981
1991
1PP-I
Project
Districts
IPP-III
ffroject
Districts
Other
All
Districts
Districts
52.0
44.3
516
20 0
29.0
47 9
57.0
29 7
40.5
48 0
56 4
27 0
37.3
610
32.1
43.3
1.2.3 Scheduled Caste and Tribal Population
As per 1991 census scheduled castes account for 16 38 percent of total
population and m heduled tribes for 4.26 percent. 1PP-I districts had the highest
percentage of scheduled caste as well as tribal population Among “Other” districts
(17 81) Bellary had highest ■■ibal population (11 08%), followed by Kodagu (7 98)
and Mysore (6 42)
f able I 2.3 I Percent Scheduled Caste and 'Tribal Population in 1991
SC I
1PP - I Districts
IPP-I1I Districts
Other Districts
All Districts
18,43
14,49
14.50
16.38
sr I
5,40
3,46
3.51
4.26
M-
1.2.4 CBR, IMR and TFR
At the state level, crude birth rate (CBR) declined from 34.5 in 1980 to 27.8 in
1990. During the same period infant mortality (IMR) declined from 85.2 to 71.0 and
total fertility (TFR) from 4.65 to 3.42.
d
■
*
J; h
‘ft
11
;’V
a
■■
6
Table 124 1 CBR, I MR, TER in 1980
IMR Males
Females
TFR
IPP-I
Project
Districts
84.3
75.6
4 51
34.3
CBR
1PP-III
Project
Districts
95 4
87 2
4.85
35.5
Other
Districts
All
Districts
87 8
77.0
4.58
34 4
89 7
80,5
4,65
34.5
The vital rates for 1980 were estimated from 1981 Census data on
births last year, children ever bom and surviving children.
I 2.5 Health Facilities
Htere are as of March 31. 1992. 176 hospitals, 184 CHCs. 1262 PHCs,
and 7793 sub-centres to cover a rural population of 30.96 million residing in 27,028
villages. On an average there is a PHC for 24,532 population as against the norm of
one PHC for 20,000 population in tribal, hill and backward areas and one for 30,000 in
other areas. Hie average population coverage by a sub-centre is 3,972 persons while
the norm is one centre for 3,000 population in tribal, hill and backward areas and 5,000
in other areas
Table 1.2.5.1 Existing Health Facilities by District as on March, 3 1,1993
District
1PP 1 Districts
IPP-111 Districts
Other Districts
All Districts
Sub
centres
1979
2608
3206
7793
PHUs
PHCs
CHCs
Hospitals
Beds
253
103
230
618
352
440
505
1297
49
75
71
195
44
64
68
176
10987
8373
12072
31432
1.2.6 Achievement: FW and MCH
The couple protection rate for the state has increased from 23.7 in 1981 to
37.1 in 1986 and to 49.1 by March 21, 1992. The immunization level has been
computed on the basis of CBR of 29 for IPP-III districts and 27 for the remaining
districts.
4
7
Table 12 6 1 Couple Protection and Immunization
IPP-I
Project
Districts
I
CPR 1981
1986
1992
_______________
IPP-Iil
Project
Other
Districts
All
Districts
24.4
40 0
52 8
23.7
37 I
47 6
89.2
87 0
87 I
77 3
85 6
93 7
88 I
88 2
80 2
90 I
Districts
24.4
38 9
49 2
22.4
32 9
97.8
93.3
93 7
93 1
84 7
77.2
90 2
416
Immunization of Children in 1992
BCG
DPT
Polio
Measles
________ ___________
Immunization of Mothers in 1992
127
86 2
94.0
84 1
Fertility
Die marital fertility in the age group 15 24 has increased during 1980 88.
while in all other age groups it has declined Hie increase in fertility in the age group
15-24 suggests that a change is taking place in the behavioural pattern of younger
couples who are marrying late and desire to complete the family earlier
Fable I 2.7 1 Age Specific Fertility
Age
15-19
20-24
25-29
30-34
35-39
40-44
45-49
TFR/GFR
General
1988
1980
83.2
87 0 __
254.3 ___ 246.5
243.6 ___ 179.8
167,0 ___ 97.1
106,2 ___ 47.0
50.1____ 22.5
8.5
213 __
3.42*
4.65
Marital
1980
240 0 __
322.3 __
262.8 __
179.5 __
1 16,6 __
59.4 __
27,3 __
6.04 ’
1988
306.0
344.0
204.2
166.4
52.3
26.7
10.0
5.55
Source: Census for 1980 data and Sample Registration Scheme for 1988 data.
1.3
KAP of Family Planning in Karnataka
The results for Karnataka of the survey “Family Planning Practices in India —
Third All India Survey" conducted in 1988-89 by ORG, Baroda for the Ministry of
Health and Family Welfare, Government of India are presented in this section.
t
.j
8
1.3.1 Awareness and Knowledge of FP Methods
*
Even though awareness of terminal methods is high, 98.6 percent for
Tubectomy and 84.0 percent for Vasectomy, few have correct knowledge about them.
Awareness of non-terminal methods is low compared to terminal methods More
couples have correct knowledge of the use of condom and oral pill than IUCD or
terminal methods.
Table 1.3.1.1 Awareness of Contraceptive Methods
Method
Vasectomy
Tubectomy
1UCD
Condom
Oral Pill
Percent of Couples
Aware but
Not
Knowledge is
Aware
Poor
Correct
63.7
20.3
160
40.1
58.4
1.4
27.2
370
35.8
49.7
36.4
140
39.9
52.0
8.0
1.3.2 Usership of FP by Method
Current users of any method, including traditional methods, account for 47.5
percent of eligible couples, 3.6 percent for past users and 48.9 percent for never users.
The current users by method are presented below.
Table 1.3.2.1 Practice of Contraception by Method
Method
1
o
Sterilization_______
IUCD____________
Condom__________
Oral Pill__________
Any modem method
Traditional methods
Any method
Percent of
all couples
38.6
31
2.1
0.7
44,5
2.5
47.5
1.3.3 Usership by Age of Wife
Nearly 1.2 million current users aged 35 years and over, forming 36.75 percent
of all current users, will go out of the reproductive age group by 1998.
r1
9
Tabic 1.3.3.1 Practice of Contraception by Age of Wife
Percent
Current user Percent of
Age of Wife
users in the
all users
couples
age group
(thousand)
34_6
0.11 ________ 8 3
15-19
11 58 _______ 28 6
20-24
_
375.6
24.10
45.2
782.1
25-29
26.51 _______ 64 5
860.2
30-34
19,73 _______ 58.5
640.1
35-39
17,02 _______ 58_5
552.3
40-44
47.5
3244.9
100.00
All couples
I
1.3.4 Usership by Living Children
The usership was the highest in the group with three or four children
Fourteen percent of those who have three or more children desire additional
children.
About 31 percent of those who do not want any children are not practicing
contraception.
Table 1 3.4.1 Practice of Contraception by Desire for Additional Children
Living children
Nil
1-2
■B
♦
1
3-4
5+
Desire for
Additional
Children
Want
Want
Don't want
_____ Both
Want
Don't want
_____ Both
Want
Don't want
Both
No. of couples Percent current
users
in thousands
622.3
1388.4
1367.7
2756.1
397.2
2095.6
2492.8
89.2
878.5
967.7
1.6
16.4
67.7
41.8
1.5
74.5
62.9
3.0
590
53 8
1.3.5 Exposure to Mass Media
*
Mass media do not reach even fifty percent of the femak popuhtw. of the
B -■
i
I ■
■
state.
'1
10
Tabic 13 5 1 Exposure to Mass Media among Women Aged 15-44
Media
News Paper
Radio_____
TV_______
Cinema
I
Percent Exposed
Males
Females
379
17 0
520
46 3
22 1
21.2
34.0
27.3
W•
iI
’•
■
I
II
Chapter 2
49
The IPP-L\ Project
2.1
Action Plan of MoHFW
The Ministry of Health and Family Welfare (MoHFW) has, in consultation with
State Governments and Union Territories Administration has evolved an Action Plan
to give requisite thrust and dynamism to the family welfare programme. The most
important aspects of the Action Plan arc:
•
•
•
•
•
•
2.2
Improvement in the quality and outreach of health and family welfare services in
the held.
Initiating innovative programmes in urban slums for propagating family welfare
activities.
Launching Child Survival and Safe Motherhood Programme.
Targeting message of small family specially to younger couples and promoting
spacing methods of contraception.
Increased involvement of voluntary agencies and non governmental organizations
in the family welfare programme with a view to make it a peoples programme.
Increased Infonnation, Education and Communication inputs and decentralization
of communication strategies to take into account the local socio-cultural ethos with
special emphasis on interpersonal communication.
The Project Proposal
It is against this background that the Government of Karnataka constituted a
Project Proposal Preparation Committee with the Director, Population Centre,
Bangalore as Chairman and the Additional Director MCH and FW, Govt, of Karnataka
as Cochairman to formulate a project proposal for submission to IDA through Ministry
of Health and Family Welfare, Government of India for financial assistance. The Joint
Directors In Directorate of Health and Family Welfare, selected District Health
Officers and representatives of STEM were members of the committee.
*i
2.2.1 The Need for the Project
B
*
►■a
■
Karnataka has achieved a couple protection rate of 49.1 percent by March, 31,
1992. In order to achieve a CPR of 60 percent by march 1998, the magnitude of effort
required is substantial. Assuming an annual compound growth of population at 1.7
percent in the coming decade and eligible couples per 1000 population at 160, the
projected eligible couples in 1998 will be 8.067 million. To achieve a CPR of 60, 4.84
million couples will have to be protected. As of March 31, 1992 3.58 million couples
were effectively protected. Out of the currently protected couples, 1.94 million will
E
12
Fr
remain in the reproductive age group by 1998. It is therefore necessary to effectively
protect 2.90 million new couples between 1992-98 or nearly 410,000 per year as
against the observed average annual rate of 147,200 couples during 1989-92. The
efforts of the Department of Health and Family Welfare have to be trebled in the five
years 1993-98, to achieve CPR of 60 by 1998.
i
In ew of this the substantial investments have to be made in extending the
outreach programme to the door step of beneficiaries distributed over 27,028 villages
in the state to achieve the target for CPR and to have a “sustainable” family welfare
programme.
2.2.2 Project Goals
The specific objective of the project is to implement a programme
sustainable at village level to reduce CBR, IMR and MMR and increase CPR as
indicated below for the state of Karnataka.
Table 2.2.2.1 Targets for Vital Rates
Infant Mortality______
Maternal Mortality
Crude Birth Rate_____
Couple Protection Rate
1990
71
__ 6
28
47
1998
50
__ 2
20
60
The strategy to be adopted for achieving the objectives is to
•
•
•
•
Involve the community in promoting and delivery of family welfare services.
Strengthen delivery of services by providing
1. drugs, health kits and supplies to TBAs, Sub-centres and PHCs,
2. make AN Ms at sub-centres mobile by providing loans for purchase of two
wheelers,
3. buildings for sub-centres with provision of residential accommodation for
ANMs, and
4. residential quarters for medical officers.
Improve the quality of services by providing training to personnel, official and non
official at various levels including TBAs, community leaders and voluntary
agencies.
Strengthen monitoring and evaluation by developing and installing MIES from
district to state level.
2.2.3 Area to be Covered by the Project
'■ 'I
While construction of buildings for sub-centres and residential quarters for
medical officers will be confined to selected thirteen districts, other activities such as
r
training. IEC and MIES will earned out in all the distnets of the state (See Map
the State of Karnataka and demarcation of thirteen districts selected for civil uorkx.
The districts selected for construction of buildings for sub-centre* ar*
residential quarters for medical officers are the eight districts not covered by IPP
IPP 111 namely. Bellary. Chikmagalur. Dakshin Kannad. Hassan, Kodagu. Mani*^
Mysore, and Uttar Kannad. and in addition Shimoga and Clnuadurga districts
under IPP I and Belgaum. Bijapur and Gulbarga covered under IPP-III.
2.2 4 Rapid Appraisal of Needs
Hie proposals outlined in the following sections arc based on rapid sunr* n
the ten of the thirteen project districts. In each district two taluks were sampled a**
from each taluk one CHC. two PHCs and four Sub-centres were selected for tacdo
survey as well as training needs survey (>nc village was selected from the
covered by the sampled sub-centre. From each sampled village a community leader ar*
one woman aged 15 years and over were interviewed for assessing beneficun a^
communication needs A study team comprising of An Additional Health
District Nursing Superintendent and the District Health Education Officer was tormoc
in each district to conduct the surveys. The facility survey and the training need surx*
for medical officers were conducted by the Additional Health Officer, the trammc
needs survey for Senior Health Assistant Female (LHV). Junior Health Asstfa"*
Female (ANM) and Trained Birth Assistant ( I BA) by the District Nursmc
Superintendent and the training needs survey for Senior Health Assistant (Male*
Junior Health Assistant (Male) as well as beneficiary and communication needs
by the District Health Education officer.
In addition to the eflorts of the district health oflicials, STEM conduca^
beneficiary and communication needs surveys in a tribal taluk of Mysore disinct
non-tribal taluk of Chitradurga district while the Population Centre conducted the
survey in Dakshin Kannad and Kodagu districts.
'w
fl
141
•a
1
PROJECT STUDY DISTRICTS IN KARNATAKA-IPP IX
KARNATAKA
UNM« ’J’VJ’
■^co
0AA4AN
S k
\ Mu
inyiA
KOLAR
r U W K U R
N.
T
e
BANGALORE
*
PVGuECT 2 ST*':’'
JN.'CW S’jD*
KI-OmET^lS
15
Chapter 3
F
Programme Linkage with Community at Local Level
I
The zilla parishad is responsible for implementing the family welfare and
maternal and child health programmes in the district The District Health Officer
reports to the Chief Secretary of the Zilla Parishad. Thus there is communitv
participation at the district level through the Zilla parishad. However it is necessary to
encourage the community to participate at the lowest level of the service delivery
system namely, the sub-centre. On an average there are six sub-centres under a PHC
and each sub-centre covers approximately four villages.
It is proposed to promote Health Advisory Committee at the sub-centre level
The Medical Officer of PHC will be entrusted with the responsibility of forming HACs
for each sub-centre under his / her jurisdiction The committee will be chaired by the
MO and will have the LHV of the PHC. ANM and Jr. Health Assistant (Male) of
concerned sub-centre and two representatives from each village covered by the sub
centre. 'Fhe representatives from the villages will be nominated by the Adhyaksha of
the respective Gram Panchayats It will be ensured that at least one woman is
represented on the committee from each village covered by the sub-centre The HAC
will meet at least once a quarter at the Sub-centre. The representatives from villages
will be reimbursed Rs. 25 towards Travelling and incidental expenses for attending
each meeting.
Ihe HAC will discuss the beneficiary needs in its territory and draw up a plan
of action to be followed by the community of each village to achieve the goals of the
project. The MO will consider the suggestions made by the community representatives
and draw up an annual plan and break it down by quarter The MO will review each
quarter the performance and if warranted, modify the plans for the next quarter. The
MO will forward the minutes of HAC meetings along with his report on the
performance in the area covered by the sub-centre to the DHO for quarterly review.
5
■ ’-S’---
•fe
5
<
The HAC committee will identify in each village a woman who is willing to
volunteer to act as a link between the families in the village and the sub-centre. In
larger villages more than one volunteer may be identified at the rate of one per
thousand population. The volunteers will be interacting with the ANM of the sub
centre covering the village
4
16
'Hie volunteers will
•
•
•
•
motivate couples to adopt appropriate contracqitive methods and refer acceptors
to ANN,
educate all pregnant women on ante natal care and refer to ANM,
promote child care programme and arrange for immunization, and
coordinate with ANM for arranging health education and environmental sanitation
programmes in the village.
This will be tried out on experimental basis in four PHCs in each district for
two years and if found successful will be extended to all PHCs. The cost per year for
HAC meetings during the experimental period will be Rs. 384,000. If the programme is
successful and extended to all PHCs, the annual expenditure will be Rs. 5.4 million.
2
3
□
3
2
J
2 3
»
1
I
7
2
1
>
18
It is also proposed to construct residential quarters for medical officers at
locations where suitable residential accommodation is not available and the doctors
have been Irving in another settlement than that in which the PHC is located. If
residential accommodation is provided in the premises of PHC or nearby the
availability of doctor is ensured in all 271 residential quarters have to be buih in the
ten districts The area of each quarters will be 70.6
and estimated to cost Rs
300.000 ( Plans for residential quarters are presented in Aimexure 2 ).
Table 4 11 Buildings to be Constructed and Cost by District
District
Beigaum______
Bella ry________
Bijapur________
Chikmagahir___
Chitradurga
Dakshin Kann ad
Gulbarga______
Hassan________
Kodagu_______
Mandya______
Mysore_______
Shimoga______
Uttar Kann ad
Total
Number o Buildings
MCTs
SubCentres Quarters
49 ______ 23
47 ______ [5
120 ______ 19
64
12
86 ______ 21
136 ______ 37
84 ______ 25
_____ 88 ______ 19
______ 31 _______ 8
______ 71 ______ [8
132 ______ 39
______ 72 ______ 19
______ 59 ______ b6
1039
271
Cost Million Rupees
MO'S
SubTotal
Centres Quarters
Cost
6 900
II 270
18 170
4 500
10 810
15 310
5.700
27 600
33.300
3 600
14 720
18 320
19.780
6.300
26 080
31 280
II 100
42.380
9,360
14 720
24 080
5 700
20 240
25.940
7 130
2 400
9,530
5.400
16 330
21,730
30,360
11,700
42.060
5.700
16.560
22.260
13 570
4 800
18 370
234.370
83.160
317.530
The 87 villages in which the sub-centres are to be constructed during the first
year have been identified and presented in Annexure 3. These have also been plotted
on taluk maps. Sites suitable for sub-centre buildings have been located in each of
these villages and shown on sketch of the village. Sample charts for one district and
one village are shown in Annexures 4, 5 and 6 respectively. In the second and third
years, 350 and 349 new buildings for sub-centre will be constructed.
s
w'
I
I'-
4.1.2 Buildings for PHCs
Out of the 1297 PHCs sanctioned and operating in the state 983 PHCs have
their own buildings or buildings are under construction. Out of the 314 PHCs without
buildings, 218 are in the thirteen project districts in which civil works are
contemplated.( See Annexure 7 for details). It is proposed to construct buildings for
40 percent of the PHCs without buildings. Each Building is estimated to cost Rs.
780,000. Table 4.1.2.1 presents the number of buildings to be constructed and their
cost by district^See Annexure 8 for Plan of PHC Building).
>
19
1
Table 4.1.2.) PHC Buildings to be Constructed and Cost
District________
Belgaum______
Bella ry________
Bijapur________
Chitradurga
Pakshin Kannad
Gulbarga______
I
Number
_____ 6
7
12
9
12
5
7
5
Hassan________
Kodagu_______
Mandy?_______
Mysore________
Shimoga_______
Uttar Kannad
Karnataka
I
4 I 3
j[
13
8
74
Million Rs.
4 680
5 460
1560
9 360
7 020
9 360
3 900
5 460
3 900
6 240
10.140
6,240
73 320
Rehabilitation of Existing Centres
Nearly 45 percent of exiting CHCs and PHCs and 60 percent of Sub-centres
require repairs to structure, replacement of electrical wiring and fittings, construction
and/or repair of toilets and provision of continuous water supply to rehabilitate them.
Tabic 4 13 1 presents estimated cost of rehabilitation.
Table 4 ) 3 1 Cost Estimates for Rehabilitation of Existing Centres
i..4
s
i
Ceiling______________________
Flooring____________________
Plastering___________________
Toilet
___________________
Water Supply & Sanitation
Electrical wiring & Fittings
Total cost per Centre_________
Number of Centres___________
Cost of all Centres (Million Rs.)
CUC I
PHC
SC
Cost per Centre in Thousand Rs.
66 I
36 6
142
24,1
183
___ 2.5
18,0
11.0
___ 2.0
_____ 0.5
0.4
0.3
_____ 5,5
3,3
___ 0.6
_____ 60
3.6
___ 0.8
120.2
73.2
20.4
_____ 48
327
2071
5.770
23.936
42.249
4.1.4 Handling Solid Waste
Apart from rehabilitating existing centres, it is proposed to provide all centres
with facilities for handling solid waste. The facilities to be provided and the cost
estimates for them are presented in Table 4.1.4.1.
■
20
■
t
I
'fl
1
i
Table 4 14 1 Equipment and Cost for Handling Solid Waste
_______
Number
Unit
Total Cost
Minion Rs
Cost Rs
Community Health Centre
127
14.000
1.778
Thret Closed containers with wheels
a Rs 3000 each and one wheel
barren d Rs 5000 each____________
Pnmary Health Centre
s-'i !
6.000
5 226
Two closed containers with wheels Rs
3OOCf each
Sub-centre
5560
250
I 390
Two closed containers (a> Rs 125 each
Total cost
8.394
* All health centres in the thirteen districts are included
4 I 5 Furniture and Equipment
Fach of the 1039 centres planned to be provided with new building will be
equipped *nh furniture and equipment costing Rs 22.500 and Rs 5,000
respect*eb (see /Xnnexure 9 for list of items and costing) The items of equipment
confirm to the norms given by MoHFW under CSSM project The total cost on this
account udl be
Furniture
Equipment
Rs. 23.378 million
Rs. 5.195 million
Shortage in furniture and equipment as compared to norms referred to above
will be assessed for each of the remaining 4521 sub-centres and deficiencies made
good It is estimated that on an average the cost of augmentation of equipment and
furniture works out to Rs 9,000 and Rs. 5,000 respectively The total cost will be as
under
I
Furniture
Equipment
Rs. 40.689 million
Rs. 22.605 million
It is proposed to purchase 13 laproscopes and 25 suction apparatus besides
getting components for repairing 42 laproscopes which are out of order. The total cost
for these is estimated at 5.15 million Rupees.
4.1.6 Improving Productivity of Paramedical Staff
The facility survey has revealed that nearly 33 percent of the ANMs do not
have kits as per standard. It is proposed to provide such ANMs with delivery kits (see
Annexure 10) for attending to deliveries both at the health centres as well as at the
>
21
,<■
home of the pregnant women The cost of equipping 3000 ANMs is estimated at Rs
6.0 million on the basis of cost of kit at Rs 2.000
The paramedical staff spend considerable time in Travelling to the villages
under their jurisdiction In order to cut down travel time, it is planned to make them
mobile by giving them loan to purchase a two wheeler of their choice out of four types
— bicycle, moped, scooter and motor cycle. A revolving fund of Rs. 105 million is
provided on the assumption that 50 percent of paramedical staff and BHEs will opt for
the scheme during the project period The details of the vehicle loan scheme are as
under
I
Each employee who has been confirmed in a permanent post, will be ehgible
for drawing advance for purchasing a two wheeler on the following terms and
conditions:
I An amount equal to 12 months pay subject to a maximum Rs. 25,000 or the
purchase price of the vehicle, will be given as advance for purchase of a brand new
vehicle
2. The vehicle will be hypothecated to the State Government
3. The advance will be recovered in 60 equal monthly installments from the salary
payable to the employee
4. All taxes, comprehensive insurance and maintenance expenses have to borne by the
employee
5 The hypothecation will be canceled after full recovery of the loan.
Che size of the revolving fund and the additional annual expenditure on fifty
percent or 9000 employees in all districts of the state will be as under.
Table 4 I 6 I Capital Expenditure to Increase Productivity of ANMs
Kits for ANMs____________
Loan for purchase of vehicle
Total
Expenditure in Million
______ Rupees______
Revolving
- Capital
Fund Expenditure
6.000
105,000
0.000
105.000
6.000
Y-
I
•
-
4.1.7 Link Workers
Majority of the community leaders and women who were interviewed for
assessment of communication needs indicated that there are capable persons willing to
volunteer for providing adult education (88%), educating the community on sanitation,
health, personal hygiene (76%), importance of immunization (75%) care of expectant
mothers, and children (72%) and motivation of couples for adoption of FP methods
(73%).
a
22
'•‘I
*
■
■
♦
■'W;6
Xj
|i|
E
i
At present a sub-centre covers on an average 4,000 population or 800
households spread over three to four villages. It is difficult for one ANM to provide
services at the sub-centre and also visit all households with required intensity of at least
once a month to provide family welfare and maternal and child care services at the
door step It is therefore proposed that the HAC identifies one volunteer worker, in
each village to act as a link between the sub-centre and the beneficiary The voluntary
w -rker will:
'-B
w
1 contact all households in the village once in a fortnight,
2. provide interpersonal communication on contraception, maternal and child care and
environmental health and sanitation as part of IEC activity
3. keep track of all pregnant women and cause to provide ante natal mtra-natal and
postnatal care.
4 ensure that all children below two years of age are immunized against specific
diseases at proper time,
5. motivate couples to adopt contraception to deiay/prevent pregnancy with particular
emphasis on the married women in the age group 15-29,
6 hold stocks of condoms and oral pills for free distribution and/or sale.
The voluntary worker will be set performance targets for the following
parameters
i
1
2.
3.
4.
i
r
I
*
►
Ww
s
Number of women registered for ANC services
Number of women provided with ANC / PNC services
Children fully immunized
Targets for couples protected by spacing methods
An incentrv e scheme will be prepared which will take into account performance
on each component Incentive will be paid on a graduated scale for performance
between 75 to 120 percent of the target. Besides the incentive, the voluntary workers
will be paid 20% of the sale proceeds of condom or oral pill
►
The Medical officer of a PHC will select for each village under his/her
jurisdiction a voluntary worker, preferably a female, from among the residents of the
respective villages to act as a link worker between the ANM of the sub-centre and the
households in the village. The choice of link worker will be made among literate
females. The trained dai's could also be considered for selection. This will be tried out
on an experimental basis in two PHCs of each district and if found successful will be
extended to all PHCs in the state during the third year of the Project.
The average incentive per voluntary worker will be Rs. 750 in a year. If the
target is achieved by all the voluntary workers, the total outgo on account of incentives
to voluntary workers will be Rs. 19.3 million per year. As it will be tried out on an
experimental basis in 40 PHCs in the first two years, the cost will be Rs. 0.574 million
per year during the experimental period.
To ensure safe and clean delivery, the ANM will make available to TBAs
disposable delivery kits for distribution to each pregnant woman in the rural area,
opting for delivery at home. The beneficiary need survey indicated that 25 percent of
#=
23
deliveries occur at home. Assuming a crude birth rate of 24. annual growth rate of
rural population at 1.5 percent during 1993-98. about 0.2 million kits each costing Rs.
12. have to be provided each year. The annual cost on this account is estimated at Rs.
2 4 million
■
j
ss
4 1
Development of CHCs into FRUs
A survey of facilities available at CHCs is being carried out to identify centres
which can be upgraded as first level referral units at minimal cost. The criteria for
selection of CHCs will be
B.
1. The centre is already functioning as a referral hospital,
2. Specialists like surgeons, obstreticians & Gynaecologists and Paediatricians have
already been sanctioned.
3. Availability of major operation theatre, and
4. Marginal inputs will are required to make them function as FRUs
w
The average cost of developing each FRU is estimated at Rs. 350.000 The
break up of cost is as under
v'
W-
W
1.
2.
3.
4.
5
Instruments (12 types)
Laboratory & OT items
Refurbishing OT
OT equipment (A/C etc.)
Supporting appliances
Total
i
:
Rs. 100,000
Rs 20,000
Rs. 75,000
Rs. 130,000
Rs. 25,000
Rs. 350,000
Out of the thirteen project districts, Chikmagalur has been selected under
CSSM project with the assistance of MoHFW. In each of the remaining eleven districts
six CHCs will be selected and developed as FRUs during the project period. The total
cost is estimated at Rs. 23.850 million.
‘Ki”
*
4.1.9 Maintenance of Buildings ,
I
E
I-i
The Directorate of Health and Family Welfare Services has initiated a survey of
all health centre buildings under its control to determine the extent of repairs to be
carried out and estimate the cost. The State and Zilla Parishad PWDs will be entrusted
with the task of carrying out the repairs. The total cost of all buildings constructed
under 1PP-I and IPP-II1 will be borne by the State Government.
'•
I
I
i
Annual maintenance will be the responsibility of respective PWD wings.
Provision will be made in the Non-Plan expenditure of the State government for annual
maintenance of all buildings used by the Directorate.
24
For the buildings proposed to be constructed under IPP IX. provision for
maintenance works is made each year at the rate of two percent of the cumulative
value of buildmgs constructed up to three years back
4 1 10 Budget for Strengthening Delivery' of Services
The phasing of capital and rev roue expenditure is presented in Table 4.1.10
Table 4 110 Phasing of Capital and Revenue Expenditure on Strengthening Delivery
of Services
9<>-97
MiIImio Rupees
97-9ll 91-99)
10 <00
tO 270
51 190
0000
19 <00
"ToToo
15 600
0 000
9 000
26 100
26 100
20 100
0 000
<944
19 924
19 614
16 202
Equipment for wild watte handling
~TW4
OOOO
0 000
10 200
0 OOO ^OOOO
Furniture for iub-<cntre buildmp
2 2 291 "21 224
7153
0 000
Equipment for rub-centre building*
l< 469
14 459
1 745 ~l 265
0 000
oooo 231 970
oooo 73 320
o~o66 oooo II 300
oooo oooo 71 954
oooo oooo IVM
oooo 0 ooo 64 067
T66b 0 000 32 931
Kits for ANM
2 000
2 000
2 000
94-9'1
Q'-96
Sub-centre but id tn jr C ivd work*
20010
PHC buiidmp Civil Works
Il 720
Quartcn for M Ox Civil works
Rehabilitation of Health ( entre*
99-00
00-01
Tool
Capit* I Expenditure
0 000
oooo 6 000
oooo 105 000
0 (mX> oooo
I l 900
oooo ■o ooo 700 S43
J 000
0 000
9 000
24 000
24 000
24 000
ITooo
TWO 6 300 6300 0000 oooo
117 135 221 007 187 452 141 050 TiToo
oooo
Incentive to voluntary workers
0 574
0 574
9 650
19 300
19 300 19 300 19 300
87 998
Delivery kits
0 311
I J 27
I 935 ~2 436
0 000
0 000
0000
0 955
2 472
3 477
13 295
Maintenance of proposed new buildings
Total Revenue Expenditure
0 955
I 701
II 515
22 69|
Revolving fund for two wheelcri
Up gradation of CHCi to FRUs
Total Capital expenditure
it
0 000
0000
Revenue Expenditure
2 472
< 994
2 472
7 172 11 291
25 249 27 766 29 644) 119 <9|
25
J
Chapter 5
Improving the Quality of Services
*
5 1
Training
5 11
Existing Training Facilities
The (riming centres currently' functioning under the Directorate of Health and
Famih Welfare services are:
5
1 Health & Family Welfare Training Centres (HFWTC)
4
2 Multi-purpose Worker (Male) Training Schools
3 ANM Training Schools
19
4 LHV Promotional Training Schools
4
7
5. Health Inspector Training Centres
6. X-ray Technician Training Centres
6
7. Graduate Food Inspector Traming Centre
I
8. Sr. Laboratory Technician I raining Centre
I
9. Condensed (ieneral Nursing Course Training Centre
2
10. Communicable Disease Investigation cum Training Centre
I
11 . TB Demonstration and Training Centre
I
12. Leprosy Training Centre
2
13. Central Malaria Laboratory
I
5.1 1.1 HFWTCs
Five Health and Family Welfare Training Centres with hostel facilities are
functioning in the state. These are located at Bangalore, Gulbarga, Hubli, Mandya, and
Ramanagaram The hostel facility at Bangalore, Gulbarga and Hubli Centres is for 30
trainees while it is for 20 trainees at the centres at Mandya and Ramanagaram The
centre at Mandya has no building and is operating in the Communicable Diseases
Investigation cum Training Centre. The centre at Ramanagaram has only one lecture
hall. These centres provide following in-service training programmes.
-w
26
Tabic 5 I I I I Courses Offered at HFWTCs
*
Course
Duration
Continued education to medical officers______________
Training of Block Health Educators__________________
Training of faculty of ANM /HIT/ centres___________
Continued education to Sr Health Assistant Male &.
Female_________________________
Continued education to staff of PH Ct________________
Orientation of Jr Health Assistants Male & Female by
mobtie training team attached to HFWTC . Bangalore
Orientation training tn Leprosy to Medical officers
Orientation training in Leprosy to Paramedical workers
Two weeks
Two ^rekx
Two seeks
Two weeks
Number
Trained tn
1992-93
_______ 160
171
_______ HO
553
One day
Two weeks
3 Days_____
Four months
171
174
<■
-W
5 11.2 Multi-purpose Workers (Male) Training Schools
The four schools sanctioned arc operating in HFWTCs at Bangalore, Hubli,
Ramanagaram and Mandya as no buildings have been provided for them. The duration
of the course is one year and the intake capacity of each centre is 60 students per batch
as no residential accommodation is provided. A total of 637 students were trained in
three batches during the three year period 1988-89 to 1990-91.
5.1.13 ANM Training Schools
There are 19 training centres, one in each district, with hostel facilities for pre
service training of Jr Health assistants (female). The duration of the course is 18
months. The admission capacity is 30 candidates per centre per course or a total of 570
per batch. Up to the year 1992, ten batches totalling 5,787 candidates were admitted
and 5,087 passed. Out of the 19 training centres eleven have their own buildings with
hostel facility. The remaining eight are functioning in district hospitals and hostel
accommodation is provided in general nursing hostel. A building is under construction
for ANM Training Centre at Chikmagahir. Buildings have to be constructed at seven
centres in the districts of Bellary, Dakshin Kannad, Hassan, Kodagu, Mandya, Mysore
and Uttar Kannad.
5.1.1.4 LHV Promotional Training Schools for ANMs
<s
There are four training centres functioning at Bangalore, Belgaum, Gulbarga
and Mangalore, for providing in-service training to Jr. Health Assistant (Female) to
make them eligible for promotion to the cadre of Sr. Health assistant (Female) The
duration of the course is six months and the admission capacity of each centre is 30
candidates. 1423 ANMs were given training in 17 batches up to the year 1992.
Building for construction of LHV School at Gulbarga is nearing completion.
The Schools at the other three centres — Bangalore, Belgaum and Mangalore do not
^-7
have own buildings and arc
Colleges
functioning m the premises of District Hospitals / Medical
■jr.
5 115 CGN Training Centres
Sr Health Assistant (female) are provided conderi' d General Nurse training at
district hospitals in Chitradurga and Dharwad with an admission capacity of 30
students at each centre The duration of the course is one year
5 11 6 Health Inspector Training Centres
There are seven health inspector training centres, each with an intake capacity
of 75 per batch The duration of course is one year The seven centres are locked at
conducted in District
Health and Family Welfare Office in these cities.
5 12 Manpower Projections
The number of CHCs. PHCs and sub-centres required to be setup by the year
2001 to cater to the needs of projected rural population is presented tn Table 5 12 1
The norms adopted for arriving at the requirement of health centres are the same as
those adopted by the state for population in plains. These are one sub-centre for every
5 000 rural population, one PHC for 30.000 rural population and one CHC for every
120 000 rural population In tribal and hilly areas, the norms are one sub-centre for
every 3 000 rural population, one PHC for 20,000 rural population
4
W-
w
1
■<
Chikmagalur, Chitradurga, Dakshin Kannad, Dharwad, GuJbarga, Hassan.
Kodagu Mandya, Mysore districts have more sub-centres than the required as per
nonX plains as they have tribal and hilly area^ On the other hand 382 new sub
centres have to be established in Bangalore. Belgaum, Bellary, Bidar Bijapur Kolar.
Raichur and Tumkur districts to meet the needs of the projected population o The: year
2001 Thirty eight new PHCs need to be set up « Belgaum, BeUary, Bijapur, Gulbarga
and Raichur districts. The CHCs in Kodagu and Uttar Kannad are ^equate to meet
the needs of the population of 2001. In other districts, 102 more CHCs have to be
established to attain a ratio of one CHC for every four PHCs.
28
Table 5.12 1 Projected Population and Requirement of Hcahh Centres by Type in the
Year 2001
r
t
£
kxrtmg ImUc'
will 91
I.<al
IhMnJ
I
>
E
k
ChMradurga
C»Cb
Sub-
MIC*
CHCb
76
19
C fTw
(49)
O
(7)
PHC«
2294
410
^9
12
459
2M6
799
1747
441
erf>
10
£49
'X
15
0
o
(5)
159
69
10
1H9
65
16
(W>
o
(6)
(M
2609
Iwnkur
CHC»
SuK
Centre*
61 10
2211
Shsuo^ia
IFF-
11156
Hdy^urn
4OK9
I 41 1
621
1946
609
1622
165
61
X
124
54
14
0
o
51^
2092
404
7-7
9
4IS
70
17
(14)
0
(W>
1919
123
II
(91)
0
112)
152
49
1006
30X1
107
12
617
103
26
(19)
o
(14)
310
1105
35
221
17
9
(4)
(2)
<4)
16
V79
X5
21
(KD
(I)
1*
II
511
W9
22
0
< 4)
(4)
11
417
71
II
0
(>
(5)
69
17
(M)
(7)
16)
456
9701
1979
h»hp«
1303
7f4>
2M3
426
77
IJhawad
4059
1192
2M>6
571
15
2*91
704
211'
467
Radiur
26X0
793
2oix
149
62
II
417
IFF HI IWnct.
IMH
4761
I U^X
2M)X
440
75
2734
111
(194)
(21)
(lx>
2272
597
1674
240
46
6
135
14
(95)
(10)
(I)
0
(haftarga
£
HK.A
Sub-
Rural
*44 M
2567
Kola
lUda
I
11 191
Centre*
I
K
llrhaj
(Drfk*)
CcxMJCt Requved s 2001
• p« txwrm
) .xWaig CeDtxta
IVtweclcd Fnpul^xm »
2001
■) IhiUKeid
HcUwv
Chikmagahtf
I 166
191
975
12X
19
6
195
12
x
0
(2)
TwdwiKwMMBd
3067
«W7
2070
692
l IO
9
414
69
17
<>
O
(■>
W.6
1426
450
61
u
213
41
12
o
0
(I
IUm»
I ^2
555
91
464
151
27
7
91
15
0
0
1
Mauha
1X75
122
1552
164
55
7
110
52
11
0
0
(6)
My*rc
w»51
1172
2479
662
117
14
496
XI
21
0
0
(7)
—
I Mar Kannad
I4I X
326
1091
302
50
II
211
16
9
0
0
2
Other DuCtuIji
1 5794
4<M»2
11712
1090
505
71
2346
191
9H
(95,
(10)
(12)
Kxmauka
52585 I74&6 35100
7791
1297
195
7019
1170
292
(312)
(31) (102)
Table 5.1 2 2 presents the phased expansion of health centres during 19942000
Table 5 1 2.2 Projected Health Centres by Type
CHCs
PHCs
SCs
1297
7793
Existing Centres
1993
195
Projected Centres
1994
212
1304
7857
1995
229
1310
7921
1996
246
1317
7985
1997
263
1323
8049
1998
280
1330
8113
1999
297
1335
8175
2000
297
1335
8175
29
1
The manpower projections are based on staffing norms presented in Table
5 12 3
Tabic 5 12 3 Norms for Staffing Health Centres
CHC
PHC
sc
MO
4
I
0
Nurse
3
I
0
Sr HA Female
0
I
0
Jr H A Female
2
I
I 33
BHE
0
I
0
Sc HI
0
I
0
Jr H A Male
0
0
0 67
Cstcyory of Staff
I
iI
a
Table 5.1.2.4 (a) presents sanctioned, existing and vacant posts as on 1 4 93
and Table 5 1.2.4 (b) presents projected strength, based on data provided on planned
health centres presented in Table 5 12 2 and staff norms presented in Table 5 12 3
year by year up to 2000 AD.
Table 5 1.2.4 (a) Staff strength as on 1.4.93
Year
Category of Staff
MOs
Nurse Sr HAF
BHE
Sr H I
Jr HAF Jr HAM
Filled
3285
317
1109
284
1120
8924
4836
Vacant
496
148
110
442
101
313
720
Sanctioned
3781
465
1219
726
1221
9237
5556
Table 5 12 4 (b) Projected Requirement of Staffby Category
Category of Staff
Year
MOs
III
fed
Mi
Nurse Sr HAF
BHE
Sr H I
Jr HAF Jr. HAM
1994
3849
523
1226
733
1228
9308
5607
1995
3917
580
1232
739
1234
9387
5658
1996
3985
638
1239
746
1241
9465
5709
1997
4053
695
1245
752
1247
9544
5760
1998
4121
753
1252
759
1254
9623
5811
1999
4189
809
1257
764
1259
9700
5861
2000
4189
809
1257
764
1259
9700
5861
I
30
•a
Chart 5.1.2.1 Promotion Path for Paramedical Staff
?! Health assistant
Femak
Sc Health Aaautanl
Femak
Distnct
Nursing Supervisor
Grade 11
5 Sr Health Inspector
Health Supervisor
Jr Health AsaiaUnt
Mak
Dy Distnct
Health Education
Officer
Bloch Health
Educator
Ihc attrition rate has been 4 I percent per annum. The posts to be filled each
year at various levels to take care of existing vacancies, attrition and new posts to be
created arc presented in Table 5.1.2.5
Tiblc 5 12 5 Manpower Requirement by Category and Year
Vacant
Posts
1994
1995
1996
1997
I99S
1999
2000
1994-
2000
Medical Officer
135
158
161
164
167
170
173
New Posts
75
74
74
75
73
0
1624
446
Total
706
232
75
236
238
242
243
173
2070
58
57
58
56
_0
492
2J
58
24
^7
13
26
28
33
177
219
78
82
83
86
31
87
33
669
45
7
50
51
7
51
7
52
0
461
6
51
6
51
New Posts
Promotion
3
_2
_2
3
3
165
59
60
61
59
366
384
119
59
388
393
398
403
ll9
119
119
963
562
60
572
61
568
116
59
579
12
30
30
31
7
6
7
6
3
464
3
3
39
40
3
40
Attrition
406
Staff Nurse
Attrition
148
New Posts
Total
Sr H A F
Attrition
110
Total
3
61
5
38
3
55
520
408
0
55
3054
712
520
462
4286
21
Jr H A F
Attrition
313
'w- •
New Posts
119
»
Promotion
165
Total
6?
578
BHE
Attrition
New Posts
Promotion
Total
442
31
7
31
31
31
5
0
38
3
3
39
3
21
697
41
34
31
Table 5.1.2.5 Manpower Requirement by Category and Year
(Continued)
Vacant
1994
1995
1996
1997
199g
1999
2000
1994-
353
Posts
i
1
Sr H 1
101
Attrition
New Posts
Promotion
Total
Jr HAM
Altnlion
New Posts
Promotion
Total
I
4
720
51
7
51
7
6
3
^2
157
59
61
60
61
1Q8
231
43
69
233
250
230
43
67
1211
340
343
235
43
69
147
46
50
—7
J
6
^3
43
43
68
344
54
_5
_3
59
52
237
42
67
238
_0
61
300
345
453
38
0
3
55
21
512
2322
256
651
3229
The Department of Health and family Welfare has started filling all vacancies
in all cadres Appointment orders have been issued to fill posts of 754 Doctors, 440
staff Nurses, 550 Jr. Health Assistants (Female). A committee has been constituted to
select candidates to fill the posts in other cadres such as BHE. Health Inspector and Jr
Health Assistant (Male) Further, the Department has planned to increase the number
of sub-cent res. PHCs and CHCs as presented in Table 5.12 6
fable 5.1.2.6. Proposed Additions to Health Centres by Year 1994-2000
Year
1994- 95
■»
1995- 96
1996- 97
1997- 98
1998- 99
1999- 00
Number of Health Centres Proposed to be
_ ________ Added Each Year
CHCs
PHCs
Sub-Centres
____
7
___
[7
_______ 64
___ 17
________ 64
___ 6
____7
___ [7
________ 64
___ 17
________ 64
___ 6
7
___ 17
________ 64
17
62
. 5
32
staff and^he mndPalrd VaCanC’eS ,n Vlnous categories of medical and paramedical
V’C‘nC,eS
promouon is presXdT TaX' ! 2 7
frOm ’"ri,,°n a"d
Table 5.1 2 7
egory
Category
Mode off
Recmn |
rnent
"dr
MO
SlafF Nurse
Sr~HA>
jTTm
BH?
sTh!
|QQ4
I9Q5
IQQ6
706
232
236
219
~78‘
~82
PR
165
Trng
96 3
IE"
dr/pr
464
PR
IV" ‘
DR
|9QX|
1999
2000 19942000
DR
Jr H A M ~ ’Trng
1997
TjTi I
238
242
243
173
83
86
~87
~~33
61
60
61
~59
~55
^520
562 "
568
Tt2
"578
Ttq
462
~1q~
~40
4286
40
~4I
39
~34
61 ’
fX)
61
~50
~55
uTT
~572
344“
347 ’
345 ‘
300
3229
mo)
2071
669
697
D.reo Recnin^m. PR Promouon from one category below.
Trng From fresh candwhlej I rained at training central
> I 3 Adequacy of 1‘re-scrv.ce and Pre l*romotion Training Schools
an < i ?.Ca' ?”Ci,y of Cx's’in8 training centres
for pre-service training for Jr. H.A.M
«"d Jr. H A l are not adequate even for
existing sanctioned strength, while the
capacity of LHV Promotion
c tools and CGN training centres is in excess of the
requirement of new centres
Fable 5 I 3 I Existing Capacity of Training Centres and Requirement
institution
Number
Course
Batch
Maximum
Required
Duration
Size
per
centre
output
with new
(months)
.ANM Training School
MPVV(M) Trng Centres |
Vocational Schools
Combined Output
LHV Promotional
School
'sThTt?^
Centres
_CGN Training School
1
in
1994-
centres
2000
up
year
2000
to
19
18
30
4
12
60
12
24
60
4
6
30
2650
1680
2160
3840
840
7
12
75
3675 ’
512
2
12
30
360
24
Common training centre for staff of Health and Family Welfare Sections.
4286
3229
520
33
I
I:.-.
During the project period 4286 ANMs are to be recruited and to meet this
demand the intake capacity of all ANM training schools has to be expanded The
twelve schools which have their own buildings were designed with hostel
accommodation for 48 students It is necessary to construct buildings with hostel
facilities for 48 students for the remaining seven ANM training schools which have no
buildings of their own
The capacity of M.P.W.(M) Training Schools together with the output of
vocational training institutions is adequate to meet the requirement of Jr HAM even if
new health centres are to be set up. In order to meet the requirement arising from
setting up of new health centres, Gulbarga H.F.WT.C has also to run MPW (M)
training school with intake of 60 students per batch.
The capacity of LHV Promotional Training schools is in excess of the
requirements arising from filling up of existing vacancies and those arising from
attrition and promotion to the cadre of Nursing Supervisor Cirade II As the Nursing
Supervisors cannot be employed as StafT Nurses, the excess training capacity can be
cut by closing down two out of the four LHV Promotional Training Schools and
increase the intake capacity of the remaining two from 30 to 36 students per batch A
building is under construction at (hilbarga for LHV Promotional Training School It is
proposed to construct building for the one at Bangalore which docs not have a
building of its own
■
There is excess training capacity for projected requirement of Sr. Health
Inspectors Two training centres each with a intake capacity of 36 students per batch
would suffice. Five of them will be closed after clearing the backlog of providing
training to fresh recruits to the cadre of Sr. Health Inspector. The remaining two
centres will also be closed down and the training activity will be shifted to two
HFWTCs
The CGN Training Centres have excess capacity as the promotional
opportunities to LHVs are limited. Even one school is more than adequate.
i
At present there are no pre-service training facilities for BHEs. Fresh graduates
are recruited and posted as BHEs. Only two weeks training is provided under
Continuing Education at HFWTCs at Bangalore, Gulbarga and Hubh There is a need
to start pre-service training course of 12 months duration at four HFWTCs each wnth
an intake capacity of 25 students.
1
<
<
5.1.4 Staffing of Training Centres and Schools.
< ♦
5.1.4.1 HFWTCs
M
*
1
The staffing pattern is not the same for all HFWTCs. Bangalore and Hubli
HFWTCs have identical staffing pattern. Gulbarga, Ramanagaram and Mandya do not
have posts of Epidemiologist, Communication Officer and Management Instructor.
Gulbarga does not have a Sanitary Engineer while Sr. Sanitarian is posted at
fc
I
34
Ramanagaram and Mandya. Raman a ga ram has one each of Sr. HAF and Sr HAM
working as Health Supervisors while Mandya has none in this category
Table 5.1 4 1 Sanctioned Staff for each HFWTC
Bangalore
Category
HuWi
Gul barga
Ramana
Mandya
gar ar__
I
i
J____
la_____
j_
i
i
i
£
Statistical Officer______________
2^
I
2
r
J____
J____
J____
i
i
i
2
I
2^
I
H E Extension Worker_________
2_
I
I
I
Epidemiologist________________
i
Social Science Instructor_______
Public Health Nursing Instructor
Health Supervisors _________
I
I
I
I
Principal______________________
Medical Lecrurer______________
Health Education Instructor
Sanitary Engineer
r
r
2
I
I
I
Management Instructor
i
i
Communication Officer
* Vacant as on I 4 Qt
a Designated as Asst Health Officer
c Senior Sanitarian
I
b one each of Sr HAF and Sr HAM
5 14 2 ANM Training Schools
According to the COI pattern the posts approved for ANM training schools are
principal, three PHNs (or LHV), two Nurse Tutors and one Senior Sanitarian
Currently, posts of Principal are vacant at schools in Belgaum. Bidar, (ntlbarga and
Raichur There are three PHNs or LHVs at all centres excepting at Shimoga and
Raichur where there are only two PHNs and at Dakshin Kann ad where there are four
LHVs/PHNs. In all there are 56 PHNs/LHVs. As against the 38 sanctioned posts of
Nurse Tutors, there are 46 in position but there are no Nurse Tutors at Karwar and
Gulbarga. There is one Sr. Sanitarian at each school excepting Karwar and
Chitradurga. On the other hand there are four Sr. Sanitarians posted at Bangalore
I
5.1.4.3 Health Inspector Training Centres
As indicated earlier there are no separate centres to impart Health Inspector
training. The classes are being conducted at District Health Office and one Sr.
Sanitarian is in charge of organizing training classes in each district.
5.1.5 In-service Training of BHEs and Paramedical Staff
-
The Population Centre, Bangalore had conducted a study1 to determine the
gaps in knowledge, skills and practices of health and family planning personnel namely
Senior and Junior Health Assistants male and female and Block Health Educators in
the six IPP-III districts of Karnataka. The study has ‘Yevealed that there are serious
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I
accommodation should be provided at the training centre as suitable lodging and
*
boarding facilities arc not available
5.1 6
Proposed Training Programme
Objectives:
■fhc training programme proposed under IPP IX l^oject is aimed at
I
updating knowledge, skills and practices of all health functionaries for effectnc
deliven' of Health FW and MCH sen ices.
2
developing communication skills to effectively carry out IEC activity in the
community.
I
3
making health functionaries aware of their job responsibilities as providers ol
primary health care,
4
5
maintaining information on performance at their level and providing feed back, and
developing knowledge and skills to act as trainers at their level
All health functionaries will be provided in-service training initially for tuo
weeks and a refresher course of two week duration after three years
Training Modules:
The training modules and their duration planned on the basis of training needs
survey, discussions with Joint Directors, DHOs and Principal and staff* of HFWTC arc
presented in the following table for different categories of staff
Fable 5 I 6 I Training Courses Planned and their Duration by Category of Staff
Module
Duration in Hours per Subject
Trainers
MO
BHE
Sr HA
1 Introduction to IPP-IX_____________________
I
I
I
____ l_
I
2 National Health Programmes_______________
______ [0
10
10
____ IO_’
10
3 Primary Health Care_______________________
_______2
6
__ £
_____ 2_'
4 IEC_________________________________
5 Eir. ironmental Sanitation__________ _
6 MCH. FP. Immunization________________
_____ 20
__ 6
20
____ 12_'
10
____ l£
4
_ £
_____ 30
30
20
_____ 8_
___ 30_'
30
7 Management
__________________________
______[6
16
____ 14_’
8 Sub-centre Management __________________
______[0
0
10
__ 0
9 Train mg___________________________________
____£
__ 1_
__ £
____ 0_'
0
10 Medico-legal_____________________________
_____ 2_
__ 0
____ 0_'
0
11 Mental Health____________________________
______ 4
__ (£'
__ oj
0
12 Paediatric Problems______________________
15 MIES____________________________________
____ £
____ £
____ £
____ £
__ £
16 Supervision__________________________
______ 3_
4
I
17, Action Plan_______________________________
____ £
18 Pre and Post Test_________________________
2
14?
_ £
_ £
__ £
__ £
97
77
13 Medical emergencies &. their Management
14 Surgical Emergencies &. Their Management
All Modules
2
3
_£
_£
_£
4
0
0
__ £
__ £
_______0_’
Jr HA
0
II
0
______ 0_’
0
____ 0_
____ 2_"
0
3j
o
_o
___
, 1
i
80
70
I
37
I
W'
1
i'
I
'W
t
fhc topics listed in Table 5)61 above arc common for all categories of staff
but the content differs significantly between categories fhc management and
supervision aspects relevant to each of the topics listed are covered as an integral part
The subjects "Management"
and "Supervision" cover general principles and
techniques of management and supervision
Lhe Joint Director (H.E.& T) is responsible for conducting in-service training
courses for medical and paramedical staff and pre-service training to ANMs and
MPW(M) All the HFWTCs, ANM and LHV Training Schools and District Training
Centres will be under his/her control The JD (H E & T) will identify the training needs
for various categories of staff and demand services from Director. SIHFW (proposed
in Section 5.3) for development of training modules for trainees and corresponding
lesson plan for faculty and training of faculty of training centres under JD (H E & T)
Hie Director. SIHFW will be responsible for development of training modules
and training of faculty of al) training centres. He / she will ensure coordination of the
new training modules to be developed with the existing materials prepared for
CSSM/UIP He / she will engage experts in different subjects with considerable
teaching experience to design the courses modules and lesson plans and coordinate
their activities Hie experts will be selected from HFWTCs, NIMHANS, Medical
Colleges, Nursing Schools. Management Institutes, Institutes of Mass Communication,
NIC and leading consultants An honorarium at the rate of Rs. 5.000 will be paid to the
specialists for developing course material and teaching aids for training module for
trainees and corresponding Lesson Plan for faculty, for ach session of one hour
duration. Hie total cost of development of course material for trainees is estimated al
1.635 million Rupees.
Tlie Training of Trainers will be conducted at S1HFW. Training courses for
Medical Officers. Block Health Educators and Senior Health Assistants Male and
female will be provided at HFWTCs. The Junior Health Assistants Male and Female
will be trained in their respective districts.
The record of training courses attended during the last two years, by each staff
member, will be compiled. This record will be utilized in scheduling training
programme and selecting participants so that those who were already trained in certain
modules are not made to under go training in the same course again.
5.1 7 Training Centres for Jr Health Assistants
It is proposed to establish a training centre for Junior Health Assistants in each
of the 19 districts (Bangalore urban and rural districts will have together one district
training centre)
Each training centre, will have a capacity to train 30 candidates at a time, at
each district head quarter town. Training courses can be conducted only during April
to December of each year as the paramedical staff will be busy during January to
March to achieve their annual targets. Each district centre can thus provide training
only for 12 batches each of 30 paramedical staff or 360 staff in a year as the centre
3K
needs a break of one week between two successive batches to enable it to get
organized to receive the next batch It will take 26 months to complete one round of
training for all paramedical staff numbering 14.693 in the field
Ehe possibility of expanding ANM training centres was considered and
discarded for the following reasons Out of the 10 ANM training centres, seven centres
do not have own buildings. As the district training centre has to train male workers
also, it is not advisable to have common hostel facilities However, wherever new
ANM centres are being constructed, the possibility of having common kitchen and
dining facilities will be examined to save on construction costs
It is proposed to constitute a district training team in each district excepting
Bangalore by re deploying existing staff and creating five additional posts
Re deployment of existing staff
w
w
1 I
Asst. District Health & FW officer (of HQ) as District Training Officer
Dy I>istrict Health Education Officer (I)
District Nursing Supervisor (I)
l>istrict Health Supervisor (I)
Support Staff: FDA (I). Typist cum clerk (I), Driver (I) and Group D (I)
One cook, one watchman and three (iroup D staff will be freshly recruited at
an additional annual cost of Rs 1,167,000 per centre pci annum.
f
<
■
■<
l*he training of paramedical staff is one of the prime responsibilities of the staff
proposed to be assigned to the District Training Centre, the other prime responsibility
being supervision. At present these staff members conduct training at PHCs which
invokes considerable amount of traveling. By conducting training classes at the district
training centre, they can provide training to larger number at a time and thus save on
traveling and training time. The time thus freed could be effectively used for the other
prime responsibility of on-site and off-site supervision.
The facilities to be provided and associated costs at each of the nineteen district
level training centres will be as under:
Capital expenses
Building: Plinth area 575 sq.m. (See Annexure 11)
Area m^
One class room to accommodate 30 pupils
Office rooms for staff, library and storage 4x12
Residential accommodation for 30 trainees
Five rooms — each to accommodate 8 students
Toilet and Bath facility
Kitchen and dining hall
Circulation area
Total
Cost Rs.
80
54
162
51
65
58
470
16,00,000
30
2.
Furniture (See Annexure 12)
Class Room @ Rs 1800 per pupil
Office rooms, library, store
Hostel rooms (ci) Rs 3,500 per bed
Dining hall @ Rs 1.500 per seat
Total
3.
4
•F
Rs
54,000
Rs 36,000
Rs 1,12,000
Rs. 48.000
2.50.000
Equipment (Sec Annexure I I)
Class room: Black board. Overhead & slide projectors
Kitchen Rs. 500 per seat
Total
Library books
lotal capital expenses per centre
20,000
16,000
r
36,000
10,000
18,96,000
Recurring costs
I
5.
6
7
8
9.
Training materials
Rs. 200 per pupil
Boarding
@ Rs 30 per pupil per day for 14 days each for 360 persons
I ravelling allowance @ Rs. 100 per pupil for 360 persons
Office expenses (e g Electricity, Water, Telephone Postage etc
. @ Rs. 10,000 p.m.)
Staff Salaries
Cook
Rs. 29.320
Class IV staff: 4
Total
t
I
Total recurring costs per year
■
-
72.000
1,51,200
36.000
1.20,000
Rs. 87.380
1.16,700
4.95,900
The total capital cost of 19 district training centres is estimated at Rs. 36.024
million and the recurring expenditure at Rs. 9.422 million per annum
Phasing of Expenditure:
i
1
Initially buildings will be constructed for seven * district training centres and
premises rented for 12 other centres. If the utilization of centres and training schedule
is as envisaged, buildings will be constructed for the remaining twelve centres. The
phasing of expenditure on district training centres for junior paramedical staff is
presented in Table 5.1.7.1.
l
■
40
i
iw
Table 5 1.7 I Phasing of Expenditure on District Training Centres
•w
1
4
I
Million Rupees
97-911 98-99) 99-00
94-95
95-96
96-97
Civil works
II 200
0 000
0 000 19 200
0 000
0000
Furniture
2 130
0 000
0000
1 920
0 000
0 000
Equipment
0 492
0 000
0 000
0 192
0000
oooo
Books
0 190
0 000
0 000
0 000
oooo
0000
Total Capital expenditure
14 712
0 000
0000 21 312
0 000
oooo
2 217
0 420
2 217
2 217
2 217
2 217
Training material*
0 840
0 840
0 840
0 840
T A /D A for Jr HAF A Jr HAM
I 09 2
2 184
2 184
2 184
2.184
2 184
Office expenses
I 140
I 140
I 140
I 140
I 140
I 728
I 728
I 728
0 000
0 000
0 000
0 224
0 224
8 109
8 109
8 333
6 605
00-01
Total
oooo
oooo
oooo
oooo
oooo
30 400
2217
2 217
0 840
0 840
15 5|9
5 460
2 184
T4 796
I 140
1 140
-7 980
0000
0 000
6912
0 224
0 608
6 605
6 919
I 280
51 U7
Capital expenditure
4 750
0 684
0 190
36 024
Revenue expenditure
Training centre staff salane*
Rent for 12 Train mg Centres
Maintenance of buildings
Total Revenue Expenditure
1 728
0 000
6W
■I
ft-.
fl
1
i
*
5 18 RoleofUEWTCs
The five Health and Family Welfare Training Centres at Bangalore, Gulbarga
Hubli. Mandya and Ramanagaram will continue to provide orientation training for
Medical officers and Health Educators. Orientation training to Senior Health
Assistants, Male and Female and Block Health Educators will also be provided by
these centres. The management training to medical officers of two weeks duration,
currently being imparted by the Population Centre will be taken over by the five
HFWTCs. Fhe duration of training course for medical officers will be three weeks. Ihc
subjects to be covered are as per list in presented in Table 5.1.6.1 but the emphasis will
be on management and supervision of the activity rather than on providing technical
knowledge
Each of the HFWTCs will be occupied for 142 weeks for providing one round
of in-service training to medical officers and other supervisory staff As a break for one
week between two batches is desirable, it will take IQS- weeks or nearly four years to
cover all staff.
Table 5.1.8.1 Training Load on HFWTCs
Medical Officers________
Block Health Educators
Senior Health Inspectors
Senior Health Assistants (F)
Total
Sanctioned
Posts
Batch
3781
765
1221
1219
6986
25
25
25
25
Size
Total
Batches
Batches
per
Centre
Duration
151
30
6
10
10
56
2
2
31
49
49
280
Weeks
2
2
Load /
Centre for
one round
Weeks
_____ 90
_____ \2_
_____ 20
_____ 20
142
41
Besides providing continuing education to medical officers and supervisory
staff, the HFWTCs will have the responsibility of providing pre-service training to Jr.
Health Assistant Male and Sr Health Inspectors which are full time courses, each of
one year duration The HFWTCs are thus fully loaded and do not have capacity to
spare for training of faculty of ANM, HIT and District Training Centres
i
l ie cost of training medical officers and supervisory staff is estimated on the
basis of data presented in Table 5.182
Tible 5 1.8.2 Recurring Costs of Training
B
1
I
Medical Officers________
Block Health Educators
Senior Health Inspectors
Senior Health Assistants (F)
T A Rs
per person
DA Rj
per Oay
200
200
200
200
50
40
40
40
Duration of
Training
(days)
______ 21
_______ 14
_______ 14
14
Ific annual cost of training materials is estimated at Rs. 400,000 on the basis of
Rs. 200 per candidate per course
'4
5.181 Upgrading Infrastructure of HFWTCs
■
If
■
-W'
s
I
The HFWTC at Ramanagaram has to be expanded to provide training to more
than one batch at a time It is proposed to construct additional space of 120 square
meters at a cost of Rs. 0 456 million. Additional accommodation to be created will
consist of one lecture half library. Audio-visual room and toilets. A sum of Rs.
125,000 is being provided towards furniture and Rs. 75,000 for equipment (See
Annexure 16)
The HFWTC Mandya which is located in Communicable Diseases Investigation
and Training Centre is proposed to be shifted to Mysore, the divisional head quarters.
A building with an area of 1365 sq. m. with class rooms, office space and hostel facility
for trainees and guest speakers has to be buih.( See Annexure 13 for Building Plan for
HFWTC Mysore). Besides residential quarters will be built for the Principal and
Medical Lecturer cum Demonstrator. The area of each structure and estimated cost is
presented below.
V|..
Table 5.1 8.1 1 Civil Works for Expansion of Mandya HFWTC
■
1
Training Centre with Hostel
Facility__________________
Residence for Principal_______
Residence for Medical Lecturer
Total
Area sq. m.
1365
Cost Million Rs.
5.187
100
90
0.380
0.342
- 5.909
I
42
The cost of acquiring additional furniture is estimated at Rs 0.325 million and
equipment at Rs 0 075 million (See Annexure 16)
The libraries at all the live centres require to be augmented with books and
reference material for use by faculty as well as trainees. It is proposed to provide Rs
20,000 to each of the five centres for purchase of books, the total investment on this
account will be Rs. 0.100 million
5.1 8.2 Phasing of Expenditure on HFWTCs
Table 5 18 2 I presents the phasing of expenditure on HFWTCs
Table 5.18 2.1 Phasing of Expenditure on HFWTCs
Milbcs Rupee*
94-95
95-96
9€»-97
97-9X
9K-99I
W-00
(KM) |
Civil UtviuB
0 4 5<»
5 'MW
O(XX)
0 000
0 (XX)
0 (XX)
0 (XX)
6
tunuturr
0 125
0 125
0(XX)
0 (XX)
0 00()
0(MM)
0 (XX)
0 4V>
0 075
0 075
0 000
0 0<X)
0 0(X)
0 (XX)
0 (XM)
0 150
1 jhrwv hnuka
0 KM)
0(XX)
0 000
0 000
0 000
0 000
0 000
0 100
vES
0 450
0 000
0 000
0 000
0 000
oooo
oooo
0 450
fuud
I 206
6 109
0 (XX)
oooo
oooo
0 000
0 (XX)
7 515
CapOl exp<ndMurc
Revenue cxpoublur*
t'A/DA t<v Ixmbiccw
I 671
I 67|
I 67|
I 67|
I 671
I 67|
I 671
I I 697
Traoung MLxmal»
0 4(X)
0 44X)
0 400
0 4(X)
0 400
oTix)
0 4(X)
2 xno
0 00*)
0 127
0 127
0 127
0 190
2 OHO
2 I9X
2 I9K
2 I9H
14 wr
MMUmmce cf buiMmga
OOOO
OOOO
OOOO
Toul
2 071
2 071
2071
5.! .9 Training of TBAs, Anganwadi Workers, Community Leaders and
Others
It is planned to entrust the task of providing one day orientation courses to
TBAs, anganwadi workers, elected members of mandals, voluntary workers and
school teachers to the PHCs. The courses planned are presented in Table 5.1.9.1.
■
■Ik
; ha..
Table 5.1.9.1 Training of TBAs, Community Leaders and Voluntary workers
Group
Persons
TBAs____________
Anganwadi Workers
Man dal Members
Voluntary Workers
School Teachers
31,000
25,810
54,987
45,430
51,920
Persons
per
Batch
____ 24
____ 20
____ 42
____ 35
40
Number
of
Batches
1292
1291
1309
1298
1298
Cost per
Batch
Rs
840
700
1470
1225
1400
Frequency
in Project
Period
_______ 3^
_______ 3
2
2
2
43
1
There will be 1298 PHCs and if each of them conducts each course for one
batch, each group Uill be covered fully The total cost for the project penod will be Rs
16 624 million and the phasing will be as under
•S'
Table 5.1.9 2 Phasing of Expenditure on Training of TBAs and Others
MiIImd R^»ec»
95-96
I A DA fee Ujiko (ixr <air)
5.2
I WX
O(XX)
9"-9X
9X-99
99-4 10
(MM))
I 'M/X
5 115
O (MM)
1
btal
K. 624
Buildings for LHV and ANM Schools
Three LHV Promotional training schools at Bangalore. Belgaum and
Mangalore do not have their own buildings. Two Training Schools at Belgaum and
Mangalore will be closed down. Ihe (raining School at Bangalore will be provided
with a building including hostel facility for 30 students as per the plan selected for
District Training Centres. The area of each building is 575 sq m and will cost Rs I 60
million (Sec Annexurc 14 or Building Plan)
As regards ANM schools seven of them have no buildings Each of these will
be provided with a building with hostel facility for 48 students. Each of these will have
an plinth area and will cost Rs. 3.00 million (sec Annexurc 11 for Building plan)
Tabic 5.2.1 Phasing of Expenditure for LHV and ANM Schools
Milhcti Rup<w»
•>6-97
97-9XI
9X-‘>9
99-00I
(MM) |
21 (MX)
0 (MX)
0 (MX)
0 (MX)
0(MX)
0 (MM) ’
22 MM»
21 (XX)
0 (XX)
0 (XX)
0 000
0 000
0 0(M)
"22 M^X)
0 000
0 (MX)
0 000
0 012
0 452
0 452
0 452 ‘
I )MX
0 (MX)
0 (MM)
O(xx)
0 012
0 452
0 452
0 452 ’
1 wx
94-9'
9S-96T
Civil wtrki
I MX)
Fetal Cap tai Ijqxndttuc
I MX)
Ikuldmg>
I (< J
CapiUd l -xpcndjturc
Mimlaixcx
Fetal Revalue I-jqxndturc
5.3.
State Institute for Health and Family Welfare (SIHFW)
At present there is no facility or staff in Karnataka for training of faculty of
HFWTCs, ANM Training Schools. LHV Promotional Training Schools, Health
Inspector Training Centres. Leprosy training Centres and District level Programme
Officers The state has to depute the faculty of the training establishments to
institutions outside the state. This has handicapped the regular training of the faculty.
Besides training of faculty, medical staff are being deputed for DPH, DPHE and
DPHN courses. Further, there are no formal management training programmes for
superintendents of hospitals and senior doctors. Therefore, there is an urgent need for
I establishing an apex institute at Bangalore.
44
?■
fc
An Institute for health and family welfare will be set up to
•F
design training courses for all categories of staff.
conduct training courses for the faculty of all training centres currently run or
proposed to be run by the Department of Health and Family welfare.
Conduct management training programmes for superintendents of hospitals and
senior doctors,
4 undertake evaluation of programmes of the Directorate of Health and Famifr
welfare, including those under IPP-IX. and suggest actions to remove deficiencies
or improve performance, and
5. offer diploma courses in DPH, DPHE and DPHN with affiliation to Bangalore
University
i
2
s
f
I
!■
w
Hie objectives 1 to 4 are necessary for strengthening and improving MCH and
FP services which is the essence of IPP-IX while, the objective 5 is required for
upgrading the professional skills of personnel in the Directorate of Health and family
welfare which will indirectly motivate personnel providing MCH and FP services
V.-
yi--'
The institute will have faculty drawn from the following disciplines.
I Public Health Management
2. Public Health engineering
3. Preventive & Social Medicine,
4. Entomology
5. Nutrition
6. Nursing
7. Maternal & Child Health
8. Family Welfare
9. Mass Communication
10. Demography
11. Bio-Statistics
12. Social Science
13. Management Science
*
i
is
I
..
E
*'
■
The staff required for the institute and proposed to be recruited under IPP -IX
project is presented in Table 5.3.1. The Joint Director and Deputy Directors will be
recruited with specialization and teaching and research experience in epidemology,
gynaecology, paediatrics, preventive and social medicine. Public health management,
public health engineering, nutrition, mass communication, social science, bio-statistics
and management science. Out of the 17 posts charged to the project 12 are for
developing modules for in-service training programmes, training of faculty of training
centres under the jurisdiction of JD (H E. & T), evaluation of utility and effectiveness
of training programmes and coordination with JD (HE. & T).
Twelve specialists with research and teaching experience and eleven accounts
and administration staff will be provided by re deployment of staff by the Directorate
of Health and Family Welfare, from the Directorate, Medical Colleges and Population
Centre of the Karnataka. The state government will be bearing the salaries of 23
I permanent staff and four guest faculty engaged for conducting post graduate
a
E
45
programmes as well evaluation and operations research studies required for IPP
and hence not included in the project cost
IX
fable 5.3.1 Additional Staff for IHFW
Designation
Director_______________
Jt Director________ _
Dy Director____________
First Division Assistants
Second Division Assistants
Drivers________________
Class IV
'S'
Grade
Number
4700-6400
3825-5825
3300-5300
1280-2375
1040-1900
940-1680
840-1340
1
I
10
2
2
4
2
Annual
salary
132,200
115,800
1,032,000
87,720
70,560
125,760
1.616,360
As part of IPP-III a new building with an arc of 1208 sq.m, to house training
centre with hostel accommodation for 32 officers was constructed for the Population
Centre in the campus of Leprosy Hospital at Magadi Road Bangalore The training
centre is also being furnished under IPP-III Project Illis building will be handed over
to the proposed SIIIIAV as a training centre for training programmes contemplated
under IPP-IX
W-
■4
i
.-ap:
J
",
Office space is required for the staff proposed to be recruited for the project
and re deployed by the Directorate. The staff to be accommodated in the proposed
building is pt evented in Tabic 5.3.2
fable 5 3.2 Staff to be Accommodated in S1HFW Office Building
Category of Staff
A-
4.
-jo
Director_________
Joint Director
Dy Directors_____
Assist Directors
Accounts Officer
Admin Officer
Research Assistants
Accounts Staff
Admin Staff_____
Total
Recruited under
HI* IX Project
_____________ l_
_____________ l_
_____________ 1_
____________ 10
_____________ 0^
_____________ 0_
_____________ 0_
_____________ 0^
_____________4_
17
Re deployed
Guest Faculty
on any day
I
3
3
1
1
5
4
5
23
0
0
4
0
0^
0
0
0
0
4
.'1 r
It is proposed to construct a building, with foundation capable of taking
additional load of one more floor, close to the new training centre building. The plinth
B
a^a of 600 m2 would be sufficient for the present requirement of office space. The
J
cost of office building is estimated at Rs. 1.9 million. (See Annexure 15 for Plan)
|
The training centre building constructed under IPP—III is being equipped and
furnished with funds available under IPP-III budget. The cost of furnishing and
equipping the proposed office building is presented in Annexure 17. A sum of Rs
K 250,000 is provided for purchase of books and training aids and Rs 200,000 for a
K video projector for the Institute.
It is planned to purchase two cars and two jeqis at a cost of Rs. 950,000 Die
two cars are for the use of the Director and Joint Director of the Institute. Hie Jeeps
are meant for use of other staff members for field visits in connection with training,
research and/or evaluation studies
5.3.1
Training Load of SIHFW.
The institute will also provide management training to medical officers in
hospitals at state, district and taluk level. This activity will be taken up after completing
initial training of MCH fW staff
Hie training load of SIHFW is presented in I able 5 3 11
'fable 5 3 I I Training Load on SIHFW
Designation
t
O'
Joint Directors__________________________
District Milins Officers_________ ________
District ID Officers______________________
District Immunization Officer_____________
District Leprosy Officers__________________
Medical Officers (FW A MCH)____________
District Training Centre Faculty____________
Faculty of HFWTCs and ANM/LHV .Schools
Doctors
Management Scientist
Social Science Instructors
Health Education Instructors
Sr Sanitarians
Health education extension officers
Public health Nursing Instructors
Sr Health Asst Female____________________
Class I Doctors A Hospital Superintendents
All Categories
Number
Batches
Duration in days
Initial
Refresher
6
16
20
20
20
20
20
80
JI
[2
1
6
f
_6
2
2
__ 6
1
_____ 6_
T
i
3
}2
________ 6
5
5
5
I
I
I
I
I
I
2
2
28
48
12
12
12
12
12
24
24
_______ 24
_______ l/
$
• 24
43
61
689
1048
3
___ ___ 1
6
104 weeks
6
6
6
6
6
12
12
______ 12
________ 6_
53 weeks
The cost of training materials is estimated at Rs. 252,000 on the basis of Rs
240 per official. Die TA / DA for the initial training will be Rs. 307,800
5.3.2 Phasing of Expenditure on SIHFW.
'.sfc'.
-
The phasing of expenditure for the institute is presented in Table 5.3 2.1
I
47
Table 5.3.2.1 Phasing of Expenditure on SIHFW
•l"
Millxu Rupee*
994X)
(XU) I
|.<J
94-95
95-961
96-97
97-981
1 9<M)
0 (MM)
(I (NN)
0 000
OOCM)
() (KN)
0 (XM)
I 9<M)
0 IM)
0 (XX)
() (XM)
0 (XX)
OCXXJ
0 (XM)
0 (XX)
0 W)
0(XX)
0 2(M)
98-99
opo»drtu/c
l
Cnii *<«k'
I lunrtiuc-
i quipmait
t
S'
1
Training malcnalx
Vehicle.
0 200
0 000
0000
0 000
0 000
0 000
0 125
0 125
0 000
0 000
0 000
0 000
0 000
0 250
0 000
0 252
0 252
0(XX)
0 000
0 000
0000
0 (XX)
0 950
0 (MM)
0 (MM)
0 000
0 000
0 000
0(XM)
O 950
0 000
1913
I <«al Capita) cxpaiditurc
5 7X7
0 12'
0 (MM)
0 000
0 000
0 (XX)
I 616
I 616
I 6|6
I 616
I 616
I 616
I 616
II H2
0 462
Revalue cxpaiiirturc
ln«4itutc ^all xalanc*
I A /1) A l«< trun.ee* (Hall)
0 1OX
0 (XM)
()(XM)
0 ID
0021
0 000
0 000
Mumloiuncc <M buikhng
0 (M n i
0 (XX)
0 (MM)
0 380
0 380
0 1X0
0 1HO
I 520
I <<al Rcvojuc l x;>aHijtiur
I 924
I 616
I 616
2 129
2017
I W6
I ‘W»
11 294
■
W-
Budget for Improving Quality of Services
5.4
I
Table 5.4 Phasing of Capital and Revenue Expenditure on Improving Quality of
Services
Milb<n Rupee*
t
91-94
|94.95
95.96
9M97
97-98
[98-99
[99W
Th<d
Cafiitul expenditure
Civil w«wkx
iupiipmail
61 265
I 5 I 56
16 9(W
0 (MM)
19 200
0 000
0 000
0 (XX)
0 767
0 075
0 (MM)
0 192
0 000
0 000
0 000
I 014
0(XX)
5 560
Furniture
1115
0 125
0 000
I 920
oooo
0 000
1 ahrary IkwAs
0 415
0 125
oooo
0 000
0 000
0 540
oooo
oooo
oooo
0 000
oooo
0(XX)
0 252
I 998
5 315
0000
I 998
16 624
5 000
I rummg nutfenal*
0 252
0 ooo
oooo
TA / DA f<< trainee* (mi) stall)
I 998
5 115
OOOO
Fireipi belliMAxhips
oooo
I 0(X)
I 000
I 000
I 000
I 000
OOOO
oooo
oooo
O(XX)
oooo
oooo
oooo
I 400
1 400
Vehicle
2 3 303
33 749
I OOO
24.311
6315
I 000
I 998
91 675
Staff Salaries
3 833
3 833
3 833
3 833
3 833
3833
3 833
26 831
Office cxpaiscs
1.140
I 140
I 140
I 140
I 140
I 140
I 140
7 980
Rent fcr Traaung Contres
1.728
1.728
1.728
I 728
OOOO
0.000
OOOO
6912
3 988
3 876
3 855
1 855
26 355
Tc<aJ Capital I .xpaiditurc
Revalue cxpaiditurc
T A / D A f<< trainees (staff)
3 071
3 855
3 855
Training material
0 820
I 240
1 240
I 240
1 240
I 240
I 240
8 260
O(XX)
OOOO
OOOO
0 645
1 183
1 183
I 567
4 578
10 592
I I 79(.
I I 796
12 574
1 I 272
11 251
I I 635
80 916
Mamtoiancc
liuildings
T<Mal Revalue Lvpaiditurc
|Q
Hie audio-visual coverage is low due to the fact that there is only one
projection unit per district Further ^7 percent of the projectors are not in working
condition
62
Comniiinication Needs
A rapid survey of communication needs assessment has revealed the following
I
One third of the community leaders and women are not aware of Child Marriage
Restraint Act However, only 12.5 percent opined that the age of girls at marriage
should be below IX years
Nearly eighty percent opim <1 that two is the ideal number of children.
Sixty percent feel that it is necessary' for a couple to have a son. However. K4
percent of them feel that a couple should not go on trying for a son irrespective of
the number of daughters they already have
Among those who stated ideal number of children as three or more, ’’child
mortality” is one of the reasons advanced by 55 percent of the respondents for
need to have more children and ’’security” as a reason by 30 percent
Hie spontaneous awareness of vasectomy and spacing methods varies between 40
to 50 percent
1i
w
w
fhe target population for II ( programmes are of three types
Ihose who have no hildren or have two or less and not practicing contraception
Such couples form 2o percent of all couples
2. lliose who have children but do not want any more and yet not practicing
contraception Such couple form 20 percent of all couples
3. Ihose who have three or more children and still want additional children Such
couples account for 7 percent of total
4 I xpectant mothers
5. Mothers with children below' five years
1
t
*
i
6 3.
IFiC Objectives and Strategy
After detailed discussions with the field staff, the IEC department has finalized
the following objectives for the IEC programme
•
•
•
•
•
•
•
To promote higher age at marriage among boys and girls.
To promote spacing methods among young couples with one child or none
To promote terminal methods at younger age than hitherto.
To achieve hundred percent ante natal registration.
To educate and motivate the community to accept referral services under CSSM
programme
To motivate women with unwanted pregnancy to avail of MTP service.
To involve and encourage the participation of the community, PVOs and NGOs in
the Family Welfare programme.
50
been
and programme .ntenentions the results ha e nJh
. .... .
leee. C0„,m ““Zi
i°d r"™
break through vmJI not come about mereh add.ng to the mfraJ™ t
tntenstfMng the same old communication approach
communication obviously will not com,.
-
■
and
efforts
M ns
M
More effective
ind
mua-ram.ly eommunieaiion «,ih oucreach effons fom.ng pan of n
" S’oese and
Hie exposure of rural females
to print media will be lou as only 29 0 percent
percent o? tern T'
0"
bV
aVlilablc for
Q8 I shows that 24 2
percent of females m the most important age group 15-29 from l,h
.he p,„g,.mme are h.era.e and ,ha. among aged
and
' point of view of
over
is
15
4 percent Even
.hough .he Ine.ae, amo„g
fcnu|cs rfa||
dunng the decade 1981-91 thit in thr
.i
ercascd ,rom 20 to 29 percent
as the addition to literate population will be in the a^esTl 7<>U'd
change materially
f'
-mg.kd ,|,a. ,hc
I
years the exposure to TV has been increas. ■■ h i
pcrecnt 1>,inng the last five
In order to have maximum impact of IR ictivitv Vi
C'nC”la l‘‘,S
d^Hning
1
^f
mteqiersonal communication and supplement it
............ ...... . would hu
maximum audience. As an integral nan
.r
.
prOposcd Io concentrate on
'he ...di..rta"’mc"1 Programmes to attract
campaigns will be networked with int -n
'
rt0nen,aI,on Programme, audio-visual
maximum unpact...................................■ntetpersonal commumcation programme to achieve
Hit I aramedical staff will be relied on to provide interpersonal
as thev are according ,0 80 perceni of re
interviewed for communication
needs survey, providing MCH and FP ;
'
‘crv.ewed for communication
h°USe 10 housc v'isits I” order
nOaraCh'?e !h'S' 2 'S eSSent'al 10 Upgrade the Pledge and
I communication skills of
an,c "-a slaff- Block Health Educators and Medical
planned tojmpan training on IEC to paramedical staff and officers It is therefore,
senior medical and non7’™?’,’ 'rainingfwi"1 fon"
P«" oronentauo.
------ in training as outlined
Male and Female will be
and at HFWTCs for medical officers and
supervisory staff The responsibility for training will rest
with Joint Director(H.E & T)
skills offfie paramedical arfftuteTperLul0^3"1"16
to each ANM
The kit would coZTf
~n,CatlOn kil
viewer, and other educational aids A ouaneV
paramedical staff will be brought out IT
IEC act.vit.es planned for ffie' onmm
communi^tion
made avadable
flaSh CardS’ fl'P charts- s,ide
etter f°r Intenial circulation to
infOnna,'°n
°th-
from paramedical staff and the names of th
’ Sh^eSt'°?S
lrnprovcn’c,1, received
ne names of those who have done outstanding work.
51
64
f W'
Equipment for I EC
■'C
It IS proposed to use video projectors instead of 16 mm film
f‘ projectors as they
are simple to operate and do not require generators for outdoor exhibitions Each
distnet and IEC wing at the Directorate will be provided with video projection
equipment The equipment can be operated easily and there is no need for a
projectionist The equipment planned to be procured for the project is listed m Table
6 4 1.
i
I
Table 6.4.1 Equipment Proposed to Be Acquired for the Project
Item
Video projectors with
screen. VCP. Audio
system. 18 volt battery
and inverter____
Automatic slide
projector-__________
Over he;id projector
TV / VCR
Transistor radio cum
cassette player *_______
Total on IEC Equipment
Unit Cost
Thousand
Rs
240 0
Quantity
26
_____ Rs
6 240
19 0
21
0 420
For DHEOs
II 2
32 0
21
121
0 235
I 872
2
800
I <>00
For DHEOs_______________
For DHEOs & Directorate 21
100 for FRUs______________
For PHCs and Mahila Swasthya
Sanghas (MSS)
Total Cost
Remarks
Million
To screen by the department for
outdoor screening of FP and
entertainment films
12 367
’ During the first year J transistor radio cum cassette players per district will be distribute among
MSSs on an expenmental basis If there are found usefol and maintamable m the field, other MSS
will also be provided similar sets from the third year onwards
is
The DHEOs have not been exclusively allotted vehicles and consequently the
field programmes are afTected. It is proposed to allot 20 long bodied jeeps — one to
each DHEO for scheduling IEC programmes in the field.
6.5.
IEC Materials
A foil fledged Communication Needs Survey (CNA), covering the entire state
will be conducted along with Beneficiary needs and Baseline surveys as soon as project
is appraised and approved. The results of these studies will be used to delineate the
target groups, the messages to be conveyed, and the appropriate media mix for each
group.
dlt
|
1
The IEC materials, whether for field exhibition by the district staff or
Doordarshan and AIR, will be designed in consultation with senior district officials
such as DHO, DHEO so that the communication materials reflect the socio-cultural
ethos of different regions of the state. This will also ensure that necessary support to
‘IEC
EC activities from senior staff will be available. Hitherto, the mechanism of
development of messages and their scheduling has been delegated
_
I to the Ministry of
information and broadcasting. It is
now proposed to involve experts in the field of
CMO25
52
1
I
I
mass communication from public and private sector institutions for development of
messages and their scheduling based on the results of CNA study Folk artists will be
supported to develop audio-visual programmes The IEC materials to be produced
during the project period are presented in Table 6 5.1.
I
Tabic 6 5 1 IEC Materials Proposed to be Designed and Reproduced
Item
I 5 minute FW films
prints of the same___________
3-4 minute FW films quickies
35 mm prints of the same_____
Tele films 15-20 minutes
VMS prints of same_________
TV Serial_________________
TV spots
VHS prints of the same_____
Cinema slides
Audio cassettes
Copies of the ;ibovc____
__
Flip charts - 7 types
Exhibition Panels with exhibits
1
Hoarding _________
Wall paintings______
Total on IEC Materials
is
Unit Cost
Thousand
Rs
Quantity
225
__4
150
•>
02
300
30
0 I
30
150
0 05
0 06
40
4
4(X)
20
2,000
36
1.800
2
200
l().(X)0
1,500
4
5.000
70,(XX)
100
20
10
I00
4(XM)
72?
Total
Cost
Million
___ Rs_
0 900
I 600
3 000
4 (XX)
4 500
0 360
0 600
6 000
Remarks
To screen by the department
using 16 mm projectors
For exhibition in cinema
theaters_______________
To screen by DD. Directorate
and hired video vans
To be telecast by DD_____
To be telecast by DD
J J00
0 450
0 6(X)
0 250
4 200
4 (XX)
For exhibition in cinema halls
For hstnbution to PHCs and
M.ihila Swasthya Sanghas
for use by ANMs/LHV_____
five sets for each district to be
used in exhibitions
2 000
4 000
37 460
IEC materials whether they be audio-visual films, slide shows, posters, folders
or wall papers have to be pre tested to assess their effectiveness in conveying intended
messages to the target population. Around 264 audio visual materials have to be pre
tested before release through mass media Each item has to be presented to sample of
target groups and the impact assessed. It is estimated that each pre test will cost on an
average Rs. 4000. A provision of Rs. 1.056 million is made for pre-testing of IEC
materials.
.
Apart from telecasting TV serials and FW films on Doordarshan, they will be
exhibited by the district staff by hiring video vans. This will be tried out on an
experimental basis in five districts during the first year and if found effective it will be
extended to another five districts in the second year and remaining districts in the third
year. Video van hiring charges depend on the period of contract. Currently the monthly
hire charge for a van is Rs. 30,000 provided a two year contract is signed. For this all
inclusive charge, films will be exhibited for 24 days in a month according to specified
schedule.
53
6 6
Mahila Swasthya Sanghas
Hie scheme of "Mahila Swasthya Sanghas" was launched in the country during
1990-91 with the objective of seeking active participation of rural women in health
issues and resolution of their health problems, particularly related to maternal and child
health and family planning. More specifically, the scheme seeks to achieve the
following four broad objectives:
Provide an opportunity to women in villages to discuss health related problems and
1
remove misconceptions, if any.
2. Establish an organized linkage between the village community and health service
providers.
3. Disseminate information and promote knowledge on safe motherhood, child
survival, nutrition, family planning, personal hygiene, environmental sanitation, and
4. Provide greater coordination among female workers of various departments to
function in an integrated manner to educate and motivate the womenfolk
In order to achieve the objectives, a number of activities arc proposed to be
undertaken These include formation of certain number of MSSs each year with
specified membership, training of members of MSSs with a specified curriculum,
meetings of MSSs every month, maintenance of registers containing specified
information by the female health workers who are member-convenors of the MSSs
It is proposed to utilize MSSs as a channel for communication to supplement
the efforts through mass media and interpersonal communication It is planned to train
the members of MSSs at PHCs and undertake, with their help, programmes such as
well baby shows, women and children’s day celebration, motivation of eligible couples
etc It is recognized that it is difficult to manage and sustain the MSSs on a large scale
and close monitoring and evaluation is necessary. It is therefore proposed to pilot this
on a limited scale and evaluate the programme and extend it only if the results are
satisfactory
Two types of evaluation are contemplated. One is called the "process”
evaluation and the other "impact" evaluation. It is well known that a scheme or a
project may not achieve its objectives not only because of inherent defects in it but also
of faulty implementation. More specifically, a scheme or a project may not achieve its
objectives because it is not implemented as it is conceived. Therefore, it is necessary' to
evaluate MSSs to find out whether they are implemented as conceived. This is what
we mean by "process" evaluation, rhe "process' evaluation will find out whether all
proposed activities including the number of MSSs to be formed every year, have been
carried out or not.
The "impact" evaluation aims at examining whether the stated objectives of
MSSs have been achieved or not. The stated objectives of MSSs are intermediary and
not easily quantifiable. It is, therefore, proposed not only to examine whether the
objectives of the MSSs are achieved are not, but also to examine whether there is
increase in the couple protection rate and reduction in infant mortality, maternal
mortality and fertility.
54
B-
1
It
w
•Wt
There are two types of research design that may be employed for evaluating the
impact of MSSs One is to conduct the evaluation by comparing the couple protection
rate, birth rate, infant mortality rate and maternal mortality rate in the selected
"experimentar villages "before" and "after" the introduction of MSSs. But this design
will not enable us to isolate the impact of MSSs, as the rates will be influenced not
only by MSSs but also by improvement in the socio-economic conditions of people
over a period of time The other research design is to conduct the evaluation by
comparing the rates in "experimentar and "control" villages. This design will enable us
to isolate the impact of MSSs and hence this design will be adopted to evaluate the
impact of MSSs. About ten "experimentar villages and ten control villages from each
of the four revenue divisions will be studied at the end of each year
6.7
Staff
The organization chart presented below indicates the proposed set up The post
of Dy. Director, Field Operations is proposed to look after scheduling and monitoring
operation of video vans, local media and involvement of NGOs and MSSs The
responsibility of the NGO component has been formally assigned to an officer under
Dy. Director Field Operations
Additional Director (Projects)
Project Coordinator
»■'
Joint Director IEC
.MDy. Director
Dy. Director
Dy. Director
Information
Field Operations
Publicity
Iw
Steps have been taken to fill up vacant posts at various level in the districts.
The following additional posts are being created at the Directorate in view of the
extensive IEC programme contemplated.
Table 6.7.1 Additional Staff to be Recruited for the Project
Designation
u
■
'
Dy Director
(Field Operations)
Social Scientist
Dy P H E Q
Artist_________
FDA_________
Typist_________
Group D
Total
Number
Grade
I
3300-5300
_1_
2_
2375-4450
1520-2900
1520-2900
1280-2375
1040-1900
870-1520
840-1340
2^
_i_
i
9
Annual Cost
______ Rs
103.200
81.900
103,080
51,540
43,860
35,280
28,680
26,160
371,220
55
5
68
I
I EC Programme for the First Year
Ihe IEC Action Plan for 1994-95. the first year of the project.
I
Table 6 8.1 IEC Action Plan for 1994-95
■’i'W
I
______ Key Message______
_____ Media_____
Imptemoitatioo Method / Control
Mamed Women
aged 15-29 with no
children or one
child
I Delay the birth of the
first child
2. Second child three years
after birth of first child
Radio. DD. video
vans, inter
personal
communication
Married women
with two or more
children aged leas
than 35 yean
Prevent Prepiancy by
adopting terminal or non
terminal methods
Radio, DD, video
vans. Inter
personal
communication
Ail women in
reproductive age
Medical termination of
unwanted pregnancy
Radio, DD. video
vans. Inter
personal
communication
All women in
reproductive ages
Maternal and Child Care
services
Advantages of Ante natal
registration
Radio. DD.
video vans. Inter
personal
communication
1. Produce two cinema slide*, one
audio cassette and three video
films for exhibiting tn cmemas and
broadcasting by AIR and DD /
video vans.
2. Produce Flip Charts and one
audio cassette for providing
complete knowledge on use of each
method by ANMs, members of
MSSs and Voluntary workers
3 ANMs, MSSs to identify
satisfied users of IUCD. OPV and
condom. Enroll their support in
talking to non-users
4 Locate dissatisfied users and
resolve their problems._________
1. Locate dissatisfied cases of
Tubectomy and resolve their
problems.
2. ANMs. MSSs to identify
satisfied adopters of Tubectomy
Enroll their support tn persuading
non-users
3. Produce one audio cassettes and
one video film for broadcasting by
AIR and DD / video vans
4 Produce Flip Charts and one
audio cassette for providing
complete knowledge on the method
by ANMs. members of MSSs and
Voluntary workers_______________
1. Produce audio cassettes and
video spots for broadcast mg by
AIR and DD
2. ANMs. MSSs to identify
specific cases, educate and
motivate them and refer to nearest
centre providing MTP facility
1. Produce two audio cassettes and
four video films for broadcasting
by AIR and DD / video vans.
2. Produce Flip Charts and audio
cassettes for providing complete
knowledge on Maternal and Child
care by ANMs, Anganwadi
workers, members of MSSs and
Voluntary workers.
Target (rroup
9
w
1
Il
•ii:
i?*. ■
56
I
-
Tabic 6 8 I IEC Action Plan for !u *4-95 (Continued)
Target Group
All adult men and
women
_______ Key Message
_____ Media
Implementation Method / Control
Use of condom prevents
pregnancy
contracting AIDS
Radio. DD .
1 Produce two audio cassettes and
two video films for broadcasting by
AIR and DD / video vans
2 Conduct of group meetings of
male participants by Jr. HAM to
explain how to use condom and the
advantages of using it
3 Conduct of group meetings of
female participants by ANM
members offMSSs to explain how
to use condom and the advantages
of using it._______________________
I. Locate dissatisfied case* of
Vasectomy and resolve their
problems
2 Jr. Hams to identify satisfied
adopters of vasectomy Enroll their
support in persuading non-users
3 Produce one audio cassettes and
one video film for broadcasting by
AIR and DD / video vans
4 Produce Flip Charts and one
audio cassette for providing
complete knowledge on the method
by Jr. HAMs and Voluntary
workers at group meetings.
video vans. Inter
personal
communication
All adult men with
two or more
children
Vasectomy to prevent birth
cf additional children
R»dio. DD. video
vans. Inter
personal
communication
I*
J
F
6.9
i
Budget for IEC
s
The phasing of capital and revenue expenditure on IEC is presented in Table
O'
6.9.1
Table 6.9.1 Phasing of Capital and Revenue Expenditure on IEC
if
1
Milhm Rupees
94-95
95-96
96-97
97-98
98-99]
99-00
00-01
Trtal
Capital expoufature
w
'1
U:C Expupmoit
10 942
0 000
0.700
0.700
0 000
0 000
0 000
12 342
Production cf IEC materials
16 680
10 620
6.810
3500
0 000
0 000
0.000
37 610
Pretesting of II-C materials
0 308
0288
0.256
0 204
0000
0 000
0000
1 056
Vehicles
7000
0 000
0.000
0 000
0 000
0 000
0 000
7000
Total capital expenditure
.34 930
10 908
7 766
4.404
0 000
0 000
0 000
58 008
Salancs ni slaif
0 387
0 387
0 387
0 387
0 387
0 387
0 387
2 709
Hire diarges far Video vans
I 800
1 800
3 600
7 200
7.200
7 200
7 200
36 000
Media hire charges
0.250
0.500
0.750
1.000
1.000
1000
1 000
5 500
Total of revalue expaidrture
2 437
2 687
4.737
8 587
8 587
8587
8 587
44 209
Revenue expenditure
1
I
.a
|
■
t
I
Chapter 7
Project Management
Apex Authority
7 1
,w-
As in the case of IPP-III. a Project Governing Board (PGB). Chaired by the
Chief Secretary, will be constituted at the state level for IPP-IX The Order No HEW
62 FPE 82 (3), Bangalore. Dated 23-2-1984 has been modified for adoption for
IPP IX and is presented below
I The Governing Board for India Population Project 111. which shall consist of
the following
Chairman
I The Chief Secretary to the Government
Member
2. Representative of the Government of India
3 The Secretary to Government. Finance Department
Member
Hie
Secretary
to
(Government.
Health
A.
F.W.
Department
Member
4.
Member
5. rhe Director of Health A F.W Services
Flic
Additional
Director
(FW
A
MCH)
Member
6.
Member Secretary
7. The Additional Director (Projects)
1.
2.
Hie following officials will be special invitees for the meetings of PGB
Hie Director. Population Centre
Die Chief Engineer, PWD (C & B)
2 Hie Governing Board shall meet as often as necessary but shall meet at least
once in every three months. The Board shall have the powers to appoint key personnel,
purchase of vehicles and stores, sanction of estimates, etc. The decisions of the Board
are final and have the concurrence of Finance and Planning Departments.
In exercise of its powers, the board shall be assisted by a steering committee
consisting of:
1.
2.
3.
4.
5.
The Secretary to Government, Health A F.W.Department Chairman
The Secretary to Government. Finance Department
Member
The Director of Health A F.W. Services
Member
The Additional Director (FW A MCH)
Member
The Additional Director (Projects)
Member Secretary
The Director Population Centre will be a special invitee for the meetings of the
Steering Committee
3. The Steering Committee shall carry out such functions as are assigned by the
Governing Board and shall furnish reports from time to time to the Board for
ratification of actions taken.
58
I The Governing Board shall generally administer, execute and evaluate the
IPP IX l^oject and in particular, exercise the following functions
a)
b)
c).
d)
e)
0
Review the progress of the project, including construction of buildings, and
ensure that the Project is implemented in accordance with the terms of the
Agreement;
Review the reports furnished by the Director, Population Centre, from time to
time, and issue such directions as are necessary for implementation of the
Project;
Take all Policy decisions regarding the desirability of experimenting with nos el
schemes on the basis of recommendations of the various units responsible for
the Project execution.
Enter into agreements / contracts with the Administrative Staff College of India.
Hyderabad. The National Institution of Nutrition, Hyderabad and other
institutions.
Approve the annual budget of the project; and
Take any other action or steps necessary for the implementation of the Project
The Project Management Structure is presented below
C
Secretary H A FW
Additional Secretary II A FW
Director
H A FW Scrvzce*
Addl Director
Projects
e
Supdt Engineer
Jt. Director
Projects
Chief Accounts
Officer
Dy. Director
MIES
____ slz
Jt Director
FW A MCH
Addl Director
FW & MCH
xlz
\Iz
xlz
Jt. Director
IEC
Jt. Director
HE &T
Demographer
The Secretary Health and Family Welfare and Director Health and Family
Welfare will jointly coordinate the activities of Additional Director (Projects) and
Additional Director (FW & MCH).
The responsibility for implementing the project rests with the Additional
Director (Projects), who will be designated as ex-officio Additional Secretary subject
to approval by the PGB. It is proposed to create a new post of the rank of Joint
Director to assist the Additional Director (Projects) in planning and monitoring area
projects and a Superintending Engineer to plan and monitor construction work. The
Joint Directors for MCH & FW, IEC and HE & Training will also be reporting to the
•F
59
Additional Director (projects) on IPP-IX activities The Additional Director (projects)
will coordinate the project activities falling under various departments and agencies
s
■■
I
I
The Task Force for day to day management of 1PP-IX will consist of the
Additional Director (Projects) and the Joint Directors for Area Projects, FW & MCH,
IEC and HE & Training The Task Force will prioritize districts for provision of
Training, IEC and Managerial inputs on the basis of the following criteria:
Mean Age at Marriage
i
Crude Birth Rate
2.
Infant Mortality Rate
3.
Incidence of Water Borne Diseases
4.
Couple Protection Rate
5.
Percent Children Fully Immunized
6
At the Divisional level, the Joint Directors of Health and Family Welfare and at
the district level the District Health Officers will assist the Project Coordinator in
implementation.
•
4
ft
i
•
•
•
•
•
The Joint Director Area Projects will be responsible for the following:
Detailing project components in consultation with respective Joint Directors and
Superintending Engineer,
Preparing annual and quarterly budgets
Monitoring progress of activity under each project component,
Providing feed back to the respective Joint Directors and recorn mending corrective
action if necessary,
Preparing reports for monthly meetings of the task force as well as those of the
Steering Committee and
Releasing funds to the Zilla Parishad.
Phe Superintending Engineer and each Joint Director will furnish to the Joint
Director, Area Projects by December of each year, the requirement of funds for the
coming financial year for the activities under him. The Joint Director, Area Projects
will prepare a consolidated statement of fund requirement and give it to the Project
Coordinator.
The Project Coordinator will in January each year, submit to MoHFW the
projected expenditure for the coming financial year so that funds will be available at
the beginning of the financial year. The Project Coordinator will authorize the Joint
Director Area Projects to disburse this amount to the operating sections. The Joint
Director Area Projects will ensure the timely availability of funds so that the project
activities will not suffer delays due to non availability of funds in time.
Table 7.1.1 Revenue Expenditure on Project Administration
Million Rupees
94-95
95-96
96-97
97-98
98-99
99-00
00-01
Total
Slatr Salaries
0 116
0 116
0.116
0 116
0 116
0 116
0 116
0 8)2
Basdmc. M)<14erm and cnd-lme studies
4000
0 400
0 400
0 400
0 400
0 400
’ 4 OCX)
10 (MX)
Tetal Revalue expenditure
4 116
0516
0516
0516
0516
0516
4 116
10812
1
60
if
hl
i f
B
J
■F
7.2
Engineering Wing
It is proposed to create an Engineering Wing in the Directorate of Health not
only to plan and expedite construction of new buildings for hospitals and residential
quarters contemplated under 1PP - IX but also for maintaining existing buildings The
main functions of the Engineering wing are
•i
I
1.
2.
j
3.
4
:!W
5.
6
-
7.
1I
Organizing all the civil construction works contemplated under 1PP-IX.
Obtaining architectural drawings and estimates from the Architectural Section
of the state government
Coordinating with various other government departments involved in land and
civil works.
Supervising and monitoring the construction programme and suggest, if
necessary, mid-course actions and corrections.
Coordinating with the PWD Departments of the Zilla-Parishad and State for
undertaking the work as scheduled and also providing funds as required
Preparing quarterly progress reports, expenditure statements and other
necessary information sheets for submission to the Government of India and
The World Bank
Planning for maintenance of the existing buildings and entrusting the task of
State and Zilla Panshad PWI>s in their respective jurisdictions.
Hie engineering wing will have the following stafT.
w
I
w
*
«
ft
w
I
■
■
Designation
Grade
Superintending Engineer
Asst Executive Engineer
Asst Engineer________
Draughtsman_________
Tracers______________
Total
3825-5825
2375-4450
2150-4200
1520-2900
II3O-2IOO
Number
1
2
Annual
salary
113,400
81,900
152,400
106,080
77,520
531,300
The Superintending Engineer is in over all charge of the Engineering wing and
is responsible for ensuring that the tasks assigned to the wing are carried out. The
Assistant Executive Engineer will be responsible for coordination with Zilla Parishads
and preparing quarterly reports as outlined in (5) and (6) above. Each Assistant
Engineer will be assigned a group of districts for monitoring construction activity,
identifying and preparing plans for renovation and rehabilitation of existing centres and
monitoring routine maintenance of buildings of the Directorate.
The Executive Engineer of respective Zilla Parishads of project districts will be
responsible for calling tenders, selecting contractors and awarding contracts, llie
buildings to be constructed in a year in the district will form a package. The valuation
will be done and payment vouchers made by the Asst Engineer , Zilla Parishad after
completion of each stage of construction.
61
The Executive Engineer. Zilla Parishad will submit to the Engineering wing of
the Directorate, a statement of fund requirement for the payments falling due in the
next 12 months The Joint Director Area project will on the recommendation of the
Engineering wing will release the amount to the Executive Engineer. Zilla Panshad
The Executive Engmeer. Zilla Parishad will submit each quarter a report on the
progress of work and statement of expenditure for the quarter.
The requirement of office furniture is valued at Rs. 15.000 for each of the four
executives and at Rs. 10,000 for 12 other staff. Two vehicles costing Rs. 3,90.000 are
required for the Engineering wing
on Engineering Wing
99-001
00-011
F.MmJ
oooo
oooo
0 000
o 2x6
oooo
0 (MM)
oooo
() (MM)
0 4(M)
0 (MM)
0000
oooo
0 (MX)
0 (XX)
0 AXO
0 5.11
ii
’I
0511
0 511
0 511
1717
0 160
o“ v
2 520
or? i
77x91
6217
94-95
95-96
< X!k« furniture
O 2 KO
O(XX)
oooo
oooo
Vducloi
0 400
0 000
oooo
own
0 (MM)
0 511
0 511
Capua) expenditure
I
al i.«pXm1 expendxurc
Revenue cxpaxblu/e
Sahricn << 'MaiT
•I
NtalMnary A euppbc*
0 160
0 160
o W)
77 >60
0 VM)
Il ital <4 rnaiui cxpaidXurc
0 X*M
0 X91
0 Kvi
0 M’) 1
0 X9I
’I
7.3.
MIES
7.3 1 Present Status
■
.1.
The Population Centre was assigned the task of developing Management
Information and Evaluation System (MIES), as part of India Population Project - 1
After a study of the existing system, the Population Centre designed and implemented
a new system for providing information to management on performance of various
components of FW and MCH programme, staff sanctioned, in position, vacant and
leave record.
The salient feature of the new system were:
1. Substantial reduction in the number of records to be maintained and reports
submitted by the field staff.
2. Simplification of information to be collected.
3. Streamlining of the recording system.
4. Strengthening feed back
5. Facilitating effective evaluation by the programme administrators.
In this system each field worker prepares only one report at the end of each
month and submits to his/her supervisor. The supervisor consolidates the reports
received from her/his subordinates and submits to the M.O. of the PHC. The Distnct
Health Officer consolidates the reports from PHCs and forwards to the Directorate of
Health and Family Welfare. There is a computer wing at the Directorate which
i
62
consolidates the reports received from the districts. Chart 1 presents the information
flow for the system designed by the Population Centre
Chart 1
Elow of Health Service Statistics
Sub-Centres
Outreach
I Mcvlnn »id liJOTXrt
I Mcvlxm and iraamml •< Malaria I H
Malaria I B
. Maternal A Child Carr. F I*.
I xpriws. Maternal A Child Care H*.
I
Ini ant. Child A Maternal deaths and
Infant. Child A Maternal deaths «id
<d Dnifp A Si^plicx
InwimnimtaJ XanrtalMai
Monthly Repons of Health Assistants Male & Female
Primary Health Centre
Consolidation of Monthly Reports
of Jr Health assistants
by Sr Health Assistants
Plus
Services Ren cred at PHC
f
. Mjlrwal At Child Care. I-1*.
I
4id UixiiMtK
I
Malaria. I II.
Inlunl. Child A Mjimial dculhv
M<«htdj<\
I >m«>d N««f»pl»CT»
CHCs and Govt. Hospitals
Pvt. Nursing Homes
Monthly Repons on
Services Render under National
Programmes on MCH. FW. Malaria.
TB. Leprosy & Blindness
Monthly Repons on
Services Render under National
Programmes on MCH. FW. Malaria.
TB. Leprosy & Blindness
f
3
!WWia
I* I*
I
te of Health
Conwidaticn of Monthly Reports
from Districts /
V
:::
...... :..... ::
Coverage of HMIS Version 2.0
I
Currently information on infrastructure facilities and their condition which is
essential for planning of health and family welfare services is not readily available.
I.
63
Ilic HMIS Version 2 0 covers only the last two stages of consol.dation of
information at districts and at the Directorate Further, the information to be covered is
only a subset of information being compiled at PHCs. Important information, such as
demographic characteristics of acceptors of FP methods is not covered
I1
«
7 3 2 Proposed Information System
It is now planned to develop a comp reh ensive database encompassing
•
•
Demographic features of the territories covered by CHCs, PHCs, and SCs
Facilities at health centres — Building, equipment, and staff,
Budget and expenditure by head of account at the state level and disaggregated up
to Sub-centre level,
Personnel information
date of joining, date of birth, academic qualification,
details of pre and in-service training provided, service record and current place of
posting
Stock on hand and consumption of drugs and supplies,
I argets and performance of components of FW A. MCH programme, and
•
Morbidity
•
•
•
•
1
I
1
HMIS could be a starting point for implementing MIES but substantial
enhancements are required to make it cover all components of Health Information
System outlined above and presented in Chart 2
It is proposed to install computers at each of the offices of District Health and
Family Welfare Officers and upgrade the facilities at the State level to create and
continually update the database.
The benefits that will accrue by implementing the proposed information system
are:
•
•
•
•
•
I
i
1
Fi 1
S'' '
•
Identifying lacunae in infrastructure facilities and initiating timely remedial actions,
Better management of facilities,
Timely identification of areas with poor performance and take necessary steps in
time,
Proper planning for personnel development through identification of training needs
and scheduling training programmes,
Freeing supervisory staff from the drudgery of compiling monthly reports and
improving quality of supervision, and
Improved systems for procurement, stocking and distribution of drugs and
supplies.
These ideas were discussed with the National Informatic Centre which has
developed HMIS and other software packages for the health services. NIC is willing to
study the requirements and undertake modification of HMIS to suit the needs of the
Directorate. The population centre, which studied the requirements of the directorate
of Health and Family Welfare and designed the earlier information system, and the
1
64
I
Directorate, arc better placed to brief NIC
on information needs. NIC is also willing to
tram the staff and implement the information system
Chart 2
Proposed Integrated Management Information System
1
I
I
Census Reports
Facility Survey
Demographic Profile
of SC. PHC. CHC
Details of buildings.
Furniture &. Fixtures
Equipment. & Staff
at each centre
I
Monthly Reports
From
Jr Health Assistants
PHCs. CHCs. Govt
and Pvt Hospitals
I
} District Health Office £
“
Computer Centre
I
1
f
I
Training
Personnel
Facilities
Training Courses Conducted
^Particulars of Trainnes
Date of joining. Qualifications
Pre A Inservice training.
Postings A Promotions
Present grade, salary, Date of
^Next Increament____________
Directorate
Computer
Centre
IEC
Inventory of materials
Media Schedules
Central Stores
J
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I
Stocks on hand, on Order
Receipts and Issues
during the month
Engineering
Construction Schedule and
Progress Reports Physical
and Financial information
x------------------------------------ /
A
3
Finance
Budget & Expenditure
by Cost Centre
f
I
G
Project Coordinator
I
►
The system presented in Chart 2 i:
----- is oriented towards aiding the management at
various levels and in different:
areas of activity of the Directorate of Health and Family
welfare. At the Lowest level of management .namely the Sr. Heahh Aumdint. he or
1
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65
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•1
<•
I
O'B.
1
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WB
t
1
n
•X
•i
she can monitor the performance of Jr. Health Assistants under her or him and pay
attention to poor performers to improve them. The Medical officer of the PHC will be
able to monitor the performance of the PHC as well as the sub-centres under his
jurisdiction. At the next higher level, the ADHO who is in-charge of a division can
monitor the facilities available at each PHC and its performance and take remedial
steps to augment the facilities and or improve the performance of those lagging behind
13)6 DHO will have necessary information to review the performance of each ADHD's
territory as well as interact with the Joint Directors and Superintending Engineer at the
Directorate to obtain necessary inputs to achieve the goals set for his district.
At the Directorate, each functionary will have direct access to information
required for monitoring of activities falling under his jurisdiction
To achieve a full integration of MIS with operational activities, workshops will
be conducted to identify the information needs at each level and parameters to be
monitored. The personnel in-charge of operational activity will be briefed on the
Proposed information system and how they can participate and make use of it in their
day to day activities.
The three most important areas which require high priority arc Facilities,
Construction, Personnel Information on these is not readily available ither at the
Directorate or at the District level. Information on these areas is necessary for
rehabilitation of existing centres, expediting construction activity and planning for
training. HMIS version 2.0 could be implemented in parallel. Enhancements to HMIS
could be taken up after completing implementation of systems for Facilities,
Construction and Personnel
7.3.3. Staffing MIES
The additional staff requirement is presented in Table 7.3.3.1
Table 7.3.3 .1 Staff Requirement
Number
Location
Designation
Grade
Directorate
Dy. Director_____
3300-5300
2150-4,200
£
2150-4.200
1280-2375
1190-2200
3300-5300
1
3
Sr. Systems
Analyst______ _
Hardware Engineer
FDA____________
Districts
S1HFW
Total
FDA____________
Asst. Director
2
20
1
Annual
sahry
103,020
152,400
76,200
131,580
877,200
103,020
1,442.800
Existing office staff in the district headquarters as well as the new recruits will
be trained in the use of computers for capturing information and producing the reports.
I
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66
7 3 4 Capital Equipment for MIES
I
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The computer systems and equipment to be procured for the districts and the
Directorate are as presented in Table 7.3.4.1
Table 7.3.4.1 Capital Equipment for MIES
Location
Number |
| Equipment
Cost Rj
Computers
Districts
I
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W'
Directorate
Directorate
SIHFW
IBM Compatible PC 386 with 4 MB Memon 100 MB
Hard disk, one 3 5" Floppy drives. Dot matrix Printer and
software_________________________________________
IBM Compatible PC 486 with 8 MB Memory. 100 MB
Hard disk, one each of 5'/4" and 3 5** Floppy drives. Laser
Printer and software_______________________________
Minicomputer with 16 MB memory.
2x12 Giga Bytes Hard disk. 3 5" and 5 25 ** floppy
drive. Cartridge Tape, six terminals. 600 Ipm printer. laser
printer, and software_______________________________
IBM Compatible PC 486 with 8 MB Memory. 2 x 200
MB Hard disk, one each of 3.5 ** and 5 25 ** Floppy drives,
leaser printer, four terminals and software
20
3.5OO.OOO
2
500.000
I
800.000
I
3'0.000
Air conditioner, Voltage stabilizert Spike buster
Air conditioners (4). UPS (3). Photo copiers (2). Fax
machines (2)
20
I
800.000
900.000
Other Equipment
Districts_________
Directorate
TTic requirement of office furniture is estimated at Rs. 75,000
■s'.
I
I
7.3.5. Stationary & Office Supplies
W'
Table 7.3.5.1 Presents estimated cost of stationary for implementing MIES.
1
w
w
Table 7.3.5.1 Cost of Stationary and Office Supplies
Item
Annual Diary for Junior Health Assistants
Monthly Report of Junior Health Assistants
Monthly Report of PHC________________
CHCs, Govt Hospitals, Pvt. Nursing Homes
Monthly Feed back Reports to Senior Health
Staff______________ _______________
Monthly Feed back Reports to PHCs_________
District Reports
_______________________
Computer Stationary_______________________
Diskettes_______________________________
Total
Wastage @ 10%___________________________
Total cost of stationary and supplies
Rate/Umt
Rs
Annual
Requirement
20
1 62
4,05
2.88
15,000
216,000
20,000
20,000
2.40
4 00
4.00
0.40
8.50
40,000
20,000
300
720,000
400
Cost Per
Annum
Million Rs,
_______0 300
_______0,350
_______0.081
0.058
0 096
0080
0 001
0288
0004
1.255
0.125
1.380
67
7.3 6 Computer Systems for Special Applications
I
Engineering wing. Health Education and Training, and IEC will each be
provided with a computer and their staff trained in use of special application in their
respective areas.
!
Table 7 4 1. Computer Systems for Special Applications
i
Department
Purpose
Configuration
Civil En&meenng
Construction
Monitoring and
Costing
IBM Compatible PC 4S6 with 8 MB Memory.
300 MB Hard disk, one each of 3.5 " and 5 25
" Floppy dnve». Dot Matrix printer. Plotter
CAD and Project Management software
Health Education
& Training
Production of
Training
Materials
Production of
IEC Materials
IBM Compatible PC 416 with I MB Memory.
300 MB Hard disk, one each of 3.5 " and 5 25
" Floppy dnvea. Laser printer and software
250,000
IBM Compatible PC 486 with 8 MB Memory.
300 MB Hard disk, one each of 3.5 " and 5 25
” Floppy drives, l^aer printer and software
35O.(XM)
!
I EC
f
I
Cost
Million
Rs____
400,000
I
7 3 7 Selection of Vendors and Consultants
The Project Coordinator will float tenders for computers, other equipment and
consultancy services. The offers will be scrutinized by the steering committee and
vendors and consultants selected for each application. Their decisions will be
forwarded to PGB for ratification.
7.3.8 Budget for MIES
The budget for MIES is presented in Table 7.3.8.
Table 7.3 7 Capital & Revenue Expenditure by Year on MIES
>■
MiUim Rupee*
94-95
95-96
96-T7
97-981
98-99
Computen*
6.150
0 000
0 000
0 000
0000
(Xhcr equipmoit
1 669
0000
oooo
0000
0 000
0 VjO
99-001
00-01
Total
0 000
0 000
6 150
0 000
0 000
I 669
Capital expenditure
1.476
0000
0000
0 000
0000
0 000
1 476
Fees to annuitants
2 100
0 750
0’50
0000
0000
0000
0000
3 600
Total capital expenditure
11 395
0 750
0’50
0.000
0 000
0.000
0 000
12 895
Salaries of sLaff
1 443
1 443
1 M3
1 443
1 443
1 443
I 443
10.101
Statunan & supplies
0 690
I 380
1 380
I 380
1 380
1.380
1.380
8 970
T<tal vf revenue expenditure
2 133
2 823
2 *2 3
2 823
2 823
2 823
2 823
19 071
Spares
Computers
Revenue expenditure
r
68
Evaluation Studies
7 4
ITe Project Coordinator will initiate with the proposed State Institute of
Health and Family Welfare. Baseline. Mid-term and End-line studies. The Baseline
studies will help in refining the project components besides providing baseline data for
evaluating the impact of the programme. Provision for other studies is made for
operational research in-service delivery, evaluating the pilot schemes and the end-line
study at the end of the project for evaluating the impact of the project.
7.5
I* low of Funds
Hie Project Coordinator will have under him an accounts wing headed by a
Chief Accounts Officer. Separate accounts will be maintained for the project and at the
end of each quarter an expenditure statement will be prepared and submitted to the
Government of India for reimbursement and forwarding to the World Bank. The
Government of India will reimburse the State Government the amount within fifteen
days of receipt of the expenditure statement
Hie Accounts will be audited at the end of each year by the Accountant
General. Karnataka, and Audited Accounts and Certificate will be submitted to the
Government of India.
Budget for Project Management
7.6
fable 7.6 Capital & Revenue Expenditure by Year on Project Management
Miilmn Rupeai
94-95
95-96
96-971
97-98
98-991
99-00
00-01
l<td
0 000
0 000
0 000
0 000
6 150
Cjpitul cvpaiditiuc
Ctvnpuicrx
6 150
0 000
0 000
0 000
(Xhcr cxpiipiiKail
I 520
0 000
0000
0 000
0 000
0 000
I 520
Spare* for Cotnpuleni
1 476
0 000
0 000
0.000
0.000
0.000
0 000
1 476
(MFicc furniture
0 280
0000
0 000
0 000
0000
0 000
0 000
0 280
Vehicles
0 400
0 000
0000
0.000
0.000
0 000
0.000
0 400
Fees to cxnsuftanls
2 100
0.750
0 750
0.000
0 000
0 000
0.000
3 600
Total capital expaiditure
I I 926 '
0 750
0 750
0000
0000
0 000
ooo
13 426
Basel me. Mid-term and aid-lme Judies
4000
0 400
0400
0 400
0 400
0 400
4000
10000
Salancs of 4ajl
2090
2090
2 090
2 090
2090
2 oxi
2090
14 630
Statunarx & supplies
I 050
1 740
I 740
1740
I 740
I 740
I 740
1 I 49<)
T(<al <4 revalue cxpaiditurc
7 140
4 230
4 230
4 230
4 2 .30
4 230
7 830
16 I 20
Revalue expaiditurc
Chapter 8
■F
Innovative Schemes
A number of innovative schemes are contemplated to supplement the effoHq of
the department in creating demand for and delivery of FW & MCH services A *,rjcf
outline of each scheme and budgetary provision are presented below
8.1
1
Health Advisory Committees will be constituted at sub-centres as ouiIhm^ jn
Chapter 3. Ilie cost will be Rs. 0 768 million in the first two year experimental p.rjo(j
and if extended in the third year to all sub-centres, the total cost during the jw^ct
period will be Rs. 27.768 million.
8.2
I
Sub-centre Health Advisory Committee
Involvement of PVOs and PMPs
I’rivate voluntary organizations having good reputation for conducting ^vcial
welfare activities will be selected for supplementing the efforts of the DircctCHae jn
promoting and / or providing FW and MCH services. Ilie potential I VOs va||
identified by the MO of the PHC and the final selection will be made by ihc Dirf) jn
consultation with the Chief Secretary of the zilla parishad
Where PVOs arc not present, the MO of the PHC will promote fomu(nn of
Mahila Swasthya Sanghas in whic' the local women leaders and female work.rs of
Health & Family Welfare, Social Welfare and Education departments. The *MCes
expected and the scale of financial assistance for different groups will be as unde
Number
Type of Organization
Services rendered
PVO
Motivation
FW & MCH
Motivation
delivery
services
for
100
&
of
20
Motivation
FW & MCH
for
1000
PVO ( Hospital / Clinic)
f'
Mahila Swasthya
Sangh
in a village_____
Financial Support to
extended Rs per annm
per village covered
Rs 2,500__________
Sterilization Rs 300
IUD Insertion: Rs 10(
Primary Immumzau*,
per child: Rs. 25
Rs 2.500
A budgetary provision of Rs. 59.786 million is made in the project propel {qjthis scheme.
t
70
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*
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8 3
Currently one sub-centre is provided for 3000 population in hilly areas Some
of the hamlets of tribal population are scattered and located in the interior of forests
where wild animals abound It is difficult for an ANM to cover these inaccessible
hamlets. Further, cultural difference also make it difficult to promote and provide
health services
It is proposed to select girls from tribal hamlets and provide them ANM
training and post them in tribal hamlets and assign them an area with 500 population
Lhe emphasis would be on health and nutrition rather than on family planning Thc
minimum educational qualifications for ANM training will be relaxed if suitable
candidates are not available In all 100 tribal girls (20 each year) will be trained and
posted as ANMs in tribal hamlets and provided midwifery kit and sub-centre
equipment
I*here arc some voluntary organizations working in tribal areas and providing
medical services. Their experience and services will be utilized iin planning and
implementing this scheme The Directorate of Health and FW services
- ....... will1 support
such organizations by providing equipment and drugs.
A budget provision of Rs 16 1 million is made in the project cost for this
scheme
84
I
Involvement of Industrial Houses in IEC
Leading industrial houses both in the private and public sectors promote and
support sports and other social activities. It is proposed to conduct workshops to get
them involved in health and family welfare education by developing IEC materials
and/or hiring time slots on DD and AIR at prime time. Leading personalities from film
industry and advertising who arc interested in social welfare will also be invited for
these workshops
8.5
I
Special Programme for Tribal Areas
Non-Formal Education For Girls and Young Women
The Education Department is having programmes to achieve 100 percent
r---- _
literacy in all districts of the State. The programme contemplated under IPP IX
Project is aimed at school dropout girls in the ages 11-14 and neo-literate young
women in the ages 15-29 years.
Hie curriculum for non-fomial education will include modules on personal
hygiene, environmental sanitation, late age at marriage, aseptic deliveries, limiting and
spacing of children etc.
I
71
?.£
I
86
Clubs for Newly Married Couples
It is proposed to form Newly Married Couples’ Clubs and use it as a forum for
to -------increase the
promoting and encouraging the members to adopt spacing imethods
--------- -interval between age at marriage and birth of first child
8 7
Community Incentives
Villages with achieving highest CPR will be given community incentives
benefiting the community such as bore well, additional class rooms etc.
1
8 8
Marketing of Nirodh
It is proposed to make available Nirodh through the public distribution system.
Hie shops will be given stocks of Nirodh free of cost or at nominal price and permitted
to sell at prefixed price and retain the profits. Hus will be in addition to marketing of
Nirodh by voluntary workers appointed in the villages
89
Monitoring of Innovative Schemes
A sub-committec consisting of the following persons will be formed to monitor
and if necessary modify each of the innovative schemes to achieve maximum impact.
I
►=
I
Hie Director Population Centre
Chairman
Hie Project Coordinator
Member
lire Joint Director, Area Projects
Member
Deputy Secretary, Department of Health and Family welfare Member Secretary
s
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11
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72
Chapter 9
Tribal Population of Karnataka
I
S-
9 1
Scheduled Tobes of Karnataka
The term Scheduled Caste and Scheduled Tribe is the expression standardized
in the Constitution of India Contrary' to usual practice, the constitution has not given
any definition of the terms Scheduled Castes and Scheduled Tribes. Articles 341 and
342 of the Constitution empower the President of India after consulting the head of a
particular State to notify by an order the castes, races or tribes or parts or groups
within castes, races or tribes which shall for the purpose of the constitution be deemed
to be Scheduled Castes / Scheduled Tribes in relation to that State.
I
Hie Scheduled Tribes arc popularly believed to constitute the aboriginal
elements of the Indian Society. They arc generally concentrated in the hill and forest
areas and until recently the political system of the different tribes enjoyed a certain
degree of autonomy. Today however, it is difficult to define tribal peoples of India by
any single set of formal criteria. TTic elements that should normally be taken into
account in such a situation are the ecological isolation of the tribal people, the relative
autonomy of their political and cultural systems, and the antiquity of their association
with their present habitat
4-A
■-saw;
The difficulty of applying a uniform set of criteria in Scheduled Tribes arises
from the fact that the tribes have been for quite some time tribes-in-transition. The
political boundaries of most tribal systems have collapsed well before the beginning of
the present century A certain amount of cultural interaction between the tribal people
and outside world existed for centuries Ijtrge segments of tribal population have
tended to get absorbed into Hindu society. In many cases it is difficult to say whether a
particular social unit is a tribe or caste. The lists of scheduled Tribes have been drawn
up after a careful consideration of individual cases.
In Karnataka, the list of Scheduled Castes and Scheduled Tribes lists
(Modification) Order 1956 ,notified by Government of India, Ministry of Home affairs
Notification No. SRO -2477A dated 29 th October 1956, formed the basis of 1961 and
1971 Censuses. The lists were amended under Scheduled Castes and Scheduled Tribes
Order (Amendment) Act 1976 (No. 108 of 1976 dated 18 th September 1976). The
only difference between the original order and the amended one has been that the
castes and tribes so notified are applicable to the whole of the State rather than to
certain fixed areas of a State. The amended order formed the basis for 1981 and 1991
Censuses. The Scheduled Tribes as per Order of 1956 is presented in Table 9.1 .1.
I Xm?
73
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I able 9 I I List of Scheduled Tribes in Karnataka as Per Scheduled Castes and
Scheduled Tribes (Modification) Order, 1956
Districts
Tribes_______________ _____
Bangalore.
Bellary.
Chikmagalur. Chitradurga,
Hassan.
Kolar
Mandya.
Mysore (except Koi legal
taluk).
Shimoga
and
Tumkur
I Gowda I u
2.Hakkipikki
3 Haularu
--------
4 Iruliga
5 Jcnu Kumha
6 Kadu Kuniba
7 Malaikudi
8 Malem
9 Soligaru_________________
Belgaum. Bijapur. Dhanvad
and Uttar Kannad
'
1 Barda
--------------------------
~
2 Bavcha or Bamcha
3
Bhil. including Bhd G»r..». Dhoh Bhil. Dungn Bhil. Dungr,
Garasia,
Mew.., Bhd. R.W.I Bhd. T.dv, Bhd. Bh.pli. Bhd.l.
P«WT».
Va\ava and Vaaavc
4 Chodhara
' I Thank a including Tadvi. Tetana
•nd Vilvi
6 iThodia
7 iThubla, including Talavuia or Halapati
e
X Gamit. or Gamta or Gavit including Mavchi. Padvi.
A-
Vatava. Vasave and Valvi
9 (>ond or Rajgond
10 Kathodi or Katkari including Dhor Kathodi
■?
Son Kathodi or Son Katkari
or Dhor Katkari and
11 Kokna, Kokni. Kukna
12 Koh Dhor. Tokro Kodi. Kolcha or Kolgha
11 M ,kdK
i
N.y.U, K.p.d,. N.y.k.
,nclud,n|‘
Mota Nayaka and Nana Nayaka
14 Pardhi. Including Advichmcher and Phanie Phardhi
15 Pateha
16 Pomla
17 Rathwa
18 Varli
________1° Vitolia, Kotwaha, or Barodia
Gulbarga,
Raichur
Bidar
and
•I Bhil
~ •
---------------
2. Chenchu or Chenchwar
3 Good (including Naikpod and Rajgond)
4 Koya (including Rhine Koya and Rajkoya)
5 Thoti
Dakshin Kannad and
Koi legal Taluk of Mysore
I Adiyan
2. Arandan
3. Irular
4 Kadar
5. Kammara
6. Kattunayakan
7. Konda Kapus
8 Konda Reddis
9. Koraga
10. Kota
11. Kudiya or Melakudi
Kollegal taluk of Mysore
Dakshin Kannad____
Kodagu
J 2. Kunchachan
13 Kurumans
14. Maha Malasar
15. Malsar
16 Malayekandi
17 Mudugar or Muduvan
18. Palliyan
19 Paniyan
20. Pulayan
21. Sholaga
22. Toda
1 Kaniyan or Kanyan
1 Marat i
1 Kora ma
2. Kudiya
3. Kuniba
4. Maratha
5. Meda
6 Yerava
74
I
Hie Tribal Population by district as per Censuses of 1961 to 1991 is presented
in Tabic Q 1 2
Table 9 I 2 Scheduled Tribe Population by District 1961-1991
Number and Percent Within District (State)
District
Bangalore
I!
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i
Belgaum
Bellary_________
Bidar
Bijapur_________
Chikmagalur
1971
1961
Number
Percent
Number
Percent
4638
0 19
10287
0 31
75627
2 60
53150
2 19
0 07
4246
0 38
59111
164582
1055
9405
7176
0 16
699
0 08
0 57
6524
10092
0 33
I 37
762
61596
0 05
3 28
15320
252009
88403
14632
1871
0 62
137461
0 11
0 10
1606
X 40
0 15
7 03
97627
10811
51673
647
1 20
Chitradurga
Dakshin Kannad
152
0 01
48678
TT7
Dharwad
10665
0 55
Gulbarga
Hass,m
0 10
Kodagu
1 352
924
710
Kolai
167
0 01
Mandya
Mysore
552
16805
45
0 06
6596
1921
2795^
0 01
19547
0 (X)
6240
0 61
402
0 01
1 148
7540
2081
Uttar Kann;id
4218
0 61
2175
0 26
Karnataka State
192096
0 80
211268
0 79
Raichur
Shimoga
Tumkur
1981
Number Percent
43150
115239
0 13
16877
113839
0 24
0 94
0 08
11653
166649
177307
52426
140117
0 58
0 13
I 53
3 90
I99|
Number
Percent
102936
I 58
83076
11 05
166693
8 82
4 33
4 80
I 68
14 18
104215
8 30
39535
26534
1 35
2 61
14 60
3 72
4 67
4 69
0 80
7 98
318381
106159
105099
106935
16581
3 94
J (K)
4 14
I O(»
8 25
151019
6 90
0 82
I 1916
0 71
6 42
?94
To21Q2
1 21
3 16
180272
74106
7 80
9753
7 08
091
167632
10168
0 81
1767961
491
1915691
4 26
5 97
1 88
7 27
lite Registrar General of India commented on 1981 Census of Tribal
Population Karnataka that the ’’Scheduled Tribe figures would appear to include high
returns relating to certain communities with nomenclature similar to those included in
the list of Scheduled Tribes consequent on the removal of area restrictions’*, for
Karnataka in 1981 Census The population of Scheduled Tribes of Karnataka in 1981
was higher than the 1971 population by 689.2 percent as against 41.8 percent at the
National level.
According to 1981 Census, 19 tribes accounted for 99.1 percent of all
Scheduled Tribes in Karnataka. Out of these tribes, sixteen tribes accounted for 90
percent of the Scheduled Tribe population in the 1971 Census. The sixteen tribes and
the districts where they reside are presented in Table 9.1.3.
The seven tribes whose numbers have increased several fold and accounted for
98.1 percent of increase in population of Scheduled Tribes in the decade 1971-81 are
presented in Table 9 14
Naik, Nayak, Beda, Bedar and Valmiki tribes have been recognized as
Scheduled Tribes vide The Constitution (Scheduled Tribes) Orders (Amendment)
Ordinance, No. 3 of 1991 dated 19 th April 1991 (issued subsequent to Census of
1991).
75
I
Table 9 | 3 Major Tribes of Karnataka by Place of Residence— 1971 Census
t
Scheduled Tribe
District
Naikda
Marat i
Belgaum. Bijapur. Dharwad. and Uttar Kannad
Yerava
Hasalaru
Soli guru
I
Kuruba
Kadu Kuruba
Koraga
Kudiya
Jenu Kuruba
I lwX'
Dakshm Kannad____________ __________________
Kodagu__________________________________ _____
Chikmaga!urandShimoga^__________________ _
Bangalore. Mandya. Mysore and Tumkur
21 12
5 94
4 85
Kodagu_________________
Bangalore. Bel Iary, Mysore
_________________
Dakshm Kannad and Mysore_____________
3 83
3 54
3 29
2 89
2 88
Kodagu
___________________ ___ _______
Bangalore. Bellary. Mysore___________________
Bangalore and Chikmagjlur
_________________
Gowda! u
Bangalore______________ ___ __________________
Dakshm Kannad and Mysore____________________
Bangalore. Mandya, Mysore. Shimoga and Tumkur
Iruliga
Sholaga
Hakkipikki
Gond
Marat ha
1
Percent Cumulativ
of State e Percent
29 68
29 68
Gulbarga. Bidar and Riiichur
50 79
56 74
61 59
(>6 B
4 75 '
70 16
~ii 71
77 (X)
79 89
82 77
___ 2 23
I 32
85 CM)
86 32
I 14
87 46
88 57
89 32
<M) 02
___
I II
0 75
0 70
Kodagu
(her 75 percent of increase in tribal population between 1971 and I9«| is
accounted by Naikdas. Kadu Kuruba and Jcnu Kuniba population registered increase
from I4,84« to 2.44,424 Four tribes, Gond, Koli Dhor, Koya and Meda which
featured in 19X1 census had together 3,505 persons in 1971 increased to nearly
1,44,610 in 19X1
w
f
IW
l able 9.1.4 Increase in Population of Selected Tribes
iB
Community
Census Population
1971)
Naikda
Kadu Kuruba
Gond
Koh Dhor
i
Koya______
Jenu Kuruba
Meda
Total
o2
Irl
I
I ti
k* ■
68632
8192
1746
1404
____ 30
6656
325
86985
1981
1260158
209677
60730
39135
27807
34747
18684
1650938
Increase in 81 over 71
Number
1191526
201485
58984
37731
27777
28091
18359
1563953
Percent
1736
2460
3378
2687
92590
422
5649
1798
Tribal Development in Karnataka
The Tribes in Karnataka are dispersed all over the State. Their concentration is
found in the districts of Chikmagalur, Dakshin Kannad, Kodagu and Mysore, where
tribes are economically, socially and educationally backward. Although the four
districts had sizable Scheduled Tribe population, the State could not declare the tribal
areas as Scheduled Areas since the scheduled tribe population in any area is less than
50 percent norm fixed by the Government of India. This norm was subsequently
77
Pockets of tribal concentrations can be identified within one administrative unit
satisfying the conditions prescribed for Modified Area Development Approach
•
•
i
•
t
I
I
f-
I
.
namely
1 A maximum tribal population of 10,000 in a pocket
2 percent of the population in the pocket should be that of tribes
3 The villages in the pockets should be contiguous
Pockets of tribal concentration be identified within an administrative unit in a
block, taluk or district It may emerge that the pockets identified in the
administrative unit are contiguous
Villages with predominantly tribal population can be identified. Such small groups
of villages are interspersed in villages where tribal population is less than 50
percent
Pockets can be identified where tubes are living in hamlets and predominantly in
non-tribal areas Those hamlets can be taken as a unit
(>n the basis of these revised norms, the State has identified 43 tribal colonies,
hamlets in the districts of Bangalore, Kolar. Mandya, Shimoga and Tumkur.
Programmes suiting to the felt needs of these tribes are being prepared
Htc Directorate of Social Welfare has decided to initiate survey in all
remaining 16 districts to locate tribal pockets/hamlets in view of the iecent additions to
the list of Scheduled tribes and earmarked Rs 4 million in the 1993-94 budget.
1
II
1
9.3
(Ethnographic Survey of Scheduled fribes
Die Anthropological Survey of India, Mysore has conducted an ethnographic
survey of Scheduled fribes of Karnataka and prepared a report ” The People of India
- National Scries. The Schedule Tribes Descriptive Data
Based on Ethnographic
Survey 85-90" This report is under print and is expected to be released by the end of
1993. However, the ASI is willing to give the Directorate of Health and Family
Welfare access to the manuscript. Steps have been initiated to copy relevant
information from the reports on 19 tribes which account for 99.1 percent of tribal
population of Karnataka
9.4 Socio-Economic and Demographic Studies of Tribes in Karnataka
The literacy level among the tribal population is less than total population but
close to that among Scheduled Castes. In 1981, 30.0 percent of males among
Scheduled fribes were literate as compared to 29.4 percent among Scheduled Caste
males. Only 10 percent of females of scheduled tribes were literate as compared to
11.6 percent among Scheduled Caste females.
78
Table 9 4 I Literacy of Total. SC and ST Population.
Year
i
Persons
I
Males
13 89
14 85
38 46
20 59
20 14
20 73
29 35
21 71
48 81
6 74
7 67
I 1 55
1003
Scheduled
1971
1981
Females
Castes
1071
1981
I
Total
Population
1971
27 71
1981
Scheduled
Tribes
29 96
*
K
I
Several scholars have studied the socio-economic and demographic
characteristics of important Scheduled Tribes in the districts of Dakshin Kannad.
Kodagu and Mysore Reddy PH. Bhattacharya PJ and Venugopala Rao M R 15 have
studied Soligas in B.R. Hills of Mysore (1983) and Koragas (1988) of Dakshin Kannad
districts. Nanjunda Rao I. has studied the Jenu Kuruba and Kadu Kuruba Tribes of
H.D. Kote6 Taluka of Mysore district (1988) Muthharayappa. R.. Lingaraju M and
Prakasha Rao A7K have studied the tribes of Kodagu district (1986-87) and the Marati.
Malekudiya and Koraga tribes of Dakshin Kannad (1992) Hie findings of these studies
are summarized in the following fable
fable 9 4 2 Infrastructure Provided for Scheduled Tribe Settlements
I
I
Tribes
■
3
* Villages
Koraga
__
1983
1901
569
164
Kadu
Kuruba
bl*
7*
170
170
43
30 I
56 b
3 3
24 6
72 I
14 3
85 7
00
23
65 3
32 4
00
63 0
37 0
21 0
43 0
36 0
67
87 7
5.5
65 2
34 2
00
34 4
36 I
14 7
57 I
28 6
00
II 2
85 9
29
10 4
56 6
23 0
68 0
32 0
00
14 6
82 9
13 5
84 1
2.4
15 0
47 6
36.5
29 3
65.8
9
13.5
80 0
65
14 1
17 1
15 0
58 2
25 8
59
12 9
16.4
74 4
92
64 0
23.3
___
Households Surveyed
_
Infrastructure______________
1 Health Facility (distance)
Within village
1-5 Km
>5 Km____________________ _
2 Primary School (distance)
Within village
1-3 Km
>3 Km____________________
3 Anganwadi Centre
W ithm village
1-3 Km
>3Km __________________
4 Market Facility
Within village
1-3 Km
>3Km______________ _
5. Protected Water Supply
6 Electricity in the household
Malokudiyni _
Jcnu
Kuruba
So I
4.3
39 I
56 6
82 6
8.7
95 1
8.20
100.0
0.0
Marti
910
21 0
7?
Fable 9 4 3 Demographic C haracteristics of Selected Scheduled I ribes
Tribes
Demographic Characteristic
Soligas
Jctiu
Kadu
Kuruba
K uruba
I Marti
Korap
Male-
Ik udiva
l‘A>l
IV83
1 Sex Ratio F ema les / 1000 ma les
96Q
1027
954
]q04
924
2 Average household Size
4 8
6 2
TT
5 0
5 4
Male
20 7
65 2
I I 5
48 2
66 2
56 5
39 0
Female
48 4
31 *
Boys
90 7
87 7
9| 0
Girls
80 0
65 9
Boys
90 9
85 7
87 0
_______________ Girls_________________
77 9
80 0
77 2
65 8
Male
3.9
12 5
Female
16 2
8 3
| S.SQ Years
Male
Female
88 9
86 2
92 7
81 9
60*
Male
53 3
|5 6
61 2
4 Literacy*
31 0
4 School Enrollment
6-9 Years
10-14 Years
5 Labour Participation
10-14 Years
Female________
i
tI
I
...
92 I
78 6
43 7
32 3
45_7
5| I
0
7 Mean Living Children___________
2 8
t 5
4 6
_2 4
\3 8
31 I
29 8
S9 4
26 4
^6 7
of Married Women in ages
15-29____________________________
9 Aware of Immunization
83 5
75 3
77 4
10 ANC____________________________
48 8
42 9
55 S
70 4
81 6
81 6
91 7
7^ 0
75 0
1 5
18 9
11 Immunization of Children
BCG
DPT 3 doses
77 I
74 6
OPV 3 doses
Measles_____________ _______________
74 6
6 8
12 Vital Rates
CBR
4^ 0
36 0
(DR
IMR_________________________
18 <
II 3
79
138
Maternal and Child Care_________
♦
%___________________________________
■f-
Percent Children below 5 Years
Ante Natal Care Received %_______
83 5
75.3
77 4
48 8
42 9
55 <
88 I
74 6
70 4
91 7
81 6
75 0
178
74 6
II 4
816
16 7
75 0
16 1
114
68
1.5
16 7
18 9
Immunized
BCG
DPT 3 Doses
Partial
OPV 3 Doses
Partial
Measles
* Literacy for all ages for Soligas .• J 7* for others
J
jI
j
I
1
42 1
l_7 q
Awareness of Child Immunization
1
it
i
s
92 6
6 Practice of Contraception
8
J
10 6
24 4
9.5 Beneficiary and Communication Needs Assessment Studies
Rapid BNA and CNA studies among general population were conducted in 80
villages — 8 from each of the ten project districts. In each sampled village one
community leader and one or two married women aged 15 and over were interviewed
80
using a structured questionnaire In all 74 community leaders and 120 women were
interviewed for BNA as well as CNA studies.
Similar studies were conducted in among Scheduled Tribes in 32 villages with
predominantly Scheduled Tribe population in the four districts of Chitradurga. Dakshin
Kannad. Kodagu and Mysore The CNA study is based on interviews with 30
community leaders and 155 married women aged 15 and over. The BNA study
covered a much larger sample 33 community leaders. 314 married women and 70
\ oluntary workers.
I
I
/kge at Marriage : Around 58 percent of tribal respondents are not aware of
the Act as compared to 33 percent of non-tribal respondents. Significantly more tribal
respondents prefer early marriage for boys and girls than non tribal respondents
1
Table 9 5.1 Ideal age at Marriage for Girls and Boys
J
Guls
Tribal
Respondents
Age
i
<15
18__
19-21'
>22
I
i
i
36 2
29 2
92
Non-T nbal
Respondents
II 9
55 2
23 7
93
Age
<21
2J__
22-24
>25
_____ Boys
T nbal
Respondents
_______ 20 5
______ 5 4
________16_8
Non-Tnbal
Respondents
__5J
___LL1
57 3
17 5
60 8
Ideal number of C hildren : Over three fourths of non-tribal respondents
stated that ideal number of children is two as compared to 44 3 percent of tribal
respondents One in two non-tribal respondents stated three or more children as ideal
while one in two tribal respondents hold similar opinion.
s
Awareness of MCH Components : There is no difference between tribal and
non tribal population in the awareness of immunization for children or growth
monitoring However when it comes to maternal care the awareness of various
components is low among tribal population as compared to non-tribal population.
t
♦i
ii
Table 9.5.2 Awareness of MCH Components
nI r
i
I
MCK Component
Immunization of Children_______
Growth Monitoring of Children
Immunization of Expectant Mothers
Ante Natal Care______________
Delivery by Trained Personnel____
Post Natal Care
Percent in Community
_______Unaware
Non-Tribal
Tribal
Respondents Respondents
_______ 2.4 _______ 10
25 9 ______ 26,2
______ 25,9 _______ 2,4
______ 34.1 _______ 4,9
______ 50,6 _______ 95
12 9
61.2
Awareness of Contraceptive Methods: Awareness of contraceptive methods
is lower among tribal respondents as compared to non-tribal respondents.
I
81
I able 9.5.3 Awareness of Contraceptive Methods
Method
Vasectomy
T ubectomy
IUCD
C ondom
Oral Pill
Withdrawal
Rhythm
Abstinence
_____ Percent Aware
TnbaJ
Non tnbaJ
Respondents
Respondents
______ 56 2
______ 82 9
_______ 90 3
______ 99 0
48 2
______ 919
______ 41 I
______ 81 4
_______ 44 3
______ 83 8
______ 114
______ 34 3
_______ H_0
______ 332.
29 7
51 4
Attitude to Contraception: The respondents have been asked as to the
attitude of the members of their community towards adoption of contraception FNearly
‘
a quarter of the respondents from tribal population indicated that few or none favour
adoption of contraception as compared to one in twenty non-tribal respondents
1
' ,'C
fable 9 5.4 Attitude to Adoption of Contraception
All favour
Majority favour
Many favour
Few favour
None Favours
Percent of Respondents
Tribal Non-Tnbal
areas
Areas
24 1
21 4
24 1
35 5
28 5
37 0
23 4 ______ 5^_
00
05
Adoption of Contraception: The level of adoption of terminal methods
appears to be the same among tribal and non-tribal populations as per impressions of
the respondents. On the other hand adoption of spacing methods is more in non-tribal
areas
Table 9.5.5 Adoption of Contraceptive M ethods
Method
Vasectomy_______
T ubectomy_______
1UCD___________
Condom_________
Oral Pill_________
Traditional Methods
Percent of respondents
indicating that "Majority" or
"Many" are adopting the
________ Method
_______ 76
8 1,
______ 88 6
95 7
______ 16 2
39 5
______ 13 0
176
______ [5J_
18 6
86
3.4
Attendance at School: There is no significant difference between girls and
boys in the age group 5-10 in school attendance both in tribal and non-tribal areas
I
82
However in the age group 11-15 years, the school attendance among gtrls is lower
than that among boys in tribal and non-tnbal areas fhe difference is more in tnbal
areas than non-tribal areas
I
I
Boys
Girls
Age Group
Tribal
Respondent
Non-Tnbal
Respondent
5-10 Years
11-15 Years
82 7________
89 2________
Non-Tnbal
Respondent
90 7
_
76 8
75 I
71 I
65 9
Tribal
Ri indent
Promotion of MCII and FW: Hie Coverage by Female Health Worker is the
same for tribal and non-tribal population (>n the other hand, the coverage by Male
Health Workers is better in tribal areas than in non-tribal areas
fable 9.5.7 Promotional Efforts by Health Workers in 1 ribal and Non-tribal Areas for
MCI I and EW
(a) Interpersonal Communication
I1
&■
Tribal
Respondent
ANM/Anganwadi
Worker_________
Health worker
Others_________
None_________
No Response
Child Care
Maternal Care
Fainilv Planning
Category of
Worker
Non-Tribal
Respondent
Tribal
Respondent
Non- Tribal
Respondent
Tribal
Respondent
Non- I ribal
Respondent
55 7
20 5
1 6
27
32
58 6
56 8
61 0
4_L
2° 5
1 i
4 8
^6 2
_58^0
21 6
4J
Lil
76
I 6
22 Q
3 2
69 I
6 2
_LA
22 9
2 7
24 8
62
2 7
6 2
While around one in two non-tribal villages are covered by special proportional
programmes, less than one in ten tribal villages are covered.
(b) Special Promotional Programmes in the Village
Programmes arranged on
Sanitation
Personal Hygiene
Family Planning_______
Family Planning Methods
Maternal Care_________
Child Care
Percent of Villages
Non-Tnbal
Tribal Areas
Areas
368
5.9
42 9
54
54 8
8 1
55 2
8 1
53 3
8.6
519
8 6
Mass Media: One in six non-tribal villages have community TV and Radio sets
while one in twenty-five tribal villages have such facility.
«3
I
S'
Infrastructure: Tnbal villages have fewer facilities as compared to non-tribal
villages
s:
Tabic Q 5 8 Facilities Available in I riba) and Non-1 riba) Villages
Percent of Villages
Non-Tnba)
Tnbal
Villages
Villages
Facility
if
is
1 Type of Access Road
Mud Road
Red Gravel / Meta) Road
Tar Road
Not Reported
2 Water Source
Bore Well
Open Well
Other
Not Reported
3 Electrified ViJIages
4 Type of Health facility
Health Guide
TBA
Sub-C entre
PHC
I
li■
PMP
Nmic
I
■
r
______ _
24 0
24
51 5
12 4
36 I
00
39 I
53 0
7 2
07
36 2
69 6
18 0
12 3
00
94 8
51 3
10 3
14 9
26
I 9 ()
63 3
49 5
I3 I
31 S
I38
71 4
4 X
34 5
House Visits by Paramedical Staff: Tribal households and non-tribal
households receive the same level of service from paramedical stall ANN is the one
who provides all types of services at outreach
fable 9.5.0 Level of Outreach Services l^rovided to Tribal and non- Iribal Households
14
II
ii
I
i
t
Service Provided
Provide medicines____________________ —
Advise on Family planning_______________
Advise on FP methods______________
Distribute FP aids________________ ______
Provide Care to Pregnant women
Conduct Deliveries at home
Advise on care of mother and new born
Immunization of pregnant women
1 mmunization of children
______
Educate mothers on nutritious food_________
Educate mothers on management of diarrhoea
Percent of Villages
Non-Tribal
Tribal
Villages
Villages_______
86 7
________ 81 3
M3
81 I
85 2
_________ 83 2
80 5
83 5
75 7
_________ 77,0
82 3
_________ 80 8
68 6
_________ 74 I
85.7
_________ 818
86,7
83 2
83 8
83.0
______
82 9
________ 818
78 6
751'
Utilization of Medical Facilities: Tribal population is mostly dependentI on
medical facilities set up by the Governmentt as few tribal settlements have private
tribal population utilizes the services of private medical
medical practitioners. The non 1
. .
84
practitioners for treatment of sickness but for all other needs utilize the services
provided by health centres and hospitals set up by the State
Table 9 5.10 Where People go for Medical Sen. ices
Purpose
Area
Percent of Respondents
' CMC
PHC
Sub
/Govt
Doctor
Centre
Hospital
37 4
41 5
74
16 8
47 6
28 1
5 7
55 8
28 8
28 5
30 2
1I 5
38 1
21 0
42 4
28
28 1
29 0
28 1
II 5
38 1
31 0
I 9
42 4
26 I
28 I
28 I
II 2
29 0
36 2
20 0
00
29 0
28 I
28 I
11 5
47 6
34 3
95
26 7
27 6
28 I
28 5
12 0
34 8
4J_
J 21)
IL?
29 7
28 3
28 3
II 5
24 1
35 2
I 4
Pvt
Treatment of Sickness
Immunization of Child
Immunization of Mothers
Monitoring Pregnancy
Delivery
ANC/PNC
FP Services
9.6
Tribal
Non-Tnbal
Tribal
Non-Tnbal
Tribal
Non-Tnbal
Tribal
Non-Tnbal
T nbal
Non-Tnbal
Tribal
Non-Tnbal
Tribal
Non-Tnbal
Proposed Studies
The 1991 Census data on total population, SC and S I population by village in
each district will be obtained to identify tribal pockets as per norms set out by the
planning commission.
It is planned to conduct Baseline Survey, Beneficiary and Communication
Needs Surveys covering the urban and rural areas of all the districts in the state as
soon as the Project Proposal is appraised and approved. Adequate representation will
be given to tribal pockets in the sample fhis study is expected to help in refining and if
necessary modifying the project components to meet the needs of target groups among
Tribal as well as.non-tribal population, fhe cost of such studies is included in the
Project Cost.
I
I
Chapter 10
Project Cost
4
10 1
iI
■i
Project Cost by Activity
Tabic
10 1
Presents the Project
Base cost by Activity
The basis * r
detennining the various elements of project cost and phasing of expenditure is
presented in Table 10.3.
Table 10.1 Project Base Cost by Activity
I
Project Management
!>
Innovative Schemes
Total Project Cost
E-
3 62
____ 8 37
III
2 96
4 07
6 22
Capital
Revenue
Total
940 087
280 835
1220 922
77 (X)
23 (X)
100 00
Strengthening Delivery of Services
I EC
I
C apital
Revenue
Total
Capital
Revenue
Total
Capital
Revenue
Total
Capital
Revenue
Total
Capital
T ype of C ost
Improving Quality of Services
Percent of
Total
57 40
9 80
67 20
7 51
6 63
___ I4J4
4~ 75
Amount
Million Rs
700 843
I 19 591
820 434
91 675
80 915
172 590
58 008
44 209
102 217
1 3 575
36 120
49 695
75 886
Activity
86
10 2 Expenditure by Category'
Table 10 2 presents expenditure by category
Table 10 2 Expenditure by Category
hcr i of cost
Million Rs
Percent of
Total
Capital Expenditure
Civil Works
530 859
43 48
Consultancy Charges
Equipment
Furniture
3 000
83 377
69 9Q7
0 25
6 83
Innovative Schemes
Library Books
75 986
0 540
Pre-testing of I EC Materials
I 056
37 610
6 22
0 04
0 09
Production of I EC Materials
Revolving Fund
Spares for Computers
TA/DA for Others
Training in MIS and Application*
Training Material Development
Foreign Fellowships
Vehicles
Sub-Total
105 (XK)
~_l 476
16 624
0 600
5 73
3 08
8 60
0 I2
I 36
0 05
0 252
5 000
~~8 800
0 02
940 08?
77 00
()41
Revenue expenditure
Baseline and Other Evaluation Studies)
Building Maintenance
Delivery Kits
10 OCX)
0 82
22 876
~I 3 295
Tin
1 09
Hire Charges for Video Vans
36 000
Incentive to Voluntary Workers
87 998
” 5 500
0 45
Office Expenses
7 980
065
Rent
6912
0 57
Staff Salaries
44 170
362
Stationary & Office Supplies
I 1 490
0 94
TA/DA for Staff
26 354
2 16
Training Materials
8 260
0.68
Sub-Total
280 835
23 00
Total Base Cost
1220 922
100 00
Media Hire Charges
7 21
10.3 Phasing and Costing of Activities
Table 10.3 presents the phasing of activities and costing of each element
Table
94-95
95-96 96-97 97-98 98-99j 99-00' 00-01
Tool
94-95
95-96
96-97
97-98
98-99
99-00
00-01[
Toll I
0
0’
0
80 270
19 500
26 100
<8 190
15 600
20 100
0 000
0 000
0000
0 000
0 000
oooo
Q
80 500
19 500
26 100
0 000
Q
20 010
18 720
9 000
oooo
°j
1039
94
271
238 970
73 320
81 300
---- I-----------
1. Strengthening Service Delivery
New Constructions
Sub-Centre buildings
PHC Buildings
Mo Staff Quarters_______________
Rehabilitation
CHC
PHC
SC_________ ____________________
Equipment for solid waste
CHC
PHC
SC________________________ ____
Furniture
New SC Buildings
Other Sub-centres_______________
Equipment
New SC Buildings
Other Sub-Centres_______________
Laproscopes new
Laproscopes repairs
Suction Apparatus_____________
Kits for ANM___________________
Revolving fund for 2
"heirs
Upgrading CHCs to FRUs
Incentive: Volunteer workers
Delivery Kits (thousands)
Maintenance of Buildings
Total revenue expenditure
Total Expenditure
Cost in Million Rupees
Number of Units
Unit Cost
Rs 000‘s
Item of cost
2j0
780
300
87
24
30
350
25
87
349
25
87
2531
20
67
0
120.2
73.2
20.4
10
45
71
20
100
500
18
100
500
0
82
500
0
0
500!
0
0
0
0
0
0
18
327
2071
1 202
3 294
I 448
2 404
7 320
10 200
2 164
7 320
10 200
0000
6 002
10 200
0 000
0 000
10 200
0 000
0 000
0 000
0 000
oooo
oooo
14
6
0.25
127
871
5560
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1 778
5 226
1 390
0 000
0 000
0 000
0 000
0 000
0000
0 000
0000
0000
oooo
0 000
0 000
0000
oooo
oooo
0-
127
871
5660
oooo
0 000
0 000
22 5
9
87
2260
350
2261
350
0
252
0
0
0
786
4521
I 958
20 340
7 875
20 349
7 852
5 693
0 000
0 000
oooo
0 000
0 000
0 000
oooo
5
5
349
350
2261 ____0
0
0
0
36
___ 0
1,000 1,000
253
_0
0
0
0
0
I 750
11 305
0 OOO
1 404
0000
2 000
2 000
0 ooo
0 ooo
oooo
0 ooo
oooo
0 ooo
0 ooo
0 ooo
0 ooo
oooo
0 ooo
0 ooo
0 ooo
0 ooo
0 ooo
0 ooo
oooo
oooo
o ooo
7
0 435
11 300
3 250
0 234
0 250
2 OOO
1 745
0 000
0 000
0
0
0
786
4521
13
42
£ ___ 25
o’ 3.000
I 265
250
39
10
2,000
87
2260
' 13
6
25
1.000
u 000
0 000
0 000
0 000
5 195
22 605
3 250
I 638
0 250
6 000
12.500
720
1,920
1.920
1,920
1.920
0
0
8.400
9 000
24 000
24 000
24 000
24 OOO
0 000
0 000
105 000
350
18
18
18
5
0
0
54
6 300
6 300
6 300
0 000
0 000
0 000
0000
18 900
117 135 221 007 187 451 141 050
34 200
0 000
0 000
700 843
19 300
19 300
19 300
87 998
__ q
o!
A
0
oi
oi
0|
(M
0
0
o
0.
0.
0,
0
oooo
oooo
0 000
oooo
5 770
23 936
42 248
1 778
5 226
1 390
21 178
4J o89
27028
0 574
0 574
9 650
19 300
12 31 75 93 92 161 25 203 0 206 0 206.0; 206 0 901 20
0 381
1 127
1 935
2 436
2 472
2 472
2 472
13 295
299 7
0 000
0 000
0000
0 955
3 477
5 994
7 872
18 298
0 955
I 701
11 585
22 691
25 249
27 766
29 644
119 591
27 766
29 644
820 434
714 pa
@2%
804
47.7
804 13514 27028 2“rO2« 27028 27028
173.8
299 7
393 6
393 6
393 6 393 6
118 090 222 708 199 036 163 741
59 449
87
Item of cost
Cost in Million Rupees
Number of Units
Unit Cost
Rs 000's
94-95 95-96 96-97 97-98] 98-99 99-00; 00-01]
Tool
94-95
95-96
96-97
97-98
98-99
99-00
00-01
Totil
2. Improving Quality of Service
District Trng.Centres
Civil works
Furniture:
Class rooms
Hostel
____________________
Equipment
Class Rooms
Hostel________________________
Library Books (lump sum)
1600
7
0
0
12
0
0
0
19
II 200
0000
0 000
19 200
0 000
0 000
0 000
30 400
90
160
19
7
0
0
0
0
o
0
0
0
0
19
19
I 710
1 120
0 000
0000
OOOO
OOOO
oooo
12
0
0
OOOO
0 000
oooo
oooo
oooo
oooo
I 710
3 040
20
19
7
19
0
0
o’
0
Oj
0
0
0
0
19
2
2
0
0
0
0 380
0 112
0 190
0 000
0000
OOOO
0 000
0 000
OOOO
0 000
0 192
OOOO
0 000
u
0
OOOO
0 000
OOOO
0 000
OOOO
OOOO
0 380
0 304
0 190
14 712
OOOO
oooo
21 312
OOOO
OOOO
36 024
0 840
5 460
J6
10
]9
o*
Sub-total Capital Expenditure
I 920
oooo
oooo
oooo
Training Material
0.2 2,100 4,200 4,200 4.200 4.200 4.200 4.200 14.693
0 420
0 840
0 840
0 840
0 840
0 840
TA / DA 1
0.52 2.100 4.200 4.200 4.200 4.200 4.200 -*,200 14.693
1 092
2 184
2 184
2 184
2 184
2 184
2 184
14 196
2 217
2 217
7777
15 519
Staff Salaries
116.7
19
19
19
19
19
19
19
19
2 217
2 217
2 217
2 217
Office Expenses
60
19
19
19
19 '
19
19
19
19
I 140
1 140
I 140
I 140
I 140
I 140
I 140
7 980
12
77
0 000
0 00
6 912
Rent
Building Maintenance
144
@2%
12
11 20
11 20
0
12
I 728
1 728
1 723
I 728
0 000
7120 30 40 30 40 3T4O 30 40
30 40
OOOO
6 597
OOOO
OOOO
0 224
0 224
0 224
8 109
8 109
8 333
6 605
6 605
0 608
6 989
I 280
51 347
0 456
oooo
OOOO
0 000
oooo
oooo
0 456
0 125
0 000
0 000
0 12'
oooo
oooo
0 000
0 000’
0 000
0 075
oooo
oooo
oooo
oooo
0 000
0 075
0 000
oooo
oooo
oooo
oooo
oooo
0 4'0
OOOO
oooo
0 000
oooo
oooo
0 325
12
0
0
Sub-total Revenue Expenditure
HFWTCs
Ramanagaram
0
0
i
0
0
7
0
0
T
0
~Q
0
"o
0
7
7
7
7
1
0^
0 __ 0
0
0
0 ____ 0
I
0
0
0
0
0
Building Extension
456
1
Furniture (lumpsum)
TT)
7
7
7
"o
0
Equipment
Mini Bus (Replacement)
"75
450
0
T
0 450
0 000
Mysore
Fumiture(lump sum)
5909
“325
Equipment
~~75
Civil works
Library Books
T A / D A for Others at PHCs
5 909
0 325'
OOOO
OOOO
0 000
0 000
0 000’
0 000
0 075
OOOO
0 000
0 000'
0 000
0 000
0 075
5 909
0
0
0
0
7
7
0
57
10
0
0
1519;
0
0
4
0 100
0 000
OOOO
0 000
0 ooo' oooo
0 000
0 100
T 57 10 208 9o
1 998
5 315
0 000
1 998
5 315
0 000
1 998
16 624
0
—7
7
0
4
o
0
“35 57 10
1519
0
oooo
oooo
0
0
88
Rs OOP's
Sub-total Capital Exp.
T.A./D.A Medical Officers
0.9
T. A./D. A. Spervisory Staff
Training Materials
Maintenance of Buildings
0.76
920
02
2000 2000 2000 2000] 2000
5 36<’ 5 365
0 45? 5 36? 5 365 5 365 5 365
5 365
@2%
0972
0 972
0972
0 972
6 804
0 699
0 699
0 699
0 699
0 099
4 893
0 699
0 400
0 400
0 400
0 400
0 400
0 400
2 800
0 400
0000
2 07?
0000
0 009
0 127
0 127
0 127
0 390
0 000]
2 07T
2 071
2 080
2 198
2 198
2 198
14 887
OOOO
21 000
OOOP
1 600
OOPP
22 600
0 699]
92’0
2(XX? 2000
0 972
3205]
20001
92?
920
24739
0 972
1080
920
1 998
0 972]
1080
920
OOOO
0000
37811
920]
1 ulal|
97-98
108 Op 1080
1080] 1080
00-01
96-97
Toul|
1080
99-00
1 998
98-99
5 3?5
94-95] 95-96
3 2O4[ II 624
99-00J 00-01
94-95] 95-96 96-97 97-98] 98-99
Sub-total Revenue Exp.
ANM/LHV Training Schools
Civil Works______________
ANM Training Schools_____
3000
LHV Prom Tmg School
1600
Sub-total Capital Exp.
Maintenance of Buildings
Sub-total Revenue Exp.
Institute of Health & FW
Building for office ______
Furniture: Sr Staff
________ Jr. Staff_______
Video Projector__________
Library Books (lump sum)
Trang Materials Developmen
Initial Course
Referesher Course________
Vehicles.
Cars
Jeeps_________ _________
Foreign Fellowships
0
7
0
7
0^
0
0
7|
oooo
21 000
0 000
0
I
1 600
0000
OOOO
OOOO
0
0000
0
I 600
21 000
oooo
0 000
0 OOP
oooo
oooo
oooo
0060
0 032
0 452
0 452
I 388
0000
0 452
OOPP
0060
0060
0 032
0 452
0 452
0 452
I 388
0000
I 9001
0000
oooo
0 OOP
0 000
0 OOP
0 OOP
I 900
I
0 000
4
oooo
oooo
oooo
0 300
0 060
0 200
22
22 60 22 60 22 60] 22
@2% 1.600 21 00 22 60
1
1900
25” "12
____ 15 _ __4
1
200 .
250,000 ” o7
0
0
01
ot
_0
0
“5
0
0
04
02
168
168
0
0
0
0
0
0
0
0
1
05
200
275
2
2
Sub-total Capital Exp.
Staff Salaries
TA/DA for Staff
6 days
13 days
26 days
0
0 000
0
0 000
0
1616
0.51
1.04
2.08
1
0
40
128
0
Ti
0
0
o!
oT
0
0
0
_0
0
0
Q
0
0
0
0
~T
0 300]
0 060
0 200
7
"3
"o
1
0 125
0 125
0
0
0
0
0
0
168
1681
0 168
0084
0
0
0
0
0
0
2
2
1
1
1
1
1
1
0
0
0
0
0
0
0
128
0
40
0
0
0
0
0
0
0
0
0 OOP
0 OPP
OOPP
0 OPP
0 OOP
0 OOP
0 OOP
0 000
0 000
0 OOP
0 000
0 000
0 OOP
0 OOP
OOOP
0 OOP
0 OOP
0 250
0 000
0 000
0 000
0 000
0 000
0 000
0 000
oooo
0 000
oooo
0 000
oooo
0 168
0 084
0 40P
0 550
OOOO
OOOO
OOOO
1 000
0.000
OOOO
I 000
OOOO
OOOO
I 000
0 000
OOOP
3.787
I 125
I 000
1000
1
1 616
1 616
I 616
1 616
0 000
168
128
0 000
0 042
0 266
0 000
0 000
0 000
0 000
0 133
0 000
oooo
0000
oooo
oooo
oooo
oooo
I 000
I 006
I 616
I 000
OOOO
OOOO
OOOO
1000
OOOO
I 616
1 616
0 021
0 000
oooo
oooo
oooo
oooo
oooo
0 000
0 000
0 400
0 550
5 000
1912
11 317
0 021
0 175
0 266
89
of COft
fUnrtCori
‘osl m Minton Rupees
Number of Cnrf*
000's
94-95 95-96 96-97 97-9t 98-99
99-00
00-01
Total
94-95
95-96
96-97
97-98
98-99
W-00
00-01
Total
0 380
I 520
0 000
0 000
0 000
0 380
0 380
0 380
Sab-total Revenue Exp.
I 924
1 616
I 616
2 129
2 017
I 996
I 99o
11 294
Tetal Capital Expenditure
23 303
33 749
I 000
24 310
6 315
I 000
I 9<)8i
9| 67'
Total Revenue Expenditure
10 592
II 796
11 796
12 574
11 271
II 2'1
II 63'
80 9|<
Total Expenditure
33 895
4' 545
12 796
36 884
17 586
1 2 251
13 633
172 '90
10 942
0000
0 700
0 700
0 000
0 000
0 000 ’
12 342
0 000
0 000
0 000
0 000
0000
0 000
6 240
0 000
0 420
olio
Maintenance of Buildings
@2%
1900
19 00
1900
1900
19 00
1900
19 00
1900
3. IEC:
Equipment
Video project! .s
Slide Projectors
Overhead Projectors
T V / V C R.——
240
~20
“io
~32
Radio cum Cassette player
26
“2?
0
0
0
"n
0
"5
0
~0
121
0
~0
—0
0
0
Too
0
350
350
0
0
0
0
0
0
0
30
6 240
0 420
0 210'
0 000
oooo
0 000
0 000
0 000
oooo
oooo
3 872
OOOO
oooo
0 ooo
oooo
0
— 2?
—n
~7o
0 000
0 000
0 000
0 000
oooo
c"6oo
0
L300
0 700
3 500
0 000
0 000
0 000
1 600
o ooo'
0 000
0 ooo
0 000
0 000
0 000
0 000
0 OOP
0 000
0 000
oooo
1 500
0 250
oooo
oooo
oooo
0 000
0 000
0 000
0 000
0 000
0 000
0 000
0 000
0 000
o pop’
oooo
37 610
0 OOP
1 600
' 000
0
0
0
0
0
0
Production of EEC Materials
0
____ 0
10
0
1000 ____ 0
12
12
600
600
50
50
2500 2500
0
I
0
0
0
__ 0
0
0
50
2500
0
0
0
0
0
0
0
G
0
500
0 OOO
0 700
10 620
6 810
0900
1 500
2 OOO
I 500
0 120
1 500
0 250
0 300
0 000
0 000
1 '00
2 000
I 500
0 120
I 500
0 250
0 300
oooo
oooo
0 ooo
oooo
oooo
0 000
oooo'
oooo
0 OOP
0 000
0
0
0
0
I3
K
o] ~76
0^
0[
1800
c
w
Too
oj 10.000
c*
0
0
0
0
0
Jr 2
Oj 1.500
0 150
0 150
0 150
0000
0
2
I
05
200 ___ 0 5800
06 20000 30000 20000
I
2000
0
0
0
oT ~
0
0
0
0
o! 8000
o! 70000
0 000
0 000
1 800
0 300
0 290
I 200
0 150
0 100
0 000
Exhibition Panels
~7b
100
"o
0
0;
Too
0 ooo
0 OOO
0 000
Hoardings
Wall Paintings
~20
0
0
100
0 500
0 '00
0 500
0 500
0
4000
~~4
350'
Togo
~5T
0
Protesting of IEC Materials
Vehicles
25
1000
77
0
~~25
0 150
0010
I 200
4 OOO'
0
264
1 000
0 303 ’
0
0
~~20
7 000
15 minute 35mm films
Prints of films____________
3-4 minute quickies
35 mm prints____________
Tele Films 15-20 mts
VHS prints______________
TV Spots
VHS prints______________
TV Serial
Cinema slides
Audio Cassettes
Copies of cassette_________
Flip Charts 7 Types
225
__ 4
150
2
125
0.2
30
0.1
300
"03
4
0
400 ___ 0
10
1000
12
_600
50
2500
I
~500
500
750
“io
20
~0
0
_25
“25
1000
1000
72
0 —V
01
0.
0.
4
400
20
2000
0 200
16 680
I 600
0 OOP
1 500
0 120
I 500
0 250
0 000
0 ooo
0 ooo
0 ooo
3 872
4 000
0 OOP
4 '00
0 ooo
0 360
0 OOP
POOP
P OOP
6 000
0 600
oooo
0 000
0 4'0
OOOO
oooo
0 OOO
0 600
0 400
0 OOO
0 OOP
0 000
0 000
0 OOP
0 000
4 000
0 000
0 000
0 000
2 000
0 000
1 000
4 200
1 000
1 OOO
1 000
0 000
0 000
0 ooo
4 000
0 288
0 000
0 256
0 OOO
0 204
0 000
0 000
0 OOO;
I 0'6
oooo
0 000
0 000
0 000|
? 000
9(»
o
W^V****
(Rs. 000's
94-95 95-96
Total Capital Expenditure
96-97 97-98| 98-99* 99-00’
3
T "7
’0-01;
Total
3 "•7
0 000
99-Poj 00-011
0 ooo 0 000
<8 008
7 200
7 200
36 000
0 387
0 387
2 70)
94-95
95-90
96-97
97-98
98-99
34 930
10 908
7 766
4 404
1 800
1 800
3 600
7 200
Total
0 387
0 387
0 387
0 387
7 200
0 387'
0 250
0 500
0 750
1 000
I ooo'
I 000
1 OOP
Tmjo
Total Revenue Expenditure
2 437
2 687
4 737
8 587
8 587
8 <87
8 587
44 2 09
Total Expenditure
37 367
13 595
12 503
12 991
S 587
8 587
8 587
102 217
---L
0 1161 0 116
0 116
0 116
0 116
0 I 16
0 116
0 812
Hire charges for video vans
Staff salaries (8 persons)
360
5
387
T
5
10
20
120
20
”7
1
—>!
i
Media Hire charges
*
4. Administration & MIES
Administration
Staff Salaries
0 116
I
I
1
I
I
I
1
i
Baselineand Evaluation studies
4 COO*
Sub-total Revenue Exp.
4 116'
0 400
0 400
0 400
0 400
Togo
0 516
0 516
0 516 • 0 516
4 116
10 812
0 000
0 000
0 000
0 000
OOOO
OOOO
0 ooo
0 ooo
0 ooo
0 ooo
0 ooo
0 OOP
oooo
oooo
0 ooo
0 ooo
n noo
o ooo
oooo
0 POP
OOPP
0 OOP
0 OOP
0 280
0 100
0 180
0 400
0 53 l'
0 531
0 OOP
0 531
0 680
3 7|7
0 360
0 360
0 360
2 <20
!
Civil Engineering
Furniture
Sr.Staff
Jr.Staff_____________________
Vehicles
0 400
0 516'
10 ooo
25
15
200
4
12
2
£
~Q
0
0
0
Staff Salaries
531
1
i
Stationary & Supplies
360
T
0
oj . J
£
0 28o|
0
oi
of
7
4
12
0 ooo
0 ooo
o isol 0 ooo
0 400’ oooo
0 680
oooo
0 000
0 lOOl
0
0
0
1
1
i
1
1
i
0 531 ‘
0 531
0 531
7
7
7
7
7
7
0 360’
0 360
0 360
0 531
0 360
0 891 ‘
0 891
0 891
0 891
0 891
0 891
0 891
6 237
6 150
0 800
0 400
0 250
0 350
0 500
0 350
3 500
I 229
0 229
1 0001
I 476|
0 000
0 000
0000
0 000
0000
oooo
0 ooo
oooo
oooo
oooo
oooo
oooo
oooo
oooo
0 ooo
0 ooo
0 ooo
0 ooo
oooo
OOOO
OOOO
oooo
oooo
oooo
oooo
oooo
oooo
oooo
0 ooo
0 ooo
oooo
0 ooo
0 ooo
oooo
oooo
oooo
oooo
oooo
oooo
0 ooo
0 ooo
oooo
0 ooo
OOOO
0 OOO
OOOO
OOOO
0 OOO
0 OOP
OOOO
6 l<0
0 800
0 400
0 250
0 350
0 <00
0 3<0
3 <00
1 229
0 229
I OOO
I 476|
Oi
Sub-total Capital Exp.
Sub-total Revenue Exp.
MIES
Computers
Directorate
Engineering
HE&T
1EC •
Department
SIHFW
Districts_____________ ___
Site preparation
Directorate
Districts___________________
Spares for Computers
800
400
250
350
250
350
175
220
___ 50
@ 24%
1
1
1
1
2
1
20
i
20
1
0
0
0
0
0
0
0
0
0^
K
0
0
0
0
0
0
0
0
0
7
0
0
0
0
0
0
0
0
0
0
0
0
0
o!
I
o
£
0
0
0!
oj_
0
0
0
0
0
0
0
—
0
0
0
0
0
0
i
i
2
oi
I
20
f
0
0
£
oi
0.
1
oooo
0 ooo
0000
0 000
0 ooo
0 000
0 ooo
0 000
oooo
oooo
0 ooo
oooo
oooo
0 ooo
0 ooo
oooo
0 ooo
oooo
0 OOO
0 OOO
oooo
0 ooo
91
•a
Item of cost
Photo Copier
Fax machines_________ _______
Consultancy Charges
MIS_________________________
MIS Training
Directorate
Districts___________________
Sub-total Capital Exp
Staff Salaries
Directorate
IHFW
Districts____________________
Stationary
Directorate
Districts___________ ______
Sub-total Revenue Exp.
Number of Units
Unit Cost
Rs 000*s
95-96| 96-97| 97-98] 98-99; 99-00’ 00-01!
94-95
°o'
01
0!
0
o[
0’
0
0 50
0 25
0 25
0
0
0
1
1
0
0
0
0
0
0
0
2
2
0
0
3,000
100
500
180
40
"T
I
0 463
0 103
) 877
1
1
1
I
1
1
1
I
I
I
jl
11
0.226
1 154
0 5
0 5
I
1
I
I
I
1
‘11i
7
1!
r-
Totil?
a
o
z
I
I
1
I
1
I
I
I
1
I
I
■
i
!
Total Capital Expenditure
7
Total Revenue Expenditure
Total Expenditure___________
Innovative Schemes (Capital)
PVOs
PMPS
Mahila Sanghas
HAC Members TA/DA
Tribal ANMs____________ ___
Total Capital Cost of Project
25
I
25
0 1
20
250
200
7680
100
1250
10*30
54000
100i
100
100
80]
60
40
750 1000i 1250 1250'. 1250
500
800 1000 1000 1000
600
400
54000 54000 54000
54000
54000
7680
T
Total Recurring Cost
Total Project Base Cost
Physical Contingency_______
Price Contingency________
I
96-97]
97-98]
98-99
t»-oo[ 00-01
0 360
0 080
0 000
0000
0 000
0 000
0 000
0 000
0 000
0 000
0 000
0000
0 000
0 000
0 360
0 080
0 000
0 000
0 000
0 000
0 000
0 000
0 000
0 000
0 000
0 000
7 140
4 230
4 230
4 230
0 000
6 000 0000
0 000
0 000
0 000
0 000
0 000~ 0000
1443" I 443
I 443
0 463
0 463
0 463
0 103
0 103
0 103
0 877
0 877
0 877
1 380'
I
380
I 380
0 226
0 226
0’226
1 154
1 154
1 154
2 823
2 823
2 823
0 000
0 000 Togo
7 830
4 230
4 230
19 215
4 980
4 980
4 230
4 230
0 750
0 000"
0 000
0 000
0000
0 750' 0 750
1 443’ 1 443’ I 443“
0 463
0 463
0 463
0 103
0 103
0 103
0 877
0 877
0 877
I 380
I
380
0 690
0 226
0 226
0 113
1 154
1 154
0 577
2
823
2 823
2 133
0 750
0 750
12 075
1 500
0 600
0 100
0 500
11395'
I
0
0
95-90
Total
94-95
0 750
0 000
0000
I 443
0 463
0 103
0 877
1 380
0 226
1 154
2 823
0 000
0 000
4 230
7 830
3 768 10 850 12 900 14 950 15 750 1 5 750
2 018
2 500
2 <00
2 500
2 000
i 500
I 000
0 500
I 2'0
1
250
1
250
1
000
0 750
0 250 0 500
: <00
2 <00
2
500
2
000
1
500
I
000
0 500
5
400
5
400
5 400
5 400
5 400
0 768
0 768
4
100
4
100
3
300
2
500
1
700
0 500
0 000
17
748
16
750
55
465
182
664
207
817
189 461 270 182
57
696
51
834
49
337
21 124 20 414 32 348 48 082
210 58? 290 596 240 165 230 746 104 803 68 '84 75 444
15 721
14 74?
3 000
0 600
0 100
0 <00
12 895
10 101
3 241
0 721
6 139
8 970
I 469
7 <01
19 07:
13 575
36 120
4‘) 695
75 986
12 500
6 250
12 500
28 536
16 200
942 087
280 835
1220 92?
24 369
17 877
15 460
2 863
I 828
2 154
80 273
40 553
49936
61 914
34 767
27 319
35 326
264 554
241 047 355 518 307 978 308 119 142 433
97 731 1 12 924 1565 749
Total Project Cost
t 10 percent for physical quantities and 5 percent
Provision for physical contingency is made at
for
1995-96,
6 0 for 1996-97 and 5*. for 1997-2000
contingency at . 7 5% for 1994-95. 6 5°o f~. .
for salaries. O & M. consultancy and honorarium and that for price
92
93
10 4
Project Sustainability
The revenue expenditure of Karnataka on Health and Family Welfare, formed
4 44 percent of total expenditure of the state tn 1983-84 and rose to 4 66 percent by
1993-94 The expenditure on Health and Family welfare has been growing at a
compound rate of 14 4 percent per annum. The non-plan expenditure which is home
by the state is nearly but thirds of the total expenditure The Total Expenditure for the
year 1999-2000 is projected at Rs. 9737.857 million of which non-plan expenditure
will be Rs. 6538.830 million or 2.3 times the level of expenditure in 1993-94.
The increase in annual recurring expenditure by Rs. 55.818 million at the end of
the project period will be 0 85 percent of the non-plan expenditure. This increase is
insignificant compared to anticipated increase in total non-plan expenditure or even
current level of expenditure. The following Table presents the trend m
tn Expenditure
during the period 1983-84 to 1993-94 and projection for 1999-2000.
Table 10 4 Actual and Projected Expenditure on
Health and Family Welfare
Million Rupee*
Year
1983- 84
1984- 85
1985- 86
1986- 87
1987- 88
1989- 90
1990- 91
1991- 92
1992- 93
1993- 94
1999-2000
Projected
Plan
expenditure
Plan
Total
Non-plan
expenditure
expenditure
expenditure
407 951
611 889
503 684
539 014
656 917
821 459
927,389
1035 134
1204 949
1477 717
3198 757
as percent of
Total
36.39
1120923
43 21
1416 133
32 53
1548 599
31 80
1694 940
33 82
1942.537
33 19
2475 013
34 26
2706,987
32.45
3190,287
32.67
3687,767
34 16
4326 043
32 85
9737.587
712 972
804.244
1044 915
1155 926
1285 620
1653 554
1779 598
2155.153
2482 818
2848 326
6538 830
<M
References
’Reddv P H and Gopal Y S. “India Population Project III. Karnataka Gaps in Knowledge. Skills and
Practices of Health and Family Planning Personnel* . Population Centre. Bangalore and Directorate of
Health and Family Welfare Services. Karnataka. P90
2 Training Needs of Medical and Paramedical Staff *'’— Report prepared by STEM based on Training
Needs Assessment study conducted by Directorate of Health and Family Welfare. Karnataka
'Bhaskara Rao N Family Planning Communication in Retrospect. Centre for Media Studies. New
Delhi
‘Reddy P H . Bhattacharya P J . Venugopala Rao M R Tribes in Karnataka - A study of Socio
economic and Demographic Characteristics of the Soligas. Population Centre. Bangalore. 1083
'Reddy P H . Bhattacharya P J . Venugopala Rao M R Tribes in Karnataka - A study of Socio
economic and Demographic Characteristics of the Soligas. Population Centre. Bangalore. I ‘>84
‘ Najunda Rao L Tribals in Heggadadevanakotc taluk. Foundation for Educational Innovations in
Asia (FENIDA). Bangalore. I ‘>8X
7Hanumantarayappa P Issues in Tribal development. (A Study of Selected Tribes in Dakshina
Kannada District of Karnataka) Population Research Centre. Institute of Social and Economic
Change. Bangalore 1992
KMuthurayappa R. Lingaraju M. Prakasha Rao A Evalu.i.ion Study of Health and Family Welfare
Programme Among Scheduled Tribes in Dakshin Kannad District of Karnataka. Population Research
Centre. Institute of Social and Economic Change. Bangalore 1992
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38
Annexure 3
Locations for Construction of Sub-Centres
During First Year of Project
Sites in eighty seven villages have been located for the first year programme
However, additional 29 villageshave been identified as standby for the first year and i
not used will be carried over for the second year
District
I Bellarv
Taluk
Village
1 Siriguppa
1 Konchigen
2 M Sugur
3 Buduguppa
4 Balakundi
5 Nittur
6 Shivapura
7 Doopadhahalh
2 Kudligi
3 Sandur
4 Haranahalli
2 Chikmagalur
3 Chitadurga
Site
Selected
Yes
Yes
Yes
K Mctnki
0 Udghatta Doddathand>
10 Madlagiri_________
11 Danapura
5 Hospct
______ 12 Nagalapura__________
Yes
1 C han nagondanahal I y
I Chikmagalur
yes
2 Ambale____________
Yes
3 Nagenahally
2 Kadur
Yes
4 Somanahally
Yes
5 S Madapura
______ 6 Hogarehally_________
Yes
7
Ballavara
3 Tankere
Yes
8 Kuncthinamadu
Yes
9 Madaburu__________
4 Narasimharajapura
Yes
10 Kumbarakoppa
5 Koppa
Yes
11 Gunavanthy
Yes
12, Hosur______________
Yes
13. Honavalli
6 Sringen
Yes
_____ , 14, Hearur__________ ___
Yes
15.
Kotigehara
7 Mudigere
Yes
_______ 16 Shibira_____________
__ L
Yes
1 Chitradurga
Yes
Doddasiddawahanahal ly
____
2 Mallapura______
Yes
3. Palavanahally
2. Hiriyur
Yes
4
Allaghatta
3 Hosadurga
Yes
________ 5. Devanagere________
Yes
_________
6
Chikkarahalli
______
4, Mallakalamum
Yes
7. Belasanna________
5. Harihara_____
Yes
8 Rangavanahally
6 Challakere
Yes
9. Ganjijunte
District
Taluk
I Mangalore
2 Udupi
3 Buntwa!
Di st net
5. Hassan
Taluk
I Hassan
2 Arasikerc
3 Chennarayapatna
4, Arakalagudu
5, Sakalshapura
6. Belur
7. Alur__________ _____
8 Holenarasapura
_
6 Kodagu
7 Mandya
Virajpct
Hebbclc
I Srirangapatna
2, Pandavapura
3. Nagatnangala
!•
11
■
I
!
8. Mysore
I. Gundulpet
2. Chamarajanagar
Village
1 Bajpe
2 Permude
3 Natekal
4 Hejaniadi
5 Tenka
VVodapadavu
7 Mangilapadavu
Village
Site
Selected
Yes
Yes
_Yes___
Yes
Yes
Site
Selected
1 Dasarakoppalu
2 Bijamaranahally
3 Maralekatte
4 Maratagere
___ _
5 Obalapura
6 Raginiarur
Yes
Yes
7 Haicbelur
8 Parasadihalli
Yes
9 Byrapura
10 Chittanahally
Yes
Kannagala
Kutta B
T bore noor____________ _
I Belagola
Gai\jant
I Kirangur
4 Acchappanakoppalu
5 Balcnahally
6 Arakere
7 Neralakere
8 Doddapalya
9 Gamanahally
10 Tadagawwadt
11 Jakkanahalli________
12 Kalmgnahalli
13 Chmchanahalli
14 Arm
15 Lakshmipura
16 Nelligere
17 Bommenahalli
18 Agachahalli
19 Ancheetinhanahalli
20 Doddajutaka
21 Kelagere__________
1 Kadsoge
2 Terakanambi
3 Honganur
4 Rachanballi
5 Nagavalh
6 Nallur
7 Daddahalli
8 V Chatra
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
i es
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
YeS
Yes
Yes
Yes
Yes
Yes
Yes
100
Dist rict
Mysore
| Taluk
3 II I) Kotc
4 Pcriapatna
5. Kollegal
6 T. Narsipura
9 Shimoga
I. Honnali
2. Channageri
3 Shimoga
4 Bhadravathi
5. Shikarigura_
6. Sorab
7. Tirthahalli
8. Hosanagar
10 Uttar Kannad
1 Ku mt a
2. Karxvar
3. Mun da god
Village
o Saragur
IQ Hainpapura __
11 Bettadapura
12 Ravandur_____
I 3 Hanur
14 Somnathapura
15 Musuvmakoplu
1 Kumbalpur
2 Muktahanhalli
3 Hodalipura
4 Bcllagere
5 Mandaghatta
6 Thadasa______
7 Nunbegundi
Sue
Selected
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
X Haragari
9 Jogihalli
10 Hiramagadi
II Chikkababbur_
12 Ubbur
13 Kukkur
14 Malhmukkc
15 Bettabasavarm
I ft Meckan______
1 7 Mavenkoppa
IS Nittur________
1 Bankikodla
Yes
2 Binaga
} Kodara______
4 Nandigatta
Yes
Yes_
Yes
Yes
5 Ku sura
____
104
Annexure 7
Status of Buildings for PHCs
District
PHC
Sanctioned
PHCs with
Own
Building
I
J
Bangalore_____
Bangalore Kural,
Belgauin____ _
Bcllary______
Bidar___
Bijapur
^Jhijanajjallur
^hitr^dujB1!____
Dakshin^Kann*^
Dharwad______
Gulbarga____
Jlassan
___
Kodagu ___ _
Kolar
_____
Mandya_______
Mysore_______
Raichur
Shimoga
Tumkur_______
Uttar Kannad
Karnataka
IPP IX Districts
Other Districts
25
54
107
46
35
77
J9
66^
20
32
65
30
28
69
34
36
PHCs
Building
Under
Construction
PHCs
without
Buildings
JL
4
14
______ 8
~_______ 29
J6
o
______ 5
____ 5
___ 0
1 10
JiO ___
85
74
IL
(ri
27
69
117
62
61
77
50
1297
632
665
46
45
13
60
31
83
13
9
__ 14
_______ 0
0
______2
9
___ [
51
20
20
28
864
412
452
__ _16
0
9
__________ 7
_______
4
________ 119
_______ __46
73
I A
ooco^7*T'ON 2 J
N G AtO r
_7
3
0
21
L°
3
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108
Annexure 9
Furniture and Equipment for Sub-centres
1 (a) Furniture for new buildings
I
E
Sri
No
o
2
3.
4.
6.
X
9
I0
I I
I2
Item Description
Quantity
Cost Rs
I
I
I
I
<.1.375
Examination table
Foot step
Wash basin with stand
Stool
Cot with mattress
Bench for visitors
Cupboards for equipment and supplies
Office table
Side rack
Chairs
Container for water storage
Bucket with lid
fol al
I
2
2
I
I
2
I
2
>
200 K"
175 ‘
250 2,975 /
3.000
9,000
3.500 ‘
500 1.000^
350 k
120
22,445
Say Rs 22.500
1 (a). Furniture for other sub-centres
Furniture worth Rs. 9,000 on an average is provided for other sub-centres
4
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109
2 Equipment for all Sub-centres
■
Sri
No
Item Description
Quantity
Cost Rs
I
350
I
5
2
I
I
1.200
500
200
100
100
2
2
1
I
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60
30
30
10
50
200
ISO
30
60
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50
50
100
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I
80
100
100
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1
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1
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200
500
KO
80
100
100
500
5,010
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3.
4.
5.
6
7
8
9
10
II
12
13
14
IS
16
17
18
19
20
21
22
23
24
25
26
^7
I
■ i
Scale Bathroom Metric/Avoirdupois:
120 KG/280 LB
Scale infant Metric 16 KGs x 20 G
Colour coded weighing scale (baby)
Basin Kidney enamel 825 ml
Basin solution deep enamel 6 litres
Tray instrument / dressing with cover
3 10 x 195 x 63 I mm S.S
Sheeting plastic clear vinyl 910 mm wide
Brush surgeon’s white nylon bristles
l ancet ( Hedgedom Suture Needle) straight 75 mm
l ape measure 1.5 M / 60” wide vinyl coated
I'lash light pre focused 2 cell
Sphygmomanometer aneroid 300 mm with cuff
Stethoscope Bianural
I orccps dressing spring type I 50 mm stainless steel
Forceps hemostat straight Kelly 140 min stainless
steel
Forceps sterilizer (utility) 200 mm Vaughn Crim
Jar dressing w/covcr 0.945 liti stainless steel
Forceps uterine vulsellum straight J and above 250
mm
Scissors surgical straight 140 mm S / B stainless steel
Speculum vaginal Bi-valve Cusco's medium stainless
steel
Reagent strips for urine test (albumen and sugar)
Rack Blood sedimentation Westergren 6-3/4 unit
Cusco's & Sims vaginal speculum
Anterior vaginal wall retractor
Measure 1/2 and I litre
Uterine sound
Haemoglobinmeter set salti type complete set
Total
Say Rs. 5,000
I IU
Annexure 10
Equipment for ANM Kit
Sri
No
I
2.
4
5
6
7
8
9
10
II
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Item Description
Sphygmomanometer aneroid 300 mm with cuff
Colour coded weighing scale (baby)
Instrument sterilizer SS 222 x 22 x 41 mm
Spring type dressing forceps - stainless steel
Basin Kidney enamel 825 ml
Sponge bowl - stainless steel - 600 ml
Urethral catheter (12 fr) runner
Sheeting plastic clear vinyl 910 mm wide
I'nema can with tubing
Clinical thermometer oral (dual Celsius /
Fahrenheit scale)
Clinical thermometer rectal (dual Celsius/
Fahrenheit scale)
Brush surgeon's white nylon bristles
Mucus extractor
Artery Forceps
Cord cutting scissors
C ord ties /rubber band packet
Nail clipper
Foethoscope (stethoscope Foetal)
Surgical scissors straight stainless steel 150 mm
Spirit lamp with screw cap : metal (60 ml)
Aluminum shield for sprit lamp
Poly urethane self sealing bag (125 x 200 mm)
Arm circumference scale
Rack Blood sedimentation Westergen 6-3/4 unit
Adhesive zinc oxide tape (25 mm x 0.9 m) roll
Tape measure 1.5 M / 60" wide vinyl coated
Flash light pre focused - 2 cell
Kit bag
Total
Quantity
Cost Rs
I
I
I
I
I
2
I
2
I
I
200
100
80
80
50
100
25
60
60
20
20
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15
50
70
60
20
20
20
80
50
20
30
20
20
80
10
50
500
1,910 .
Say Rs. 2.000
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113
Annexure 12
T*
Furniture and Equipment for each District Training Centre
I Furniture:
Item
A Class Room
1. Fable and Chair for Faculty
2. TraineesWork bench and 2 chairs: 15 @ Rs. 3.200 each
3. White Board 6' x 4'
Total
Rs
2.800
48.000
3.200
54.000
B Oflicc Rooms
1 Sr Staff: Fable and 3 Chairs. 4 Sets (S) Rs 5,400
2 Jr Staff Table and 2 Chairs 2 sets @ Rs 4,200
3. Cupboards: 2 Nos @ Rs. 3.000 each
4 Slotted angle rack: one
Total
21,600
8.400
6.000
1 j JO
36,000
C Hostel Rooms
I Cots with Mattress: 30
Rs. 2,500 each
2. Work bench and Chair. 30 @ Rs. 1,200 each
75.000
Total
36,000
1,11.000
Total
21,600
27,000
48,600
1. Overhead Projector with Screen and accessories
2. 35 mm Slide Projector with accessories
Total
8,640
16,200
24,840
1) Dining Hall
1 l ables : 9 @ Rs 2,400 each
2. Chairs: 36 @ Rs. 750 each
Equipment
A. Class Room
B Kitchen
1 Cooking Range
2. Kitchen utensils
3. Dining plate, 3, Katoris one cup , glass Stainless Steel:
36 sets @ Rs. 200
Total
2,500
3,000
7,200
12,700
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Annexure 16
Furniture and Equipment for HFWTCs
(a) Furniture Required for HFWTC Mysore
Item
I Principal's Room
1 Steel Officers Table I 83m I x 0 91 m w x 0 76m h
2 Executive Revolving Chair with full high back
with head rest
3 "S" Type continuous arm chair with full cushion
4 Steel Telephone Stand
II Office Room
1. Superintendent Table
2 Typist Table (Teak wood)
3 Typist chair
III Faculty Room
1 Officers T W Table I 22m I x 0 61 m w x 0 76 m h
2. Executive Revolving Chair with cane seat & back
Qty
Rate
Amount Rs
2
2
3.699
3,696
7.398
7.392
1(H3
750
945
9.750
945
1
I
3.080
2.704
905
9.240
2.704
905
6
6
2.860
1,680
17.160
10.080
30
30
30
30
I 650
236
750
450
49.500
7,080
22.500
13,500
20
<)9
1.980
12
110
1.320
1
5
2.340
4290
2,340
23.450
20
3712
74,240
25
25
157
600
3.925
15,000
1
1
1,144
1.092
1.144
3.016
1
1.092
1.066
1,092
31.980
Total
KST @ 4%
Total with Tax
3.15.641
12,626
3.28.267
1
3
IV Hostel Room
■
1 Steel Cot I 90m I x 0 78m w x 0 60m h !4Gg
2. Mosquito Curtain Pole 1.90 I x 0 79 b x I 22m h
3. Beds 1.98m lx 091m w
4. Mosquito Curtain
V General
I. Steel Trays Size P 40 x 0 27 0 10 M at top and
0 38m x 0 25m at bottom using 24G
2 Steel Dust Bin size 27 94 cms sqare at top and
2O.32cms square at bottom with a height of
30.48 cms
3. News Paper Stand
4. Steel Almirah Size I 83m 0 915m x D O 48m
glass doors fitted with four shelves making 5
compartments
5. Steel AlmirahSize 1.83m 0 915m x D O 48m
fitted with four shelves making
6. Folding Chair Steel
7. MSH Type Continuous arm chair
VI Lecture Hall
1. Black Board Size 152.4 x 91.44 x 76 cm
2. Teak Wood Office Table
Size 152.4 x 91.44 x 76 cm
3. Teak Wood Office Chairs with arm
4. Teak Wood Chair with writing pad on right hand
side
*
30
125
(b) Furniture Required for HFWTC Ramanagaram
Item
1 Steel Officers Table
I 83m I x 09|m wx 0 76m h
2 Executive Revolving Chair
with full high back with head rest
3 Steel Almirah
Size 1 83m 0 915m x D O 48m
fitted with four shelves making
4 Steel Cot
I 90m I x 0 78m w x 0 (>0m h l4Gg
5 Mosquito Curtain Pole
I 90 I x 0 79 b x I 22m h
6 “S" Type continuous arm chair
7 “S’* Type continuous arm chair with full
cushion
8 Steel Almirah Size
I 83m 0 915m x D O 48 glass doors
fitted with four shelves making
5 compartments
9 Steel Table with Laminated Top
10 "S’* Type Chair without arms
Qty
Rate
Amount Rs
2
3.6Q9
7.398
2
3.696
7.392
6
3712
22.272
20
1.650
33.000
20
236
4.720
30
15
600
750
18.000
11.250
3
4.290
12.870
10
1.925
476
Total
KST @ 4%
19.250
5.712
1.50.165
i otal with Tax
1.56.171
12
6.006
(c) Equipment Requirement for HFWTC Mysore and Ramanagaram
Each of the HFWTCs at Ramanagaram and Mysore will be provided with the
following equipment.
1. T V and VCR
2. Overhead Projector with Screen and accessories
3.35 mm Slide Projector with accessories
4. PC for presentations
Total
Rs. 32,000
Rs 8,640
Rs. 16,200
Rs. 18,000
74,840
«■
126
Annexure 17
I urniturc and Equipment for SIHFW
Furniture Required for SIHFW
Qty
Rate
Amount Rs
1 Steel Officers Table I 81m I x 0 91m wx 0 76m h
2 Executive Revolving Chair with full high back
i
i
3.699
3.696
3.699
3.696
with head mt
1 "S" Type continuous arm chair with full cushion
6
750
945
4.290
4.500
945
4.290
1.712
7.424
Total
24.554
Total with Tax
25.5 Io
Item
Sr Staff (per member i
4 Steel Telephone Stand
5 Steel Almirah Size I 83m 0 9|5m x DO 48m
glass doors fitted with four shelves making 5
I
I
compartments
c» Steel Almirah Size I 81m 0 91 5m x D O 48m
fitted with four shelves making
Jr Staff (per member)
1 Superintendent Table
2 Executive Revolving Chair with cane seat
btK’k
I "S" Type continuous arm chair with full cushion
4 Steel Almirah Size I 81m 0 915m x DO 48m
£lass doors fitted with four shelves making 5
compartments
5 Steel Almirah Size I 81m 0 915m x D O 48m
fitted with four shelves making
i
I.0K0
I
3.080
I.6R0
750
4.290
1.500
4.290
I
1.712
1.712
T otal
14.262
Total with Tax
14.812
i
i
*
1.6K0
Equipment
SIHFW will be provided with video projector costing Rs. 200,000.
1
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Position: 2604 (2 views)