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extracted text: Reproductive and Child Health

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Sub-Project Proposal
Bellarv District

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Department of Health and Family Welfare Services
Government of Karnataka
Bangalore, November 1996

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CONTENTS
CHAPTER

>

3
3
4

Profile of Bellary District
Socio-Economic & Demographic Characteristics
Health Infrastructure
Budget for Primary' Health Care
Health System Staff
Performance Indicators of FP Sl MCH
Selection of the Distnct
Policv Commitment bv the State

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8
10
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3.

Gaps in the Health Care Delivery & Utilisation

11

4.

On-going Externally Aided Projects in Bellary District
India Population Project IX(K)
KFW (German Project)

13
16

Ability of the district to implement the Sub-project

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Objective & Scope of the Project
Logical Frame Analysis (LFA)

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19

2.1
•> ?

2.3
2.4
2.5
2.6

4.1
4.2

5.
6.

6.1

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PAGE NO.

Background

1.

-

TITLE

7.

Output Indicators : Desired Achievements
.Anticipated Values of Indicators
7.1
Impact Indicators
7.1.1
^^ority Groups and Beneficiaries
7.2

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26
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8.

Activities of the Project
Strengthen delivery’ of Services
8.1
Civil Works
8.1.1
Equipment
8.1.2
Furniture
8.1.3
8.1.4
Vehicles
Communication Facility'
8.1.5
Incremental Staff
8.1.6
Improving Quality of Services
8.2
Training
8.2.1
8.2.2
Drugs
8.3
EEC
8.4
Community Participation

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29
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31
32
35
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36
36
36
39
40
42

CHAPTER

TITLE

Project Management
Organisation Structure
9.1
Staff Deployment
9.2
Civil Works and Procurement
9.3
Financial Management
9.4
Organisation Chart
Project Monitoring
9.5
Action Plan for One Year
9.6
Project Cost
10
Sustainability
11

9.

59

Annexe-11
Form A - Health Facilities (New Construction Works)

67

Annexe - IV

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44
44
45
45
45
46
47
53
55

Annexe-1
Form A - Health Facilities (New Construction Works)

z\nnexe - III
Form C - Health Facilities
(Expansion and or Renovation of Existing
Facilities and Miscellaneous Repair)

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PAGE NO.

74

From A - Health Facilities (New Construction Works)

80

Annexe - V
List of Drugs for RTL'STl

85

Annexe - VI
List of Private Hospitals in Bellary District

86

Annexe - VII
List of Voluntary Organizations

88

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SUB-PROJECT PROPOSAL
ON
REPRODUCTIVE AND CHILD HEALTH (RCH)
BELLARY DISTRICT
1. BACKGROUND

The Ministry of Health and Family Welfare. (MoHFW) Government of
India, planning to develop and launch Reproductive and Child Health
Project with financial assistance from the World Bank which will replace the
CSSM and Family Planning interventions. The MoHFW has requested the
State Governments to prepare model family welfare and health care project
proposal for one district keeping in view the guidelines provided by it.
The objective of the proposed RCH project is to implement recent policy
decisions for improving the quality and coverage of the family welfare
proaramme and for providing reproductive and child health services. The
main features of the Project are:

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Perceving the client’s needs, oroviding user-friendly services
and enabling clients to mak^, xii ?rmed choices.

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Improving access to essential package of health sen ices which address
the needs of women and men tV-nughout the reproductive cycle.
Integration of field level functionaries and workers and involving
private medical practioners and voluntary' organisations.

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The package of services proposed fall under two broad heads.—
Reproductive health and child survival. The elements covered under
each head are as listed i »w.

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REPRODUCTIVE HEALTH:
*

Promotion of responsible and health} sexual behaviour

♦

Interx'entions to promote safe motherhood

♦

Prevention of unwanted pregnancies

*

Provision of services for safe abortion

♦

Provision of pregnancy and deliver} services

*

Management of reproductive tract infections (RTFs) and sexually
transmitted diseases (STD's)

*

Establishment of effective referral facilities for pregnant women at risk.

CHILD SURVIVAL:
*

Prevention of vaccine preventable diseases

*

Provision of essential new bom care

*

Integrated management of sick child

♦

Promoting maternal and child nutrition and providing micronutrients

♦

Integration with Anganwadi workers 1CDS programme and other
programmes of Department of Women and Child

Bellary district has been chosen as the project district on the basis oi the guicKxmes to
selection of distirct for the sub-project provided by MoHFW.

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2.

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PROFILE OF BELLARY DISTRICT:

Bellary district lies in the central region of the eastern sector of the state
between 14° 35’ and 15 ° 50' North latitude and 75 ° 40’ and 77 0 1 1 east
longitude and is bounded by Raichur district in the north. Dharwar district
in the west Chitradurga district in the south ot Karnataka state and in the
east by Kumool and Anantapur districts of Andhra Pradesh. 1 he district is
one of the five backward districts of the State. Table 2.1 provides a
compansion of socio-economic and demographic characteristics ot Bellary
district with those of the State. Bellary district is being covered under
secondary' level health care project (German assistance) and also IPP-1X as
it did not benefit under IPP-I or IPP-1II. (Refer item 4).'

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2.1. Socio-economic and Demographic Characteristics

Bellary district is below the state average on almost all demographic
and socioeconomic characteristics. The popultation density is halt that ot
the State, has 28.1 percent SC/ST population as compared to 20.7 percent in
the State, low female literacy, early marriage and consequently higher
number of women in the reproductive age group, lower couple protection
rate, high birth rate and infant mortality as compared to the State average.

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Table 2 .1 Socio-Economic and Demographic Characten sties of
Bellarv Distnct & State

______ District________
I

_____

Period
1991

Persons in million__________
______ 1991
Density per Sq. Km._______
1981-91
______
Annual Compound Growth %
_______ 1991
Females to thousand Males
_______ 1991
Percent Urban____________
___ [_ .1991 __
_ PcrccHt Literate Male
1991
Percent Literate Female_____
1991
Percent SC_______________
-I
1991
Percent ST_______________
T
1981
Mean .Age at Marriage______
I
T
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1981
Married Females Thousand persons
1987
CBR________________________

1987
1995
_L993_
1991-92

IMR________________________

CPR________________________
CBR________________________
GDP Rs.

Bellary
1.890
16.0
I
2.41
| 957.0 ~
29.9
59.3
32.5
! 19.3
~~ 8.8
i 18.1
. 170.8
! 33.4
92.0
46.9

;

29.2
5.293

i Karnataka
44.977
j 235.0
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1.93
I

960.0

30.9
67.3
44.3 ____
__

4.3
19.2 ____
1 161.9
28.0
81.0
54^_____
25.5
5.898

22 Health Infrastructure:

HEALTH INSTITUTIONS:
♦

There are 260 subcentres. 60 primary health centres and 7 community
health centres in the district apart from 24 primary health units.

♦

There are 3 postpartum centres including one A type at Medical College
Hospital.

♦

There are 10 centres providing MTP services.

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Table 2.2 presents the information on health infrastructure in Bellary
District vis-a-vis Karnataka State. It will be observed that Bellary’ district
has fewer doctors as well as fewer hospitals beds as compared to the State
average. Further, majority of the doctors and hospital beds in the private
sector are concentrated in Bellary and Hospet towns. The primary health
care institutions in the government sector when standardised for population
size., are fewer in Bellary’ district as compared to the state average. Further
because of low population density, the area covered by a sub-centre is 39 sq.
km while that for the State is 23 sq. km., that by a PHC is 164.8 sq. km. as
against 131.7 sq. km. for the state.

Table 2.2 Health Infrastructure in Bellaiy District vis-a-vis Karnataka State.

______ Infrastructure Type______________
I Doctors per thousand persons___________
Doctors per thousand persons (Govt, sector)
Doctors per thousand persons (Pvt, sector)
Hospital beds per thousand persons_______
Hospital beds per thousand persons (Govt)
Hospital beds per thousand persons (Pvt.)
Population per sub-centres______________
Population per PHC___________________
Population per cHC__________________
Sq. km. covered by sub-centre___________
Sq. km. covered by PHC_______________
Sq. km. covered by CHC

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Bellary

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0.21
0.08
0.13
0.968
0.606
0.362
7,470
31,500
270,000'
39.1
164.8
1412.1

Karnataka
0.30
0.07
0.23
1.428
0.586
0.842
5,557
29.805
193,866
23.7
131.7
826.6

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2.3 Budget for Primary Health Care:

The budget of Bellary Zilla Panchayat for primary health care has
increased by 66 percent between 1992-93 to 1996-97. The per capita
expenditure has increased by 51 percent during the same period.

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Table 2.4 Staff position- Sanctioned and Deployed

SI. No.
1.
2.

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~T
4.
5.
6.
7.
8.

9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.

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Designation

Sanctioned

Lady Medical Officers
21
97
Health Officer
(Junior) Class I._____
Deputy Surgeons____
2
12
Physician Cl. Ill_____
4
Assistant Deputy Surgeons
9
Senior Pharmacists_______
33
Block Health Educator
45
Health Assistants Senior
(Male)_________________
Health Assistants Junior 279
(Male)_________________
Health Assistants Senior
52
''Female)_______________
Health Assistants Junior 389
(Female)_______________
59
Paramedical Workers_____
68
Junior Pharmacists_______
8
Senior Lab.Technicians
Junior Lab. Technicians
69
7
X-ray Technicians________
Opthalmic Assistants_____
18
5
Physiotherapists_________
4C'
StaffNurses____________
Drivers
48

7

° oage in
position
76
77

Working

Vacant

16
75

5
22

1
6
13
33

1
7
4
3
20
12

144

135

52

40

12

77

334

55

86

31
46
3
16
5
12
3
16
38

28
22
5
53
2
6
2
22
10

52
68
38
23
71
67
60
40
79

5

50
41

,

66
39
73

4---------

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2.5 Performance Indicators of MCI! <& FW Activities:
It will be observed from Table 2.5 that in 1995-96. the Bellary
district is well below the State average in respect of all perfonnance
indicators of MCH & FW component. The institutional deliveries
account for around 25 percent of all deliveries in the district as
compared to 40 percent in the State. Infant and maternal mortality
are also higher in Bellary district as compared to the State average.
The couple protection rate is 47 percent as against 55 percent for the
State. Immunisation rates for children and pregnant women are
lower in the district as compared to the State averages. The
relatively poor health facilities in Bellary district as compared to the
State average and the higher percent of vacant posts among medical
and paramedical staff are contributory' factors for the poor
performance of the district.

A multi-indicator cluster survey conducted in 1995-96 revealed
that among pregnant women
ANC check up was conducted for 64.5 pcivcnt
*

TT coverage was 75.7 percent.

*

IFA was received by 79.9 percent but consumed by 74.5
percent.

*

The age at first pregnancy was less than 20 years in 84.2
percent of the cases, and

* 10 Percent of children received breast milk within one hour of
birth.

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Table 2.5 Indicators of MCH & FW Activity 1995-96

Bellary
____ Characteristic______________
gg.'T
.Ante-natal registration as °o of target______
82.8
, TT coverage of pregnant women_________
24.3
i Deliveries per thousand population
23.6
Percent Institutional deliveries___________
76.4
, Percent Domiciliary deliveries___________
28.9
___ by Health .Assistant Female______
33.1
_______by Tramed Dais_____________ _
14.4
i_______ by Untrained Dais_____________
22.7
| Ratio of infant deaths to thousand live births
1.6
i Ratio of maternal deaths to thousand births
46.9
Fcpr
6.0
i IUD component of CPR 0/q____________
67.0
FP users with 3^ children %___________
60.0
Sterilisation: percent to target___________
62.3
IUD insertion: percent to target__________
76.8
Fully immunised %__________________
83.0
Immunisation : DPT_________________
I
: i-olio_________________
83.0
96.1
Ii------------------------ -—--------------------------------------------------------------: BCG
76.8
: Measles

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Karnataka
94.2

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99.6

20.1
40.6
59.4
29.7
23.1
6.6

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14.5
T
1.0
i
54.8
7.0
52.4
84.8
92.7
92.9
98.8
___ 99.0
105.4
92.9

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2.6 Selection of the District:
In light of the foregoing, Bellary district satisfies the following criteria for
selecting it for Sub-project on Reproductive and Child Health:

1. IMR is higher than the State average.
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Crude birth rate is higher than State average.

3. Percent of SC/ST population is higher than State average
4. Last rank among districts in fully immunized status of children.

5. Couple protection rate is lower than State average.
6. Percent of institutional deliveries is less than State average.

7.

FP users with 3 children and over is 67% as compared to 52% for the
state.

8. Practice of spacing methods is less than State average.
9. Female lietracy rate is below State average.

2. 7 Policy Commitment by the State:
1. 86% of the sanctioned ANMs of the Sub-centres are in position in
Bellary District. The remaining vacant posts will be filled up by 1997
since the ban on recuritment has been lifted.

2. Budget provision towards drugs for FRUs, PHCs and Sub-centres
has been enhanced and would be maintained throughout the life of the
project.

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3. Essential services for emergency obstetric care will be provided at all
FRUs in the district without any disruption of continuity as there are
adequate specialists in the district.
4. Key positions of Lady Medical Officer, Staff Nurse, Anaesthetist,
Drivers and Lab. Technicians will be hired on contract basis to
provide the services.

5. State has discontinued motivator fee for FP methods.
6. Stale has decided to cut down the compensation amount for surgical
contraception, considerably enhancing the provision for drugs.

1

Both at the State and District level, monitoring of the contraceptive
acceptor achievements based on targets has been stopped in view of
implementing Target Free Approach under FW programme in the
entire state.

8. Not only the present level (1996-97) of budget provision towards
primary health care; RCH related activities will be maintained but also
the outlay will be enhanced to the extent of 10-15% in successive
years.

3. GAPS IN THE HEALTH CARE SERVICE DELIVERY
AND UTILIZATION:

From the Preceeding sections it is evident that the major gaps in the
delivery and utilisation of health care services in Bellary district are:

1

Access to government run health care services in general and
Reproductive ahd Child Health care services in particular is poor due
to low population density and insufficient number of health centres.

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2. Absence of properly equipped institutions in the private sector
providing RCH services (excepting in Bellary and Hospet towns).
3. Shortage of medical and paramedical staff.

4. Limitation on movement due to large area to cover and lack of
transport.
5. Low awareness and lack of community participation.
6. Inadequate referral facilities.

7. Lack of convergence of services provided by Health, Women and
Child and Education Departments.

8. Non-availability of reliable data on reproductive health, RTIs and
STIs.

4. ONGOING EXTERNALL Y AIDED PROJECTS IN
BELLARY DISTRICT:

The Child Survival and Safe Motherhood Programme is under
implementation in the district. The training under this component was
completed during 1994-95.
Apart from this, IPP-IX (K)Project is under implementation in the
district. KfW (German), project is also being sanctioned to improve the
secondary level hospitals in the district.

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4.1 India population project- IX (K):
The project launched in 1994 has components such as Civil Works,
Renovation of the existing buildings, strengthening service delivery.
Training, IEC and monitoring and evaluation. These activities are under
implementation in Bellary district.

4.1.1

Civil Works:

The fresh civil works include Construction of Sub-centres, Residential
quarters for Medical Ofiicers of PHCs, Building for Primary Health Centres
and District Training Centres. Civil works are indicated below:
Sl.No.

Item

1.

Sub-centres

47

2.

Residential quarters for
Medical Officers of PHCs

15

3.

PHC Building

7

4.

District Training Centres

1

No. Of Units

Apart from these, renovation involving:

* Repairs to walls and roof to prevent seepage of water
*

Repairs to flooring

*

Repairs to ro:lets & sanitary lines

*

Replacement of defective electrical wiring and fittings

*

Provision of safe water supply

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*

will be taken up for One building of ANM training School, 91 Sub-centres,
16 PHCs and 2 Community health centres. None of the above said civil
works will be covered under the present RCH project.
4.1.2

Furniture and Equipment:

Furniture and equipment is being provided under IPP-IX to 240 sub
centres existing as on 31.3.93. The 13 sub-centres set-up subsequently have
to be provided with furniture and equipment. No provision has been made
under IPP-IX for replacing defective equipment for the existing PHCs or
furnishing and equipping fifteen newly created PHCs.

4.1.3

Training:

Training is planned for all Medical officers and paramedical staff.
While the Medical officers. Block Health Educators and Senior Health
assistants will be trained at HFWTCs, the Junior Health assistants will be
trained at the District Training Centre to be established at Bellary. The
Training Programme is aimed at

1. Updating knowledge, skills and practices of all health functionaries
for effective delivery of Health FW and MCH services.

2. Developing communication skills to effectively carry out 1EC
activity in the community.
3. Making health functionaries aware of their job responsibilities as
providers of primary health care in general and RCH services in
particular.

4. Maintaining iformation on performance at their level aix
providing feed back and
5. 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.

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4.1.4

IEC Activity:

The IPP-IX Project also envisages strengthening of IEC activity.

In order to have maximum impact of IEC activity it is proposed to
concentrate on interpersonal communication and supplement it with audio
visual media. The audio-visual programmes would be dovetailed with
entertainment programmes to attract maximum audience. As an integral
part of the programme, audio-visual campaigns will be networked with
interpersonal communication programme to achieve maximum impact. 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. Inter personal communication kit consisting of items
such as flash cards, flip charts, slide viewer, and other educational aids will
be made available to each ANM to assist her in interpersonal
communication. Audio- visual films will be produced and exhibited in
villages through Audio-visual vans.
4.1.5 Community Participation:

Community participation will be ensured through setting up of Health
Advisory Conunittee at each Sub-centre. The members will be drawn from
the villages covered by the Sub-centre. The MO of the PHC will be the
Chairman of the Committee and will have the paramedical staff servicing the
sub-centre also as membres. The 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 HAC committee will identify in each
village a woman who is willing to vlounteer to act as a link between the
families in the village and the sub-centre. In larger villages more than one
volunteer will 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. The volunteers will

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* Motivate couples to adopt appropriate contraceptive methods and refer
acceptors to ANM,
*

Educate all pregnant women on antenatal care and refer to ANM,

*

Promote child care programme and arrange for immunisation, and

*

Co-ordinate with ANM for arranging health education sessions in the
villages.

4.2 KfW (German project):

Secondary level hospitals will be upgraded, financed by grant from
KfW Germany. This is applicable to all the Districts of Gulbarga division of
which Bellary is also included. There will be addition of 208 beds under
this project. 5 Taluka hospitals, 2 Community health centres will be
upgraded to 50 beds capacity. In addition, 2 Community health centres will
be upgraded to 30 beds capacity. 2 Blood banks are also being proposed.
Each hospital will be provided with equipment for waste management.
Equipment Maintenance Unit will be Established at the District Hospital at
Bellary to maintain hospital plant and equipment of all district and sub
districts hospitals . The world Bank will as part of State Health Systems
Development Project will fund for introducing MIS in each hospitals and for
upgrading of clinical skills of Medical and Nursing Staff. Camps will be
conducted to provide annual health Check up for SC/ST population and
provide treatment for those who are in need.
While planning for each of the above activities, under RCH project,
the programmes planned for Bellary district under IPP-IX, State Health
Systems Development Project-II funded by the World Bank and the
upgrading Secondary Level Hospital Facilities Project funded by KfW have
been taken into account so that duplication is avoided.

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5. ABILITY OF THE DISTRICT TO IMPLEMENT THE
SUB-PROJECT:
5.1 Decentralisation:

Karnataka has introduced the Panchayat Raj System as early as 1987.
The Zilla Panchayats are experienced in planning and implementation of
developmental projects. Provision of primary health care and management
of hospitals with bed strength below 100 beds is one of the responsibilities
assigned to the zilla Panchayats. Apart from passing on the grants received
from the centre for centrally sponsored schemes, the Government of
Karnataka gives lump sum grants to Zilla Panchayats for meeting the
projected expenditure.
The District Health & Family Welfare Officer is in-charge of primary
health care institutions in the district. He has under him District Family
Planning Officer to look after Family Planning programme and District
MCH officer to look after Mother and Child Health Programme in the
district. There are also programme officers for control of specific diseases.
The Medical officers of PHCs have hitherto been directly reporting to the
DHO. As the DHO is overburdened, the Government of Karnataka has
created the post of Taluka Medical Officer to look after all primary health
care institutions in the Taluka and monitor the implementation of Centrally
sponspored schemes. In order to imporve his mobility, each Taluka Medical
Officer is being provided with a vehicle under the State Health Systems
Development Project. This strengthening of the management set up in the
district will be of use in implementing the RCH project in Bellary district.

5.2 Filling up of Vacant Posts:

The State Government has lifted the ban on recruitment and the
roster (based on reservation for different castes) has been prepared and steps
have been initiated at the State level to recruit personnel to fill up vacancies
in all categories. It is expected that by the end of 1997 all vacancies would
be filled up.

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5.3 Private Sector and Voluntary Organisations:

There are 67 nursing homes/hospitals in Bellary district. Of these
two-thirds offer Family Planning and MCH services.
There are 108 voluntary organisations operating in Bellary district.
There is also an active branch of FPAI and a Leading Organisation for
Rural Development (LORD).
The Indian Medical Association is also interested in involving its
members in service delivery.

5.4 Community participation:
The promotion of Sub-centre Health Advisory Committee under IPP-IX
will create a platform for community participation in helath programmes.
The SHACs and the voluntary workers enrolled by them will be of use in
launching RCH activities in Bellary district.

5.5 Voluntary Workers.
As part of IPP-IX, Trained Birth Attendants and Anganwadi workers
are proposed to be enrolled as voluntary workers at the village level. These
workers will act as a link between the Sub-centre ANM and the target
population in the village to promote contraception and mother and child
health programmes. This group would also be used for promoting activities.

6. OBJECTIVES AND SCOPE OF THE SUB-PROJECT:

The objective of the RCH Sub-project is to implement the recent
policy decisions for improving the quality and coverage of the Family
Welfare Programme and for providing Reproductive and Child Health
Services as a replacement to CSSM programme. The project will provide
for 100 percent coverage of mother and child health, screening facilities for
elements under RCH interventions and improving the utilisation of spacing
methods for preventing pregnancy. The main objectives of the project are:

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Improve the capacity and efficiency of the health care delivery system
to address the felt needs of the community.

Create awareness and generate demand for quality' health care services.

Increase male participation.
Improve access to essential package of RCH sendees which address the
needs of women throughout the reproductive life cycle and providing
user friendly services.

Improve identification, management and/or referral of high nsk
pregnancies neonatal emergencies and detection and treatment of
reproductive disorders.

* Integrate the activities of field level functionaries of various Government
Departments and private medical practitioners and non-governmental
organisations.
Obtain baseline data regarding the magnitude of Reproductive Health
problems in the community including RTIs and STDs

6.1 Logical Frame Analysis (LFA):
For effective monitoring of the project, LFA is very essential. The LFA
besides providing nanative summary under inputs, output , outcome and
impact indicators, also provides the performance indicators, source of
information, year 1 (one) bench-mark and also risks under each such as
inputs, output, outcome and impact.

The LFA give a clarity of the contents of the project and put them in
realistic terms for implementation. It is proposed to draw such LFA for very
important interventions.
The LFA for child survival, sate motherhood. Reproductive Health and
RTIs & STIs is shown in Tables.

19

LOGICAL FRAME ANALYSIS FOR SAFE MOTHERHOOD AND REPRODUCTIVE HEALTH

Year I Bench Mark
4

Risks
5

Narrative Summary
I
IMPA Cl':

Performance ImEcators
2

Source of Information
J

* Reduction in maternal
mortality and morbidity

* Maternal mortality rate
* Crude Birth rate
* Couple protection rate

* Hospital data
* Service Statistics
* Indirect estimates

I'o be assessed in first year
and future years

I lospital data service
statistics do not reflect the
real situation

* Coverage rates of
ANCs, PNCs.
* Deliver) by trained
personnel
* Male & Female
contraception
* Referral of emergecy
obstetric cases R 1 Is &
STIs.

* Rapid assessment.

Referral System lor
emergency obstetric care

Not made lulls functional

♦ Reduction in unwanted
pregnacies

OUTCOME

* Improved quality & access
to essential RCH services.
* Increase in male
involvement
♦ Improved referral of
emergency obstetric cases

*

Report of PI ICTRI Is

* Technical assessment

20

Off IFF I :
lnc[Cd>j u>c »»l MGII
Services

Increase in the
institutional
deliveries.
♦ Increase in safe abortions
♦ Increase in male &
female contraception
♦ Increase in refenal of
FRl’s

♦ Complicated deliveries
conducted at refenal
centres

♦ Pciiorniance reports of
the service deliver}
points

* Improving trends in the
output indicators

* Actixity report

* Beneficiaries provided
with RCH services

I\Pl IS
* Institutional engthening
* 1 raining & II C
* Supply of drugs &
equipments
* Establishment of refenal
system

* Slafl in position
* Equipments provided
* Functioning status

* Te hnical assessment of
t! . referral cases
* Facility suivcv

21

* Atlcast 3 FRUs services
available
* 20°o of the institutions
strengthened

Not met the full
requirements as per norms

LOGICAL FRAME ANALYSIS - CHILD SURVIVAL

Performance Indicators
2

Source of Information
3

Year 1 Bench Mark
4

Reduction in perinatal &

Perinatal mortality' rates

Sample surveys

To be assessed in first and
future years

neonatal mortality rales.

Neonatal mortality rates

Service reports

Coverage rate for new bom
care, ORT appropriate,
management of ARI and
full immunization.

PMC/FRU reports
Registers

Narrative Summary
1

Risks
5

IMPACT:

Survey may not be possible
Service reports only
tentative data

OUTCOME:
I ligher proportion of
beneficiaries using services
and referral

22

Base-line survey

Institution not made fully
functional

1

•'/

2

3

4

5

OUTPUT:

* Increase in coverage of
new born care

* Increase in the No. of
beneficiaries

* Performance reports
(MIS)
* SC PIKM RU
reports registers

* Increased trend in output
indicators

* Repoiling not complete in
time and tentative
* coverage gaps

* Staff in position
* Service facilities fully
made functional

* fechnical assessment
* Facility Survey

* Service facility available
in 20°o of the Project

* Existing inputs in position
is inadequate.

* Use of OR E appropriate
management of

* Increase of immunization

INPUT:

♦ Institutional strengthening
* d raining & IEC
* Supply of equipments,
drugs, repoiling formats
♦ Establishment of referral
System

District.

23

LOGICAL FRAME ANALYSIS RTIs & STIs
Narrative Summary

I

Performance Indicators
2

Year 1 Bench Mark

Source of Information

3

4

Risks
5

IMPACT:

* Reduction in the
prevalance of
RTIs & STIs

* Percent of women
having reproductive
tract infection and
sexual transmitted
infection.

Special studies

Impact to be assessed
first year

No funds

* Coverage rates of
adolescents and
married couples
* Percent of ref erral
* Community
satisfaction

Service reports of
subcentiles, PHCs,
CI ICs. and FRUs.

Referral system is
place in 2 FRl

* Late arrival of
the quipments
* l^tc start of the
training
programme
* Drug supply did
not made in time

OUTCOME (KAT)

* Increase in the
accessibility and
quality of services.

24

Oi rPl I:

* Increase in the use of
services by adolescent
girls, tnanied couples

+ Cure rate

* Performance reports

from PHCs. FRUs
* Beneficiaries provided

* All the subcentres and
PI ICs show improvement
over the year

with counselling, service
* Referral s\ stern

* Referral system

INPVTS:

* Surveys
* Training of ANMs
* Sensitization of
women
organization (MSS)

♦ f illing up the ANM posts
♦ Providing basic
instruments
♦ No. Trained in syndrome
approach

* Technical assessment of
the service points and
evaluation KAI’ of the
official

* Supply' of drugs
* Placement of referral
system

25

* 100°o ANMs trained
l()0°o MSS sensitized
100% referral services
available at FRUs for R1 Is
and STIs

* Key trainers for ANM
training inadequate

H

7 OUTPUT INDICATORS; DESIRED ACHIEVEMENTS^

The aim is to achieve improvement in performance over the project
period as reflected by selected indicators for monitoring progress. The
indicators and the level to be attained are presented in Table 7.1
Table 7.1 Anticipated Values of Indicators for Monitoring Progress
SI.
no.
1.
->

3.
4.
5
6.

7.

8.
9.
10.
11.
12.
13.

14.

Indicator

1997

1998

1999

2000

2001

90

92

94

96

100

90

92

94

95

98

100

60

65

70

75

85

100

24
76
6.0

28
80
6.5

30
82
7.0

35
85
8.0

40
95
9.0

50
100
10.0

33

40

45

50

55

60

10

20

30

35

40

5u

50
10
0
5

60
25
50
25

70
35
70
30

75
45
100
40

80
55
100
50

90
75
100
75

5

25

50

60

75

100

0

5

10

15

30

50

Baseline
1996
88
women

Percent of pregnant
registered
women
percent of pregnant
receiving two doses of TT
women
Percent of pregnant
receiving IF A
Percent of institutional deliveries
Immunisation of infants
Percent of IUD acceptors in
contraceptive mix
Couples having two or less children
practising contraception
Number of institutions oiiering
MTP services
ORT use rate
Percent of new bom weighed
Percent of health providers trained
Percent of males and females
reached with key messages
Percent of ANIvls diagnosing and
treating .ARI
Percent reduction in prevalence of
RTI

26

u
7.1.1. Impact Indicators *
The impact of the Sub-Project will be assessed by the following
indicators 1. Crude Birth Rate.
2. Crude Death Rate.
3. Infant mortality.

4. Maternal mortality.

5. Percent of pregnant women who are anemic.
6. Unmet need for FP.

7. Percent of infants with low birth weight.
8. Incidence of vaccine preventable diseases.
9. Incidence of HIV/STD.
* Data will be obtained from Baseline survey, midline survey, and endline
survey.

7.2 Priority Groups & Beneficiaries:

The implementation of the project will benefit nearly 1.9 million
population, particularly a large number of poor and under previleged people
in the district who have been deprived of services due to poor access and
availability of the facilities.

27

u
Table 7.2.1 Beneficiaries in Sub-Project District Bellary

Beneficiaries
Total eligible couples (15-44 years)
Total Adolescents
Pregnant Women
Total Children below 5 years
Total infants
Scheduled Caste population
Scheduled Tribe population
Eligible couples to be protected

SI. No.
1.
2.
3.
4.
5.
6.
7.
8.

As of 1991 in million
Bellary
0.32
0.40
0.06
0.24
0.06
0.36
0.17
0.17

8. ACTIVITIES OF THE PROJECT:
The activities planned to be taken up under the project are.
♦

Improve infrastructure facilities in terms of buildings, staffing,
equipment, drugs and supplies.

Improve the quality and efficiency of reproductive and child health
care delivery system.
Generate demand reproductive and child health care services.
♦

Involve the community and non-govemment organisations in
generating demand for as well as delivery of reproductive and child
health care services.

*

Carry out baseline survey to assess the prevalence of infant, child
and maternal mortality and incidence of RTls and STDs in the
district.

28

u
8.1 Strengthen Delivery' of Sendees:
Since the RCH programme calls for multi-directional approach to the
existing Rural Health Care delivery network in order to strengthen the
svstem. Priority will be given to proposals addressing weaker areas in the
delivery of services and gaps in service provision rather than to expansion
per-se.

A large number of Health Institutions such as Sub-centres, Primary
Health Centres and Primary Health Units do not have buildings, equipments
and other infiastructure essential for the delivery of services. It is proposed
to remedy the situation by providing buildings, furniture and equipment for
the health centres not covered under externally aided or state funded
projects.
Programme interventions requiring strengthening of existing physical
facilities provision are as follows:

- Vasectomy at PHC levels
- Diagnosis of eclampsia, malaria, TB, diabetes etc. at SC level
- Treatment of children's infections at PHC level
- Syphilis serology testing capability at PHC level
- MTP services at FRU and PHC level
- Treatment of high risk pregnancies and cesarean sections at FRU

8.1.1 Civil Works:

A survey conducted by the DH & FW officer in Septemoer 1996
revealed that 180 out of 260 Sub-centres in the district do not have any
buildings. 26 are at the head quarter town/village of PHCs and PHUs and
the remaining 154 are in other villages. It is propsed to construct 76 sub
centres with clinic cum residential accomodation for ANMs at a cost of
RS.3.83 lakh per centre. The type design for sub-centres developed under
IPP-IX and approved by the World Bank will be adopted. The sites have to
be acquired but no difficulty' is envisaged. See Annexe filled in for sub
centres.

29

1

Out of 60 PHCs, 30 centres are housed in own buildings and
buildings-are under consturction for 20 centres leaving 10 centres without
own buildings. New buildings will be constructed for 10 PHCs which do
not have own buildings. Each PHC will have 6 beded ward apart from other
facilities. The cost of each building is estimated at Rs. 17,11.840. The type
designed developed under IPP-IX and approved by the World Bank will be
for these have been aquired. See Annexe tilled in tor
adopted. The
— sites
-

PHCs.
In the erstwhile princely state of MysoreiKarnataka) large no. of
curative centred institutions by name Primary Health Units(PHUs) were
sanctioned. Each Primary Health Unit was expected to sen-e a population of
about 20.000 staffed with One doctor, One ANM, One Pharmacist, One
clerk cum typist and One to Two Class-D employees. These units were
meeting the ’felt needs’ of the rural population and hence they were verypopular. In view of bringing uniformity in the 3 tier health infrastructure
under MNP. these PHUs have been easily up-graded into PHCs based on the
population norms of the taluk/district. Wherever the requirement of PHCs
is met with, other PHUs are still being continued as before and these popular
institutions at present lack any facilities for Institutional deliveries
including emergency obstetric care. Accordingly there are still 24 PHUs in
Bellary district and 8 of them in Bellary town itself. Staff employed in these
institutions are adequate to provide institution based services such as
Deliveries, Surgical sterilization of FP acceptors and essential RCH services.
; To provide round the clock services in these institutions also contractual
services of Lady Medical Officers, Lab. technicians and Staff nurses will be
! utilized.

Eleven PHUs will be expanded by provision of OT, Labour room and
6 bed ward. The cost of expansion of each unit is estimated at Rs.
11,07,800. See Annexe (Expansion and or Renovation of Existing Facilities
and Miscellaneous Repair) filled in for PHCs.
In view of great demand for delivery’ services, essential RCH services
including promotion of FP methods and adequacy of the staff, four of the
PHUs in Bellary town will be upgraded to the level of FRUs with addition ot
10 beds. Civil works for the upgradation of PHU into FRU is estimated at
Rs.27,98.800 See Annexe filled in for PHCs which have to be proposed to
be upgraded as FRUs.

30

The total cost of civil works is presented in Table 8.1.1.1
Quantity

ITEM

76
10
11

Sub-centres New Buildings
[
PHCs New Buildings
_______ [
Expansion of PHUs to provide RCH |
services___________________________ i
Upgradadon of PHU as Maternity I

4

Homes
Total

Cost/Unit
i Rs.
! 3.83,280
! 17,11,040
’ 11,07,800

.Amount
Million Rs.
j
29.129
17.110
12.180

' 27,98.800

11.195

I

69.620

I

It is proposed to award contracts for civil works valued at nearly Rs.
35 million during the first year as the type designs and model bid documents
are approved under IPP-IX and the same will be used under the Sub-project.
The works will be completed during the second year.

Table 8.1.1.2 Value of Contracts for Civil Works
to be Awarded in the First Year
ITEM

! Quantity

£

Construction of new Sub-centres
Construction of new PHCs__________
Expansion of PHUs for RCH services
L’pgradation of urban PHUs as Maternity ,
Homes
Total

5_
5_
4

‘ CosVUnit Rs.

3,83.280
17,11,040
i 11,07,800
’ 27,98,800

‘

.Amount
Million Rs.
1
9.582
8.555
5.539
11.195

i

34.871

8.1.2 Equipment:

a|
Equipment Kits A, B,C and G will be supplied to all 76 sub-centres
W l°r which new buildings are proposed to be consturcted new suo-centres
al while only IUD insertion kit will supplied to all 177 old sub-centres. All
Mj PHCs (60 in number) and eleven PHUs which are proposed for upgradation
® to provide RCH services will supplied with kits D. F, G, H, I and for MTP
fl and screening for STI and RTI. The four PHUs which are proposed to be
fl upgraded to the level of maternity homes with 20 beds will be supplied with
fl Kits D to P and for MTP and screening for STI and RTI.

31

I

I
Table 8.1.2.1 Equipment for Health Centres
® ^Equipment groups/Health Centre

Centres

I Cost'Unit Rs,

B ■"Sub^cen^eT^athnew buildings:
B Kits A.B,C & G __________
B t~~OtherSub»centres: Kit G______

76

7,520

.Amount
Million Rs.
0.572

174
10

965
7,520

0.168
0.075

71

46,840

B r~Kits D,F,G,H,I & J for PHCs &
I
B

■ upgraded PHUs
_
_
Kits D to P and for urban PHUs
converted as Maternity Homes

B Total

1 anc

I

I

_ ______________

4.620

Table 8.1.2.2 Value of Equipment for Health Centres
(Planned to be Procured in the first year)
Equipment groups/Health Centre

Centres

174
10
50

Other Sub-centres: Kit G ____________
"PHU/UFWCs: Kits A,B,C & G________
Kits D,F,G,HJ & J for PHCs & upgraded
PHUs__________________________ _
Total

Cost/Umt
Lakh Rs.
965
7,520
46,840

.Amount Lakh
Rs.________
0.168
1
0.075
2.342

1

2.585

8.1.3 Furniture

a) Sub-centres

The furniture listed below costing Rs. 24,500 is proposed to be
supplied to the 76
v Sub-centre buildings. The total cost is u imated at
Rs. 1.71 million.

32

Table 8.1.3.1 Furniture for New Sub-centre Buildings
Cost Rs.
1,430
200

Item Description__________i Quantity
" 1
Examination table__________________
1___
Foot step ______________________ _
2.
I
1___ _
1 Wash basin with stand______________
J
__
T
i Stool____________________________
4.
J__
| Cot with mattress________________ _
5.
2
I Bench for visitors________________ _
6.
2
Cupboards for equipment and supplies
7. ””
Office table_______________________
8^
1
Side rack_________________________
9.
2
I Chairs__________________________
_J0_
1
! Container for water storage_________
11.
2
I Bucket with lid____________________
12.
T TOTAL

SLNo.

2X3
333

175 n

I

250
2,975
5,000
9,000
3,500
__ 500
1,000
350
120
24,500

I

I

bj New PHC Buildings and Upgraded PHUs
Furniture for labour room and ward will be provided for ten new
PHC buildings and 11 upgraded PHUs each at a cost of Rs. 55,405. The
total cost of furnishing the upgraded PHUs is estimated at Rs. 1.080 million.

Table 8.1.3.2 Furniture for New PHC Buildings & upgraded PHUs
SL_No. ,_________ Item Description
1.
Examination table______
2
Foot step ___________
~3~~~ i Wash basin___________
4.
I Stool
__ 5_
____
' ________
Cot with mattress
___ 6____ [_ Bedside locker
_ 7.
1 Bench for visitors__________________
8.
; Cupboards for equipment and supplies
I TOTAL

33

Quantity
1
1
1
1
6
6
~4

r
I
T

Cost Rs.
1,430
200
175
250
17,850

7,500
10,000
18,000
55,405

“1

-1

II
c) Maternity Homes

The four maternity homes proposed to be set up in Bellary town
will equipped with the equipment listed below at a cost of Rs. 0.666 million.

SI. No.
1.
2.

rzz

4.
5. _
6.

8.
"9.

iL_
14.
15.

_lf
_19.
20.
21.
22.
23.
24.

Cost Rs.
Quantity
Item Description
2
2,800
Examination table __________
" 1,250
1
1 Delivery table
____________
1.200
2
! Foot steps__________________
2,000
4
1 Bedside screen______________
1,000
4
i Revolving stool_____________
3,400
4
; Saline stand________________
1,500
1
Wheel chair________________
2,900
1
Stretcher on trolley _________
300
I
_1
__
Oxygen trolley______________
T
59,500
20
I Iron cot with mattress and pillow
18,000
10
I Baby cot______ ____________
I
20
Bedside Locker __________
4 25,000
1,650
____ 1
i
Dressing trolley
________
4,250
___ 1_
Instrument cabinet__________
t
1,600
____
1
i Instrument trolley___________
l
T
T
1,100
____ 1
Linen trolley_______________
f Attendant stool_____________
'
5,000
20
18,000
4
I Steel cupboard ___________
4,000
1
I Blood donar table wooden
i
10,000
4
Wooden benches___________
!
480
____ 4
> Bucket galvanised___________
750
____ 5
I Bed pans & urinals__________
!
500
____ 5
Bowls_______________ __
400
5
Kidney tray________________
! 1,66,850
I TOTAL

1-------- --------

34

1

I
g_],4 I'ehicles

Mobility of medical and paramedical staff is important for delivery of
services. Under IPP-IX, interest free loans are being given to ANMs and
other paramedical staff for purchase of two wheelers. Upto March 31,1995,
81 ANMs, 6 LHVs and 2 BHEs from Bellary district have applied for loan
and 19 have been given loan. As of September 30, 1996, 70 applications
from paramedical staff from the district for loan are being processed.

The district has 58 vehicles— 1 minibus, 9 ambulances, 1 car and 47
jeeps. Out of the 47 jeeps, 18 are condemned and 10 were bought over ten
years ago and no longer economical to operate. Thus only 19 jeeps are
economically viable to operate.The number of driver posts sanctioned for the
district is 40( forty).
Out of the 9 ambulances, 1 ambulance will be given to each Taluka
headquarters and the remaining 2 will be shared by the four maternity
homes in Bellary town. Seventy one jeeps are required if every PHC /
Upgraded PHU is to be provided with a vehicle.
There are only 29
serviceable vehicles available including ten which are aged over ten years
leaving a deficit of 42 vehicles.There are forty sanctioned posts of drivers
and hence 41 posts of drivers have to be hired on contract basis. It is
proposed to procure 44 jeeps at a cost of Rs. 15.40 million. Of these 3 jeeps
will given one each to Family Planning Association of India, Bellary and one
vehicle to NGO, Leading Organisation for Rural Development (LORD), and
one vehicle to Indian Medical Association (IMA).The NGO’s have to engage
their own drivers.

8.1.5 Communication Facility

It is proposed to provide each of the 71 PHCs/upgraded PHUs and
tour maternity hom<: with telephone facility under O.Y.T special >,>, ..egory at
a cost of Rs. 1.50 million. This will facilitate fast communication dunnc
emergency transport as well as emergency obstretric care.

35

8 1.6 Incremental Staff

It is proposed to employ the following categones of staff' on contract
basis, to provide round the clock service.
Table 8.1.6.1 Incremental Staff
Category of Staff

Number

Grade

Project Assistant
LMO for PHCs
StaffNurse_____
"tab. technician
Anaesthetist
Drivers_______

1 ~
19
39
.
4.—
4
41
’ 108

1900-3700
2375-4450
1520-2900
1280-2375
(retainer)
' 1040-1900

Total _______

i
1

.Annual cost per Cost per year
Million Rs.
person Rs.
0.076
75,600
1.751
92,140
2.331
59,670
0.197
49,350
0.120
30,000
1.158
28,080
-4
5.633
J

The success of the project depends on having a Project Assistant to
co-ordinate with District MCH and FP Officers. 19 additional LMOs are
needed on the basis of 1 LMO for two PHCs/upgraded PHUs and 1 LMO
lor each maternity home. 39 additional staff nurses are needed on the basis
of 1 staff nurse for PHC/upgraded PHU and two for each maternity home. 1
Ub technician and 1 part time anaesthetist are provided for each maternity
home.

A 2 IMPROVING QUALITY OF SERVICES

8,2.1 Training
The family welfare programme has undergone a shift in approach by
adopting a target free approach for the entire state. The emphasis ot the
programme is on imporving the quality of family welfare services and client
satisfaction. The policy change has necessitated an urgent need on
retraining the entire personnel in both government on non-govemmenl
, sectors providing family welfare services.

36

Under IPP-IX, a comprehensive training programme for medical and
paramedical staff has been envisaged.

. ™ Medical Officers and Senior Health Assistants(Male and Female) are
L undergo a two week training programme at the Health and Family

Welfare training Centres.
L The Junior Health Assistants (Male and Female) will undergo a two week
training programme at District Training Centres being established under

I IPP-IX
I • Dms and Anganwadi workers will undergo orientation course at PHCs.
I The traimne will be a continuing activity. The trainers required tor the
I training programme are being trained at State Institute of Health & Family

I Welfare and also at institutions outside the state.

I
The successful implementation of the RCH project depends on the
I orientation and technical skills provided to the medical and paramedical
I staff. Besides the staff of the Health Department, Dais and Anganwadi
I workers have to be sensitised. The standardised tnmng modules are readily
I availble and these have been pre-tested. The training material produced by
I MoIIFW, Govt, of India would be adopted, translated, reproduced an
I incorporated into the training sessions for training vanous fategones o
I personnel.
A standard training module for Joint training of AWWs and
I AN Ms for 2 days has been prepared in Kannada language. Planning an
I implementation of training will be the responsibility of the istnct
I administration and would form part of district health and family welfare
I plan. It is planned to complete training for all categories in the first year
| itself by utilising all training institutions available in the district such as
I District Training Centre, ANM training School and be decentralising training
I of peripheral workers to the taluka and PHC level. The training institutions
| will also be linked with service delivery insitutions/hospitals tor skill
b
1
d|l. development. The guidelines for developing in service training plan at
UK district level will be followed.

1

JI

All categories of health care providers will undergo training at least
twice in the project period. The number of persons to be trained in each
...fHonrv the duration of the course and the batch size is presented in the
Table 8.2.1

Table 8.2.1. Number of Persons to be Trained, Duration and Batch Size
Category of Worker
Medical Officer __________
_Block Health Educator_______
"Staff Nurse
__________
Senior Health .Assistant, Female
Senior Health .Assistant, Male
"juruorHealth Assistant, Female
Junior Health .Assistant, Male
Pats________________
~ Anganwadi Workers________

Course
Duration
6 days
6 days
6 days
6 days
6 days
6 days
6 days
3 days
2 days

Total
Number
116
31
40
53
45
493
270
1,319
1,573

Batch size

25
15
20
25
25
25
30
30
30

Number of
I batches
I
_5_
2
_2_
2
2
T 20
9
i
44
53

I

The training materials will be translated, edited and printed for each
category of personnel. Further, T.A. and D.A have to be paid to the
personnel attending the training course. The cost of training materials per
person and T.A 7 D.A for one course is given in Table 8.2.2. The cost of
training materials is estimated at Rs. 3,707 million and the T.A and D.A at
Rs. 1,853 million for the entire project period.
Table 8.2.2 Cost of Training Material & T.A/D.A per course
Category of Personnel
Medical Officer____________
Block Health Educator_______
Staff Nurse
.Senior Health .Assistant, Female
.Senior Health Assistant, Male
Junior Health .Assistant, Female
Junior Health Assistant., Male
JDais
------------------Anganawach Workers

Training Materials
1,800
600

1,800
1,800
1,200
1.800
600
I
T _______ 150
t
100
1

38

T.A/D.A
1,200
900
900
900
900
600
600

75
50

Besides organising training programmes for health care providers, one
d v orientation programme is planned for elected members of the Panchayat
Raj institutions to improve community participation in the project activities.

• The activities and training needs for providing RCH package at various
levels such as community, sub-centre, primary health centre, and FRUs as
per the guidelines will be dealt in the training programme (Refer manual
Insemce training under FW programme GOI, 1996).
* The training needs for acquiring manegenal and IEC skills for medical
officers and Paramedical personnel will be given top priority through
discussion and group exercises.
• Further for each intervention, specific needs such as theory, skill
development and also counselling will be dealt during training.
8.2.2 Drugs

The Zilla parishad had spent Rs. 4.43 million on drugs out ot its
budget. Essential drugs and vaccines are being supplied by MoHFW and it
is assumed that these supplies are continued to be supplied by MoHFW to
the health centres. The annual cost of supplying EOC and RTIs drugs etc.,
is presented in Table 8.2.2.1. The total cost during the project period will be
Rs.35.21 million.

Table 8.2.2.I. Supply of Drugs and Estimated Cost per year
Equipment groups/Health Centre

Centres

Cost/Unit Rs.

• PHCs.PHUs: E.O.C drugs and
[-drugs for treatment of STI & RTI
■ Maternity Homes, CHCs and
laiuka Hospitals
LJotal

71

25,000

1 Amount Million I
i RS.__________ ;
1,775

14

75,000

1,050
2.825

Since RCH focuses on RTI/STI, the drugs required for both, will
added to the usual standard drugs list of the Sub-centre, PHC and
FRU. The list of drugs is enclosed as Annexe V.

39

i

8.3 IEC

The objectives for the IEC programme of the IPP-IX are to:
• promote higher age at marriage among boys and girls,
• promote spacing methods among young couples with one child or none,
• promote terminal methods among couples with two or more children at
younger age than hitherto,
• achieve hundred percent antenatal registration,

• educate and motivate the community to accept maternal and child health
services,
• motivate women with unwanted pregnancy to avail MTP service, and
• involve and encourage the participation of the community and
non- governmental organisations in the Family Welfare programme.

These objectives form a subset of the objectives of the RCH project.
In addition the RCH project aims at

* creating awareness of and need for treatment ot sexually transmitted
diseases and reproductive tract infections.
’ promoting personal hygiene especially during menstrual period, and
* promoting safe sex.
The target population for IEC programme of RCH is a superset of that
for IPP-I. In addition to the couples in the reproductive age gruup, women
in the ages 45 to 60 and adolescent girls have to be reached through the IEC
programme.

40

In order to have maximum impact of IEC activity under IPP-IX it was
ed to concentrate on interpersonal communication and supplement it
PrTludio visual media. The audio-visual programmes would be dovetailed
with entertainment programmes to attract maximum audience. As an
of reonentation programme, audio-visual campaignsi will be
integral part c. .
to achieve
networked with interpersonal communication programme U
maximum impact.
to provide interpersonal
The paramedical1 staff will be relied on
percent of respondents
communication as 1they are, according to 80
communication needs survey, providing MCH and FP
interviewed lor <
services 1through house to house visits. Apart trom conducting training
programme to improve the communication skills ot the paramedical staff
ion kit will be made available to each ANM. The
inter personal communication
kit would consist of items such as flash cards, flip charts, slide viewer, and
other educational aids.
Vkl

•J

--------------------

,

.

.

The target groups for RCH activities, the messages to be conveyed,
and the appropriate media mix for each of the target groups will be finalised
on the basis of communication needs survey planned to be conducted along
with beneficiary needs and baseline surveys. Insititutions such as the
Population Research Centre. Dharwar may be engaged to conduct such
studies which will be completed within a period of 6 weeks.

The IEC materials, whether for field exhibition by the district staff or
for broadcasting by 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 the district. This will also ensure
that necessary support to IEC activities from senior staff will be available.
Experts in the field of mass communication from public and private sector
institutions will be involved in the development ot messages. IEC materials
such as flip charts etc. to assist in inter personal communication, posters,
pamphlets and audio-visual aids. The IEC materials will be pre tested beiore
release through media.
Even though emphasis will be on inter personal communication, other
media such as AIR, Doordarshan and programmes by folk artistis. Video
vans and Swasthva melas will also be used to sensitise the population and
create demand for RCH services

41

i
8.4

CommunUy Participation

Community participation will be realised through Sub-centre Health
Advisor Committees (HAC) formed as part of IPP-IX project. There will
■ two representatives from each village under the jurisdiction ot the Subntre At least one member from each village will be a woman. The non
CetTicial members of the committee will not only assist in creating awareness
of the services provided by the PHC and the sub-centres but also
communicate the needs of the community to the service providers and ensure
that activities are planned to meet the felt needs.
HAC committee will identify in each village a woman who is willing
J to volunteer to act as a link between the families in the village and the ANM
al the sub-centre. In larger villages more than one volunteer many be
I identified at the rate of one per thousand population. The volunteers will be
interacting with the ANM of the sub-centre covering the village. The
E volunteers will:

♦ motivate couples to adopt appropnated contraceptive methods and
refer acceptors to ANM,

♦ educate all pregnant women on antenatal care ana refer to ANM,
* promote child care programme and arrange for immunisation.

* create awareness of and need for treatment for sexually
transmittted diseases and reproductive infections, and
* co-ordinate with ANM for arranging health education and environ
mental sanitation programmes in the village.

The anganwadi workers would be given preference in selecting
| volunteer workers as they are experience in some aspects ot child care and
f further they are free in the afternoons. They will be given performance
based incentive on graded scale. They will also be allowed to sell condoms
[ and oral pills at a fixed price and retain the sale proceeds.

42

In all there will be 253 HACs and 220 Gram Panchayats covering 617
villages in the district. These institutions would be involved in promoting
RCH activities. The voluntary workers will be trained to promote selected
components ot the RCH project.

There are 20 voluntary’ organisations in the distnet engaged in
promoting MCH and FP services. FPAI and LORD are among the active
organisations. Each of the organisations will be allocated a group of villages
for promotion of RCH and/or providing services. Assistance in kind, such as
IEC materials, conveyance, drugs, vaccines will be provided to them
according to their needs.

'J

The Indian Medical Association (IMA), The family Planning
Assosication of India (FPAI), The Leading Organisation for Rural
Development (LORD) are keen to involve and extend their help not only to
-enhance the awareness but also provide services through mobile units or in
the form of Swasthya mela, RCH clinics etc..
Make shift arrangements will also be provided to them in the
PHCs/PHUs/Sub-centres to hold clinics and Women Health Checkup camps.

NGOs will also be involved to form village level ‘Kumari clubs’
to sensitize adolescent girls in health and Nutrition.
The expenditure budget on IEC activities is presented in Table 8.3.1.1

Table8.3.1.1 Budget Provision for IEC activity
I

| |

Quantity

Component

r - ,°!IHP.iyication Needs Assessment
T
I __P[£JestmgJEC materials________
minute Video Film_____________ 6
I i
Chan
900
| I—Pamphlets (thousands)_________
3000
I L S^jsthya mela/NGO participation
32.

Rate/unit
thousand Rs

I
I

I | L__ total
1

43

225
__ 6

_5
450

Amount
■ Million Rs.__
1
030
.020
1.350
5.400
~ 1.500 ~
J4.400____
22.700

Performance
Performance based incentives will be given to 625 voluntary workers tor
- m and
or providing RCH services. On the basis of average incentive
promotion
of Rs 1
per person, the annual cost is estimated at Rs. 0.75 million.
9 PROJECT MANAGEMENT:

9 1 Organisation Structure
♦ The Director of Health and F.W. Services will overall supervise the
activities of the RCH project of Bellary district.
* The Additional Director (FW & MCH) will be the State Level
Project Director for this sub-project. He will be the Head ot the
Project Management. He will have the tollowing functions.

a) Plan and implement State Level component of the project

b) Supervise and monitor the programme at State level.
c) Consolidating and reviewing performance and evaluation
reports and ensure efficient and quality control.
d) He will co-ordinate the training programme of the field
functionary and ensure that there will be no overlapping.

* The Joint Director (FW & MCH) is the RCH Co-ordinator at ilie
State level. He will have the following functions:

a) He will guide the district project unit to plan, implement and
supervise the project.

b) He will monitor and report on inputs proc s and outputs on
quality assurance and evaluation ot outcomes on monthly
basis.
c) He will actively involve NGOs, private medical practioners
in implementation of the project.
d) He will co-ordinate between various departments.
44

I
* The Joint Director (IEC) will be responsible for guiding in
production, procurement of IEC materials and also guide the district
project unit in planning and implementation of the IEC activities.
* The District Health and Family Welfare Officer is the head of the
District project unit who is responsible for planning, implementation
monitoring, evaluation and reporting of the activities of District
RCH Project.

* The District MCH Officer will be the RCH Co-ordinator and
responsible for management of the project activities in the distirct.
* The Project Assistant, who will be responsible to co-ordinate the
functions of District MCH officer who looks after MCH activities
and also Family Planning Officer who looks after FP activities.
9.2 Staff Deployment:

The Director of Health & F, W. Services will be responsible for
placement of staff such as Lady Medical Officers, Staff Nurse, Lab.
Technicians, Drivers on contratual basis through the Depur Commissioners
of the Districts.
9.3 Civil Works and Procurement:

The civil works will be executed by IPP-IX Engineering Cell.
Procurement will be made by IPP-IX Procurement Cell.
9.4. Financial Management:

At present funds for Externally Aided Projects are being routed
through State Government. Hence under this project also funds will flow
directly from the Centre/World Bank to the State Government. The Project
Engineering Unit of Externally Aided Project will in turn delegate powers to
next level depending on the circumstances. The Organization chart is
presented.

45

STATE LEVEL ORGANISATION
Director of Health FW Services

Additional Director (FW&MCH)
Project Director
I

Joint Director (IEC)

Joint Director (FW&MCH)
State RCH Co-ordinator
i

D.D.(MCH)

D.D. (FW)

D.D. (Info.)

D.D. (IUD)

D.D. (Publication)

DISTRICT LEVEL ORGANISATION

t

Zilla Panchayat
Chief Executive Officer

M

I

.■C

____ I

I_____

district Health A F.W. Offlcer|""-{ Project Assistant
I
District
MCH Officer

District
FP Officer

Taiuka
Medical Officer (8)

I PHCs/PHuT]
1

Sub-Centres

-

§

46

|

I
9.5 Project Monitoring

The monthly activity report and the technical assessment checklist will
be inbuilt into the monotroing and evaluation system. Form No. 14 which is
already being implemented under the Target Free Approach will be linked
to the monitoring and evaluation system. The performance indicators
proposed to be monitored are listed below.

Performance indicators
IEC

1. Correct age of mamage of boys and girls.
2. Knowledge of three antenatal check ups.
3. Knowledge of spacing methods among eligible couples.
4. Knowledge of facilities available for M.T.P.

4

5. Identification and referral of cases of high risk pregnancies.

I

6. Knowledge of signs of RTI/STI.

I

ANTENATAL CARE

i

Effect indicators;

-

£

1. Number of percentage of pregnant women identified that are
‘>high-risk’\

■y-

I

I

2. Percentage of women who made three or more prenatal visits
during their last pregnancy.

47

7
4

3. Percentage of women who received two doses of tetanus toxoid

to confer protection pnor to delivery.
4. Percentage of women who complied with iron lolate supplemen
tation regime during last pregnancy.
5. Percentage of women gaming less than 1 kg, month during the
second and third trimester.

■I

Output indicators:
'■

1. Percentage of women who received at least one antenatal visit
while they are pregnant.

2. Average number of contact per pregnant women.

•J
3. Percentage of workers who regularly track high-risk
pregnancies

4. Percentage of high-risk women seen by a health worker.

i

5. P ercentage of health workers providing medical attention to
high-risk pregnant women or referring them.

Input indicators:

■

I

6. Percentage of health units which expenenced shortages of iron
supplements/malaria prophylaxis.

14

7. Number of days when iron supplements/malaria prophylaxis were
out of stock in the clinic.

• *.

8. Percentage of women of reproductive age weighing less than 38 kg
before pregnancy.

1
48

SAFE DELIVERY
Effect indicators:

I. Percentage of deliveries in preferred locations.
2. Percentage of births attended by trained health provider.
3. Percentage of mothers with knowledge of danger signs and where
to go if complications arise.

4. Percentage of families with members are of danger signs of
pregnancy, delivery and puerperium.
5. Ratio of positively treated obstetrical complications to all
mplica tions during the last 3-6 months.

I

6. Percentage of women with optimum weight gain.

Output indicators:

1. Percentage of pregnant women who were trained about the danger
signs of delivery and instructed where to go.
2. Percentage of obstetrical complication cases treated.
Input indicators:

I

I

1

1. Percentage of TBA trained in family planning, recognition of
obstetrical complications, and hygienic birthing practices, and
linked with the forma! health service delivery system.
2. Percentage of district hospitals equipped and functioning as first
referral centres.
3. Percentage of facilities and staff using standardised referral
protocols to manage obstetrical complications.

49

I

i

lr
1
4. Percentage of health cadres and staff trained in care of obstetrical
complications, especially emergency cases.

5. Percentage of communities with organised transport systems in
place to effect referral.

I

POSTNATAL CARE

Effect indicators:
1. Percentage of women receiving postnatal care from health workers.
2. Percentage of postnatal women who return for follow-up visits.

3. Percentage of women who have delivered and know when and
w’here to return for a postnatal follow-up visit.
Output indicators:

iI

1. Percentage of women who have delivered and were seen at least
once during the postnatal period.

f

2. Percentage of health workers counselling mothers on potential
danger signs in postpartum period requiring consultation with health
worker.

I

I

I

3. Percentage of health workers using stenle materials for cutting and
bandaging the umbilical cord, or percentage of mothers who said
that health worker used clean materials for cutting and bandaging
umbilical cord.

4. Percentage of mothers delivered by a trained bin!, attendant who
received counselling on child services after delivery

$

i
50

1

Input indicators:
1. Percentage of clinics/local health workers experiencing shortages
of sterile equipment and supplies for appropriate care of the
umbilical cord (razor blade, bandages, etc.,)
2. Percentage of facilities with one or more health staff trained in
postnatal care and counselling.

FAMILY PLANNING
Effect indicators:
1. Percentage of eligible women knowing at least one modem family
planning method and where to obtain it.

2. Percentage of women of child bearing age currently using modem
family planning methods.
3. Percentage of last pregnancies not intended.

4. Average length of time current users of modem methods have used
the method.

5. Percentage of births, with less than 24 months’ spacing, among
younger women 15—29 years.

II

6. Ratio of births to women below 19 or above 34 years.

'St

f

Output indicators:

t

1. Percentage of eligible women contacted by health worker, for
outreach.
2. Distribution of women receiving methods from CHW, by
contraceptive method.
3. Distribution of new acceptors by method, particularly longer acting
methods.
—...
LIBRARY
(

010^1

AND
DOCUMENTATION
v
UN<T
U’KT

’ r. V- <

/ rj

y

■t

I
4. Percentage of women seen who were referred from other providers
for clinic based services.

5. Percentage of health workers who explain where and when to go
for routine follow-up for family planning services.
6. Percentage of women who received counselling on possible side
effects of the contraceptive chosen, or who were asked about side
effects on follow-up visits.
Input indicators:

1. Percentage of health units experiencing stock shortages of each
contraceptive method in the last month.

2. Percentage of health units who had less than two types of
contraceptives in stock at any time during the month.
3. Percentage of villages without a regular supplier of contraceptive.

- II

1 I
S

I

I

M

i

CHILD IMMUNISATION
Effect indicators:
1. Percentage of children age 12-23 months who are fully immunised
with BCG, DPT, measles, and polio vaccines.
2. Percentage of children age 12-23 months never immunised with
BCG, DPT, measles, and polio vaccines.

I

3. Percentage of mothers who know the age at which children should
be immunised against measles (9-12 months of age).

4. Percentage of mothers whose children are not completely
immunised who know when to return for the next immunisation.

I

I

5. Percentage of children age 12-23 months whose mothers can
present a completely (per local standards) filled immunisation
card, given the age of the child.

%

52
9

I

Output indicators:

1. Percentage of health units (or number or percentage of immunisa
tion sessions) which experience shortages of vaccines, needles,
syringes, and/or immunisation cards.
2. Percentage of health units whose refrigerator has not been at a
temperature between 0 and 8 at all times during the previous

period.
9.6 Action Plan for one year
Activity

Filling up of incremental posts

i Time frame
12 weeks

2 weeks
Identifying NGOs
4 weeks
Training of health workers______
8 weeks
Hiring of quarters___________ __
6-12 weeks
Vehicles_____________________
4 weeks
Hiring LMO___________ ____
4 weeks
Communication Needs .Assessment
4
weeks
Pre testing IEC Materials_______
6 weeks
15 minute Video Films_________
6 weeks
Flip charts___________________
6 weeks
' Pamphlets (thousands)_________
I Swastya Melas___________________ 4 weeks
| Village Health Committee fomation | 6 weeks

53

Implementing
Officer_____
D.H.S

■ Place
of
i Implementation
I Pirectorate,BLR

PHO_______ j District HQ
PHO_______ T~bistrict HQ
i PHO/MOH~ I PHCs/SCs
PHS_______ I Directorate
Taluka _
Taluka M.O.
District
I PRC Pharwar
District
Film Dev.Corp. I District
District
District
Pirectorate
' PHO
i PHC level
i SC level
; MOKPHC

1

ANNUAL ACTIVITY PLAN - GANTT CHART
Activity

SI.
No.

Period (1st Year)

Responsibility

April

I
1

SERVICE DELIVERY
Civil Works

lPP-IX(Engg. Cell)

2

Procurement of Equipments

IPP-IX (Procurement
Cell)

3

Procurement of Vechicles

IPP-IX (Procurement
Cell)

4

Installation of Phones

IPP-IX (Procurement
Cell)

5

Contract of StaiF

Director ( H&FW)

6

Baseline Survey

PRC , Dharwar

7

Procurement of Drugs

G'." t Medical Stores
(Directorate)

II

TRAINING

Distnct Training
Coordinator (DH afwo)

III

IEC ACTIVITY

1

CNA

PRC, Dharwar

2

Pretesting IEC Materials

(MEM Wing)

3

Production of Finns / Filleis

KFIDC

4

Flip (’harts

FW Bureau

5

NGO Activities

DH&FWO

May

June

July

Aug

Sept

Oct

Nov

Dec

Jan

Feb

Mar

J
10. PROJECT COST:
The project cost is estimated Rs. 190.60 Million.
Expenditure is presented in table 10.1

The phasing of

Table 10.1 Project Cost and its Phasing by Year

r

■4

II

1

Item

97-98

^98-99

Million Rs./year
99-00 i 00-01

i 01-02 I Total

I Capital Expenditure
_____ I ___ i
21.079 I 7.474 i______
____ Civil works________ ' 8.718 : 32.350
0.000 I ~ 69.621
0.703
!
____ Equipment_________
2.585
1.136 I
0.196 ! 0.000 i
4.620
1.222 ' 0.637 I 0.000 j
1.834
____ Furniture__________ , 0.000
3.693
____ Vehicles___________ j 15.400 j 0.000 j 0.000 ! 0.000 1 0.000 1 15.400 I
1.500 j
0.000 j 0.000 1
Communication_____ * 1.500 j 0.000 i 0.000
Training__________ i 5.654
0.000
0.000
2.780 I 0.000 :
g.434 i
Drugs____________ 4j________
2.825 ; 2.825
2.825
2.825 ■ 2.825 i 14.125
i
21.075
i
15.475
IEC______________
0.100
0.000
0.000
36.650
_____ Subtotal__________ ' 57.757 \ 53.620
25.930 13.912
2.825 154.043
I
Recurring Expenditure _______ ___
3.029 j "TsTT" 5.753
Additional Staff Salaries
5.663
5.663 25.950
i
1.540
'
2.310
j
Vehicle Vlaintenance____
3.080
3.080
3.080 I 13.090
j 0.258 I 0.556 | 0.748
Equipment Maintenance
0.831 i 0.831 ' 3.225
9.581
1
Subtotal___________ ] 4.828
8.710 I
9.574 i 9.574 42.265
TOTAL PROJECT COST j 62 584 ! 62.330 ~35.510 j 23.485 12.399] 196.308

1

55

L_

'TfV-J ■<'_/-■,

C'

Phasing of Project Activities and Estimates of Cost

li<*.m of Act vii>
Ch'l *orks
iib-ccntrti
PJUs
PHCs
Milemiry Ibxes
SubHocaJ
kquipneot

Sub-cvoirvs Dew>
Ctbcr Sub-txntrai
PHIk'l.TW-’s.
PHCt'jppnkJ rm
Maicratly lt«*;s
Sub-t(4al
Fumimre
Sub-xnln.^(ncA;
rilCkVpgrilcd ?1HI»
Matmity Rtts
5nb-t«tal
Transport

Jeep.*
bub-total
Com no uni u tk®
OYT Trlqvxxs
Sub-<>)ul
Traiojog MMtrialj
kkdicil Ofxxr
Rkx± Heal n EakK-au-r
TNune
’ jo: Her It ASSJl Female
Scour Hea ih .As.it. btak
.limiot licsia Acjiamt Fanale
Junior llealh Aiiistant Male
Dais
Aigaiu adi W'uAexs
Zill* Paiutiyat Men ben
Taluka Parduyai Members
Nyaya PEnxhiyy. Members
Sub-<o<al

Coa-Unit Rs

I

KfitlionRs

Uniu/Year
2
3

4

5

Total

1

2

'

4

5

ToLll

’’6

2 3955
1.3848
2 1388
2 7988
1.711

9 582
5816
8.5552
8 3964
32.3S1

9.678
4.985
6.416
OOOO
21.179

‘ 474
6.000
uCkk)
0 000
7.474

Ob-Xi
OGjj

29 129
12.186
I? no
il 195
69 621

D.OOC0 168
0075
2 342
D.tKiO
2.58S

0.188
0.000
0.000

0.196
(J OOO
0CO0

0060
0000
0 006

A AHA

6 (ifMl

0 000
□ 194

o eco

0.572
0 168
0075
3 126
0.480

1.136

0.188
0.000
0 OOO
0 515
0 600
1.703

4.000

4 620

1 IU>2
I IM
<i 667
3.693

25
6
5
0

26
0
0
0

0
0

0
0

0
0

0

0
174
10
50
0

25
0
0
lu

25
0
0

26
0

0
0

0

0

li

u
0

u
0

25
10
4

26
0
0

0

0
0

76
21
4

0 OOO
(,.000
(I ooo
0 IM

0613
0.554
U.667
1.134

0613
0 609
0 000
1222

0 coo

0
U
0

25
II
0

0 637

24.500
55.405
166.850

ouoo

0.000
0000
MOO

0

0

0

0

44

15 400
15.400

oooo

0.000

0 40 ft-

0 fOO
0.004

0 ooo

44

0 000

350,000

B.001

15 44»O
15.401

j

0

0

?5

1 500
1.500

0.060
0.010

O.CKM«
U.OOCM

I). OOO
0.100

1.5(K!

75

0

U.000

20.000

• ooo

1.500

1800
600
1800
1800
1200
1800
600
150
100
100
100
50

116
31
40
53
45
493
270
1319
1573
50
200
4725

0
0
0

0

116
31
40
53
45
493
270
1319
1573
0
0
<3

u
0
0
0
0
0
(I
0
0
0
0

232
62
8ft
106
90
986
540
2638
3146
50
200
4725

0.209
0 019
0 072
0.095
0 054
0.887
0 162
0.198
0 157
0 065
0 020
0 236
2.115

0.000

oocc

o ooo

0<*C

0 000
0000

(I DOC

0 209
C 019
0.072
0 095
0 ft54
u 887
0 162
0 198
0 157
0 DOO
0 OOO

0 OC>0
0 O jU
0 30G
0 OOv

0.418
(I 037
0.144
0 191
0.108
1.775
ft 324
0 396
O 315
O.l‘05
0 020
0 236
3.968

383,2550
1,107.800
1,711.040
2,798,806

25

7,520
965
7.520
46.840
120,020

5
5
4

4

0
0
0
0

0
0
0

0

c

0

(i

ft
0
0
0

0
0
0
0
0
0

5'^

II
10
4

6

76
174
10
71
4

(I

A 4^0

0 480

0.000

o.ooo
O.OiK)
0000
0 000

uooo
0 000

oooo
0 404

o.ooc

oooc
o.ooc
0.MA

o ooc
oooc
0 ooc
V.O0C
0
0.004

OOOO
0.637

ooo:
oooo
1004

oooo
o.ooo
0 (K«c
oooo
0 coo
1)000

oooo

oooo
oooo

IJ S3

0.400

Phasing of Project Activities and Estimates of Cost

luan of Activity
Trsiaiog T.VB A
MedicJ Officer
Block 1 koltb jsdtiLJir
SuiT Nurse
Senior Hcalih .Vibl Feaale
Senior Health A<>bl Mac
Junior Health AsxirjcJ Ferrule
Junior Ikalxh
Male
Dais
Anfiiuadi Workers
ZUU rincru.ym
laluka Pinxhrylli
Oram BanduyMi
Sob-coral
Dru^i
PHCupcraJod PHU
.Malcnilty/CIIOT^aka HospUals
Sub-total
Ik.C Mauriafo
Coarunurucauen Nualc .Arunsmcni
Pre IttUnf IEC Makcralt
15 minute Vuko Fikn
flip chart
Pamphlets (tbouuiiL)
Sv '-thya MuU
v
real
.* ‘ 2'tiona! raff ulaHes
Lay Secretary
LMO
SlafT Nurse
Lab TatuuciMi
Ansetthcusi
Driven
beentne to \t>! injury wortm
Sub-total
Vehicle Mzisteoistt
Equipment Mxintcau»<e
Graad Total

1

2

UmisYear
3

1200
900
900
900
900
600
600
75
50
iuw
1000
500

116
31
40
53
45
493
270
1319
1573

0
0
0
0
0
0
0
0
0

10

0
0

25.006
75,000

71
14

71
14

300.000
200.000
225,00G
6,000
5.000
450,000

I
0
3
900
1500
16

0
05
J
0
1500
16

Cost Unii Rs.

75.600
92.140
59.670
49.350
30,000
23.0SO
1,200

I
4
21
0
0
41
150

0
15
13
4
4
0
400

MiioQ Rs. /Near
4

5

Total

I

2

3

4

5

Total

0
0
0
0
0
0
0
0
0

116
31
40
53
45
493
270
1319
1573

0
0
0
0
0
0
0
0
0

A

r.

t;

0
0

0.000
O.OoO
0 000
0 DOG
0.000
O.OOO
0000
0.000
O.OOO
•i hao
0000
0.000
0.001

0 00-3
0.000
0 000
0 000
0.000
0 000
0000
(J 000
0000
nnoo
0 000
0 000
• 006

OOCG
0 000
0000
0060
0 000
0.000
0d<>6
0 600
0 DOC'
n ioc

0
0

0 139
0 028
C.036
0.048
G.04I
6.296
0.162
(j 099
0.079
n a<a
0.200
2363
3.539

0 139
0 028
0 036
0048
0.041
0.296
0.162
0.099
0 079

0
0

232
62
80
106
90
986
540
2638
3146
2
10

0.000
0.000
•.927

ocoo

3278
0.056
G.072
0095
0.081
0.592
0.324
0.198
0 157
0.056
0.266
2 363
4.466

71
14

71
14

71
14

1 775
1 050
2J25

1.775
1 050
2 825

I 775
I 050
2J25

1.775
1 050
2J25

1.775
I 050

8.875
5 250
14.125

0
0.5
0
0
0
0

0
0
0
0
0
G

0
0
0
0
0
0

0300
0000
0 675
5 400
7.500
7200
21.075

0 000
0.100
0 675
0000
7.500
7.200
15.475

0 000
0 100
0.000
0.000
0000
0 000

0 ooo

0 000
0 000
0.000
O.OOv
0.000

e.ioo

0.000
0 000
0.000
0.000
0 000
•JOI

1606

0.3OC
0.200
1.350
5 400
15 000
14 400
36.650

0 076
0 369
I 253
7 000
0 000
1.151
0.180
3.029
1.540
0.259
62384

0 116
0 116
1 751
1.751
2G29
2.327
0 197
0.197
0.120
0 120
1.151
1.151
0 480
0 090
S.844
5.753
131*
3.080
0.748
0-556
61330 35-510

0 116
I 751
2327
0.197
0 120
1.151
0 000
5.663
3.080
02131
23.485

0 116
1 751
2 327
0 19?
0 120
1.151
0.000
5.66J
3.080
I 831
12J99

0 540
7 371
10.263
0.790
0.480
5 756
0.750
25-95e
13.090
3J25
196308

0
0
5
0
0
0
75

0
0
0
0
0
0
0

0
0
0
0
0

0
0

I
19
39
4
4
41
625

n non

0000
• 004

oooo

1

11. SUSTAINABILITY:
♦

The incremental annual recurring cost at the end of the project is
estimated at Rs. 8.4 million. The State Government has been increasing
allocations to the health sector at 6 percent per annum at constant prices.
The allocation during the period 1994-97 averaged at Rs.97.55 million per
year. Applying the past trend in increase of annual allocation of 6 percent,
the allocation to Bellary district is expected to increase by 33.8 percent or by
Rs.32.99 million. The incremental expenditure resulting from the Project on
the other hand is only Rs.9.6 million or 29.0 percent of anticipated increase
in allocation to health sector in Bellary District.
*

Under the Minimum Needs Programme the existing PHUs have been
upgraded into Primary Health Centres based on Population Norms. At the
end of RCH Project period of 5 years, Bellary District would be requiring
Additional Primary Health Centres. Hence the upgraded PHUs in this
Project will be converted in to Primary Health Centres and necessary staff
will be deployed phasing out contract services.

1

II

1
|
■'T

1i
4

t
58

I

I

Annexe I
District Level Submission
for

State Level Appraisal

Form A - Health Facilities

(New Construction Works)

1.

Name of the District: Bellary

State: Karnataka

2.

Type of Proposed Health Care Facility (check one)
a.

Pre-Referral/Primary Level (check one)

Sub-centre

Primary Health Centre (PHC)
b.

Referral/Secondary Level

First Referral Unit (FRU)
Community Health Centre (CHC)
Sub-Divisional Hospital

Rural Hospital

□
□

Taluka Hospital

Area Hospital
District Hospital

Will the proposed design of the facility be (check one)

£

Non-standardised - Need specific (non repetitive)

Standardised (repetitive)

V

■i
If the answer above is ^Non-standardised" - (need specific) then go to columns 5.6.7
& 8 below.

If the answer above is “Standardised”, then answer column 4 below.

59

List of Standardised design in District

4.

(Design Approved by World Bank for IPP-IX)

Type Design: Sub-eentre

Number of locations:

Location of Proposed
Sites (Taluka 8c village)

T
f•

|
&

1

I

5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22

2?
24
25
26
27

28
29
30

Total

Site Status

Catchment
population
Acquired

1
2

76

Beilary Taluka_______
Badanahatti___________
Emmiganur A_________
Emmiganur B_________
Havinahal Veerapura
Kolagallu____________
Kolur________________
Kudathini A__________
Kudathini B__________
Moka_______________
Mustagatta___________
Nelludi______________
Oravi
__________
Pattanasaragu________
Rupanagudi__________
Sidaragadda__________
Thimmalapura________
Vaddahatti___________
¥ erragudi___________
Hadagalli Taluka
Ayyanahalli__________
Hadagalli A__________
Hadagalli B__________
Hakandi_____________
Katebennur__________
Kuravathi___________
Makarabbi__________
Mannera Masalavada

Not
Acquired

Under
Negotiation

Not
Identified

~7~
~7~
-

I

~T
T

I
1

!

~T
~7
V
4

V
J

7“

~7

Sovinahalli__________
Hagaribommanahalli
Taluka_____________
Alabur_____________
Dasmapura__________
Gaddikeri

~7
~7
60

Location of Proposed
Sites

Acquired

31
32
33

34
35
36
37
38
39
40
41
42
43

I

I
II

ftI
w■S

•=]

Total

Site Status

Catchment
population

Not
Acquired
✓

Moregeri___________
Nellukudiri__________
Ulavathi____________
Harapanahalli Taiuka
Bagali_____________
Duggavatti__________
Kadabageri_________
Kanchikeri
Mydur_____________

Under
Negotiation

Not
Identified

7
7“

V
~T

~7
~7
~7
~7
~7

Nichapura

Nittur_____________
Ragimasalawada_____
Sasivahalli__________
Towdur____________
Hospet Taiuka______
44 Devalapura_________
45 Devasamudra_______
46 Mariyammanahalli 1
Mariyammanahalli 2
47
48 Kamalapura 1_______
49 Kamalapura 2_______
50 Sriramarangapura
Kudligi Taiuka_____
Appainahalli________
51
Malapanagudi______
52
Metriki____________
53
Papinayakanahalli
54
Hireheggadahal_____
55
K.Iyyanahalli_______
56
J2_ Sivapura__________
Sandur Taiuka_____
i_____
I 58 Bandri____________
59 Kodalu___________
60
Metriki___________
Rajapur___________
61
Sovenahalli________
62
Vitt alapur_________
63
I 64
Thorangal R S_____
Y eswanthanagar
! 65
Siruguppa Taiuka
66
Balakundi_________
67
Dasanur__________
68
Halekota

~7
~7
V
~7
~7
J

~7
~7
J

~7
~7

TV
~7

~7
~7
—I

V
~7
61

□
j

1

Location of Proposed
Sites

Catchment

Site Status
Acquired

69
70

71
72
73
74

75
76

Total

population

Hayinahal
Ravihal
Tekkalkota 1
Tekkalkota 2
Karchiganur
Kotchalsugur
Mitte Suuur-Nittur

Not
Acquired

Under
Negotiation

Not
Identified

"7
7
7

7
7
7

Columns 5.6.7 and 8 omitted.

9.

Has the site any legal, municipal or legislative obstacles'.’ (Check one)

Yes Q

No

1J

10.

0

Can the construction start immediately on the site? (Check one)

0

Yes

A

No

Others (Specify) [

j

Levelling /reclamation /temporary: relocation
/demolition needed
11.

Site Selection Criteria
Does the proposed site satisfy the site selection criteria

t

as per paragraph 4.3

item (b) of Manual Booklet -A? (Check as below)

Criteria

^Yes | No

Favourable accessibility and location

~7

, Availability of drinking water

! Favourable subsoil water table
—__________________
Favourable soil report
•-------------------Availability of electricity

"

I

Earthquake consideration

I

flood level safeTv consideration

62

To be Augmented/Comments

J
12.

Provide proposed outline specifications of the items below

!

a.

I

Structure

Load bearing walls

Framed R..C.C. structure
other, (specify)

3X0mm

[7~| 230mm thickbrick wall [7]

b.

External stone wall

c.

Internal wall load beanng230mm |

d.

Class of brick

e.

Anti-termite treatment Provided

f.

Roofing

g.

Water proofing 20mm thick plastering in CM 1:6 with WP cement

h.

Floor finish

i.

External plaster for stone masonry pointing/ brick masonry:

1 class

| 115 mm thick (partition) |

[7] II class |

| III class

|

|

|

RCC sloped roof

Terrazo/Tandoor blue/ polished shahbad stone

20mm thick plastering

J-

Internal plaster

12mm thick plastering

k.

Damp proofing course

not provided

1.

Doors & windows

(Mathi or Nandi) wood doors and steel

windows
m.

Toilet/sanitary fixtures

White vitreous china clay 8c C.P fixture

n.

Skirting

Mosaic (terrazo)

o.

Dado

Ceramic tiles

P-

Water supply

India Mark II Hand Pump
/
(Where running water supply is not available)
Municipal water supply

q-

Sewage disposal

Septic tank and Soak pit
(Where running water supply is not available)

Municipal sewage line

Electrical specifications : (Internal)

I
1

Concealed wiring

7

Diesel Generator

[

Surface mounted wiring

!

Uninterrupted Power System (UPS)

63

Other special outline electrical specifications if any :

s.

Construction Schedule

13.

(Check as below)

Year

Progress Stages
1997 to 1998

1998 10 1999 1 1999 to 2000

2000 to 2001 j
I

Approval
Preliminary Drawing/
Outline Specification/
Preliminary cost estimates
Approval of tender documents
Approval of contract award

Yes
Yes
Yes
Yes
25

25

21

Commencement of construction

25

25

21

25

25

Completion of construction

365 days from date of completion

Defect liability guarantee period

14.

21

Provide cost information for type design
(1)

Net floor area of proposed facility

(2)

Add 20% for service/corridor & wall thickness etc. Sq.m. : 10.7

(3)

Total Area (1=2 above)

Sq.m.: 64.0

(4)

Multiply (3) by Rs 4600/ Sq.m.

Rs. 2,94,400

(5)

Add electrical installation cost as estimated

Rs.

30,000

(6)

Add 20% of (4) as external development
including external water/electncity to (4)

Rs.

58,880

Add (4) + (5) + (6) = Unit Cost =

Rs. 3,83.280

(7)

Sq.m. : 53.3

15. Omitted as applies only to Need Specific Individual designs
16.

Provide name/names of construction management agency/agencies chosen to
carry out construction work as below:
a.

Panchayat Board

b.

Rural Engineering Services

c.

Zilla Parishad

■

5'

6U-

d.

Other State Government Undertakings
Name

e.

PWD

f.

Private Contractors

g-

□

Non Governmental Organisation
Name

• .1

I

'■'I

7

I
65

!

4.

List of Standardised design in District
(PHC Design Approved by World Bank for IPP IX . Proposed additional

Ward with 20 beds to be approved)

Type Design: PHC
Number of locations:

Location of Proposed
Sites (Taluka & village)

Catchment
population

Site Status
Acquired

2
4

2
6
7

8
9
A

10

Bellary Taluka
Chellagurki
Kolur_______________
Korlagundi_______
Siddammanahalli
Harpanahalli Taluka
Mathihalli___________
Sasvihalli____________
Uchangidurga________
Kudligi Taluka
Hudem____________
Sandur Taluka_______
Bandri_______
Siruguppa Taluka
Tekkalkota

Not
Acquired

I.
14

l

—“------------ - —»•

I

Has the site any legal, municipal or legislative obstacles? (Check one)

Yes O
No
10.

Can the construction start immediately on the site? (Check one)

i

Yes

I

No

i
I

Others (Specify) |

Total

Under
I Not
Negotiation ■ Identified

Columns 5,6,7 and 8 omitted.

9.

10

[

Levelling /reclamation /temporary relocation

/demolition needed

68

I
11.

Site Selection Criteria
Does the proposed site satisfy the site selection criteria as per paragraph 4.3

item (b) of Manual Booklet - A? (Check as below)

Criteria

No

Yes

To be Augmented/

Comments
Favourable accessibility and location

Availability of drinking water

Favourable subsoil water table
Favourable soil report
Availability of electricity

Earthquake consideration
Favourable flood level safety
I consideration
12.

Provide proposed outline specifications of the items below

a.

Structure

Load bearing walls
Framed R.C.C. structure
other, (specify)

b.

External stone wall

c.

Internal load bearing wall 230mm|

d.

Class of brick

e.

Anti-term

f.

Roofing

RCC sloped roof

g-

Water proofing

20mm thick plastering in CM 1:6 with

230mm thick brick wall !

j

I 115 mm thick (partition) |

|

380mm

0 II class Q HI class

I class

|

I

treatment Provided

■

i

WP cement

h.

Floor finish

TerrazoHandoor blue/ polished shahbad stone

i.

External plaster

for stone masonry' pointing/' brick masonry:20mm
thick plastering

J-

Internal plaster

12mm thick plastering

69

k.

Damp proofing course

not provided

(Mathi or Nandi) wood doors and steel
windows

1. Doors &. windows

m.

Toilet/sanitary fixtures

White vitreous china clay & C.P fixture

n.

Skirting

Mosaic (terrazo)

o.

Dado

Ceramic tiles

P-

Water supply

India Mark II Hand Pump
[/
(^here running water supply is not available)
Municipal water supply

q-

Sewage disposal

0

Septic tank and Soak pit
(Where running water supply is not available)

Municipal sewage line
r.

Electrical specifications : (Internal)
Concealed wiring

0

Surface mounted wiring

Uninterrupted Power System (UPS)

Diesel Generator

s.

p

Other special outline electrical specifications if any :

i
I

13.

Construction Schedule

{Check as below)

Year

Progress Stages
1997 to 1998

1998 io 1999

Approval
Preliminary Drawing
Outline Specification
Preliminary cost estimates
Approval of tender documents
Approval of contract award

Yes
Yes
Yes
Yes
5

5

Commencement of construction

5

5
5

Completion of construction

i

1999 io 2000 I 2000 to 2001

5

365 days from date of completion

Defect liability guarantee period

70

14.

Provide cost information for type design

Sq.m. : 198.8

(1)

Net floor area of proposed facility

(2)

Add 46% for service/comdor & wall thickness etc. Sq.m. : 91.6

(3)

Total Area (1

(4)

Multiply (3) by Rs. 4600/ Sq.m.

Rs. 13.35.840

(5)

Add electrical installation cost as estimated

Rs. 1.08.000

(6)

Add 20% of (4) as external development

(7)

2 above)

Sq.m.: 290.4

including external water/electncity to (4)

Rs. 2.67.200

Add (4) + (5) + (6) = Unit Cost =

Rs. 17.1 1.040

15. Omitted as applies only to Need Specific Individual designs

16.

Provide name/names of construction management agency/agencies chosen to

carry out construction work as below:
a.

Panchayat Board

b.

Rural Engineering Services

c.

Zilla Parishad

d.

Other State Government Undertakings

Name

I

e.

PWD

f.

Private Contractors

g-

Non Governmental Organisation
Name

i

I

f

71

Annexe III

District Level Submission
for

State Level Appraisal
Form C - Health Facilities

(Expansion and or Renovation of Existing

Facilities and Miscellaneous Repair)

1.

Name of the District: Bellary

2.

Type of Proposed Health Care Facility (check one)
a.

State: Karnataka

Pre-Referral/Primary Level (check one)

Sub-centre
Primary Health Centre (PHC)

b.

Referral/Secondary Level
First Referral Unit (FRU)

Community Health Centre (CHC)
Sub-Divisional Hospital

Rural Hospital
Taluka Hospital

Area Hospital

District Hospital

3.

Will the proposed design of the facility be (check one)

Non-standardised - Need specific (non repetitive)

Standardised (repetitive)

7

If the answer above is "Non-standardised" - (need specific) then go to columns 5.6.7

& 8 below.
If the answer above is “Standardised", then answer column 4 below.

7^
■ 7

List of Standardised design m District

4.

(Design Approved by World Bank for IPP-IX)

Type Design: Upgrade PHU to PHC
Number of locations:

Location of Proposed
Sites (Taluka &. village)

Catchment
population
Not

Acquired

Hadagalli Taluka
Ayyanahalli_________
Holagundi__________
Magala_____________
Hagaribommanahalli
Taluka_____________
Hansi______________
Harapanahalli Taluka
Aligilawada_________
Bannihalli___________
Hiremagalagere______
Nandibevoor________
Kudligi Taluka______
Alur_______________
Siruguppa Taluka
Bagawady__________
Kuruvalli

2

3

4
5

2
8

9
10

11

Total

Site Status
Acquired

2

Under
Negotiation

Not
Identified

V
V

I

I

T
V
~7
7
J

~7

Columns 5.6.7 and 8 omitted.

9.

Has the site any legal, municipal or legislative obstacles? (Check one)

Yes Q]
No
10.

71

Can the construction start immediately on the site? (Check one)

Yes
No

Others (Specify) |

|
Levelling /reclamation /temporary' relocation

/demolition needed

i

11

11

75

I
11.

I

Site Selection Criteria
Does the proposed site satisfy the site selection criteria as per paragraph 4.3

item (b) of Manual Booklet -A? (Check as below)

I

■

No

Yes

Criteria

To be Augmented/

Comments
Favourable accessibility and location
/

Availability of drinking water
Favourable subsoil water table
Favourable soil report
Availability of electricity
Earthquake consideration

Favourable flood level safety
consideration

I

12.

I

Provide proposed outline specifications of the items below

a.

I

Structure
Load bearing walls

I

Framed R.C.C. structure
other, (specify)

I
b.

I

c.

External stone wall

380mm

R~l 230mm thick brick wall

Internal wall load beanng230mm |

1 class

| 115 mm thick (partition) QU

;• ~| II class |

|

Class of brick

e.

Anti-termite treatment Provided

f.

Roofing

g-

Water proofing 20mm thick plastering in CM 1:6 with WP cement

h.

Floor finish

i.

External plaster for stone masonry pointing/ bnck masonry:

RCC sloped roof

Terrazo Tandoor blue/ pohshed shahbad stone

20mm thick plastering

.it

j III class

d.

76

|

14.

Provide cost information for type design
(1)

Net floor area of proposed facility

Sq.m. : 133.9

(2)

Add 40% for service/corridor & wall thickness etc

Sq.m. : 53.6

(3)

Total Area (1 - 2 above)

Sq.m.: 187.5

(4)

Multiply (3) by Rs. 4600/ Sq.m.

Rs. 8.62,500

(5)

Add electrical installation cost as estimated

Rs.

(6)

Add 20% of (4) as external development

(7)

72,800

including external water/electncity to (4)

Rs. 1.72,500

Add (4) + (5) + (6) = Unit Cost

Rs. 11,07.800

15. Omitted as applies only to Need Specific Individual designs

16.

Provide name/names of construction management agency/agencies chosen to

carry out construction work as below:
a.

Panchayat Board

b.

Rural Engineering Services

c.

Zilla Parishad

d.

Other State Government Undertakings
Name

e.

PWD

f.

Private Contractors

g-

Non Governmental Organisation

Name

78

4

Annexe IV
District Level Submission

for
State Level Appraisal

Eorm A - Health Facilities

(New Construction Works)

1.

Name of the District: Bellary

State: Karnataka

2.

Type of Proposed Health Care Facility (check one)
a.

Pre-Referral/Primary Level (check one)

Sub-centre

Primary Health Centre (PHC)

b.

Referral/Secondary Level
First Referral Unit (FRU)

Community Health Centre (CHC)
Sub-Divisional Hospital

Rural Hospital
Taluka Hospital
Area Hospital

District Hospital

Will the proposed design of the facility be (check one)

Non-standardised - Need specific (non repetitive)

Standardised (repetitive)

J

If the answer above is -Non-standardised" - (need specific) then go to columns 5.6.7

& 8 below.

If the answer above is "Standardised”, then answer column 4 below.

80

4.

List of Standardised design in District
(PHC Design Approved by World Bank for IPP-IX . Proposed additional

Ward with 20 beds to be approved)
Type Design: Maternity Home
Number of locations:

Location of Proposed
Sites (Taluka & village)

Catchment
population

Site Status
Acquired

2
_2
3_
4

Bellary Town
Cowl Bazar
Gandhinagar
Miliarpet
Parvathinagar

Not
Acquired

Under
Negotiation

Total
Not
Identified

V
~7

Columns 5,6.7 and 8 omitted.

9.

Has the site any legal, municipal or legislative obstacles? (Check one)

Yes Q]
No 0
10.

Can the construction start immediately on the site? (Check one)
Yes
No

Others (Specify) [

|
Levelling /reclamation /temporary' relocation
/demolition needed

4

4

8l

11.

Site Selection Criteria
Does the proposed site satisfy the site selection criteria as per paragraph 4.3

item (b) of Manual Booklet -A? (Check, as below)

To be Augmented/

No

Yes

Criteria

Comments

Favourable accessibility and location
Availability of drinking water
Favourable subsoil water table
Favourable soil report

Availability of electricity

Earthquake consideration
Favourable flood level safety
I consideration

12.

Provide proposed outline specifications of the items below

a.

Structure
Load bearing walls
Framed R.C.C. structure
other, (specify)

b.

External stone wall

380mm

c.

Internal load bearing wall 230mmQ 115 mm thick (partition) Q

d.

Class of brick

e.

Anti-termite treatment Provided

f

Roofing

RCC sloped roof

g-

Water proofing

20mm thick plastering in CM 1:6 with

1 class

P~| 230mm thick brick wall |

PH II class |

| III class

j

|

|

WP cement
h.

Floor finish

Terrazo/Tandoor blue/ polished shahbad stone

i.

External plaster

for stone masonry pointing/ brick masonry:20mm

thick plastering
J-

Internal plaster

12mm thick plastering

k.

not provided

Damp proofing course

(Mathi or Nandi) wood doors and steel
windows

1. Doors & windows
m.

Toilet/sanitary fixtures

White vitreous china clay & C.P fixture

n.

Skirting

Mosaic (terrazo)

o.

Dado

Ceramic tiles

P-

Water supply

India Mark II Hand Pump
[/
(Where running water supply is not available)

Municipal water supply

q-

Sewage disposal

Septic tank and Soak pit
(Where running water supply is not available)

p

Municipal sewage line

r.

Electrical specifications : (Internal)

Concealed wiring

□

Surface mounted wiring

Uninterrupted Power System (UPS)

Diesel Generator

s.

13.

Other special outline electrical specifications if any :

Construction Schedule

(Check as below)

Progress Stages

Year
1997 to 1998

Approval
Preliminary Drawing/
Outline Specification/
Preliminary cost estimates
Approval of tender documents
Approval of contract award

Yes
Yes
Yes
Yes

Commencement of construction

4

1998 to 1999

1999 to 2000

2000 to 2001

4

Completion of construction

4

Defect liability guarantee period

365 days from date of completion

83

14.

Provide cost information for type design
Sq.m. : 338.2

(1)

Net floor area of proposed facility

(2)

Add 40 % for service/corridor & wall thickness etc. Sq.m. : 135.3

(3)

Total Area (1=2 above)

Sq.m.: 473.7

(4)

Multiply (3) by Rs. 4600/ Sq.m.

Rs. 21,79,000

(5)

Add electrical installation cost as estimated

Rs. 1,84,000

(6)

Add 20% of (4) as external development

(7)

including external water/electricity to (4)

Rs. 4,35,800

Add (4) + (5) + (6) = Unit Cost =

Rs. 27,98,800

15. Omitted as applies only to Need Specific Individual designs

16.

Provide name/names of construction management agency/agencies chosen to
carry out construction work as below:

a.

Panchayat Board

b.

Rural Engineering Services

c.

Zilla Parishad

d.

Other State Government Undertakings

Name

0

e.

PWD

f.

Private Contractors

g-

Non Governmental Organisation

Name

8U-

Annexe V

List of Drugs For RTI / STI
1. Tab. Cotnmaxazole

2. Tab. Nortloxacm
3. Cap. Ampicillin
4. Gynae-CVP

5. Cap. Doxycycline

6. Tab. Metronidazole
7. Nalidixic Acid

8. Inj. Penicillin. L.A..

9. Vaginal Pessary ( Cenestin )
10. Benzyle Benzoate lotion

i

35.

Annexe VI
List of Private Hospitals in Bellary District
Name of Hospital

Adress

Hospital Type

Adarsha Nursing Home

(janhmanai

General hopsitai

/Xnupama Nursing Home

Dr. Ajit Kulkami. <>pp. Radhika theatre

MCH/OBG/Pediatic

Basaveswara Nursing Home

II Cross. Basaveswara Nagar

General hopsitai

Bellary Nursing Home

Behind Nataraj Theatre

General hopsitai

Dhanvanthan Nursing Home

139. Kalamma Street

MCILOBG/PediaUc

Dr. A Duraiswamy Nursing Home

Kolachalam Compound

General hopstal

Dr. Madhun Nursing Home and Eye Hospital

Bellary

General hopsitai

Dr. Ravi Tippa Nursing Home

Comme Road

General hopsitai

Dr. Subba Rao Hospital

Contronment

General hopsitai

Dr. Y P Vittal Ent Nursing I lome

1-40/2 Kalamma Street

General hopsitai

Dwaraka Nursing Home

K Shanta Sectharam. Moka Road

General hopsitai

Geetha Nursing Home

Dr. Ratna. S N Pet

MCH/OBG/Pediahc

L V Surgical & Maternity Home

Opposite Wardla High School

General hopsial

Murthy Nursing Home

No.8. Gandhi Nagar. 1 Cross

General hops tai

Nirmala Clinic & Nursing Home

20/22. Main Road Cowl Bazar

MCH/OBG-Pediauc

Parkview Nursing Home

45/25 Near Zoo Radio Park, Cowl liazar

General hops tai

R K Nursing Home

H M Saiiullah Khan. Ill Cross. Sathyanarayanapet

Gtneral hops tai

Shakti Nursing Home

Tallvr Road. Parvathi Nagar

General hops tai

Shiva Specialist Centre Hospital

Opp. Ksrtc Bus Stand

General hops tai

Sri Manjunath Nursing Home

Bangalore Road

General hops tai

Sri Venkateswara Nursing Home

2 Cross. Gandhi Nagar

General hops tai

Sri Venkateswara Nursing Home

II Cross. Gandi Nagar

General hops tai

St Mary Hospital

Cantronment

General hops tai

St Mary's Hospital

Dr. Malikarjuna Reddy

General hops tai

Star Nursing Home

Bandatti Road. Cowl Bazaar

MCH/OBG/Pediatic

Sukrutha Nursing Home

Gopalaswamy Road. Gandhinagar

General hops tai

Usha Nursing Home

Dr. P Radha Krishna Rao, Cowl Bazaar

General hops tai

Vijaya Maternity Home

K M Nariswamy. S N Pet, II Cross

General hops tai

Hagaribommanahalli

Hagari bonunanahalli

Chatanya Nursing Home

Hagari Rommanaha 11 i

MCH/OBG/Pediauc

M S Kulkami Hospital

Hagari Rommana halli

General hopsitai

Poqja Nursing Home

Basavaraja Reddy

General hopsitai

Shantala Nursing Home

Ran Nagar

General hopsitai

Shushmtha Nursing Home

Hagari Bommanahalh

General hopsitai

Harpanahalli

Harpanahalli

Balaji Nursing Home

Hospet Road. Davangere

MCH/OBG/Pediatic

Chethana Nursmh Home

Middle Street

General hops tai

Maruthi Clinic

KMC Reg

General hops tai

Shree Manjunatha Nursing Home

Kottur Road

General hops tai

Suchethana Hospital

Main Road

General hops tai

H os pet

Danapur

Ramarad Memorial Hospital

Vyasankere Colony

Hos pet

Hospet

Amar Joythi Nursing Home

Ballary Road Circle

General hops tai

Amereswara Nursing Home

Patel Nagar

General hops tai

Anand Nursing Home

Anaravathi. Sinaram Road

General hops tai

Bijoy Hospital

New Vegitable Market

MCH/OBG-Pcdiauc

Dr. B R Achar Maternity & Nursing Home

Station Road

General hops tai

Dr. B T Kulkami Surgical and Nursing Home

Valmiki Cirkle Dam Road

General hopstal

I

86 ‘

General hops tai

Annexe VI

List of Private Hospitals in Bellary District
Name of Hospital

Adress

Hospital Type

Dr. Kopekar Eye Clime

House No. 4/339. Patel Road

Opthalomogy

I>r. Rajasekhar Kanthi Nursing Home

Hospet

MCILOBG/Pediatic

K L S Nursing Home

Mam Bazar

(leneral hopsital

Malhgi Nursing Home

Kottvr Swann Matt Near Mam Bajar

MClLOBG/PcdiaUc

Malhgi Nursing Home

Near Kottuswaim Mutt Mam liazar

General hopsital

Nctra Laksun Chantable Trust

Sandur Road

Opthalomogy

Padma Nursing Home

College Road

General hopsital

R M Orthahmc Nursing and Childre Hospital

College Road

General hopsital

Radha Nursing Home

Ballery Road

MCH/OBG/Pcdiauc

Renuka Maternity Home

Markandeshwar Temple. Mrujynjaya Nagar

MCILOBGPediaUc

Sanjecvuu Nursing Home

Near Rotary Club. Patel Nagar

MCILOBG/Pediatic

Shashikala Gugn Nursing Home

College Road

MCH OBGPediatic

Sita Nursing & Maternity Home

Near Bus Stand

MCILOBGPediaUc

Sri Maruthi Clime and Maternity

Opp. to Delhi Sweet Stall. Near Three Shops

Gaieral hopsital

Snpati Maternity & Children Nursing Home

Station Road

General hopsital

T M Aie Society Amo Hospital

Dam Road Circle

General hopsital

Hospet

Kampli

Dr. Jambunatha Goud Maternity and Nursing Home

Kampli

Sandur

Donimalai

Nmdc Arogya Vardham Hospital

Donimalai

MCIl/OBG/PediaUc

Snriore Hospital

Deo gin

MCH/OBG/Pcdiauc

Siraguppa

Siraguppa

B C P Memorial Nursing Home

Ramadevi

MCH/OBGPediadc

Lakshmi Nursing Home

Siruguppa

General hopsital

Vijayamarie Nursing Home

Simguppa

MCH/OBG/Pediabc

(jeneral ho psi tai

87 J

J

Annexe VII
List of Voluntary Organisations
Bellary Taluka
1
Srce. Shanma Basveswara yuvaka manda, H. Vcerapura
2
Sree Sadgum Yuvaka Sangha, D. Kagallu
3
Adharsha Yuvaka Kreeda Sangha, Yellabanchi
4
Sree Basveswara Yuvaka Sangha, Sreedhagadda
5
Kauadda Yuvaka Sangha, Kurugodu
6
Navodaya Yuvaka Sangha, Kurugodu
7
Jaya Friends Yovaka Sangha, Gading Street, Bellary
8
Adharsha Yuvathi Mandali, Patilnagar. Bellary
9
In gals Club, ContonmenL Bellary
10
Yuvaka Sangha, Kakaberanahalli
11
Mahathama Ghandi Yuvathi Sangha, Fort, Bellary
12
Jana Ghat Yuvaka Sangha, M.M.Mutt, Bellary
13
Yuvaka Sangha, Y. Kagall
14
Chayatlnna Yuvaka Association, Brahim Street, Bellary
15
Y.Bheema Yuvaka Sangha, Basavapura
16
Bellary Sport Club, Bellary
17
Kannada Abhimani Sangha, Bellary
18
Varasiddi Vinayaka Yuvaka Sangha, Sreedhagadda
19
Vmayaka Yuvaka Sangha, Misivipura
20
Jai Bheema Yuvaka Sangha, Basavapura
21
Sree Ramanhaveya Yuva Sangha, Hosabhavi
22
Bapuji Yuvaka Sangha, Karchude
23
Nava Karnataka Yuvaka Sangha, Vaddarahalli
24
Kannada Abhimani’s Sangha, Thyamana Katta
25
Vevakananda Yuvaka sangha, Durgamma Temple
Hospet Taluk
26
Nehru Yuvaka Sangha, Hospet
27
Praghati Yuvaka Sangha, Hospet
28
Sharana Basaveshwara Yuvaka Sangha, Deva sumudhra
29
Dr. Ambedkar Yuvaka Sangha, Hospet
30
Sanjeevini Vmayaka Yuvaka Sangha, Hospet
31
Sharda Yuvathi Mandali, Hospet
32
Sree. Seva Lal Yuvaka Sangha, Neethalam Thanda, Hospet
33
Gaythri Yuvathi Mandli, Bukkasagara
34
Navachathana Yuvaka Sangha, Hospet
35
Navakirana Yuvaka Sangha, Hospet
36
Shanthi Yuvathi Mandali, Bellary Road, Hospet
37
Ambedkar Yuvaka Sangha, Hospet
38
Vikas Yuvaka Sangha, Car Street Hospet
39
Arunodaya Yuvaka Sangha, Anan*hasana Temple, Hospet
40
Friends Yuvaka Club, 15th ward, 1 .ospet
41
Dr. B.R. Ambedkar Yuvaka Sangha, Koduguhallu, Gadiganur Post
Sandur Taluk
42
Sree Basaveshwara yuvaka Sangha, Sandur
43
Maruthi Yuvaka Sangha, Yardhamanahalli
44
Nehru Yuvaka Kendhra, Byghadar
45
Deepak Yuvaka Sangha, Sandur
Hadagali Taluk
46
Trimurthy Students Youth Association, Uncle Tanaha, Hadagali
47
Peeta Basaveshwara Yuvaka Sangha, Manayara Maasidhapura, Hadagali
48
Snehamayi Navayuvaka Sangha, Vidhaithi Yuvaka Mandali, Kannalagatti Thanda
49
Sree Anhinaya Yuvaka Sangha, AraviBasalapura, Hadagali Tandhr
50
Sevala Yuvaka Sangha, Linganayakana Halli
51
Kannada Abhimani Mandali, Bediratti

88

I

52
Revanasiddeswara yuvaka Sangha, hadagali. Siddapura
53
Kalleshwara Raitha Bhajana Sangha
Siruguppa Taluk
54
Nava Karnataka Yuvaka Sangha. Tekkalakota
Ambedkar Yuvaka Sangha. Mannasugur
56
Swami Vcvakananda Yuvaka Sangha. Ycthanure
57
.Ambedkar Yuvaka Sangha
58
Navedia Yuvaka Sangha. Hochalli
59
Tippu Yuvaka Sangha. Tekkalakota
60
Neethaji Yuvaka Sangha. Dhorop
Harapanahalli
61
Durga Yuvaka Sangha. Rangapura
62
Mandura Uuvathi Mandah, H. Halli
63
Pansara Premigala Yuvaka Sangha, H. Halli
Krushi Karyagara Yuvaka Sangha, H Halli
'?5
Sevalal Yuvaka Sangha. Nandibevoor
^>0
Adarsha Yuvaka Sangha, H.Halli
67
Shiva Chatrapathi Shivaji Marata Yuvaka San glia. H. Halli
68
Kalleswara yuvaka Sangha, Halwagalu
69
Vinayaka Friends Association. Yuvaka Sangha. H.Halli
70
Sevalal Yuvaka Sangha, Bena Halli Tandha
Kudlagi Taluk
71
Vivekananda Friends Association, Kudligi
Ambedkar Yuvaka Sangha, Imrahapura
Sree Tulsi Bhavam Yuvathi Mandala, Poojarhalh Tandha
Navajyothi Yuvakara Sangha, Kudligi
75
Fathima Yuvathi Mandah,Kudligi
76
Kanyamma Yuvathi Mandah,Kudligi
Kittur Chanamma Yuvathi Mandah, Bellanalh
78
Mahaswan Yuvathi Mandah, Kudligi
79
Chanamma Yuvathi Mandah, Devalapura
80
Renuka Yuvathi Mandali,Kudhgi
81
Sport Association,Kakanahalli Taluk
82
Subhan Yuvaka Sangha, KakanahalhTaluk
83
Maruthi Yuvaka Sangha, Kudligi
84
Krishna Yuvaka Sangha,Kallahalli
85
Maruthi Yuvaka Sangha, Bommenahalh
86
Sevalal Yuvaka Sangha,Thimalur Tandha
87
Valmiki Yuvaka Sangha, Rampura, Kudligi Taluk
88
Valmiki Yuvaka Sangha, Kyasarapura. Ken
89
Ambedikar Yuvakara Sangha.Chandrashakarapura
90
Basaweswara Yuvaka Sangha,Murlihallu
91
Ambedikar Yuvaka Sangha, Ujjani,Kudligi Taluk
92
Koodi Basweswara Yuvaka Sangha, Hirehagdal
93
Jhansi Ram Yuvati Mandah. Kudligi

H.B. Halli Taluk
94
Nataji Yuvaka Sangha, HJB.Balli
95
Snaha Bharathai Yuvathi Mandali.H.B. Halli
96
Bharathi Yuvathi Mandah, FLB. Halli
97
Maruti Yuvaka Sanglia, Hampa Patna H.B. Halli
98
Arunodhaya Yuvaka Sangha. H.B. Halli
99
Vasundhara Yuvaka Sangha, Haralihalli
100
Sharada Yuvaka Sangha, Ramasamuudhra
101
Narayana Yuvaka Sangha, Lokappanahalli
102
Pnyanka Yuvaka Sangha. Beenakal
103
Basewaswara Yuvaka Sangha. Alasugur
104
Maruthi Yuvaka Sangha, Anakal Tlianda
105
Sevalal Yuvaka Sangha, Anakal Thanda
106
Adharsha Yuvaka Sangha, Koondanahalli
107
Durgamba Yuvathi Sangha, Beevanahalli
Qn

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