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Strengthening of Family Welfare
and
Maternal and Child Health Services
/
India Population Project-IX Proposal
Final Version Approved by GOI and IDA
Department of Health and Family Welfare,
Karnataka
June 1994
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Foreword
The Department of Health and Family welfare Government of Karnataka, had at
the meeting held in Washington in the first week of May 1994, requested the inclusion
of civil works in the three districts — Belgaum. Bijapur and Gulbarga in’IPP-IX, at an
additional cost of Rs., 133.503 million. The Ministry of Health and Family Welfare,
Government of India and the International Development Agency have reviewed the
request and agreed to fund additional Rs. 70 million., thus raising the total funding to
Rs. 1147.50 million against the total base cost of Rs. 1220.922 million.
This document updates the Final IPP-IX Proposal dated March 1994
incorporating the proposals for the three districts — Belgaum, Bijapur and Gulbarga in
the appropriate sections.
The Government of Karnataka would like to place on record its appreciation of
the understanding and support received from the officials of the Ministry of Health and
Family Welfare, Government of India and the Leader and members of Appraisal Mission
and officials of the International Development Agency.
The present volume incorporates all the documents submitted subsequent to the
Final Revision of the Project Proposal and replaces the previous versions of the project
proposal.
Bangalore
June^27. 1994
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Gautam Basu IAS
Secretary, Government of Karnataka
Department of Health & Family Welfare
Contents
Page
Executive Summary
1. Introduction
1.1 India Population Projects
1.1.1 India Population Project I
1.1.2 India Population Project - III
1.1.3 Lacunae in Implementation
1.2. Profile of Karnataka
1.2.1 Population and Growth
1.2.2 Literacy
1.2.3 Scheduled Caste and Tribal Population
1.2.4 CBR, IMR and TER
1.2.5 Health Facilities
1.2.6 Achievement: FW and MCH
1.2.7 Fertility
1.3. KAP of Family Planning in Karnataka
1.3.1 Awareness and Knowledge of FP Methods
1.3.2 Usership of FP by Method
1.3.3 Usership by Age of Wife
1.3.4 Usership by Living Children
1.3.5 Exposure to Mass Media
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2. The 1PP-IX Project
2.1 Action Plan of MoHFW
2.2. Project Proposal
2.2.1 Need for the Project
2.2.2 Project Goals
2.2.3 Area to be Covered by the Project
2.2.4 Rapid Appraisal of Needs
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3. Programme Linkage with Community at Local Level
15
4. Strengthening of FW and MCH Services
4.1 Strengthening of Health Centre
4.1.1 Buildings
4.1.2 Buildings for PHCs
4.1.3 Rehabilitation of Existing Centres
4.1.4 Handling Solid Waste
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4.1.5 Furniture and Equipment
4.1.6 Improving Productivity of Paramedical Staff
4.1.7 Link Workers
4.1.8 Development of CHCs into FRUs
4.1.9 Maintenance of Buildings
4.1.10 Budget for Strengthening Delivery of Services
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24
5. Improving the Quality of Services
25
5.1 Training
25
5.1.1 Existing Training Facilities
25
5.1.1.1 HFWTCs
25
5.1.1.2 Multipurpose Worker (Male) Training Schools 26
5.1.1.3 ANM Training Schools
26
5.1.1.4 LHV Promotional Training Schools for ANMs 26
5.1.1.5 CGN Training Centres
27
5.1.1.6 Health Inspector Training Centres
27
5.1.2 Manpower Projections
27
5.1.3 Adequacy of Pre Service and Pre Promotion Training
Schools
32
5.1.4 Staffing of Training Centre and Schools
33
5.1.4.1 HFWTCs
33
5.1.4.2 ANM Training Centres
34
5.1.4.3 Health Inspector Training Centres
34
5.1.5 In sendee Training of BHEs and Paramedical Staff
34
5.1.6 Proposed Training Programme
36
5.1.7 Training Centres For Jr. Health Assistants
37
5.1.8. Role of HFWTCs
40
5.1.8.1 Upgrading Infrastructure of HFWTCs
41
5.1.8.2 Phasing of Expenditure on HFWTCs
42
5.1.9 Training for TBAs, Anganwadi Workers, Community
Leaders and Others
42
5.2 Buildings for ANM schools
43
5.3 State Institute for Health and Family Welfare (SIHFW)
43
5.3.1 Training Load of IHFW
46
5.3.2 Phasing of Expenditure on IHFW
46
5.4 Budget for Improving Quality of Services
47
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6. IEC Activity
6.1 IEC Wing in Karnataka
6.2 Communication Needs
6.3 IEC Objectives and Strategy
6.4 Equipment for IEC
6.5 IEC Materials
6.6 Mahila Swasthya Sanghas
6.7 Staff
6.8 IEC Programme for the First Year
6.9 Budget for IEC
7. Project Management
7.1. Apex Authority
7.2 Engineering Wing
7.3 MIES
7.3.1 Present Status
7.j.2 Proposed Information system
7.3.3 Staffing for MIES
7.3.4 Capital Equipment for MIES
7.j.5 Stationary' and Office Supplies
7.3.6 Computer Systems for Special Applications
7.3.7 Selection of Vendors and Consultants
7.3.8 Budget for MIES
7.4 Evaluation Studies
7.5 Flow of Funds
7.6 Budget for Project Management
8. Innovative Schemes
8.1 Sub-Centre Health Advisory Committee
8.2 Involvement ofPVOs and PMPs
8.3 Special Programme for Tribal Areas
8.4 Involvement of Industrial Houses in IEC
8.5 Non-Formal Education for Girls and Young Women
8.6 Clubs for Newly Married Couples
8.7 Community Incentives
8.8 Marketing ofNirodh
8.9 Monitoring of Innovative Schemes
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9. Tribal Population of Karnataka
9.1 Scheduled Tribes of Karnataka
9.2 Tribal Development in Karnataka
9.3 Ethnographic Survey of Scheduled Tribes of Karnataka
9.4 Socio-Economic and Demographic Studies of Tribes in
Karnataka
9.5 Beneficiary and Communication Needs Assessment
Studies
9.6 Proposed Studies
10. Project Costs
10.1 Project Cost by Activity
10.2 Expenditure by Category
10.3 Phasing and Costing of Activities
10.4 Project Sustainability
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References
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77
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Annexures
1. Plan of Sub-Centres Building
2. Plan of Residential Quarters for MOs
3. List of V illages Selectedfor First Year construction of
Sub-Centres
4. District Map: Mandya
5. Taluk MAP: Nagamangala
6. Milage MAP
7. Status of Buildings for PHCs in Karnataka
8. Plan For PHC Building
9. Furniture and Equipment for Sub-Centres
10. Equipmentfor ANM Kits
11. Plan of District Training Centre
12. Furniture and Equipment for District Training Centre
13. Plan of Buildingfor HFWTC Mysore
14. Plan of Building for ANM Training School
15. Plan of Building for SIHEW
16. Furniture and Equipmentfor HFWTCs
17. Furniture and Equipment for SIHFW
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Executive Summary
1.
Project Objectives
Hie specific objective of the project is to implement a p
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programme
sustainable at village level to reduce CBR. IMP and MMR and increase CPR to reach the
national target forihe year 2000.
The strategy to be adopted for achieving the objectives is to
1. Involve the community in promoting and delivery' of family welfare
services.
2. Strengthen delivery' of services by providing
a. equipment kits.and supplies to TBAs. Sub-centres and PHCs,
b. make ANMs at sub-centres mobile by providing loans for purchase of two
wheelers,
for sub-centres with provision of residential accommodation for ANMs.
c. buildings tor
d. buildings for PHCs. and
e. residential quarters for medical officers.
2
Improve the quality of services by providing training to personnel, official and non
official at various levels including TBAs. community leaders and voluntary agencies.
4. Strengthen monitoring and evaluation by developing and installing MIES from district
to state level.
Area to be Covered by the Project
While construction of buildings for sub-centres. PHCs and residential quarters for
medical officers will be confined to selected thirteen districts, other activities such as
Training. IEC and MIES will be carried out in all the districts of the state.
Hie districts selected for construction of buildings for sub-centres, PHCs and
residential quarters for medical officers are the eight districts not covered by IPP-I and
IPP-1II namely, Bellary. Chikmagalur, Dakshin Kannad, Hassan. Kodagu, Mandya,
Mysore, and Uttar Kannad. In addition. Shimoga and Chitradurga districts covered under
IPP-I and Belgaum, Bijapur and Gulbarga covered under IPP-III are also included.
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3.
Civil Works
3.1. Buildings for Sub-Centres
There are 2076 sub-centres without buildings in the thirteen districts. It is
proposed to construct buildings for fifty percent of sub-centres (i.e. 1039 sub-centres) in
thirteen selected districts. Each new sub-centre building will have an examination room,
and a multi-purpose hall that can serve as a waiting room or meeting room as w'ell as
office area for Jr. Health Assistants(ANM). Besides it will have residential quarters for
ANM. The total area will be 64 sq. m. and is estimated to cost Rs. 230,000 per unit.
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The selection of sub-centres for construction of new buildings will be based on the
following criteria:
1.
2.
3.
4.
5.
6.
Accessibility to’nearest PHC (distance and transport facility).
Low level of immunization of children.
Low level of contraception.
Availability of unencumbered site of 225 sq.m within the middle of the village
The site should be well drained.
Environmental conditions around the site.
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3.2. Buildings for PHCs
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Out of the 1297 PHCs sanctioned and operating in the state 983 PHCs have their
own buildings or buildings are under construction. Out of the 314 PHCs without
buildings, 218 are in the project districts in which civil works are contemplated. It is
proposed to construct buildings for 94 PHCs at an estimated cost of Rs. 780,000 for each
PHC building..
3.3. Residential Quarters for MOs
Residential quarters for medical officers will be constructed at locations where
suitable residential accommodation is not available and the doctors have been living in
settlement other than that in which the PHC is located. If residential accommodation is
provided in the premises of PHC or nearby the availability of doctor is ensured. In all 271
residential quarters are planned to be built in the thirteen districts. The area of each
quarters will be 70.6 sq.m, and estimated to cost Rs. 300,000.
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3.4. Buildings for Training Establishments
3.4.1 Buildings for ANM Training Schools
ANM Training Centres in the districts of Bellary, Dakshin Kannad, Hassan.
Kodagu. Mandya. Mysore and Uttar Kannad have no buildings. Each of these will be
provided with a building with hostel facility for 48 students at a cost of 3.00 million.
3.4.2 LHV Promotional Training Schools for ANMs
Out of the four LHV Promotional training schools two Training Schools at
Belgaum and Mangalore will be closed down as there is excess capacity. Tlie schools in
these cities have no buildings. A building is under construction for the Training School at
Gulbarga while the one in Bangalore has no building. A building with an area of 575 sq.m,
will be constructed for the Training School including hostel facility for 30 students at
Bangalore at a cost of Rs. 1.60 million.
3.4.3 District Training Centres
It is proposed to construct one training school in each district to provide in-service
training to paramedical staff. Each centre will have hostel facility for 30 trainees and will
cost Rs. 1.60 million.
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3.4.4 Health and Family Welfare Training Centres
Tlie Health and Family Welfare Training Centre (HFWTC) at Mandya located in
communicable Diseases Investigation and Training Centre is proposed to be shifted to
Mysore. A Building with an area of 1365 Sq.m will be constructed at a cost of Rs. 5.187
million. Quarters for Principal and Medical Lecturer will also be. built at a cost of Rs.
0.722 million.
The HFWTC at Ramanagaram will be expanded by constructing additional lecture
halls and other facilities at a cost of Rs. 0.456 million.
3.4.5 Institute of Health and Family Welfare
It is proposed to set up an apex institute at Bangalore to design training courses
for all categories of staff and conduct training courses for the faculty of all training centres
currently run or proposed to be run by the Department of Health and Family welfare. Tlie
institute will also take up evaluation of programmes undertaken by the Department and
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suggest actions to remove deficiencies or improve performance. At a later stage, the
institute will offer diploma course in selected subjects for which substantial number are
deputed to institutes outside the State for training. An office building at a cost of Rs. 1.90
million will be constructed at the campus of Leprosy Hospital at Magadi Road, Bangalore
where a training centre building with hostel facility for 32 senior officers has been
constructed under IPP—III.
3.5. Rehabilitation of Existing Health Centres
It is estimated that 48 CHCs, 327 PHCs and 2212 Sub-centres in the thirteen
districts covered by the project need repairs to structure, replacement of electrical wiring
and fittings, repair of toilets, provision of continuous water supply. A provision of Rs.
43.919 million has been made in the Project Cost.
The State Government has to undertake at its cost rehabilitation of health centres
in the remaining seven districts. It has also to provide for regular maintenance of all health
centre buildings.
3.6. Upgrading CHCs into FRUs
A survey of facilities available at CHCs is being carried out to identify centres
which can be upgraded as first le\el referral units (FRUs) at minimal cost. The criteria for
selection of CHCs wall be:
1. The centre is already functioning as a referral hospital.
2. Specialists like surgeons, obstreticians & Gynaecologists and Paediatricians have
already been sanctioned,
3. Availability of major operation theatre, and
4. Marginal inputs will are required to make them function as FRUs
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The average cost of developing each FRU is estimated at Rs. 0.350 million.
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Strengthening Delivery of Services
5.
Apart from construction of buildings for sub-centres and renovating existing health
centres other steps are proposed for strengthening of delivery of health and family welfare
services.
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4.1.
Furniture and Equipment
Sub-centres which are being provided new buildings will be given full complement
of equipment and furniture. For other sub-centres, missing furniture and equipment will be
replaced. A provision of Rs. 97.005 million has been made for this purpose.
4.2.
Improving Productivity of Paramedical Staff
One-third of the ANMs who do not have midwifery kits will be provided with
equipment kit at a cost of Rs. 6.0 million. In order to save the time of paramedical staff in
travelling, loan will be given for purchase of vehicle of their choice.,oup.of fpm types. A
revolving fund of Rs. 105 million is proposed for this purpose.
4.3.
Link Workers
It is proposed to set up Health Advisor.' Committees (HAC) for each sub-centre to
orient delivery of services to the needs of the community. Apart from the health officials
two persons from each village served by the sub-centre will be nominated to the
committee by the Chairmen, of the respective Gram Panchayats. At least one nominated
member from each village will be a female.
Hie HAC will select a voluntary worker from each village to act as a link between
the sub-centre and the beneficiaries. The voluntary workers will be paid^performance
based incentives. A provision of Rs. 87.998 million has been made for payment of
incentives to link workers.
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4.3
Delivery Kits
To ensure safe and clean delivery. Trained Birth Attendants (dais)in each village
will be provided disposable deliver', kits free of cost. A provision of Rs. 13.295 million has
been made for meeting the cost of these kits.
5.'
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In-Service Training of Staff
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A study/JPopulation Centre. Bangalore revealed that there are serious gaps in the
knowledge, skills and practices of personnel in regard to family planning, maternal and
child health, nutrition, immunization, control of communicable diseases, environmental
sanitation, vital statistics and health education. It was indicated that there is an urgent need
for retraining of all paramedical staff. The Training Needs Assessment of paramedical staff j
initiated by the Project Proposal Team indicated that the situation did not seem to have /
materially changed.
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The training programme proposed under IPP-IX Project is aimed at
1.
2.
3.
4.
5.
updating knowledge, skills and practices of all health functionaries for effective
delivery of Health FW and MCH services,
developing communication skills to effectively carry out IEC activity in the
community.
making health functionaries aw are of their job responsibilities as providers of primary
health care,
maintaining information on performance at their level and providing feed back, and
developing knowledge and skills to act as trainers at their level.
All health functionaries will be provided in-service training initially for two weeks
and a refresher course of two week duration after three years.
The training modules and their duration for different categories of staff were
planned on the basis of training needs suivey, discussions with Joint Directors, DHOs and
Principal and staff of HFWTC.
The Joint Director (H.E.& T) will be responsible for conducting in-service training
courses for medical and paramedical staff and pre-service training to ANMs and
MPW(M). It is proposed to establish a training centre for Junior Health Assistants in each
of the 19 districts (Bangalore urban and rural districts will have together one district
training centre). Nearly 15,000 Junior Health Assistants (Male & Female) will be trained
at the district training centres.
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Training courses for Medical Officers. Block Health Educators and Senior Health
Assistants Male and Female will be provided at HFWTCs. Tlie Junior Health Assistants
Male and Female will be trained in their respective districts. Around 7000 Medical
Officers, Block Health Educators and Senior Health Assistants (Male & Female) will be
trained at the five HFWTCs. Besides providing continuing education to medical officers
and supervisory staff, the HFWTCs will have the responsibility of providing pre-service
training to Jr. Health Assistant Male and Sr. Health Inspectors which are full time courses,
each of one year duration.
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It is proposed to set up A State Institute for Health and Family Welfare to
1. design training courses for all categories of staff,
2. conduct training courses for the faculty of all training centres currently run or
proposed to be run by the Department of Health and Family welfare,
2 Conduct management training programmes for superintendents of hospitals and senior
doctors,
4. undertake evaluation of programmes of the Directorate of Health and Family w elfare,
including those under IPP-IX, and suggest actions to remove deficiencies or improve
performance, and
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5. offer diploma ..courses in DPH, DPHE and DPHN with affiliation to Bangalore
University.
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Experts in different subjects with considerable teaching experience will be ensased
to review existing materials prepared for CSSM/UIP and design the courses modules and
lesson plans and coordinate their activities. The expens will be selected from HFWTCs,
NIMHANS, Medical Colleges. Nursing Schools, Management Institutes, Institutes of
Mass Communication, NIC and leading consultants, fire training . The total cost of
development of course material for trainees is estimated at 1.635 million Rupees.
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One day orientation courses to 52,000 persons — TBAs, anganwadi workers,
workers.
selected members of gram panchayats, voluntary' workers and school teachers will be
conducted at the PHCs at a cost of Rs. 16.624 million during the project period.
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IEC
The Information Communication and Education activity is being strengthened by
providing equipment and additional manpower at the Directorate. Interpersonal
communication supplemented by audio-visual media will be the main modes of
communication.
The objectives for the IEC programme are:.
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To promote higher age at marriage among boys and girls.
I o promote spacing methods among young couples with one child or none.
I o promote terminal methods at younger age than hitherto.
To achieve hundred percent ante natal registration.
To educate and motivate the community to accept referral services under CSSM
programme.
To motivate women with unwanted pregnancy to avail of MTP service.
To involve and encourage the participation of the community, PVOs and NGOs in the
Family Welfare programme.
Hie Paramedical staff will be relied on to provide interpersonal communication as
they are. according to 80 percent of respondents interviewed for communication needs
survey, providing MCH and FP services through house to house visits. Apart from
conducting training programme to improve the communication skills of the paramedical
staff, inter personal communication kit will be made available to each ANM. The kit
would consist of items such as flash cards, flip charts, slide viewer, and other educational
aids. A quarterly news letter for internal circulation to paramedical staff will be brought
out. This news letter will give information on other IEC activities planned for the coming
quarter, suggestions for improvement received from paramedical staff and the names of
those who have done outstanding work.
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It is proposed to provide one each of video projector with VCP, TV/VCR, Slide
projector, overhead projector and a long bodied jeep to each district. TV/VCRs will be
provided to Ninety five selected CHCs will be provided with TV/VCRs and 800 Mahila
Swathya Sanghas will be given radio cum cassette player. A sum of Rs. 18.367 million has
been provided for equipment and vehicles..
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The IEC materials, whether for field exhibition by the district staff or Doordarshan
and AIR, will be designed in consultation with senior district officials such as DHO,
DHEO so that the communication materials reflect the socio-cultural ethos of different
regions of the state. It is proposed to invok e experts in the field of mass communication
from public and private sector institutions for development of messages and their
scheduling based on the results of communication needs study. Folk artists will be
supported to develop audio-visual programmes. An outlay of Rs. 37.46 million is
proposed for development of IEC materials.
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IEC materials whether they be audio-visual films, slide shows, posters, folders or
wall papers have to be pre tested to assess their effectiveness in conveying intended
, messages to the target population. A provision of Rs. 1.056 million is made for pre-testing
of IEC materials.
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Apart from telecasting TV serials and FW films on Doordarshan, they will be
exhibited by the district staff by hiring video vans. This will be tried out on an
experimental basis in five districts during the first year and if found effective it will be
extended to another five districts in the second year and remaining districts in the third
year. A sum of Rs. 41.5 million has been provided for hiring of video vans and buying time
on AIR and Doordarshan.
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It is proposed to form Mahila Swasthya Sanghas (MSSs) and utilize them as a
channel for communication to supplement the efforts through mass media and
interpersonal communication. It is planned to train the members of MSSs at PHCs and
undertake, with their help, programmes such as well baby shows, women and children's
day celebration, motivation of eligible couples etc. As it is difficult to manage and sustain
the MSSs on a large scale,, it is proposed to pilot MSSs on a limited scale and evaluate the
programme and extend it only if the results are satisfactory.
The IEC Staff at the Directorate will be augmented to manage the increased 1EC
activity.
7.
Project Management
9.
The apex body for management of IPP-IX is the Project Goveniing Board (PGB)
consisting of the Chief Secretary, and Secretaries for Finance, Health and Family Welfare,
Director Health and Family Welfare Sendees, Additional Director (FW & MCH), and
Additional Director (Projects) of Karnataka and Representative of Government of India.
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A Steering Committee consisting of the Secretaries of Health and Family Welfare
and Finance, Director Health and Family Welfare Services, Additional Director (FW &
MCH), and Additional Director (Projects) will carry out such functions as are assigned by
the Project Governing Board and shall furnish reports from time to time to the Board for
ratification of actions taken.
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The Additional Director (Projects) will be responsible for implementation of
IPP-IX: A post of Jt. Director (Area Projects) is created to assist the Additional Director
(Projects) in coordinating activities of various departments / agencies.
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An Engineering wing is being set up to plan and coordinate construction,
renovation and maintenance activities with State and Zilla Parishad PWDs.
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A comprehensive.management information system will be implemented. Computer
systems will be installed at the offices of District Health Officer and at the Directorate.
Computer systems will also be provided to Engineering, IEC and Training wings for
specialized applications in their respective areas.
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A sum of Rs. 9.826 million is provided for equipment and vehicles and Rs. 3.60
million towards consultancy services for project management.
8.
Innovative Schemes
A number of innovative schemes are contemplated. The most important being:
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Participation of community through Health Advisory Committee at Sub-centre
level
Involvement of PVOs and PMPs in promotion and/or delivery of services
Provide ANM training to Tribal Girls and post them to new sub-centres in tribal
villages
Involvement of industrial houses in IEC activity
Providing non-formal education for girls and young women
Promoting clubs for newly married couples
Offer community incentives for reaching MCH targets
Marketing of condoms through public distribution system
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Project Duration and Cost
The Duration of the project is seven years. The Breakup of base cost of the Project
by activity is Presented in Table 8.1.
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Table 8.1 Breakup of Project Cost by Activity
Activity
Strengthening Delivery of Health
Facilities
Improving Quality of Health Facilities
EEC
Administration & MIES
Innovative Schemes
TotalI
Capital
Revenue
Total
Capital
Revenue
Total
Capital
Revenue
Total
Capital
Revenue
Total
Capital
Capital
Revenue
Total
Million
Rs.
700.843
119.591
820,434
91.675
80.915
172.590
58.008
44.209
102.217
13.575'
36.120
49.695
Percent
of Total
57.40
9.80
67.20
7.51
6.63
14.14
4.75
3.62
8.37
1.11
2.96
75,886"
940.087 "
6,22
77.00
23.00
100.00
280.835
1220.922
4.07
Table 8.2 presents the phasing of expenditure by year between 1993-2000
Table 8.2 Phasing of Expenditure
Million Rupees
Total capital expenditure
Total revenue expenditure
Total Project cost_________
Physical contingency_______
Price contingency________
Project cost with Contingency
93-94
94-95 95-96
96-97
97-98
98-89
99-00 (Total
189.461 270.182 207,817 182.664 55,465
16.750
17.748
042.087
21,124 20.414! 32.348 48.082 49.337 51.834
57,696
280,835
210,585 290,596 240.165 230,746 104,803 68.584 75.444
1220.922
15,721 24,369
17,877
15,460
2.863
1.828
2.154
80,273
14.741 40,553 49.936 61.914 34,767 27.319 35.326
264.554
241,047| 355,518 307.978 308.1 19 142.433| 97.731 ' 112.924
1565.749
The Government of India and the International Development Agency have
approved a Base Cost of Rs. 1147.5 million at the negotiations held in Washington during
May 1994.
5
......
Chapter 1
Introduction
1.1
India Population Projects
Karnataka has benefited from the India Population Projects — IPP-I and
IPP—III. which together covered seventy percent of the population of the state. While
the overall objectives of both the projects focused around health and family welfare,
there were some differences in the emphasis on service components.
1.1.1
India Population Project - I
IPP-I was supported by Ministry of Health and Family Welfare (MoHFW),
Government of India, with assistance from the International Development Association
(IDA) and the Swedish International Development Authority (SIDA). The project was
implemented during the penod April 1973 - March 1980 in the six districts of
Bangalore Revenue Division — Bangalore Urban, Bangalore Rural, Chitradurga,
Kolar, Shimoga and Tumkur. The project area had as per 1991 census a population of
15.1 million comprising 33.6 percent of the population of the state.
•
•
•
•
•
•
•
The project aimed at
expansion of health infrastructure,
linking the provision of family planning services with a supplementary nutrition
programme,
creation of population centre to evaluate performance on a continual basis and
to design and operate MIES and evaluate performance, and
provision of technical assistance.
IPP " I (Karnataka) consisted of the following wings'
construction or engineering wing to take care of the construction of building
and other physical facilities;
implementation wing for recruitment and appointment of staff provision of
supplies and equipment and supplementary nutrition; and
population centre for conducting research studies and monitoring and
evaluation of the project.
The activities of all the three wings were coordinated by a Project Coordinator.
The responsibility for implementation of the project was entrusted to the Project
Governing Board (PGB) chaired by the Minister for Health and Family Planning,
Government of Karnataka. A steering committee with the Secretary, Health as
Chairman was formed to assist the PGB and to carry out such functions as were
assigned to it by the PGB and furnish reports to the PGB for ratification of actions
taken.
1■
r
r
I
1
2
The institutions contracted to provide services were: (1) Administrative Staff
College, Hyderabad for consultancy in management information, technical report
preparation and training; (2) National Institute of Nutrition, Hyderabad for assistance
in the implementation, monitoring and evaluation of supplementary feeding
programme; and (3) Central Food Technological Research Institute to manufacture
and supply energy food for the supplementary feeding programme.
IK
rrc
On
Sixty-five “major'1 buildings, 694 sub-centres and 97 additional buildings were
constructed under IPP-I. Of these buildings, 784 were provided with safe drinking
water and .417 with compound walls. As many as 11 1 four wheeled vehicles were
provided and equipment and furniture worth Rs. 12 million was purchased and put in
place.
X1O1
1.1.2 India Population Project - III
op
anc
■q
noi
rc
)G
IPP-II1 was implemented during 1984- 1992. with support from the Ministry of
Health and Family Welfare and the IDA, in Bclgaum. Bijapur and Dharwad districts of
Bclgaum Revenue Division and Bidar Gulbarga and Raichur districts of Gulbarga
Revenue Division. These six project districts had a population of 16.2 million in 1991
and accounted for 35.9 percent of the state population.
iC
h?
The objective of the project was the attainment of goals of population policy of
India namely, to reduce fertility, and lower infant, child and maternal mortality. The
goals were sought to be achieved by
•
•
•
.•
•
generating demand for services.
augmenting staff and facilities.
improving professional and technical skills,
improving management, and
involving community, voluntary organizations, other government departments and
local bodies in the family welfare programme.
..1
imp
c
new
due
The components of IPP-III were formulated on the basis of experience gained
from IPP-I. The supplementary feeding programme for pregnant women in the last
trimester, nursing mothers during the first six months of lactation and toddlers aged 6
to 24 months which formed part of IPP-I was not included in IPP-III. On the other
hand IEC and population education components were introduced for the first time in
IPP-III to generate demand for family welfare sen-ices.
'Flie total cost of IPP-III was Rs. 713.1 million and its break up by the four
major components is presented in Table 1.1,2.1.
TT
io
Ker
re
.df
anOt
Plan
1
• i
Proj
.
/
3
Table 1.1.2.1 Break up of Expenditure on IPP-III
Activity________________
Service delivery__________
IEC & population education
Research evaluation_____
Project management
f
rt
-a
Percent
83.0
6.4
___ Z9
7.7
2
re
re
2
3
in
Under IPP-III, as many as 2,344 buildings of different types w'ere constructed
and 83 PHC's were repaired or provided with extensions. Safe drinking water was
provided to 720 buildings and compound walls were constructed for 654 buildings.
One hundred and fifty four-wheeled vehicles and 512 motor cycles were provided.
Equipment and furniture worth Rs. 26 million was purchased and supplied to different
hospitals. The managerial and professional skills of many medical, paramedical and
non-medical personnel have been improved through w'ell organized training
programmes.
IPP-III had a construction wing, an implementation wing and an IEC wing.
Population education activity was entrusted to State Council of Education Research
and Training of the Department of Education. Government of Karnataka. The research
and evaluation activities were assigned to the Population Centre in Bangalore.
f
ga
1
f
a
IPP-III (Karnataka) also had a Project Governing Board (PGB) with the Chief
Secretary as the Chairman and a StepringX^^^
with the Secretary Health as
Chairman.
1.1.3
Lacunae in Implementation
Delay in implementation has been one of the problems experienced in
implementing both IPP-I and IPP-III resulting in prolonging the duration of the
projects from five years to se\ en years or more. The start of the project is delaved due
to delays in deputing personnel from other government departments and appointing
new staff
e
■I
-^iijxUijlliflWMl-iT' ———Or*!*
•
■
I
nd
; 6
n
r
Delay in cpnstnAQtion of buildings has been a serious problem. This has arisen
due to handing over responsibility of construction to Public Works Department, Land
Army Corporation and Karnataka Construction Corporation which have their own
priorities and independent construction programmes besides being under staffed. In
Kerala all the buildings under IPP-III could be constructed without delay because the
Directorate of Health and Family welfare Services has its own construction wing which
undertook the construction activity.
Delay due to lack_pf clarity in-pmjecL..management at different levels has been
another serious problem. Tlie objective of having the Secretaries of Finance and
Planning Departments on the Project Governing Board was to create a single window
for all approvals needed for project implementation. In spite of this understanding.
Project coordinators were required to obtain sanctions from Finance and Planning
1
I
4
Departments for activities approved by the board. Thus, the Project Governing
Boards, which were expected to cut down delays, became one more tier in the
sanctioning process.
19S
!V
Delays due to conflicts between officers in—charge of IPP project and those
in-charge of ongoing schemes have also occurred. India Population Programmes are
supposed to be implemented as part of ongoing family welfare programmes. However,
the Project coordinator who implements India Population Projects does not report to
the Additional Director (FW &- MCH) who is responsible for ongoing MCH and family
welfare programmes leading to conflicts between them. In IPP-III, an India Population
Project District Health Officer was appointed to implement project activities while the
regular District Health. Officer was looking after ongoing MCH and family welfare
programmes. This resulted not only in unhealthy competition but also conflicts
between the two officers.
1.2
Profile of Karnataka
1.2.1
Population and Growth
iPF
TPf
1.2
The population of Karnataka, as per 1991 census was 44.98 million and
accounted for 5.31 percent of the population of the country. The annual compound
growth rate has declined from 2.38 percent in the decade 1971-81 to 1.90 in the
decade 1981-91. While the decline in growth rate was substantial in IPP-I and
“Other" districts it was marginal in IPP-I1I districts.
pop
7
and
The urban population was 30.91 percent of the state population in 1991
The sex ratio has declined from 963 in 1981 to 961 in 1991. The decline has
occurred in Bangalore Rural, Bellary, Bidar, Bijapur, Dharwad, Gulbarga, Kolar,
, Raichur and Tumkur districts.
Table 1.2.1.1 Population, Percent Urban, Sex Ratio and Growth Rate
Population
(in thousands)
Urban %
Sex Ratio
Growth %
__________
Year
rpp-i
All
Districts
Other
Districts
1991
Project
Districts
15,125
EPP-III
Project
Districts
16,163
13,689
44,977
1981
1991
1981
1991
1981
1991
38.6
42.8
940
.939
2.91
2.12
23.8
25.4
968
960
2.08
2.05
21.2
24.5
980
987
2.24
1.60
28.9
30.9
963
961
2.38
1.93
1 2
IQQ
ta
|
!
4
1g
5
1.2.2 Literacy
.he
>se
re
er,
to
'iy
on
he
re
cts
The literacy among females aged seven and over increased from 27.0 percent in
1981 to 37.3 percent in 1991. During the same period
period the
the literacy
literacy among
among males
males aged
aged
seven and over increased from 48.0 to 56.4 percent. The six districts covered under
IPP-III had in 1991, the-lowest literacy level among males and females as compared to
IPP - I and other districts.
Table 1.2.2.1 Percent Literate among Males and Females Aged 7 & Ox er
Year
Males
Females
1981
1991
1981
1991
IPP-I
Project
IPP-III
Project
Districts
Districts
52.0
61.0
32.1
43.3
44.3
51.6
20.0
29.0
Other
All
Districts
Districts
47.9
57.0
29.7
40.5
48.0
56.4
27.0
37.3
I
1.2.3 Scheduled Caste and Tribal Population
>
nd
id
he
:nd
1
As per 1991 census scheduled castes account for 16.38 percent of total
population and scheduled tribes for 4.26 percent. IPP-I districts had the highest
percentage of scheduled caste as well as tribal population Among “Other" districts
(17.81) Bellary had highest tribal population (11.08%), followed by Kodagu (7 98)
and Mysore (6.42).
Table 1.2.3.1 Percent Scheduled Caste and Tribal Population in 1991
3
as
ar.
IPP - I Districts
IPP-III Districts
Other Districts
All Districts
SC
18.43
14.49
14.50
16.38
ST
5.40
3.46
3.51
4.26
1.2.4 CBR, IMR and TFR
At the state level, crude birth rate (CBR) declined from 34.5 in 1980 to 27.8 in
1090. During the same period infant mortality (IMR) declined from 85 2 to 7] 0 and
total fertility (TFR) from 4.65 to 3.42.
I
I
6
Table 1.2.4.1 CBR, IMR. TFR in 1980
IMR: Males
Females
TFR
CBR
IPP-III
Project
Districts
95.4
87.2
4,85
35.5
IPP-1
Project
Districts
84.3
75.6
4.51
34.3
Other
Districts
All
Districts
87.8
77,0
4.58
34.4
89.7
80.5
4.65
34.5
In
B
D
P(
V
(r
The vital rates for 1980 were estimated from 1981 Census data on
births last-yeaf, children ever bom and surviving children.
1.2.5 Health Facilities
1.^.7
There arc as of March 31. 1992. 176 hospitals, 184 CHCs, 1262 PHCs,
and 7793 sub-centres to cover a rural population of 30.96 million residing in 27.028
villages. On an average there is a PHC for 24,532 population as against the nomt of
one PHC for 20,000 population in tribal, hill and backward areas and one for 30.000 in
other areas. The average population coverage by a sub-centre is 3,972 persons while
the norm is one centre for 3.000 population in tribal, hill and backward areas and 5.000
while
l c 2c< pl
in other areas.
Table 1.2.5.1 Existing Health Facilities by District as on March, 31.1993
District
1PP-I Districts
IPP-III Districts
Other Districts
All Districts
Sub
centres
1979
2608
3206
7793
PHUs
PHCs
CHCs
Hospitals
Beds
253
103
230
618
352
440
505
1297
49
75
71
195
44
64
68
176
10987
8373
12072
31432
1.2.6 Achievement: FW and MCH
(
The couple protection rate for the state has increased from 23.7 in 1981 to
37.1 in 1986 and to 49.1 by March 21, 1992. The immunization level has been
basis of CBR of 29 for IPP-III districts and 27 for the remaining
computed on the
t----------
I
districts.
T re
F ill
I
7
6
Table 1.2.6.1 Couple I^otection and Immunization
CPR 1981
1986
1992 __________________
Immunization of Children in 1992
BCG
DPT
Polio
Measles______ ‘
Immunization of Mothers in 1992
ipp-m
IPP-I
Project
Districts
24.4
38.9
49.2
Project
Districts
22.4
32.9
41.6
97.8
93.3
93.1
86.2
94.0
93.7
84.1
84.7
77.2
90.2
Other
Districts
All
1 ^‘.i i icts
24.4
40.0
52.8
89.2
87.0
87.1
77.3
85.6
23.7
37.1
47.6
93.7
88.1
88.2
80.2
90.1
8
The marital fertility in the age group 15-24 has increased during Iuko
*8,
while in all other age groups it has declined, fhe increase in fertility in the agr
group
15-24 suggests that a change is taking place in the behavioural pattern of
vounger
couples who are marrying late and desire to complete the family earlier.
I able 1.2.7.1 Age Specific Fertility
Age_____
15-19
20-24
25-29
30-34
35-39
40-44
45-49
TFR/GFR
o
General
1980 |
1988
87.0 ___ 83.2
254,3 ___ 246.5
243.6 ___ 179.8
167,0 ___ 97.1
106,2 ___ 47.0
50.1 ___ 22.5
21,3 ___
8.5
4.65
3.42
Marital
1980
1988
240,0 ___ 306.0
322,3 ___ 344.0
262,8 ___ 204.2
179,5 ___ 166.4
1 16,6 ___ 52.3
59,4 ___ 26.7
27,3 ___ 10.0
6.04 '
5.55
Source: Census for 1980 data and Sample Registration Scheme for 1988 data
1.3
KAP of Family Planning in Karnataka
Hie results for Karnataka of the sun ey "Family Planning Practices in India
Third All India Survey" conducted in 1988-89 by ORG, Baroda for the Ministry of
Health and Family Welfare, Government of India are presented in this section.
1
!
I
1.2.7 Fertility
r
I
I
8
1.3.1
Awareness and Knowledge of FP Methods
Even though awareness of tenninal methods is high, 98.6 percent for
Tubectomy and 84.0 percent for Vasectomy, few have correct knowledge about them.
Awareness of non-temiinal methods is low compared to terminal methods. More
couples have correct knowledge of the use of condom and oral pill than IUCD or
terminal methods.
Table 1.3.1.1 Awareness of Contraceptive Methods
Method
Vasectomy
Tubectomy
IUCD
Condom
Oral Pill
Percent of Couples
Aware but
Not
Knowledge is
Aware
Correct
Poor
20.3
63.7
16.0
40.1
58.4
1.4
27,2
35,8
37,0
49.7
14.0
36.4
52.0
8.0
39.9
(’ ’Id
(
it
1.3.2 Usership of FP by Method
Current users of any method, including traditional methods, account for 47.5
percent of eligible couples, 3.6 percent for past users and 48.9 percent for never users.
The current users by method arc presented below.
Table 1.3.2.1 Practice of Contraception by Method
Method
Sterilization_______
IUCD___________
Condom__________
Oral Pill__________
Any modem method
Traditional methods
Any method
Percent of
all couples
38.6
3,1
2.1
0.7
44.5
2.5
47.5
1.3.3 Usership by Age of Wife
Nearly 1.2 million current users aged 35 years and over, forming 36.75 percent
of all current users, will go out of the reproductive age group by 1998.
3.
tc
9
8
Table 1,3.3.1 Practice of Contraception by Age of Wife
Age of Wife
Current user Percent of
Percent
couples
all users
users in the
(thousand)
age group
15-19
_______ 34,6
0.1 1 ________ 8.3
20-24
375.6
11.58 _______ 28,6
25-29
782.1
24.10
45.2
30-34
860.2
26.51 _______ 64,5
35-39
640.1
19.73 _______ 58,5
40-44
552.3
17.02 _______ 58^
All couples
3244.9
100.00
47.5
:or
m.
re
or
1.3.4 Usership by Living Children
The usership was the highest in the group with three or four children.
!
Fourteen percent of those who have three or more children desire additional
children.
About 31 percent of those who do not want any children are not practicing
contraception.
j
Table 1.3.4.1 Practice of Contraception by Desire for Additional Children
Living children
Nil
1-2
3-4
5+
Desire for
Additional
Children
_____ Want
Want
Don't want
_____ Both
Want
Don't want
_____ Both
Want
Don't want
Both
No. of couples
in thousands
Percent current
users
622.3
1388.4
1367.7
2756.1
397.2
2095.6
2492.8
89.2
878.5
967.7
1.6
16.4
67.7
41.8
1.5
74.5
62.9
3.0
59.0
53.8
1
1 -3.5 Exposure to Mass Media
t
state.
Mass media do not reach even fifty percent of the female population of the
I
10
Table 1.3.5.1 Exposure to Mass Media among Women Aged 15-44
Media
News Paper
Radio_____
TV
Cinema
I
Percent Exposed
Males
Females
37,9
17.0
52.0
46.3
22,1
21,2
34.0
27.3
2.1
Stat G
to £ e
importa
the
it
acth
1 ai
ar
spa
Tnc
t
Inc
f.
)C
21
Prujec
B?nga
as oc
of He;
Drct
O :e
2.
1
1( .2.
requn
pi :e
piujC<
millio
\\ e
11
Chapter 2
io
The IPP-IX Project
Action Plan of MoHFW
2.1
The Ministn of Health and Family Welfare (MoHFW) has, in consultation with
State Governments and Union Territories Administration has evolved an Action Plan
to give requisite thrust and dynamism to the family welfare programme. The most
important aspects of the Action Plan are:
•
•
•
•
•
•
Improvement in the quality and outreach of health and family welfare services in
the field.
Initiating innovative programmes in urban slums for propagating family welfare
activities.
Launching Child Survival and Safe Motherhood Programme.
Targeting message of small family specially to younger couples and promoting
spacing methods of contraception.
Increased involvement of voluntary agencies and non governmental organizations
in the family welfare programme with a view to make it a peoples programme.
Increased Information, Education and Communication inputs and decentralization
of communication strategies to take into account the local socio-cultural ethos with
special emphasis on interpersonal communication.
The Project Proposal
It is against this background that the Government of Karnataka constituted a
Project Proposal Preparation Committee with the Director, Population Centre.
Bangalore as Chairman and the Additional Director MCH and FW, Govt, of Karnataka
as Cochairman to formulate a project proposal for submission to IDA through Ministry
of Health and Family Welfare, Government of India for financial assistance. The Joint
Directors In Directorate of Health and Family Welfare, selected District Health
Officers and representatives of STEM were members of the committee.
2.2.1
The Need for the Project
Karnataka has achieved a couple protection rate of 49.1 percent by March, 3 1,
1^92. In order to achieve a CPR of 6)0 percent by march 1998, the magnitude of effort
required is substantial. Assuming an annual compound growth of population at 1.7
percent in the coming decade and eligible couples per 1000 population at 160, the
projected eligible couples in 1998 will be 8.067 million. To achieve a CPR of 60, 4.84
million couples will have to be protected. As of March 31, 1992 3.58 million couples
were effectively protected. Out of the currently protected couples, 1.94 million will
£
■
l
—
12
remain in the reproductive age group by 1998. It is therefore necessary to effectively
protect 2.90 million new couples between 1992-98 or nearly 410,000 per year as
against the observed average annual rate of 147,200 couples during 1989-92. The
efforts of the Department of Health and Family Welfare have to be trebled in the five
years 1993-98, to achieve CPR of 60 by 1998.
I
I
I
I
I
I
In view of this the substantial investments have to be made in extending the
outreach programme to the door step of beneficiaries distributed over 27,028 villages
in the state to achieve the target for CPR and to have a ‘"sustainable” family welfare
programme.
tra
n;
the ~t<r
resiuei
IPP-I1
M} )r
unuer
2.2.2 Project Goals
2.2.4
The specific objective of the project is to implement a programme
sustainable at village level to reduce CBR, IMR and MMR and increase CPR as
indicated below for the state of Karnataka.
Table 2.2.2.1 Targets for Vital Rates
I
I
Infant Mortality______
Maternal Mortality
Crude Birth Rate_____
Couple Protection Rate
I
i
I
l
1990
1998
71
50
___ 2
20
___ 6
28
47
60
i
I
The strategy to be adopted for achieving the objectives is to
i
i
l
i
I
•
•
i
i
i
I
i
i
i
•
I
I
•
Involve the community in promoting and delivery of family welfare sendees.
Strengthen delivery of sendees by providing
1. drugs, health kits and supplies to TBAs, Sub-centres and PHCs,
2. make ANMs at sub-centres mobile by providing loans for purchase of two
wheelers,
3. buildings for sub-centres with provision of residential accommodation for
ANMs, and
4. residential quarters for medical officers.
Improve the quality of services by providing training to personnel, official and non
official at various levels including TBAs, community leaders and voluntary
agencies.
Strengthen monitoring and evaluation by developing and installing MIES from
district to state level.
2.2.3 Area to be Covered bv the Project
Wliile construction of buildings for sub-centres and residential quarters for
medical officers will be confined to selected thirteen districts, other activities such as
the tei
fro e
sui jy
covert
on w
CO..1.T1
Distric
in cl!
foi m<
ne^s
Fe il
Superi
Ju"Ar
by ie
be fi
non-tr
su
I
12
ively
■ as
The
five
the
ges
.are
13
training. IEC and MIES will carried out in all the districts of the state. (See Map I for
the State of Karnataka and demarcation of thirteen districts selected for civil w orks).
»
Tlie districts selected for construction of buildinss for sub-centres and
residential quarters for medical officers are the eight districts not covered by IPP-I and
IPP-III namely. Bellaiy. Chikmagalur. Dakshin Kannad, Hassan, Kodagu, Mandya,
Mysore, and Uttar Kannad; and in addition Shimoga and Chitradurga districts covered
under IPP-I. and Belgaum. Bijapur and Gulbarga covered under IPP-III.
2.2.4 Rapid Appraisal of Needs
ime
as
The proposals outlined in the following sections are based on irapid survey of
the ten of the thirteen project districts. In each district two taluks were sampled and
from each taluk one CHC. two PHCs and four Sub-centres were selected for facility
survey as well as training needs survey. One village was selected from the villages
covered by the sampled sub-centre. From each sampled village a community leader and
one woman aged 15 years and over were interviewed for assessing beneficiary and
communication needs. A study team comprising of An Additional Health Officer,
District Nursing Superintendent and the District Health Education Officer was formed
in each district to conduct the surveys. The facility survey and the training need survey
for medical officers were conducted by the Additional Health Officer, the training
needs survey for Senior Health Assistant Female (LHV), Junior Health Assistant
Female (ANM) and Trained Birth Assistant (TBA) by the District Nursing
Superintendent and the training needs survey for Senior Health Assistant (Male) and
Junior Health Assistant (Male) as well as beneficiary and communication needs surveys
by the District Health Education officer.
)
!
In addition to the efforts of the district health officials. STEM conducted
beneficiary and communication needs surveys in a tribal taluk of Mysore district and
non-tnbal taluk of Chitradurga district while the Population Centre conducted the
' survey in Dakshin Kannad and Kodagu districts.
31
|>r
Is
14
PROJECT STUDY DISTRICTS IN KARNATAKA-IPP IX
-
KARNATAKA
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14
15
Chapter 3
Programme Linkage with Community at Local Level
The zilla parishad is responsible for implementing the family welfare and
maternal and child health programmes in the district. The District Health Officer
reports to the Chief Secretary' of the Zilla Parishad. 'Elms there is community
participation at the district level through the Zilla parishad. However it is necessary to
encourage the community to participate at the lowest level of the service delivery
system namely, the sub-centre. On an average there are six sub-centres under a PHC
and each sub-centre covers approximately four villages.
It is proposed to promote Health Advisory Committee at the sub-centre level.
The Medical Officer of PHC will be entrusted with the responsibility of forming HAC's
for each sub-centre under his / her jurisdiction. 'Hie committee will be chaired by the
MO and will have the LHV of the PHC, ANM and Jr. Health Assistant (Male) of
concerned sub-centre and two representatives from each village covered by the sub
centre. The representatives from the villages will be nominated by the Adhyaksha of
the respective Gram Panchayats. It will be ensured that at least one woman is
represented on the committee from each village covered by the sub-centre. The HAC
will meet at least once a quarter at the Sub-centre. The representatives from villages
will be reimbursed Rs. 25 towards Travelling and incidental expenses for attending
each meeting.
-
The HAC will discuss the beneficiary needs in its territory' and draw up a plan
of action to be follow ed by the community of each village to achieve the goals of the
project. The MO will consider the suggestions made by the community representatives
and draw up an annual plan and break it down by quarter. The MO will review each
quarter the performance and if warranted, modify the plans for the next quarter. The
MO will forward the minutes of HAC meetings along with his report on the
performance in the area covered by the sub-centre to the DHO for quarterly review.
The HAC committee will identify in each village a woman who is willing to
volunteer to act as a link between the families in the village and the sub-centre. In
larger villages more than one volunteer may be identified at the rate of one per
thousand population. The volunteers will be interacting with the ANM of the sub
centre covering the village.
I
I
i
-
1
16
I
The volunteers will
I
•motivate couples to adopt appropriate contraceptive methods and refer acceptors
to ANM,
• educate all pregnant women on ante natal care and refer to ANM,
• promote child care programme and arrange for immunization, and
• coordinate with ANM for arranging health education and environmental sanitation
programmes in the village.
4.1
4.1 1
19c'. »
This will be tried out on experimental basis in four PHCs in each district for
two years and if found successful will be extended to all PI ICs. The cost per year for
HAC meetings during the experimental period will be Rs. 384,000. If the programme is
successful and extended to all PHCs. the annual expenditure will be Rs. 5.4 million.
by e
in ' b
Pi
o
rn me
ro^m,
w a
ANM
(P’-u
th
c
1.
2.
/
3. [
4. /
J
17
Chapter 4
Strengthening of FW and MCH Services
4.1
Strengthening of Health Centres
4.1.1
Buildings
There are 7793 sub-centres functioning in Karnataka State as on March 31,
1993. Of these 4394 sub-centres have no buildings.
There are 130 CHCs, 890 PHCs and 5548 SCs in the 13 districts to be covered
by the project. Major findings of the facility survey, relevant to buildings, are presented
in Table 4.1.1.1.
I
7 able 4.1.1.1 Condition of Structures of Health Centres
Does not have owned or rented building
Building has cracks in
Percent of centres
CHC
PHC
SC
0
2.4
40.2
Ceiling
44.4
Walls
33.3
Floor
Has no water supply at all
Has no continuous water supply_______
Has no water seal toilet
27.8
5.6
27.8
43.9
36.6
29.2
4.9
58.7
58.7
54.3
48.8
87.0
11.1
19.5
19.6
J
10.9
fhere are 2075 sub-centres without buildings in the thirteen districts. It is
proposed to construct buildings for fifty percent of sub-centres (i.e. 1039 sub-centres)
in the thirteen selected districts. Each new sub-centre building will have an examination
room, and a multi-purpose hall that can serve as a waiting room or meeting room as
well as office area for Jr. Health Assistants. Besides it will have residential quarters for
ANM. The total area will be 64 m2 and is estimated to cost Rs. 2,30,000 per unit.
(Plans for sub-centre buildings are presented in Annexure 1).
The.selection of sub-centres for construction of new buildings will be based on
the following criteria:
1. Accessibility to nearest PHC (distance and transport facility).
2. Low level of immunization of children.
Low level of contraception.
4. Availability of unencumbered site of 225 sq.m within the middle of the village.
5. The site should be well drained.
6. Environmental conditions around the site.
/
J.
'
‘
'■ SCAT ’
18
It is also proposed to construct residential quarters for medical officers at
locations where suitable residential accommodation is not available and the doctors
have been living in another settlement than that in which the PHC is located. If
residential accommodation is provided in the premises of PHC or nearby the
availability of doctor is ensured. In all 271 residential quarters have to be built in the
ten districts. The area of each quarters will be 70.6 m^ and estimated to cost Rs.
300,000. ( Plans for residential quarters are presented in Annexure 2 ).
Table 4.1.1 Buildings to be Constructed and Cost by District
District
Belga urn______
Bcllary________
Bijapur________
Chikniagalur
Chitradurga
Dak shin Kann ad
Gulbarga______
Hassan________
Kodagu_______
Mandya_______
Mysore________
Shimoga______
Uttar Kannad
Total
Number o "Buildings
SubMO's
Centres Quarters
49 _______23
47 ______ [2
120 _______ 1_9
______ 64 _______ 12_
86 ______ 21
136 _______ 37
______ 84 _______ 25
88 _______ 19_
31 ________ 8^
______71 _______ 18
132 _______ 39
______72 _______ [9_
______ 59 _______ 16_
271
1039
Cost Million Rupees
Total
MO's
Sub
Cost
Centres Quarters
18.170
6,900
1 1.270
4,500
'
15,310
10.810
5,700
33,300
27,600
3,600
'
18,320
14,720
6.300 '
26,080
19,780
1
1,100
'
31.280
42,380
9,360
'
24,080
14,720
5.700 |
25.940
20,240
2.400 ~
7,130
9,530
5.400
'
16,330
21.730
1
1,700
'
30,360
42,060
5.700 |
22,260
16,560
18,370
13,570
4,800 I
83.160
i
234.370
317.530
4 .3
re in
and/o
T ’ le
The 87 villages in which the sub-centres are to be constructed during the first
year have been identified and presented in Annexure 3. These have also been plotted
on taluk maps. Sites suitable for sub-centre buildings have been located in each of
these villages and shown on sketch of the village. Sample charts for one district and
one village are shown in Annexures 4, 5 and 6 respectively. In the second and third
years, 350 and 349 new buildings for sub-centre will be constructed.
4.1.2 Buildings for PHCs
Out of the 1297 PHCs sanctioned and operating in the state 983 PHCs have
their own buildings or buildings arc under construction. Out of the 3 14 PHCs without
buildings, 218 arc in the thirteen project districts in which civil works are
contemplated.( See Annexure 7 for details). It is proposed to construct buildings for
40 percent of the PHCs without buildings. Each Building is estimated to cost Rs.
780,000. Table 4.1.2.1 presents the number of buildings to be constructed and their
cost by district.(See Annexure 8 for Plan of PHC Building).
4
esti
18
19
Table 4.1.2.1 PHC Buildings to be Constructed and Cost
cers at
octors
ed. If
by the
in the
st Rs.
District_______
Belgaum______
Bellary_______
Bijap ur_______
Chitradurga
Dakshin Kann ad
Gulbarga
Hassan_______
Kodagu_______
Mandy a_______
• Mysore________
Shimoga______
Uttar Kann ad
Kam at aka
>ta
9 St
70_
J_0
30_
Number
______6
______7
_____ 2_
_____ 12
_____ 9_
____ 12
_____ 5_
_____ 7_
_____ 5_
_____ 8_
____ 13
_____ 8_^
74
Million Rs.
4.680
5.460
1.560
9.366°
7.020
9.360
3.900
5.460
3.900
6.240
10.140
6,240
73.320
J0_
S7)_
[0_
J0_
-10_
0^
30
0_
_0_
4.1.3
Rehabilitation of Existing Centres
Nearly 45 percent of existing CHCs and PHCs and 60 percent of Sub-centres
require repairs to structure, replacement of electrical wiring and fittings, construction
and/or repair of toilets and provision of continuous water supply to rehabilitate them
1 able 4.1, j. I presents estimated cost of rehabilitation.
Table 4.1.3.1 Cost Estimates for Rehabilitation of Existing Centres
■T)_
0
first
tted
ii of
and
lird
ive
.out
are
for
Rs.
leir
CHC|
PUC
|________
sc]
Cost per Centre in Thousand Rs.
Ceiling_____________
Flooring
Plastering_____
Toilet
Water Supply & Sanitation
Electrical wiring & Fitt in a s
Total cost per Centre
Number of Centres_______
Cost of all Centres (Million Rs.)
66.1
24.1
18.0
__ 0.5
__ 5,5
6.0
120,2
__ 48
5.770
36,6
14.2
18,3
1 1,0
0.4
___ 2,5
___ 2.0
3.6
0.8
20.4
2071
42.249
73,2
327
23.936
___ 0.3
___ 0.6
4.1.4 Handling Solid Waste
Apart from rehabilitating existing centres, it is proposed to provide all centres
with facthues for handling solid waste. 'The facilities to be provided and the cost
estimates for them are presented in Table 4.1.4.1.
I
i
i
20
i
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i
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i
Table 4.1.4.1 Equipment and Cost for Handling Solid Waste
127
Unit
Cost Rs.
14,000
Total Cost
Million Rs.
1.778
871
6,000
5.226
5560
250
1.390
Number
i
i
i
I
i
i
i
i
i
i
i
i
i
i
i
i
i
i
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i
I
Community Health Centre
Three Closed containers with wheels
@ Rs. 3000 each and one wheel
barrow @ Rs. 5000 each____________
Primary Health Centre
Two closed containers with wheels Rs.
3000 each_________________________
Sub-centre
Two closed containers @ Rs. 125 each
Total cost
8.394
* All health centres in the thirteen districts are included
i
i
i
4.1.5 Furniture and Equipment
i
i
i
i
i
I
i
Each of the 1039 centres planned to be provided with new building will be
equipped with furniture and equipment costing Rs. 22,500 and Rs. 5.000
respectively.(see Annexure 9 for list of items and costing). The items of equipment
confinn to the norms given by MoHFW under CSSM project. The total cost on this
account will be
i
i
i
i
I
i
i
i
i
i
i
i
i
i
i
i
i
i
J
ur 4 er
m »il
— bi»
pi /i»
th sc
under
for d
C( di
1. A
Pi
vc
2. T
3. T
P*
4. A
er
5. T
P' :e
i
I
home
6.n m
Furniture
Equipment
Rs. 23.378 million
Rs. 5.195 million
Shortage in furniture and equipment as compared to nonns referred to above
will be assessed for each of the remaining 4521 sub-centres and deficiencies made
good. It is estimated that on an average the cost of augmentation of equipment and
.furniture works out to Rs. 9,000 and Rs. 5,000 respectively. The total cost will be as
under.
Furniture
Equipment
Rs. 40.689 million
Rs. 22.605 million
It is proposed to purchase 13 laproscopes and 25 suction apparatus besides
getting components for repairing 42 laproscopes which are out of order. The total cost
for these is estimated at 5.15 million Rupees.
1
4
a: :
4.1.6 Improving Productivity of Paramedical Staff
The facility survey has revealed that nearly 33 percent of the ANMs do not
have kits as per standard. It is proposed to provide such ANMs with deliver}' kits (see
Annexure 10) for attending to deliveries both at the health centres as well as at the
Von
he^j—
rr _
20
21
home of the pregnant women. The cost of equipping 3000 ANMs is estimated at Rs.
6.0 million on the basis of cost of kit at Rs. 2,000.
st
3
6
i
4
1 be
.000
■’lent
The paramedical staff spend considerable time in Travelling to the villages
under their jurisdiction. In order to cut down travel time, it is planned to make them
mobile by giving them loan to purchase a two wheeler of their choice out of four types
— bicycle, moped, scooter and motor cycle. A revolving fund of Rs. 105 million is
provided on the assumption that 50 percent of paramedical staff and BHEs will opt for
the scheme during the project period, 'file details of the vehicle loan scheme are as
under.
Each employee who has been confirmed in a permanent post, will be eligible
for drawing advance for purchasing a two wheeler on the following terms and
conditions:
1. An amount equal to 12 months pay subject to a maximum Rs. 25,000 or the
purchase price of the vehicle, will be given as advance for purchase of a brand new
vehicle.
2. The vehicle will be hypothecated to the State Government.
3. The advance will be recovered in 60 equal monthly installments from the salary
payable to the employee.
4. All taxes, comprehensive insurance and maintenance expenses have to home by the
employee.
5. The hypothecation will be canceled after full recoveiy of the loan.
this
The size of the revok ing fund and the additional annual expenditure on fifty
percent or 9000 employees in all districts of the state will be as under.
1 able 4.1.6.1 Capital Expenditure to Increase Productivity of ANMs
ove
nade
and
e as
Kits for ANMs___________
Loan for purchase of vehicle
Total
sides
°ost
not
see
the
Expenditure in Million
______ Rupees_____
Revolving
Capital
Fund Expenditure
6.000
105,000
0.000
105.000
6.000
4.1.7 Link Workers
Majority of the community leaders and women who w'ere interviewed for
assessment of communication needs indicated that there are capable persons willins to
volunteer for providing adult education (88%), educating the community on sanitation,
health, personal hygiene (76%), importance of immunization (75%) care of expectant
mothers, and children (72%) and motivation of couples for adoption of FP methods
I
22
At present a sub-centre covers on an average 4.000 population or 800
households spread over three to four villages. It is difficult for one ANM to provide
services at the sub-centre and also visit all households with required intensity of at least
once a month to provide family welfare and maternal and child care sendees at the
door step. It is therefore proposed that the HAC identifies one volunteer worker, in
each village to act as a link between the sub-centre and the beneficiary'. The voluntary
worker will:
1.
2.
4.
5.
6.
contact all households in the xillage once in a fortnight,
provide inteq^ersonal communication on contraception, maternal and child care and
environmental health and sanitation as part of IEC activity.
keep track of all pregnant w omen and cause to provide ante natal, intra-natal and
postnatal care,
ensure that all children below two years of age are immunized against specific
diseases at proper time,
motivate couples to adopt contraception to delay/prevent pregnancy with particular
emphasis on the married women in the age group 15-29,
hold stocks of condoms and oral pills for free distribution and/or sale.
The voluntary' worker will be set performance targets for the following
parameters:
dciivc
n-°l
1 h
2.4 n
4.If
whicl
S'
;C
I
I
S
a
A
IV
2
4
b al
Number of women registered for ANC sendees
2. Number of women provided with ANC / PNC services
3. Children fully immunized
4. Targets for couples protected by spacing methods
1.
An incentive scheme will be prepared which will take into account performance
on each component. Incentive will be paid on a graduated scale for performance
between 75 to 120 percent of the target. Besides the incentive, the voluntary w orkers
will be paid 20% of the sale proceeds of condom or oral pill
The Medical officer of a PHC will select for each village under his/her
jurisdiction a voluntary' worker, preferably a female, from among the residents of the
respective villages to act as a link worker between the ANM of the sub-centre and the
households in the village. The choice of link worker will be made among literate
females. The trained dai’s could also be considered for selection. This will be tried out
on an experimental basis in tw o PHCs of each district and if found successful will be
extended to all PHCs in the state during the third year of the Project.
The average incentive per voluntary' worker will be Rs. 750 in a year. If the
target is achieved by all the voluntary' workers, the total outgo on account of incentives
to voluntary workers will be Rs. 19.3 million per year. As it will be tried out on an
experimental basis in 40 PHCs in the first two years, the cost will be Rs. 0.574 million
per year during the experimental period.
To ensure safe and clean delivery; the ANM will make available to TBAs
disposable delivery kits for distribution to each pregnant woman in the rural area,
opting for delivery at home. The beneficiary need survey indicated that 25 percent of
( S
six C
c^st
I.
(
T
will-
r d=
c
ma—
4
-
Illi
22
23
800
ovide
least
t the
er. in
itary
deliveries occur at home. Assuming a cnide birth rate of 24, annual growth rate of
rural population at 1.5 percent during 1993-98, about 0.2 million kits each costing Rs.
12, have to be provided each year. The annual cost on this account is estimated at Rs.
2.4 million.
4.1.8 Development of CHCs into FRUs
and
and
ecific
cular
King
;ance
nice
Kers
Jher
f the
the
.rate
1 out
I be
the
lives
an
A survey of facilities available at CHCs is being carried out to identify centres
which can be upgraded as first level referral units at minimal cost. The criteria for
selection of CHCs will be:
1. The centre is already functioning as a referral hospital.
2. Specialists like surgeons, obstreticians & Gynaecologists and Paediatricians have
already been sanctioned.
3. Availability of major operation theatre, and
4. Marginal inputs will are required to make them function as FRUs
The average cost of developing each FRU is estimated at Rs. 350,000. The
break up of cost is as under.
1.
2.
3.
4.
5.
Instruments (12 t\pes)
Laboratory & OT items
Refurbishing OT
OT equipment (AZC etc.)
Supporting appliances
Total
Rs. 100.000
Rs. 20,000
Rs. 75.000
Rs. 130.000
Rs. 25.000
Rs. 350.000
Out of the thirteen project districts. Chikmagalur has been selected under
CSSM project with the assistance of MoHFW. In each of the remaining eleven districts
six CHCs will be selected and developed as FRUs during the project period. The total
cost is estimated at Rs. 23.850 million.
4.1.9 Maintenance of Buildings
The Directorate of Health and Family Welfare Services has initiated a survey of
all health centre buildings under its control to determine the extent of repairs to be
carried out and estimate the cost. The State and Zilla Parishad PWDs will be entrusted
with the task of carrying out the repairs. The total cost of all buildings constructed
under IPP-I and IPP-HI will be borne by the State Government.
lion
lAs
area.
I of
Annual maintenance will be the responsibility of respective PWD wings.
Provision will be made in the Non-Plan expenditure of the State government for annual
maintenance of all buildings used by the Directorate.
24
For the buildings proposed to be constructed under IPP-IX, provision for
maintenance works is made each year at the rate of two percent of the cumulative
value of buildings constructed up to three years back.
1
4.1.10 Budget for Strengthening Delivery of Services
The phasing of capital and revenue expenditure is presented in Table 4.1.10.
Table 4.1.10 Phasing of Capital and Revenue Expenditure on Strengthening Delivery
of Sendees
94-95
95-96
96-97
Million Rupees
98-99
97-98
99-00I 00-011
5.1
5.1.1
Total
Family
Capital Expenditure
58.190
0.000
0.000
0.000 238.970
19.500
15.600
0.000
0.000
0.000
73.320
0.000
0.000
0 000
81.300
Sub-centre building. Civil works
20 010
80.500
80.270
PHC buildings: Civil Works
18.720
19.500
Quarters for M.Os: Civil works
9.000
26.100
26.100
20.100
Rehabilitation of Health Centres
5 Q44
19.924
19.684
16.202
10.200
0.000
0 000
0.000
0 000’
71 954
0 000
8 394
Equipment for solid waste handling
8 394
0.000
0.000
0.000
F urniture for sub-centre buildings
28.224
7.853
5.693
0.000
0.000
0.000
64.067
Equipment for sub-centre buildings
22 298
15 469
14 459
1.745
1.265
0 000
0 000
0.000
32 938
Kits for ANM
2.000
2.000
2.000
0.000
0.000
0.000
0.000
6 000
24 000
0.000
0.000
105.000
18.900
Revolving fund for two wheelers
9 000
24 000
24.000
24.000
Up gradation of CHCs to FRUs
6 300
6.300
6.300
0.000
0.000
0.000
0.000
117 135 221.007 187 452 141.050
34.200
0.000
0.000 700.843
Total Capital expenditure
Revenue Expenditure
19.300
19.300 19.300 19.300
87.998
1.935
2.436
2.472
2.472
2.472
13.295
3.477
5.994
7.872
18.298
25.249 27.766 29.644 119.59]
Incentive to voluntary workers
0.574
0.574
9 650
Deliver,' kits
0 381
1.127
Maintenance of proposed new buildings
0 000
0.000
0 000
0.955
Total Revenue Expenditure
0.955
1.701
1 1.585
22.691
51.1
i
R la
traine
c< r
It
is
hall.
i
I
’4
25
or
ce
Chapter 5
Improving the Quality of Services
5.1
Training
5.1.1
Existing Training Facilities
The training centres currently functioning under the Directorate of Health and
Family Welfare services are:
ota I
.970
1. Health & Family Welfare Training Centres (HFWTC)
5
2. Multi-purpose Worker (Male) Training Schools
4
3. ANM Training Schools
19
4. LHV Promotional Training Schools
4
5. Health Inspector Training Centres
7
6. X-ray Technician Training Centres
6
7. Graduate Food Inspector Training Centre
1
8. Sr. Laboratory Technician Training Centre
1
2
9. Condensed General Nursing Course Training Centre
10. Communicable Disease Investigation cum Training Centre 1
I 1. TB Demonstration and Training Centre
1
2
12. Leprosy Training Centre
13. Central Malaria Laboratory'
1
J20
1 300
954
394
4 067
"938
"ooo
< 000
"900
."843
998
"295
8.298
"59?
-
5.1.1.1 HFWTCs
Five Health and Family Welfare Training Centres with hostel facilities are
functioning in the state. These are located at Bangalore, Gulbarga, Hubli, Mandya, and
Ramanagaram. The hostel facility at Bangalore, Gulbarga and Hubli Centres is for 30
trainees while it is for 20 trainees at the centres at Mandya and Ramanagaram. The
centre at Mandya has no building and is operating in the Communicable Diseases
Investigation cum Training Centre. The centre at Ramanagaram has only one lecture
hall. These centres provide following in-service training programmes.
I
)
8
26
Table 5.1.1.1.1 Courses OfFered at HFWTCs
Course
Duration
Continued education to medical officers
Training of Block Health Educators
_____________
Training of faculty of ANM /H I T / centres
Continued education to Sr. Health Assistant Male &
Female________________________________ _ ______
Continued education to staff of PHCs
Orientation of Jr. Health Assistants Male & Female by
mobile training team attached to HFWTC.. Bangalore
Orientation training in Leprosy to Medical officers
Orientation training in Leprosy to Paramedical workers
Two weeks
Two weeks
Two weeks
Two weeks
Number
Trained in
1992-93
______ 160
______ 171
______ HO
553
ha
c
Cones
5.1.1
One day
Two weeks
3 Days_____
Four months
distric
st et
171
174
5 .1
5.1.1.2 Multi-purpose Workers (Male) Training Schools
5
Beige
0
The four schools sanctioned are operating in HFWTCs at Bangalore, Hubli,
Ramanagaram and Mandya as no buildings have been provided for them. The duration
of the course is one year and the intake capacity of each centre is 60 students per batch
as no residential accommodation is provided. A total of 637 students were trained in
tl* ‘ 36
F
three batches during the three year period 1988-89 to 1990-91.
5 .
5.1.1.3 ANM Training Schools
There are 19 training centres, one in each district, with hostel facilities for pre
service training of Jr. Health assistants (female). The duration of the course is 18
months. The admission capacity is 30 candidates per centre per course or a total of 570
per batch. Up to the year 1992, ten batches totalling 5,787 candidates were admitted
and 5,087 passed. Out of the 19 training centres eleven have their own buildings with
hostel facility. The remaining eight are functioning in district hospitals and hostel
accommodation is provided in general nursing hostel. A building is under construction
for ANM Training Centre at Chikmagalur. Buildings have to be constructed at seven
centres in the districts of Bellary. Dakshin Kannad, Hassan, Kodagu, Mandya, Mysore
and Uttar Kannad.
5.1.1.4 LHV Promotional Training Schools for ANMs
There are four training centres functioning at Bangalore, Belgaum, Gulbarga
and Mangalore, for providing in-ser\ice training to Jr. Health Assistant (Female) to
make them eligible for promotion to the cadre of Sr. Health assistant (Female) file
duration of the course is six months and thp admission capacity of each centre is 30
candidates. 1423 ANMs were given training in 17 batches up to the year 1992.
Building for construction of LHV School at Gulbarga is nearing completion.
Belgaum and Mangalore do not
TTie Schools at the other three centres — Bangalore,
1
ilt
2.JI
The
tl sc
5,v0(
120 J
e r
i
I d
non*
( it
1 ic
200
i 1
1 5
est;
26
27
have own buildings and are functioning in the premises of District Hospitals / Medical
Colleges.
5.1.1.5 CGN Training Centres
I
I
J
Sr. Health Assistant uemale) are provided condensed General Nurse training at
district hospitals in Chitradurga and Dharwad with an admission capacity of 30
students at each centre. The duration cf the course is one year.
5.1.1.6 Health Inspector Training Centres
There are seven health inspector training centres, each with an intake capacity
of /5 per batch. The duration of course is one year. The seven centres are located at
Belgaum. Bellary. Dharwad. Gulbarga, Mandya, Mangalore and Mysore. None of
these have either own building or hostels for trainees. Classes are conducted in District
Health and Family Welfare Office in these cities.
ubli,
’ion
tch
d in
5.1.2 Manpower Projections
The number of CHCs. PHCs and sub-centres required to be setup by the year
2001 to cater to the needs of projected rural population is presented in Table 5.1.2.1.
The norms adopted for arriving at the requirement of health centres are the same as
those adopted by the state for population in plains. These are one sub-centre for every
5.000 rural population, one PHC for 30.000 rural population and one CHC for every'
120.000 rural population. In tribal and hilly areas, the norms are one sub-centre for
every' 3.000 rural population, one PHC for 20.000 rural population.
ore18
.70
:ted
ith
>tel
•on
en
ore
I
!
rga
to
Chikmagalur. Chitradurga. Dakshin Kannad, Dharwad, Gulbarga, Hassan,
Kodagu, Mandya, Mysore districts have more sub-centres than the required as per
norm for plains as they have tribal and hilly areas. On the other hand. 382 new sub
centres have to be established in Bangalore, Belgaum. Bellary, Bidar, Bijqpur, Kolar,
Raichur and Tumkur districts to meet the needs of the projected population of the year
2001. Tliirty eight new PHCs need to be set up in Belgaum, Bellary, Bijapur, Gulbarga
and Raichur districts. The CHCs in Kodagu and Uttar Kannad are adequate to meet
the needs of the population of 2001. In other districts, 102 more CHCs have to be
established to attain a ratio of one CHC for ex ery' four PHCs.
le
30
on.
Dt
/
I
I
I
I
28
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
Table 5.1.2.1 Projected Population and Requirement of Health Centres by Type in the
Year 2001.
Existing Centres
as <ii 31.3 93
I’rojccted Population in
2001
in ’Diousand
District
'local
Urban
Rural
Bangalore
8404
6110
2294
I
I
I
I
I
I
I
I
|
I
I
I
I
i
I
|
I
I
I
I
19
0
(7)
0
(5)
76
1747
441
66
10
349
58
15
Kolar
2567
621
1946
359
69
10
389
65
16
(30)
0
(0)
(6)
Shinioga
2231
609
1622
365
61
8
324
54
14
0
0
Tuinkur
2609
517
2092
404
77
9
418
70
17
(H)
0
(K)
0
(32)
IPP-1 Districts
18356
8656
9701
1979
352
49
1939
323
81
(93)
Belga uni
4089
1006 • 3083
578
107
12
617
103
26
(39)
0
(14)
(4)
(2)
(4)
Bidar
1415
310
1105
217
35
5
221
37
9
Bijap ur
3303
760
2543
426
77
16
509
85
21
(83)
f8)
(5)
89
22
0
(4)
(4)
1392
2666
571
85
18
533
I
I
Gulbarga
2891
705
2185
467
74
13
437
73
18
0
0
(5)
I
Raiditu
2680
5951
2085
349
62
1 1
417
69
17
(68)
(7)
(6)
I
I
IPP-III Districts
18435
4768
I 3668
2608
440
75
2734
456
113
(194)
(21)
(38)
Bellary
2272
597
1674
240
46
(>
335
56
14
(95)
(10)
(8)
Chikmagaiur
1166
191
975
328
39
6
195
32
8
0
0
(2)
Daksiun Kannad
3067
997
2070
692
I 10
9
414
69
17
0
0
(8)
()
(1)
11assan
Kcxlagu
1792
366
1426
45(1
61
I 1
285
48
12
0
555
91
464
158
27
7
93
15
4
0
0
3
()
(6)
Mandva
1875
322
1552
3<»4
55
Mysnre
3651
1172
2479
662
117
310
52
13
0
14
496
83
21
0
()
(7)
36
9
0
()
2
(10)
(32)
Uttar Kannad
1418
326
1091
302
5o
11
218
Other Districts
15794
4062
11732
3090
505
71
2346
39)
98
(95)
Karnataka
52585 17486 35100
7793
1297
195
7019
1170
292
(382)
an^ T;
health
ve b
(31) (102)
Table 5.1.2.2 presents the phased expansion of health centres during 1994-
2000
Table 5.1.2.2 Projected Health Centres by Type
CHCs
PHCs
SCs
1297
7793
Existing Centres
1993
195
Projected Centres
1994
212
1304
7857
1995
229
1310
7921
I
1996
246
1317
7985
I
I
I
1997
263
1323
8049
1998
280
1330
8113
1999
297
1335
8175
2000
297
1335
8175
I
I
I
I
CHCs
799
I
I
I
PHCs
CHCs
2546
I
|
12
SubC entres
(49)
PHCs
Chitraiiurga
i
I
I
79
SubC entres
459
4059
I
|
CHCs
Dharwad
I
I
I
I
I
PHCs
5.1.2.3
0
I
i
Sub
Centres
410
(l)dkit)
Centres Required m 2001
as per norms
Existing Centres
as on 31.3 93
I
I
n
28
29
le
The manpower projections are based on staffing norms presented in Table
5.1.2.3
JHCs
Table 5.1.2.3 Norms for Staffing Health Centres
(7)
“(5)
CHC
PHC
SC
MO
4
1
0
Nurse
3
I
C
Sr H A Female
0
I
0
Jr. H.A Female
2
1
1.33
0
1
0
Category of Staff
“cj
(14)
—)
“(5)
BHE
(4)
Sr. H.I
0
1
0
Jr H.A Male
0
0
0.67
r
~(6?
■
Tn
Table 5.1.2.4.(a) presents sanctioned, existing and vacant posts as on 1.4.93
and Table 5.1.2.4.(b) presents projected strength, based on data provided on planned
health centres presented in Table 5.1.2.2 and staff norms presented in Table 5.1.2.3
year by year up to 2000 AD.
(6)
Table 5.1.2.4 (a) Staff strength as on 1.4.93
fX)
r
2
Category of Staff
Year
^32)
MOsI
102)
Nursel Sr HAF
BHE
Sr. H I
Jr. HAF Jr. HAM
Filled
3285|
317l
1 109
284
1120
8924
4836
Vacant
496
148
1 10
442
101
313
720
Sanctioned
3781
465
1219
726
1221
9237
5556
Table 5.1.2.4 (b) Projected Requirement of Staff by Category
I
Category of Staff
Year
MOs
Nurse Sr. HAF
BHE
Sr. H I
Jr. HAF Jr. HAM
1994
3849
523
1226
733
1228
9308
5607
1995
3917
580
1232
739
1234
9387
5658
1996
3985
638
1239
746
1241
9465
5709
1997
4053
695
1245
752
1247
9544
5760
1998
4121
753
1252
759'
1254
9623
5811
1999
4189
809
1257
764
1259
9700
5861
2000
4189
809
1257
764
1259
9700
5861
MA
30
The promotion path for paramedical staff is presented in Chart 5.1.2.1
Chart 5.1.2.1 Promotion Path for Paramedical Staff
i
Jr. Health assistant
District
Sr. Health Assistant
Female
Female
Nursing Supervisor
Grade II
I
Sr H
A"ri
Health Supervisor
Sr. Health Inspector
iv
Hon
Jr. Health Assistant
Male
Dy. District
Health Education
Officer
Block Health
Educator
• H
Attri
w
Tota
'Elie attrition rate has been 4.1 percent per annum. The posts to be filled each
year at various levels to take care of existing vacancies, attrition and new posts to be
created are presented in Table 5.1.2.5
Table 5.1.2.5 Manpower Requirement by Category' and Year
Vacant
1994
1995
1996
1997
1998
1999
2000
19942000
________________ Posts
Medical Officer
135
158
161
164
167
170
173
1624
New Posts
75
74
75
74
75
73
0
446
Total
706
232
236
238
242
243
173
2070
58
57
58
57
58
56
0
492
13
21
24
26
28
33
177
219
78
82
83
86
31
87
33
669
45
7
50
51
51
51
51
52
461
6
7
6
7
5
0
38
3
3
3
3
3
21
165
59
61
60
61
59
55
520
366
384
388
393
398
403
408
3054
New Posts
119
119
119
119
119
116
0
712
Promotion
165,
59
ol
60
520
963
562
568
572
59
579
55
Total
61
578
462
4286
12
30
30
31
31
31
31
31
7
6
7
6
7
5
0
38
3
3
3
41
39
34
21
697
Attrition
496
Staff Nurse
Attrition
148
New Posts
Total
Sr. H.A.F
Attrition
110
New Posts
Promotion
3
Total
Jr. H.A.F
Attrition
. 313
BHE
Attrition
New Posts
Promotion
Total
442
3
3
3
3
464
39
40
40
c
m
sta N
select <
He h
of _b-
0
31
Table 5.1.2.5 Manpower Requirement by Category and Year
(Continued)
Vacant
1094
1995
1996
1997
1998
1999
2000
19942000
46
50
6
~3
51
7
51
__7
3
3
3
757
59
61
51
6
3
60
51
~7
61
59
52
0
3
55
453
38
21
512
198
230
43
67
340
231
233
43
68
744
235
43
69
347
237
42
67
345
238
0
61
300
2322
256
651
3229
Posts
Sr H 1
Attrition
101
New Posts
Promotion
Total
Jr. HAM
Attrition
New Posts
Promotion
Total
720
•
250
1211
JI.
69
343
Ch
e
The Department of Health and Family Welfare has started filling all vacancies
in all cadres. Appointment orders have been issued to fill posts of 754 Doctors, 440
staff Nurses. 550 Jr. Health Assistants (Female). A committee has been constituted to
select candidates to fill the posts in other cadres such as BHE, Health Inspector and Jr.
Health Assistant (Male). Further, the Department has planned to increase the number
of sub-centres. PHCs and CHCs as presented in Table 5.1.2.6.
Table 5.1.2.6, Proposed Additions to Health Centres by Year 1994-2000
Year
1994- 95
1995- 96
1996- 97
1997- 98
1998- 99
1999- 00
Number of Health Centres Proposed to be
__________ Added Each Year
CHCs
PHCs
Sub-Centres
___
[7
____
7
64
________ 64
________ 64
________ 64
________ 64
62
____ 6
___ [7
____ 7
___ 6
____ 7
5
__ n
___ 17
___ 17
17
32
The anticipated vacancies in various categories of medical and paramedical
staff and the mode of recruitment for filling all the vacancies arising from attrition and
promotion is presented in Table 5.1.2.7.
dem?nd
tweb
accommfacili*^s
builc g
Table 5.1.2.7 Projected Vacancies and Mode of Recruitment by Category.
2000 1994-
1994
MO.
Mode of
Recruit
ment
DR
706
232
236
238
242
243
173
2071
Staff Nurse
DR
219
78
82
83
86
87
33
669
Sr. H.A.F.
PR
165
59
61
60
61
59
55
520
Jr. H.A.F
963
562
568
572
578
579
462
4286
B.H.E
Trng/
DR/PR
464
39
40
40
41
39
34
697
Sr. H I.
PR
157
59
61
60
61
59
55
512
Jr. H.A.M.
Trng.
1211
340
343
344
347
345
300
3229
Category
1995
1996
1998
1997
1999
2000
voc; 3r
new he;
setti .
trail g
reqi er
attritior
Sup vi
cut
increase
buil
propose
buiMms
D.R.: Direct Recruitment, PR.: Promotion from one category below,
Trng.: From fresh candidates trained at training centres.
5.1.3 Adequacy of Pre-service and Pre Promotion Training Schools.
The capacity of existing training centres for pre-service training for Jr. H.A.M
and Jr. H.A.F are not adequate even for existing sanctioned strength, while the
capacity of LHV Promotion Schools and CGN training centres is in excess of the
requirement of new centres.
Table 5.1.3.1 Existing Capacity of Training Centres and Requirement.
Institution
ANM Training School
MPW(M) Trng Centres
Vocational Schools
Combined.Output_____
LHV Promotional
School_____________
Sr. H.I. Trng.
Centres_____________
CGN Training School
*
Required
with new
centres
up
to
year
2000
4286
3229
Batch
Size
per
centre
Maximum
output in
19942000
12
18
12
24
30
60
60
4
6
30
2650
1680
2160
3840
840
7
12
75
3675
512
2
12
30
360
24
Number
19
4
Course
Duration
(months)
Common training centre for staff of Health and Family Welfare Sections.
520
!
I
Inspect
wo i
training
cen* ^s
HF T
opi rt
an e
Continto ar
an ...ta
5.1.4
5. 4
H V
have
G ?a
32
33
nedical
non and
During the project period 4286 ANMs are to be recruited and to meet this
demand the intake capacity of all ANM training schools has to be expanded. The
twelve schools which have their own buildings were designed with hostel
accommodation for 48 students. It is necessary to construct buildings with hostel
facilities for 48 students for the remaining seven ANM training schools which have no
buildings of their own.
94)00
The capacity of M.P.W.(M) Training Schools together with the output of
vocational training institutions is adequate to meet the requirement of Jr. HAM even if
new health centres are to be set up. In order to meet the requirement arising from
setting up of new health centres. Gulbarga H.F.W.T.C has also to run MPW (M)
training school with intake of 60 students per batch.
2071
669
520
4286
697
T12
3229
...A.M
ile the
f the
-nd
w
s
to
.9
1
The capacity of LHV Promotional Training schools is in excess of the
requirements arising from filling up of existing vacancies and those arising from
attrition and promotion to the cadre of Nursing Supervisor Grade II. As the Nursine
Supervisors cannot be employed as Staff Nurses, the excess training capacity can be
cut by closing down two out of the four LHV Promotional Training Schools and
increase the intake capacity of the remaining two from 30 to 36 students per batch. A
building is under construction at Gulbarga for LHV Promotional Training School. It is
proposed to construct building for the one at Bangalore which does not have a
building of its own.
I
Tliere is excess training capacity for projected requirement of Sr Health
Inspectors. Two training centres each with a intake capacity of 36 students per batch
would suffice Five of them will be closed after clearing the backlog of providing
training to fresh recruits to the cadre of Sr Health Inspector. The remaining two
centres will also be closed down and the training activity will be shifted to two
HFWTCs.
The CGN Training Centres have excess capacity as the promotional
opportunities to LHVs are limited. Even one school is more than adequate.
At present there are no pre-service training facilities for BHEs. Fresh graduates
are recruited and posted as BHEs. Only two weeks training is provided under
Continuing Education at HFWTCs at Bangalore, Gulbarga and Hubli. There is a need
to start pre-service training course of 12 months duration at four HFWTCs each with
an intake capacity of 25 students.
_o
5.1.4 Staffing of Training Centres and Schools
2
5.1.4 1 HFWTCs
^4
Tlie staffing pattern is not the same for all HFWTCs. Bangalore and Hubli
HFWTCs have identical staffing pattern. Gulbarga. Ramanagaram and Mandya do not
have posts of Epidemiologist. Communication Officer and Management Instructor.
Gulbarga does not have a Sanitary Engineer while Sr. Sanitarian is posted at
1
j
I
34
Ramanagarain and Mandya. Ramanagaram has one each of Sr. HAF and Sr. HAM
working as Health Supervisors while Mandya has none in this category.
Tabic 5.1.4.1. Sanctioned Staff for each HFWTC
Category
Bangalore , Hnbli
Principal_____________________
Medical Lecturer______________
Health Education Instructor
Statistical Officer______________
Social Science Instructor_______
Public Health Nursing Instructor
Health Supervisors_____
H E, Extension Worker________
Epidemiologist________________
Communication Officer________
Sanitary Engineer_____________
Management Instructor
* Vacant as on 1.4.93
| 1
HI
11
11
i i
i
2
1
1
i r
tr
11
Gulbarga
■ i
53
i
i
i
i
11
11
11
n
I 1
h
P____
0
_1______
_1______
_1______
1
75
1
1
r
i
| Mandva
__
I 1______
_1______
_1______
_1______
J____
1
1
Pro
'St
Ne<r y
and is
met a
doc. rs
which
Me :a
I -
i
i
11
a Designated as Asst. Health Officer
c Senior Sanitarian
Ramana
garam
1
gap: n
materna
envi n
earl
f
retrainit
in di te
lc*
I lc
Are
b one each of Sr. HAF and Sr HAM
iC
__ du
Ira
■oi
or
5.1.4.2 ANM Training Schools
According to the GOI pattern the posts approved for ANM training schools are
principal, three PHNs (or LHV), two Nurse Tutors and one Senior Sanitarian.
Currently, posts of Principal are vacant at schools in Belgaum, Bidar. Gulbarga and
Raichur. There arc three PHNs or LHVs at all centres excepting at Shimoga and
Raichur where there are only two PHNs and at Dakshin Kannad where there are four
LHVs/PHNs. In all there are 56 PHNs/LHVs. As against the 38 sanctioned posts of
Nurse Tutors, there arc 46 in position but there are no Nurse Tutors at Karwar and
Gulbarga. There is one Sr. Sanitarian at each school excepting Karwar and
Chitradurga. On the other hand there are four Sr. Sanitarians posted at Bangalore.
.-.at
Cor
Io
or
I En\
'JI
le;
g
JC
mi
I ILI
le»
IhI
5.1.4.3 Health Inspector Training Centres
>u
ol
As indicated earlier there are no separate centres to impart Health Inspector
training. 'Hie classes are being conducted at District Health Office and one Sr.
Sanitarian is in charge of organizing training classes in each district.
Tr;
I Ml
In
5.1.5
In-service Training of BHEs and Paramedical Staff
The Population Centre. Bangalore had conducted a study1 to determine the
gaps in knowledge, skills and practices of health and family planning personnel namely
Senior and Junior Health Assistants male and female and Block Health Educators in
the six IPP-III districts of Karnataka. The study has “revealed that there are serious
Wi
<S
O...cc
that a
ot
j
I
35
34
HAM
saps in the knowledge, skills and practices of personnel in regard to family planning,
maternal and child health, nutrition, immunization, control of communicable diseases,
environmental sanitation, vital statistics and health education.” It was observed that the
earlier single puqwse workers have been retrained as multipurpose workers but the
retraining did not appear to be adequate both in duration and of topics. It was
indicated that there is an urgent need for retraining of all paramedical staff.
dya
The Training Needs Assessment2 of paramedical staff initiated by the Project
Proposal Team indicates that the situation does not seem to have materially changed.
Nearly half the paramedical workers indicated that current level of skills is insufficient
and is an obstacle in deirierv of FP and MCH xrxices Around 60 percent of the
medical officers feel that paramedical staff need training. Further. 80 percent of the
doctors stated that the health centre does not have adequate training aids. The areas in
which training is to be imparted to vanous categories of staff as indicated by the
Medical officers..is presented in Table 5 I 5 1
’
Table 5.1.5 I Area in Which Training is Required for Paramedical Staff
Area in which training is required
HAM
ils are
man.
... and
a and
four
-ots of
•r and
and
ctor
e Sr.
ie the
nely
•’fs in
‘Hous
BHF I
I EC_____________________________________ ___
Education through mass media________________
Training m audio-visual aids m public health
programmes_________________________________
Communitv parti.ipation in implementation of
National Health Programmes
Community Education
Motivation for P.V__________________
Community approach___________________
Environmental Sanitation. Nutrition. MCH. TB.
AIDS. Malaria and Mental Health_____________
Health Education_________________
Family Welfare_____________________
FP Methods
MCH. UIP, CSSM___________________________
Immunization_____________
IUD insertion_________________
1CDS_______________________________________
Reorientation in National Health Programmes
Orientation in F W programme in urban areas
Health services in urban slums________________
Supervision
Job Orientation______________________________
Sanitation
Communicable diseases and their control______
Training in Laboratory tests__________________
Vital Statistics______________________________
MIES •_______________
Training for promotion
Category of Paramedical Staff_______
l.HV j‘ ANM j Sr HAM I Jr HAM
\ es j
\ es ■
I
\es i
'i es
\ 05 I
\ es
Yes
\ es
Yes !
Yes I
\ es
Yes
_____ I
Yes 1
Yes
Yes
Yes
Yes
\ es
Yes
Yes
y^t
Yes
Yes
Yes
Yes
Yes
Yes
____
Yes
yTT
Yes
Yes
Yes
Yes
Yes
Yes
Yes
\’es
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
The subject of training needs for paramedical staff was discussed at the
workshop. All the participants, — Joint Directors of Health and District Health
Officers, felt that there is an immediate need to retrain all paramedical staff They felt
that all paramedical staff should be retrained; preferably at the district level, at least
once in three years. 'Hie duration of training should be two weeks. Hostel
36
accommodation should be provided at the training centre as suitable lodging and
boarding facilities are not available.
but
sup
The
tec
5.1.6 Proposed Training Programme
h
\i
S’
iq
Objectives:
The training programme proposed under IPP-IX Project is aimed at
I
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 IEC activity in the
community,
2 making health functionaries aware of their job responsibilities as providers of
primary health care.
4. maintaining information on performance at their level and providing feed back, and
5. developing knowledge and skills to act as trainers at their level.
1.
i
am’ n
ne' t
CSSM
te<r lii
the i
Colleg
N1 a
sp_ ia
trainee
du ti*
1.G.5
All health functionaries will be provided in-service training initially for two
weeks and a refresher course of two week duration after three years.
Training Modules:
'Flic training modules and their duration planned on the basis of training needs
survey, discussions with Joint Directors, DHOs and Principal and staff of HFWTC are
presented in the following table for different categories of staff.
Table 5.1.6.1 Training Courses Planned and their Duration by Category of Staff
Module
Trainers
1. Introduction to 1PP-1X__________________
2. National Health Programmes_____________
3. Primary Health Care____________________
4. IEC__________________________________
5. Environmental Sanitation________________
6. MCH. FP, Immunization_________________
7. Management_________________________ _
8. Sub-centre Management_________________
9. Training________
10. Medico-legal_________________________
11. Mental Health________________________
12. Paediatric Problems______
13. Medical emergencies & their Management
14. Surgical Emergencies & Their Management
15. MIES________________
16. Supervision_______ _______
17. Action Plan__________ _ ______________
18. Pre and Post Test_____________________
All Modules
_______________
1
_____ [0_
______ 2_
_____ 20
_____ 10
_____ 30
_____ 16
_____ 10_
5
2
4
______ 6
______ 6
______ 6
6
2
2
14?
Duration m Hours per Subject
BHE
Sr. HA
MO
~
1
___ 1_
1
___ 10
__ 10
10
2
___ 2_
_
__ 6_'
20
12
__ 4_'
__ 8_
____ 8_
__ 30_
30
20
M
__ 1£
16
__ 0_'
____ 0
___0
____ 0
___ 0
1
’___ 2_'
____ 0
___ 0
____ 0
___ 1_
3
____ 0
___ 0
4
4'
____ 0
__ 0
0
__ 0
__
’____ 2
4
__ 4_'
___ 1_
___!_/
i
___ 1_
1
___ 1_
___1_
so
77
97 I
coi ;e
MI v/(
Centre
for ar
in dec
les‘-n
Meuic
Jr HA
____ 1_
___ 10
___ 2_
___[0_
___ 8_
30
____ 0
2_ H_
___ o
___ o
___ o
___ o
___ o
___ o
Femal
wi bt
-
m ib
progr
m lu
5.1.7
of the
tr hi
____ 2_
____ 0
____ 0
e;
___ !_
to D(
i
76
o
/
I
36
37
ring and
Die topics listed in Table 5.1.6.1 above are common for all categories of staff
but the content differs significantly between categories. The management and
supervision aspects relevant to each of the topics listed are covered as an integral part.
The subjects "Management"
and "Supervision" cover general principles and
techniques of management and superv ision.
The Joint Director (H.E.& T) is responsible for conducting in-service training
courses for medical and paramedical staff and pre-service training to ANMs and
MPW(M). All the HFWTCs. ANM and LHV Training Schools and District Training
Centres will be under his/her control. The JD (H.E &. T) will identify the training needs
for various categories of staff and demand services from Director. SIHFW7 (proposed
in Section 5.3) for development of training modules for trainees and conesponding
lesson plan for faculty and training of faculty of training centres under JD (H.E &. T).
fective
in the
ers of
The Director. SIHFW will be responsible for development of training modules
and training of faculty of all training centres. He / she will ensure coordination of the
new training modules to be developed with the existing materials prepared for
CSSM/UIP. Fie / she will engage experts in different subjects with considerable
teaching experience to design the courses modules and lesson plans and coordinate
their activities. The experts will be selected from HFWTCs, NIMHANS. Medical
Colleges, Nursing Schools. Management Institutes. Institutes of Mass Communication.
NIC and leading consultants. An honorarium at the rate of Rs. 5.000 will be paid to the
specialists for developing course material and teaching aids for training module for
trainees and corresponding Lesson Plan for faculty, for each session of one hour
duration. The total cost of development of course material for trainees is estimated at
1.635 million Rupees.
.. and
r two
needs
2 are
The Training of Trainers will be conducted at SIHFW. Training courses for
Medical Officers, Block Health Educators and Senior Health Assistants Male and
Female will be provided al HFWTCs. The Junior Health Assistants Male and Female
will be trained in their respective districts.
f
Jr HA
~ 1
Hie record of training courses attended during the last two years, by each staff
member, will be compiled. This record will be utilized in scheduling training
programme and selecting participants so that those who were already trained in certain
modules are not made to under go training in the same course again.
___ [0
___ 2_
10
___ 8_
30
___ 0_
__ 11
___ 0_
__ 0_
0
___ 0_
___0_
0_
2_
___ 0_
0_
1
76
I
5.1.7 Training Centres for Jr. Health Assistants
It is proposed to establish a training centre for Junior Health Assistants in each
of the 10 districts (Bangalore urban and rural districts will have together one district
training centre).
Each training centre, will have a capacity to train 30 candidates at a time, at
each district head quarter town. Training courses can be conducted only during April
to December of each year as the paramedical staff will be busy during January' to
March to achieve their annual targets. Each district centre can thus provide training
only for 12 batches each of 30 paramedical staff or 360 staff in a year as the centre
1-
38
needs a break of one week between two successive batches to enable it to get
organized to receive the next batch. It will take 26 months to complete one round of
training for all paramedical staff numbering 14,693 in the field.
2.
The possibility of expanding ANM training centres was considered and
discarded for the following reasons. Out of the 19 ANM training centres, seven centres
do not have own buildings. As the district training centre has to train male workers
also, it is not advisable to have common hostel facilities. However, wherever new
ANM centres are being constructed, the possibility of having common kitchen and
dining facilities will be examined to save on construction costs.
It is proposed to constitute a district training team in each district excepting
Bangalore by re deploying existing staff and creating fix e additional posts.
Re deployment of existing staff:
4.
Asst. District Health &, FW officer (of HQ) as District Training Officer
Dy. District Health Education Officer (1)
District Nursing Supervisor (1)
District Health Supervisor (1)
Support Staff: FDA (1), Typist cum clerk (1). Driver (1) and Group D (1)
•
•
•
•
•
One cook, one watchman and three Group D staff will be freshly recruited at
an additional annual cost of Rs. 1.167,000 per centre per annum.
Re
I
9.
To 11
The facilities to be provided and associated costs at each of the nineteen district
level training centres will be as under:
mi Dr
Pb-i
Capital expenses
Building: Plinth area 575 sq.m. (See Annexure 11)
One class room to accommodate 30 pupils
Office rooms for staff, library and storage 4x12 m2
Residential accommodation for 30 trainees
Five rooms— each to accommodate 8 students
Toilet and Bath facility
Kitchen and dining hall
Circulation area
Total
5.
6.
7.
8.
The training of paramedical staff is one of the prime responsibilities of the staff
proposed to be assigned to the District Training Centre, the other prime responsibility
being supervision. At present these staff members conduct training at PHCs which
involves considerable amount of traveling. By conducting training classes at the district
training centre, they can provide training to larger number at a time and thus save on
traveling and training time. The time thus freed could be effectively used for the other
prime responsibility of on-site and off-site supervision.
1.
rr
Area m2
80
54
162
51
65
58
470
pr
is ; t
ph a sin
pr er
Cost Rs.
i
16,00,000
38
get
lid of
39
2.
Furniture (See Annexure 12)
and
“tres
kers
new
and
Class Room Tb Rs. 1800 per pupil
Office rooms, library, store
Hostel rooms @ Rs.. 3.500 per bed
Dining hall (a Rs 1.500 per seat
1
Total
^5
ting
Rs. 54,000
Rs. 36,000
Rs. 1,12,000
Rs. 48,000
4.
2,50,000
Equipment (See Annexure 1 1)
Class room: Black board. Overhead &. slide projectors
Kitchen Rs. 500 per seat
Total
Library books
Total capital expenses per centre
20,000
16,000
j
36,000
10,000
18,96,000
Recurring costs
I
1 at
:afT
lity
iiich
"ict
on
liter
5.
Training materials (a Rs. 200 per pupil
6.
Boarding
@ Rs 30 per pupil per day for 14 days each for 360 persons
7.
Travelling allowance a Rs. 100 per pupil for 360 persons
8.
Office expenses (e.g. Electricity, Water, Telephone Postage etc.
. @ Rs. 10.000 p.m.)
9.
Staff Salaries
Cook
Rs. 29,320
Class IV staff- 4
Rs. 87,380
Total
Total recurring costs per year
72,000
1,51,200
36.000
1,20,000
1.16.700
4,95,900
u
The total capital cost of 19 district training centres is estimated at Rs. 36.024
million and the recurring expenditure at Rs. 9.422 million per annum.
tri ct
Phasing of Expenditure:
[
Initially buildings will be constructed for seven district training centres and
premises rented for 12 other centres. If the utilization of centres and training schedule
is as envisaged, buildings will be constructed for the remaining twelve centres. The
phasing of’ expenditure on district training centres for junior paramedical staff is
presented in Table 5.1.7.1.
'00
-—„—
-
I ft
40
Table 5.1.7.1 Phasing of Expenditure on District Training Centres
94-95
95-961 96-97
Million Rupees
97-98 98-99| 99-00| 00-01|
t
He h
one ye
sp< f
sta
Total
Capital expenditure
Civil works
Total Capital expenditure
1 1.200
2.830
0.492
0.190
14.712
Revenue expenditure
3 raining centre staff salaries
Training materials
0.000
0.000 19.200
0.000
0.000
0.000
0 000
1.920
0.000
0.000
0.000
0.192
0.000
0.000
0.000
0.000
0.000
2.217
0.420
T.A /D.A for Jr. HAF & Jr.HAM
Office expenses
0 000
30.400
0 000
0.000!
4.750
0 000
0 000
0.684
0.000
0.000
0.000
0.190
0.000 21.312
0.000
0.000
0 000
36.024
2.217
0.840
2.217
0.840
2.217
0.840
1.092
2.184
2.184
1.140
1.140
Rent for 12 Training Centres
1 728
1.728
0.000
0.000
Total Revenue Expenditure
6 <97
8.109
2.217
0 840
2.184
1 140
0.000
0 608
6 989
15.519
5.460
14.196
7.980
~ 6.912
Maintenance of buildings
1 140
1.728
0.000
8 109
2.217
0.840
2.184
1.140
0.000
0.224
6 605
Furniture
Equipment
Books
2.217
0.840
2.184
1.140
1.728
0.224
8.333
2.184
1.140
0 000
0.224
6 605
ba s
1.280
<1.347
5.1.8 RoleofHFWTCs
Rs. 0(
The five Health and Family Welfare Training Centres at Bangalore. Gulbarga
Hubli, Mandya and Ramanagaram will continue to provide orientation training for
Medical Officers and Health Educators. Orientation training to Senior Health
Assistants, Male and Female and Block Health Educators will also be provided by
these centres. The management training to medical officers of two weeks duration,
currently being imparted by the Population Centre will be taken over bv the five
HFWTCs. The duration of training course for medical officers will be three weeks. The
subjects to be covered are as per list in presented in Table 5.1.6.1 but the emphasis will
be on management and supervision of the actix ity rather than on providing technical
knowledge.
Each of the HFWTCs will be occupied for 142 weeks for providing one round
of in-service training to medical officers and other supervisory staff. As a break for one
week between two batches is desirable, it will take 198 weeks or nearly four years to
cover all staff.
Table 5.1.8.1 Training Load on HFWTCs
Sanctioned
Posts
Medical Officers___________
Block Health Educators
Senior Health Inspectors
Senior Health Assistants (F)
Total
o
3781
765
1221
1219
6986
Batch
Size
25 |
25 !
'25_'
25
Total
Batches
Batches
per
Centre
151
31
49
49
280
30
6
10
10
56
Duration
Weeks
Load /
Centre for
one round
Weeks
_______ 90
_______ 12
______ 20
______ 20_
142
5.1 .3.
i
than ot
meters
cot st
125,UO
am’ ~r
Al 1c
for trai
HF T
Me cf
present
i
40
41
Besides providing continuing education to medical officers and supervisory
staff the HFWTCs will have the responsibility of providing pre-sen ice training to Jr.
Health Assistant Male and Sr. Health Inspectors which are full time courses, each of
one year duration. The HFWTCs are thus fully loaded and do not have capacity to
spare for training of faculty of ANM. HIT and District Training Centres.
Total
0|
30.400
4.750
0.684
0.190
I
The cost of training medical officers and supervisory staff is estimated on the
basis of data presented in Table 5.1.8.2
36.024
i
Table 5.1.8.2 Recurring Costs of Training
•I
15.519
5.460
14.196
7.980
6 912
1.280
51.347
Medical Officers________
Block Health Educators
Senior Health Inspectors
Senior Health Assistants (F)
T.A. Rs.
per person
D.A. Rs.
per Day
200
200
200
200
50
40
40
40
Duration of
Training
(days)
______ 21
______ 14
______ [4_
14
The annual cost of training materials is estimated at Rs. 400.000 on the basis of
Rs. 200 per candidate per course.
ilbarga
° for
. lea 1th
led by
ition.
c five
Hie
; will
-hnical
round
one
s to
)ad /
J for
round
90
__ 12_
20
20
142
5.1.8.1 Upgrading Infrastructure of HFWTCs
I
The HFWTC at Ramanagaram has to be expanded to provide training to more
than one batch at a time. It is proposed to construct additional space of 120 square
meters at a cost of Rs. 0.456 million. Additional accommodation to be created will
consist of one lecture hall, library. Audio-visual room and toilets. A sum of Rs.
125,000 is being
1 '
provided towards furniture and Rs. 75.000 for equipment.(See
Annexure 16)
The HFWTC Mandya which is located in Communicable
Communicable Diseases
Diseases Investigation
Investigation
and Training Centre is proposed to be shifted to Mysore, the divisional head quarters.
A building with an area of 1365 sq. m. with class rooms, office space and hostel facility
fortrainees and guest speakers has to be built.( See Annexure 13 for Building Plan for
FWTC Mysore). Besides residential quarters will be built for the Principal and
e ical Lecturer cum Demonstrator. The area of each structure and estimated cost is
presented below.
Table 5.1.8.1.1 Civil Works for Expansion ofMandya HFWTC
Training Centre with Hostel
Facility
Residence for Principal_______
Residence for Medical Lecturer
Total
Area sq. m.
1365
Cost Million Rs.
5.187
100
90
0.380
0.342
5.909
i
42
The cost of acquiring additional funiiture is estimated at Rs. 0.325 million and
equipment at Rs. 0.075 million.(See Annexure 16)
H
: batcl er
16.624 i
The libraries at all the fixe centres require to be augmented with books and
reference material for use by faculty as well as trainees. It is proposed to prox ide Rs.
20,000 to each of the five centres for purchase of books, the total investment on this
account will be Rs. 0.100 million.
5.1.8.2 Phasing of Expenditure on HFWTCs
TA / DA
Table 5.1.8.2.1 presents the phasing of expenditure on HFWTCs.
5.2.
Table 5.1.8.2.1 Phasing of Expenditure on HFWTCs
I
Millim Rupees
j------------
I
94-95
95-96
9<»-97|
97-98
98-99
99-00
(KM) 1
l.<al
Civil winks
0 456
5.909
0 OOO
0 000
0.000
0.000
0 OOO
6 365
lumilure
0.125
0.325
0 000
0.000
0.000
0 000
0 OOO
0 450
I quipnuait
0075
0 075
O OOO
0 OOO
0.000
0 000
0 (XX)
o 150
1 .ibrarv books
0.100
o.ooo
0 OOO
0 (KM)
0.000
0.0<X)
Vehicle
0450
0.000
0.000
0 000
0.000
J <<al
1.206
6 .309
0 OOO
0.000
0.000
1 671
1.671
1 671
1.671
1.671
I
Capital expenditure
-------- L
0 (MX)
0 KM)
0.000
0 (MX)
0 450
0 000
o (><x)
7 515
1.671
1.6" | |
1 1 697
2 8(X)
Revenue cxpaiditure
TA/DA lor trainees
I raining Materials
0.400
0.400
0 400
0 400
0 400
0.400
0 4(X)j
Maintaiance of buildings
0.000
0.000
0 OOO
0 009
0.127
0.127
0.1 2"i
0 390
r«al
2.071
2.071
2 071
2.080
2 198
2.198
2.198|
14 887
Mar lb
Mar lb
xvith a I
Di st ’ 1
mill I.
be p »v
an plint
Capital I
5.1.9 Training of TBAs, Anganwadi Workers. Community Leaders and
Others
It is planned to entrust the task of providing one day orientation courses to
TBAs, anganwadi workers, elected members of mandals, voluntary' workers and
school teachers to the PHCs. The courses planned are presented in Table 5.1.9.1.
Cr
co
To.
Ca
Mamlcn:
Tc
Re
5.3
Table 5.1.9.1 Training of TBAs, Community Leaders and Voluntary' workers
Group
Persons
TBAs___________
Anganwadi Workers
Mandal Members
Voluntary Workers
School Teachers
31.000
25.810
54.987
45.430
51.920
Persons
per
Batch
____ 24
20
____42
___ 35
40
Number
of
Batches
1292
1291
1309
1298
1298
Cost per
Batch
Rs.
840
700
1470
1225
1400
v.;
Frequency
in Project
Period
n
.
HF T
Inspect
Ofi 2r
in si., at
Beside:
DP N
supciin
estaNis
42
43
on and
There will be 1298 PHCs and if each of them conducts each course for one
: batch, each group will be covered fully. The total cost for the project period will be Rs.
16.624 million and the phasing will be as under
ks and
.de Rs.
on this
Table 5.1.9.2 Phasing of Expenditure on Training of TBAs and Others
Millnti Rupees
TA / DA for trainees (n<ti stall')
5.2.
l«al
6 365
I
7) 450
0 150
7 |(K)
94-95
95-961
96-97
97-98
98-99
99-00
00-01
Total
I 99X
5.315 '
0 000
1.998
5.315
0.(X)0
1 998
16 624
Buildings for LHV and ANM Schools
Three LHV Promotional training schools at Bangalore, Belgaum and
Mangalore do not have their own buildings. Two Training Schools at Belsaum and
Mangalore will be closed down. The Training School1 al Bangalore will be provided
with a building including hostel facility for 30 students as per the plan selected for
District Training Centres. The area of each building is 575 sq.m, and will cost Rs. 1 60
million. (See Annexure 14 or Building Plan)
7450
As regards ANM schools seven of them have no buildings. Each of these will
be provided with a building with hostel facility for 48 students. Each of these will have
an plinth area and will cost Rs. 3.00 million.
—■ (seeAnnexure 1 1 for Building plan)
7515
I 1 697
2.800
Table 5.2.1 Phasing of Expenditure for LHV and ANM Schools.
0.390
14 8X7
Millmi Rupees
94-95
95-96
1.600
2 1.000
1.600
21.000
0.000
0 000
7ooo
0 000
0.000
7. (xxi
97-9xi
98-99 |
99-001
(X>-011
0.000
0.000
0.000
0 000
0 000
22.600
7.000
7 000
0.000
7.000
0 000
22.600
7.032
7.452
0.452
7452
1.3X8
0.032
7.452
0.452
0452
1.388
96-97
Capital Expenditure
d
Civil works
Fftal Capital Expenditure
Maintenance of Buildings
l aal Revenue Expenditure
i to
T«al
and
5.3.
!■
I
State Institute for Health and Family Welfare (SIHFW)
At present there is no facility or staff in Karnataka for training of faculty of
hi^oS’fANM Training Scl,00ls’ LHV ^omotional
Training Schools. Health
Officers. nie"7a8f C?ntreS’ LeProsy training Centres and District level Programme
institutions oute d
l° depute tlie facu,ly op the training establishments to
Besides training of fa Mt'5' "'a- ’T 1'andicapped tlle regular training of the faculty.
OPHN courses8 F J
7 medlcal staff are ben’g deputed for DPH, DPHE and
superintendents of ho 7’ I
n° fOr"laI managenient training programmes for
ors-nerefore'there is an urB“‘ n"d f“
I
I!
i
44
An Institute for health and family welfare will be set up to
design training courses for all categories of staff,
conduct training courses for the faculty of all training centres currently run or
proposed to be run by the Department of Health and Family welfare,
Conduct management training programmes for superintendents of hospitals and
senior doctors,
4. undertake evaluation of programmes of the Directorate of Health and Family
welfare, including those under IPP-IX, and suggest actions to remove deficiencies
or improve performance, and
5. offer diploma courses in DPH, DPHE and DPHN wdth affiliation to Bangalore
University.
1.
2.
The objectives 1 to 4 are necessary for strengthening and improving MCH and
FP services which is the essence of IPP-IX while, the objective 5 is required for
upgrading the professional skills of personnel in the Directorate of Health and family
welfare which wall indirectly motivate personnel providing MCH and FP services.
The institute will have faculty drawn from the following disciplines.
1.
2.
3.
4.
5.
6.
Public Health Management
Public Health engineering
Preventive & Social Medicine,
Entomology
Nutrition
Nursing
Maternal & Child Health
Family Welfare
7.
8.
9. Mass Communication
10. Demography
1 1. Bio-Statistics
12. Social Science
13. Management Science
The staff required for the institute and proposed to be recruited under IPP-IX
project is presented in Table 5.3.1. The Joint Director and Deputy Directors will be
recruited with specialization and teaching and research experience in epidemology,
gynaecology, paediatrics, preventive and social medicine, Public health management,
public health engineering, nutrition, mass communication, social science, bio-statistics
and management science. Out of the 17 posts charged to the project 12 are for
developing modules for in-senice training programmes, training of faculty of training
centres under the jurisdiction of JD (H.E. & T), evaluation of utility and effectiveness
of training programmes and coordination with JD (H.E. & T).
Twelve specialists with research and teaching experience and eleven accounts
and administration staff will be provided by re deployment of staff by the Directorate
of Health and Family Welfare, from the Directorate, Medical Colleges and Population
Centre of the Karnataka. The state government will be bearing the salaries of 23
permanent staff and four guest faculty engaged for conducting post graduate
1 '.iih
ai
ai
C(
fu
ec
25
/i<
45
programmes as well evaluation and operations research studies required for IPP IX
and hence not included in the project cost.
rcqmreu tor II I - IX
Table 5.3.1 Additional Staff for IHFW
Designation
Director
Jt, Director
Dy Director
First Division Assistants
Second Division Assistants
Drivers
~
Class IV .
"
Grade
Number
4700-6400
3825-5825
3300-5300
1280-2375
1040-1900
940-1680
840-1340 |
1
1
10
2
T
2
Annual
salary
132,200
115,800
1,032,000
87,720
70,560
125,760
1,616.360
As pan of IPP-III a new building with an are of 1208
sq.m, to house training
centre with hostel accommodation for 32 officers was r
for theTEPopulation
Centre m the campus of Leprosy Hospital at Maaadi constructed
Road Banaalore
p
z:
under IPP-IX.
“' 3rrainer "",g’p‘Centre
,n for train
™'ngs buiprogrammes
“"8 - contemplated
Table 5.3.2 Staff to be Accommodated in
Category of Staff
Recruited
under
SIHFW Office Building
Re deployed
IPP-IX Project
Director
Joint Director
D>. Directors
Assist. Directors
Accounts Officer
Admin, Officer
Research .Assistants
Accounts Staff
Admin. Staff
Total
______________1_
_____________ 1_
_______
1
____________ 10
~0~
_____________ 0
_____________ 0
______________ 0_
______________ 4_
_____
17
1
3
3
1
1
5
4
5
23
Guest Faculty
on any day
________ 0
__________0
_________ 4_
_________ 0_
_________ 0_
_________ 0_
_________ 0
_________ 0
0
4
It is proposed to construct albuilding,
”“
with foundation capable of taking
additional load of one more floor, close to the
area of 600 m? would be sufficient for the new training centre building. The plinth
present requirement of office space. The
cost of office building is estimated at Rs. 1.9 million.
-(See Annexure 15 for Plan)
The training centre building constructed under IPP-I.............
is being
and
mtshed with funds available under IPP-III budeet TheIII"cosf
of f equipped
■“
---- 17 furnishing
and
equ.pptng the proposed office building is presented in Annexure
A ■
• • i sum of Rs.
of boois “d
* - * *0^
,
-
a
46
It is planned to purchase two cars and two jeeps at a cost of Rs. 950,000. The
two cars are for the use of the Director and Joint Director of the Institute. Hie Jeeps
are meant for use of other staff members for field visits in connection with training,
research and/or evaluation studies.
5.3.1 Training Load of SIHFW:
The institute will also proxide management training to medical officers in
hospitals at state, district and taluk level. This activity will be taken up after completing
initial training of MCH & FW staff.
lhe training load of SIHFW is presented in Table 5.3.1.1
Table 5.3.1.1 Training Load on SIHFW
Designation
Joint Directors______________
District Malaria Officers______
District TB. Officers __________________
District Immunization Officer
District Leprosy Officers________________
Medical Officers (FW & MCH)___________
District Training Centre Faculty_______
Faculty of HFWTCs and ANM/LHV Schools
Doctors
Management Scientist
Social Science Instructors
Health Education instructors
Sr. Sanitarians
Health education extension officers
Public health Nursing Instructors
Sr Health Asst Female__________
Class I Doctors & Hospital Superintendents
All Categories
Number
Batches
16
20
20
20
20
20
80
5
5
5
5
5
24
43
61
689
1048
I
3
1
1
1
1
1
1
2
2
28
48
Duration m days
Initial
Refresher
____ L2
_______6
_____6
______ 3_
_____6
______ 3_
____ 6
____ 6
____ 12
18
12
12
12
12
12
24
24
______ 24
______ 1_2_
104 weeks
3
_______ 6_
6
6
6
6
6
6
12
12
______ 12_
_______ 6
53 weeks
i
The cost of training materials is estimated at Rs. 252,000 on the basis of Rs.
240 per official. The TA / DA for the initial training will be Rs. 307,800.
5.3.2 Phasing of Expenditure on SIHFW:
The phasing of expenditure for the institute is presented in Table 5.3.2.1
47
Table 5.3.2.1 Phasing of Expenditure on SIHFW
Millidt Klip,i ecs
945
95-96
96-971
97-98
Capita) cxpatdihuc
98^99
99-00
00-01 [
Total
0.000
1 900
Civil Murks
1 tininure
1.900
0.000
0.000
0.000
0.000
0.000
0.360
0.000
0 000
0.000
0.000
o.ooo
o.ooo
0.360
0.200
0.000
0 000
0.000
0.000
0.000
0.000
0.200
iquipmcnt
B.x*ks
i ranting materials
0.125
0.125
0 000
0.000
0.000
0.000
0.000
0.252
0.250
0 000
0 000
0.000
0.000
o.ooo
OOOO
0.252
Vehicles
1 ‘Xal Capital expenditure
0.950
0.000
O.(XX)
0.000
0 000
0.000
O.OtK.)
3 7X7
0.950
0.1 25
OfKX)
0.000
0.000
0.000
O(XX)
3 912
Rex atue expenditure
IrKitutc stall salaries
I A
I) ,A lor trainees (stall;
Mainlatance <>l building
1.616
1.616
1.616
1616
1616
I 616
I 1.312
0.30X
0.000
0.000
0.133
0.02 1
(J 000
o.ooo
0.462
O.O(X)
0.000
0.3X0
0.3X0
0.3X0
0.380 ’
1.520
1.616
1616
2.129
2 017
I 996
1.9961
0.000
I i«al Revenue kxpenditurc
5.4.
1 616
1.924
13.294
Budget for Improving Quality of Services
I able 5.4 Phasing of Capital and Revenue Expenditure on Improving Quality of
Services
I
Million Rupees
94-94
94-95
95-96
196-97
197-98
Capita) expenditure
Civil work'.
1-quipniati
lumiture
i.ihrarx Books
Training materials
1 A |)A lor trainees (mu .stall')
I'oreign I ellou.ships
Vehicle
I <Xal Capital IXpaiditure
Stair Salaries
Rent (<>r Training Catlrcs
I A . I) A f<«r trainees (stall')
I raining material
MaintaiuiKc <>l Buildings
I <Xal Rcxame l-..xj)aidilurc
[994)0
[TxaF
15.156
26 909
0.000
19.200
0.000
0.0(X)
0.000
0.767
61.265
0.075
0 000
0.192
0.000
0.000
0.000
3.315
1.034
0.325
0.000
1.920
O.OCH)
0.000
0.000
0 415
5.560
0 125
0.000
0.000
o.ooo.
0.000
0.000
0.540
0.252
0.000
0 000
o.ooo
0.000
0.000
0.000
1 99X
0.252
5.315
0.000
1.998
5.315
0.000
1 99X
16.624
5.000
0 000
1 000
1.000
1 000
1.000
1.000
0.000
I 400
0.000
0 000
0.000
0.000
0.000
0.000
I 400
I 000
24.31
6.315
1.000
1.998
91.675
26.8.31
2.3.303
3.3.749
Revenue expaidilure
(Mice expotses
9X-99
3.833
3.833
3.833
3.833
3.833
3.833
3.833
1.140
1 140
1 140
I 140
1.140
1.140
1.140
7.980
1 728
1 728
0.000
0.000
0.000
6.912
26 .35 5
I 728
17728 ’
3 07|
3 855
3 855
3 988
3 876
3.855
3 855
0.820
1.240
1.240
17240 ’
1.240
1.240
1.240
0 000
8.260
0.000
0 000
0645
1.1 8.3
1.1 8.3
1.567
4 578
12.574
1 1.272
I 1.251
1 1 635
80 916
10 592
I I 796
I I 796
7
48
Chapter 6
1EC Activity
6.1.
IEC Wina in Karnataka
IEC wing at the state level is responsible for planning, implementing and
monitoring IEC activities in the state. The Government of India allocates funds for IEC
and guidelines are issued even' year. IEC plans for the state are developed and
discussed with IEC wing of Ministry' of Health and Family Welfare. The IEC plan is
prepared in two parts — one for the state sector and the second for zilla parishad
sector.
At the district level, the District Health Education Officer (DHEO) is
responsible for planning, implementing and monitoring all IEC activities of FW &.
MCH along with all other national health programmes. He is assisted by two Deputy
Health Education Officers. The DHEO reports to the District Health & FW officer.
The Block Health Educator (BHE) is responsible for all IEC activities at the PHC
level. The BHEs report to the Medical officer of PHC but work under the guidance of
DHEO. There are a number of posts vacant at the district and lower levels. Persons are
working as in-charge basis in a number of posts. A separate IEC cell was created under
IPP-III and there was no coordination between the existing IEC wing and that under
IPP-III. Even at the district level there was no coordination as the IEC staff under
IPP-III were working independently of regular IEC staff. It is proposed that IEC
activities under the proposed project will be planned and implemented by the regular
IEC staff and no parallel posts will be created.
1
2
3
During the communication needs sur\ey. the community leaders and women
were asked as to whether any programmes have been arranged in their village since
January 1992, to promote various health and family welfare components. Nearly 50
percent of the respondents indicated that no programmes on FW or MCH were
arranged in their village. In those villages where programmes were arranged, inter
personal communication through house to house visits was adopted in most of the
programmes.
Percent of Villages
l-'W »>r MCI I Compcm ent
Isnviraninaitjl S:nntati<»>
PersuKi] Hygiene________
family Planning_________
ktniily Planning Methods
Care of l:\pcelant M<idlers
Care of Childrai
No programme
arranged
64.9
60.6
48.6
48.2
49.3
49.6
6.
the
Method of IVomotnxi
Inter perstna
commiuiicalicn
Ixcture to a
group
Audio-visual
presentalnn
9~9
12.1
________6.7
________ 78
________ 7.4
________ 71
8.5
78
________ 6.0
________ 2.1
_________ 2.8
________ 2__1_
9.6
__________ 20.9
__________ 31.9
__________ 35.5
__________ 35.8
25.5
4.
5.
49
Hie audio-visual coverage is low due to the fact that there is only one
projection unit per district. Further 57 percent of the projectors are not in working
condition.
6
6.2.
Communication Needs
A rapid survey of communication needs assessment has revealed the following:
One third of the community leaders and women are not aware of Child Marriage
I
However- only I2-5 Percent opined that the age of girls at marriage
should be below 18 years.
6
Nearly eighty percent opined that two is the ideal number of children.
Sixty percent feel that it is necessary for a couple to have a son. However 84
percent of them feel that a couple should not go on trying for a son irrespective of
the number of daughters they already have.
Among those who stated ideal number of children as three or more "child
mortality1 is one of the reasons advanced by 55 percent of the respondents for
need to have more children and "security" as a reason by 30 percent.
Tlie spontaneous awareness of vasectomy and spacing methods varies between 40
to 50 percent.
Flie target population for IEC programmes are of three types:
1. 7 hose who have no children or have two or less and not practicing contraception
Such couples form 26 percent of all couples
2. Those who have children but do not want any more and yet not practicing
contraception. Such couple form 20 percent of all couples.
j. Those who have three or more children and still want additional children. Such
couples account for 7 percent of total.
4. Expectant mothers
5. Mothers with children below five years
6.3.
IEC Objectives and Strategy
After detailed discussions with the field staff, the IEC department has fihalized
the following objectives for the IEC programme.
•
•
•
To promote higher age at marriage among boys and girls.
Io promote spacing methods among young couples with one child or none.
To promote terminal methods at younger age than hitherto.
Jo achieve hundred percent ante natal registration.
To educate and motivate the community to accept referral services under CSSM
programme.
Io motivate women with unwanted pregnancy to avail of MTP service.
T° involve and encourage the participation of the community, PVOs and NGOs in
the Family Welfare programme.
"ri"J'
''1
"'
;
"--J:’-
’tt ■sEsr
m.
_____
&
.
AM
50
Bhaskara Rao N3 has observed that the Indian family planning programme has
been in operation for well over 40 years and despite additional inputs, infrastructure
and programme interventions, the results have not been commensurate and anywhere
near anticipated level. Communication remains the weakest link. The much needed
break through will not come about merely adding to the infrastructure or repeating or
intensifying the same old communication approach and efforts. More effective
communication obviously will not come about without going beyond the conventional
use of mass media and encouraging interpersonal, more specifically inter-spouse and
intra-family communication with outreach efforts forming part of it.
The exposure of rural females to print media wall be low as only 29.0 percent
are literate per 1991 census. Data on literacy by age available for 1981 shows that 24.2
percent of females in the most important age group 15-29 from the point of view of
the programme are literate and that among aged 15 and over is 15.4 percent. Even
though the literacy among rural females of all ages increased from 20 to 29 percent
during the decade 1981-91. that in the reproductive group would not change materially
as the addition to literate population will be in the ages 5-14.
The Third All India Survey on Family Planning Practices conducted in 1988 has
revealed that the exposure of married females in the reproductive ages to conventional
media —newspapers, radio. TV and cinema is low. lite maximum exposure is to radio
47 percent, followed by cinema 27 percent and TV 21 percent. During the last five
years the exposure to TV has been increasing while that to cinema has been declining.
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 reorientation 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. In order
to achieve this, it is essential to upgrade the knowledge and communication skills of
paramedical staff. Block Health Educators and Medical officers. It is therefore,
planned to impart training on IEC to paramedical staff and senior medical and non
medical officers. This training will form integral part of orientation training as outlined
in Chapter 5. The training for Junior Health Assistants Male and Female wall be
conducted at District Training Centres and at HFWTCs for medical officers and
supervisory staff. The responsibility for training will rest with Joint DircctorfH.E &, T).
V
f
e
f
v
h
t
Apart from conducting training programme to improve the communication
skills of the paramedical staff, inter personal communication kit will be made available
to each ANM. The kit would consist of items such as flash cards, flip charts, slide
viewer, and other educational aids. A quarterly news letter for internal circulation to
paramedical staff will be brought out. This news letter will give information on other
IEC activities planned for the coming quarter, suggestions for improvement received
from paramedical staff and the names of those who have done outstanding work.
g
E
s
e
I>
d
ir
.....
51
6.4.
Equipment for IEC
It is proposed to use video projectors instead of 16 mm f.:...
film projectors as they
are simple to operate and do not require generators for outdoor exhibitions Each
district and IEC wing at the Directorate will be provided with video projection
equipment. The equipment can be operated easily and there is no need' for a
projectionist. The equipment planned to be procured for the project is listed in Table
6.4.1.
Table 6.4.1 Equipment Proposed to Be Acquired for the Project.
Item
Video projectors with
screen. VCP. Audio
system. 18 volt battery
and inverter
Automatic slide
projectorOver head projector
TV/VCR
Transistor radio cum
cassette player *
Total on IEC Equipment
Unit Cost
Thousand
_____ Rs
240.0
Quantity
26
______ Rs
6.240
19.0
21
0.420
For DHEOs
11.2
32.0
_21
121'
0.235
3.872
800
1.600
For DHEOs
For DHEOs & Directorate 21
100 for FRUs
For PHCs and Mahila Swasthya
Sanghas (MSS)
Total Cost
Million
Remarks
To screen by the department for
outdoor screening of FP and
entertainment films
12.367
’ During the first year 5 transistor radio cum cassette players per district will be distribute among
Ss on an experimental basis If there are found useful and maintainable in the field other MSS
will also be provided similar sets from the third year onwards
The DHEOs have not been exclusively allotted vehicles and consequently the
field programmes are afFected. It is proposed to allot 20 long bodied jeeps — one to
each DHEO for scheduling IEC programmes in the field.
6.5.
IEC Materials
A full fledged Communication Needs Survey (CNA), covering the entire state
will be conducted along with Beneficiary needs and Baseline surveys as soon as project
is appraised and approved. The results of these studies will be used to delineate the
target groups, the messages to be conveyed, and the appropriate media mix for each
group.
The IEC materials, whether for field exhibition by the district staff or
Doordarshan and AIR. will be designed in consultation with senior district officials
such as DHO. DHEO so that the communication materials reflect the socio-cultural
ethos of different regions of the state. This will also ensure that necessary support to
EC activities from senior staff will be available. Hitherto, the mechanism of
development of messages and their scheduling has been delegated to the Ministry of
information and broadcasting. It is now proposed to involve experts in the field of
IaJH - 10's
10 2 2 7
h (>
z
o
z
I- ( K <
CC
< I cc
\ <£ o
w
. <
< B: 'I>
UJ
O O!
Z
)'
52
mass communication from public and private sector institutions for development of
messages and their scheduling based on the results of CNA study. Folk artists will be
supported to develop audio-visual programmes. The IEC materials to be produced
during the project period are presented in Table 6.5.1.
3
Q
Table 6.5.1 I EC Materials Proposed to be Designed and Reproduced
ISSU
’ "3
Item
15 minute FW Films
prints of the same____________
3-4 minute FW films quickies
35 mm prints of the same_____
Tele films 15-20 minutes
VHS prints of same_____ '
TV Serial_________________ __
TV spots
VHS prints of the same_______
Cinema slides_______________
Audio cassettes
Copies of the above__________
Flip charts - 7 types__________
Exhibition Panels with exhibits
Hoardings___________
Wall paintings_______
Total on I EC Materials
Unit Cost
Thousand
Rs.
Quantity
225
4
4
400
20
2,000
36
1,800
n
150
2
125
0.2
300
30
0 1
30
150
0.05
0 06
40
200
10,000
1,500
4
5,000
70,000
100
20
10
100
4000
Total
Cost
Million
Rs
0.900
1 600
3.000
4,000
4.500
0.360
0 600
6.000
1,000
0.450
0.600
0.250
4,200
4.000
Remarks
11
1.
To screen by the department
using 16 mm projectors_____
For exhibition in cinema
theaters___________________
To screen by DD, Directorate
and hired video vans_______
To be telecast by DD_______
To be telecast by DD
For exhibition in cinema halls
For distribution to PHCs and
Mahila Swasthya Sanghas
for use by ANMs/LHV______
five sets for each district to be
used in exhibitions.
2.000
4.000
37.460
4.
in
s-p
Tlf
n
b
th
IEC materials whether they be audio-visual films, slide show's, posters, folders
or wall papers have to be pre tested to assess their effectiveness in conveying intended
messages to the target population. Around 264 audio visual materials have to be pre
tested before release through mass media. Each item has to be presented to sample of
target groups and the impact assessed. It is estimated that each pre test will cost on an
average Rs. 4000. A provision of Rs. 1.056 million is made for pre-testing of IEC
materials.
Apart from telecasting TV serials and FW films on Doordarshan, they will be
exhibited by the district staff by hiring video vans. This will be tried out on an
experimental basis in five districts during the first year and if found effective it will be
extended to another five districts in the second year and remaining districts in the third
year. Video van hiring charges depend on the period of contract. Currently the monthly
hire charge for a van is Rs. 30,000 provided a two year contract is signed. For this all
inclusive charge, films will be exhibited for 24 days in a month according to specified
schedule.
....................................................................
■
w
et
at
o
si
e
P
c
C
€
\
I
t
53
6.6.
Mahila Swasthya Sanghas
The scheme of Mahila Swasthya Sanghas" was launched in the country during
1990-91 with the objective of seeking active participation of rural women in health
issues and resolution of their health problems, particularly related to maternal and child
health and family planning. More specifically, the scheme seeks to achieve the
following four broad objectives:
1. Provide an opportunity to women in
in villages
villages to
to discuss
discuss health
health related
related problems
problems and
and
remove misconceptions, if any.
2. Establish an organized linkage between the village community and health sendee
providers.
Disseminate information and promote knowledge on safe motherhood, child
survival, nutrition, family planning, personal hygiene, environmental sanitation, and
4. Provide greater coordination among female workers of various departments to
function m an integrated manner to educate and motivate the womenfolk.
In order to achieve the objectives, a number of activities are proposed to be
undenaken. These include formation of certain number of MSSs each year with
specified membership, training of members of MSSs with a specified curriculum,
meetings of MSSs every month, maintenance of registers containing specified
information by the female health workers who are member-convenors of the MSSs
It is proposed to utilize MSSs as a channel for communication to supplement
the efiorts through mass media and inteqiersonal communication. It is planned to train
the members of MSSs at PHCs and undertake, with their help, programmes such as
well baby shows, women and children's day celebration, motivation of eligible couples
etc. It is recognized that it is difficult to manage and sustain the MSSs on a laree scale
and close monitoring and evaluation is necessary. It is therefore proposed to pilot this
on a limited scale and evaluate the programme and extend it only if the results are
satisfactory.
Two tjpes of evaluation are contemplated. One is called the "process"
evaluation and the other "impact" evaluation It is well known that a scheme or a
project may not achieve its objectives not only because of inherent defects in it but also
of faulty implementation. More specifically, a scheme or a project may not achieve its
objectives because it is not implemented as it is conceived. Therefore, it is necessary to
evaluate MSSs to find out whether they are implemented as conceived This is what
we mean by "process" evaluation. The "process" evaluation will find out whether all
proposed activities including the number of MSSs to be formed every year, have been
carried out or not.
the impact" evaluation aims at examining whether the stated objectives of
MSSs Have been achieved or not. Hie stated objectives of MSSs are intermediary and
not easily quantifiable. It is, therefore, proposed not only to examine whether the
objectives of the MSSs are achieved are not. but also to examine whether there is
increase m the couple protection rate and reduction in infant mortality, maternal
mortality and fertility.
54
There are two types of research design that may be employed for evaluating the
impact of MSSs. One is to conduct the evaluation by comparing the couple protection
rate, birth rate, infant mortality rate and maternal mortality rate in the selected
"experimental” villages ’’before" and "after" the introduction of MSSs. But this design
will not enable us to isolate the impact of MSSs, as the rates will be influenced not
only by MSSs but also by improvement in the socio-economic conditions of people
ox er a period of time. The other research design is to conduct the evaluation by
comparing the rates in "experimental" and "control" villages. This design will enable us
to isolate the impact of MSSs and hence this design will be adopted to evaluate the
impact of MSSs. About ten "experimental" villages and ten control villages from each
of the four revenue divisions will be studied at the end of each year.
6.7.
Staff
The organization chart presented below indicates the proposed set up. 'fhe post
of Dy. Director. Field Operations is proposed to look after scheduling and monitoring
operation of video vans, local media and involvement of NGOs and MSSs. The
responsibility of the NGO component has been formally assigned to an officer under
Dy. Director Field Operations.
Additional Director (Projects)
Project Coordinator
Joint Director IEC
Dv. Director
Dv. Director
Dy. Director
Information
Field Operations
Publicity
Steps have been taken to fill up vacant posts at various level in the districts.
The following additional posts are being created at the Directorate in view of the
extensive IEC programme contemplated.
Table 6.7.1 Additional Staff to be Recruited for the Project
Designation
Dy. Director
(Field Operations)
Social.Scientist
Number
Grade
Annual Cost
_______ Rs.
1
3300-5300
103,200
2375-4450
1520-2900
1520-2900
1280-2375
1040-1900
870-1520
840-1340
81,900
103,080
51.540
43,860
35,280
28,680
26,160
371,220
Dy. D.H.E.O
An ist_________
7
F DA__________
Typist__________
Group D
i
Total
9
6.8.
IEC Programme for the First Year
Tlie IEC Action
Plan for 1994-95, the first year of the prow-
Fable 6.8.1 IEC Action Plan for 1904.05
|
Target Group
• j Mamed Women
aged 15-29 with no
I children or one
child
Married women
with two or more
children aged less
than 35 years
_______ Rev Message
1. Delay the birth of the
first child
2. Second child three years
after birth of first child
Prevent Pregnancy by
adopting terminal or non
terminal methods
_____ Media
I
Method / Control
Radio. DD. video 1 1 hxxiiKx' -'*0 cmema slides, one
vans. Inter
audio
and three video
personal
films hv ^Ktibitmg in cinemas and
communication
brvMdcJi's:»rit by AIR and DD /
Radio. DD. vjdeo
vans. Inter
personal
communication
video
2 PnxiiKV ';iP Charts and one
audio
for providing
complete
ledge on use of each
method b' WMs. members of
MSSs am* \oluntarx workers
3 ANMx MSSs to identify
satisfied wv.'" of II CD. OPV and
condom I* oil their support in
talking to m**-users
4. LiKate d^tisfied users and
resolve theo oioblems_________
1. Locate di^tisfied cases of
Tubet-tonn aud resolve their
j
problems
2. ANMs. MSSs to identify
(
satisfied adsH'tors of Tubectomy.
All women in
reproductive age
All women in
reproductive ages
Medical termination of
unwanted pregnancy
Maternal and Child Care
services
Advantages of Antenatal
registration
i
Enroll then support tn persuading I
non-uscis
3. Produce one audio cassettes and I
one video film tor broadcasting by j
AIR and I )D udeo vans
4. Prodiu e I bp ( harts and one
audio cassette tor providing
i
complete knoo ledge on the method I
by ANMs. members of MSSs and
_ Voiuntniy oo1 kCIS_____________
Radio, DD. video
1. Produce audio cassettes and
vans. Inter
video spot* foi broadcasting by
personal
AIR and DD
communication
2. ANMs. MNSs to identify
specific cmm’s. educate and
motivate them ‘“id refer to nearest
centre provi<ImM I P facility.
Radio, DD ,
1. Produce I vs o audio cassettes and
video vans. Inter
four video film* l°r broadcasting
personal
by AIR and DD ■ video vans.
communication
2. Produce flip t harts and audio
cassettes hit pioviding complete
knowledge <m Maternal and Child
care by ANM" Anganwadi
workers, inemhcis of MSSs and
Voluntary w«»!■ ‘22
I
I
56
Table 6.8.1 IEC Action Plan for 1994-95 (Continued)
Target Group
All adult men and
women
______ Key Message
Use of condom prevents
pregnancy
contracting AIDS
_____ Media
Radio, DD ,
video vans. Inter
personal
communication
All adult men with
two or more
children
Vasectomy to prevent birth
of additional children
Radio. DD, video
vans. Inter
personal
communication
6.9.
Implementation Method / Control
1. Produce two audio cassettes and
two video films for broadcasting by
AIR and DD / video vans.
2. Conduct of group meetings of
male participants by Jr. HAM to
explain how to use condom and the
advantages of using it.
3. Conduct of group meetings of
female participants by ANM
members off MSSs to explain how
to use condom and the advantages
of using it.____________________
1. Locate dissatisfied cases of
Vasectomy and resolve their
problems.
2. Jr. Hams to identify satisfied
adopters of vasectomy. Enroll their
support in persuading non-users.
3. Produce one audio cassettes and
one video film for broadcasting by
AIR and DD / video vans
4. Produce Flip Charts and one
audio cassette for providing
complete knowledge on the method
by Jr. HAMs and Voluntary
workers at group meetings
Budget for IEC
The phasing of capital and revenue expenditure on IEC is presented in Table
6.9.1
Table 6.9.1 Phasing of Capital and Revenue Expenditure on IEC
Millian Rupees
98-99
99-00
00-01
Total
94-95
95-96
96-97
97-98
IEC Equipment
10.942
0.000
0.700
0.700
0.000
0.000
0.000
12.342
IVoducliixi of IEC materials
16.680
10.620
6.810
3.500
0.000
0.000
0.000
37.610
IVe-testmg of IEC materials
0.308
0.288
0.256
0.204
0.000
0.000
0.000
1.056
Vehicles
7.000
0.000
0.000
0.000
0.000
0.000
0.000
7.000
Total capital expenditure
34.930
10.908
7.766
4.404
0.000
0.000
0.000
58.008
0.387
0.387
0.387
0.387
0.387
0.387
0.387
2.709
Capital cxpaiditiirc
Revenue expenditure
Salaries of staff
Hire charges for Video vans
1.800
1.800
3.600
7.200
7.200
7.200
7.200
36.000
Media hire charges
0.250
0.500
0.750
1.000
1.000
1.000
1.000
5.500
Total ol revenue expenditure
2 437
2 687
4.737
8.587
8.587
8.587
8.587
44.209
57
Chapter 7
Project Management
7.1
Apex Authority
L .T87.(J)- Ban8alore- Dated 23-2-1984 has been modified for adoption for
IPP-IX and is presented below.
1. The Governing Board for ffidi, P„p„btio„
the following:
1. The Chief Secretary to the Government
2. Representative of the Government of India
The Secretary to Government, Finance Department
4. Fhe Secretary to Government, Health & F.W. Department
5. The Director of Health & F.W. Services
6. The Additional Director (FW & MCH)
7. The Additional Director (Projects)
1.
2.
Cha'
mJ™11
Member
Member
L f
K<en\
M'™b" j.^.^
officials 0,11 be special invi.ees fo, ,l,e meetings of RGB
The Director, Population Centre
The Chief Engineer, PWD (C & B)
once in eve^th™n“ rdT.n
consisting or^'56
1.
2.
3.
4.
5.
of
P°WerS’
s“
b°ard Sha" be aSSisted by
The Secretary to Government, Health & F.W
. Department
The Secretary to Government, Finance Department
Tire Director of Health & F.W. Services
The Additional Director (FW & MCH)
Tire Additional Director (Projects)
b“‘ sh’“
«'
a steering committee
Chairman
Member
Member
Member
Member Secretary
The Director Population Centre will be a
special invitee for the meetings of the
Steering Committee.
ratification of actions taken.
Board for
58:
A
w
4. The Governing Board shall generally administer, execute and evaluate the I
IPP-IX Project and in particular, exercise the following functions :
!
A
a).
b).
c).
d).
e).
D-
Review the progress of the project, including construction of buildings, and
ensure that the Project is implemented in accordance with the terms of the
Agreement;
Review the reports furnished by the Director, Population Centre, from time to
time, and issue such directions as are necessary for implementation of the
Project;
Take all Policy decisions regarding the desirability of experimenting with novel
schemes on the basis of recommendations of the various units responsible for
the Project execution;
Enter into agreements / contracts with the Administrative Staff College of India,
Hyderabad, The National Institution of Nutrition, Hyderabad and other
institutions;
Approve the annual budget of the project; and
Take any other action or steps necessary' for the implementation of the Project.
The Project Management Structure is presented below.
Secretary H & FW
Additional Secretary H & FW'
'... xlz ...... ..... ..
Director
H & FW Services
Add!. Director
FW & MCH
Addl. Director
Projects
Supdt. Engineer
Jt. Director
Projects
Chief Accounts
Officer
Dy. Director
MIES
si;—
Jt. Director
FW & MCH
Jt. Director
IEC
Jt. Director
H.E. &T
Demographer
The Secretary Health and Family Welfare and Director Health and Family
Welfare will jointly coordinate the activities of Additional Director (Projects) and
Additional Director (FW &. MCH).
The responsibility for implementing the project rests with the Additional
Director (Projects), who will be designated as ex-officio Additional Secretary subject
to approval by the PGB. It is proposed to create a new post of the rank of Joint
Director to assist the Additional Director (Projects) in planning and monitoring area
projects and a Superintending Engineer to plan and monitor construction work. The
Joint Directors for MCH &, FW, IEC and HE & Training will also be reporting to the
III
1
2
4
6
t
i
59
Additional Director (projects) a 1PP-IX activities. The Additional Director (projects)
wdl coordinate the project actrmes falling under various departments and agencies.
Tlie Task Force for as io day management of IPP-IX will consist of the
Additional Director (Projects i aa the Joint Directors for Area Projects, FW & MCH,
IEC and FIE & Training. Tn ask Force will prioritize districts for provision of
1 raining. IEC and Managerial i-ats on the basis of the following criteria:
1.
Mean Age at Marriage^
2.
Crude Birth Rate
3.
Infant Mortality Rate
4.
Incidence of Water Bomt Jiseases
5.
Couple Protection Rate
6.
Percent Children Fully Inrunized.
and at
assist the Project Coordinator in
the (”
implementation.
•
•
•
The Joint Director Arer -meets will be responsible for the followingDetaihng project component n consultation with respective Joint Directors and
Superintending Engineer.
virectors and
Preparing annual and quarter nudgets
Monitoring progress of actr-. under each project component
m.Xb“k “
’
•
•
r'”“iVe **■ Direc,°rs •nd
on^ive
Preparing reports for montr: meetings of the task force as well as those of the
Steering Committee and
Releasing funds to the Zilla L nshad.
r>
.
e”F - and each Joint Director will taish to the Joint
D,rector Area Projects by Decker of each yea,, the requtrement of hl d fo I
corntne hn.ne.al year for the act sties under him. The Joint Director Are. lb '
Q Zim “ “"“"da'ed smre”t »f
"9-ieement and give h to the Project
The Project Coordinate* vill iinn JJanuary each year, submit to MoHFW the
projected expenditure for the ccmng financial year
so that funds will be available at
the beginning of the financial yer
;
The Project Coordinator will authorize the Joint
Director Area Projects to disburc- :his amount to the operating sections. The Joint
Director Area Projects will ensu- he timely availability of funds so
that the project
activities will not suffer delays du-. o non availability of funds in time.
Table 7.1.1 Revenue expenditure on Project Administration
MiIIkmi Rupees
95-96
96-97
97-98 '
98-99
99-00
00-01
: 16
OH 6
Tl 16
0.116'
0.116
0.116
0.116
T -00
0.812
0 400
0.400
0.400 '
0.400
0.400
4.000
To. ooo
0.516
0.516
0.516 '
0.516
0.516
4?116
To.812
L
Sial) Salaries
Baseline. Mid-lerm and end-line studies
Fetal Revenue expenditure
<16
Total
I.
t
■ jl
/■
fl
60
1
t
7.2.
Engineering Wing:
i
I
It is proposed to create an Engineering Wing in the Directorate of Health not
only to plan and expedite construction of new buildings for hospitals and residential
quarters contemplated under IPP - IX but also for maintaining existing buildings. The
main functions of the Engineering wing are :
1.
2.
4.
5.
6.
7.
Organizing all the civil construction works contemplated under IPP-IX.
Obtaining architectural drawings and estimates from the Architectural Section
of the state government.
Coordinating with various other government departments involved in land and
civil Works.
Supervising and monitoring the construction programme and suggest, if
necessary, mid-course actions and corrections.
Coordinating with the PWD Departments of the Zilla-Parishad and State for
undertaking the work as scheduled and also providing funds as required.
Preparing quarterly progress reports, expenditure statements and other
necessary information sheets for submission to the Government of India and
The World Bank.
Planning for maintenance of the existing buildings and entrusting the task of
preparation of tender documents as well as execution of the works etc. to the
State and Zilla Parishad PWDs in their respective jurisdictions.
The engineering wing will have the following staff.
Designation
Grade
Superintending Engineer
Asst. Executive Engineer
Asst. Engineer________
Draughtsman__________
Tracers______________
Total
3825-5825
2375-4450
2150-4200
1520-2900
1130-2100
Number
1
_2
2_
2
Annual
salary
1 13.400
81,900
152,400
106,080
77,520
531,300
The Superintending Engineer is in over all charge of the Engineering wing and
sponsible
for ensuring that the tasks assigned to the wing are carried out. The
is re:
Assistant Executive Engineer will be responsible for coordination with Zilla Parishads
and preparing quarterly reports as outlined in (5) and (6) above. Each Assistant
Engineer will be assigned a group of districts for monitoring construction activity,
identifying and preparing plans for renovation and rehabilitation of existing centres and
monitoring routine maintenance of buildings of the Directorate.
The Executive Engineer of respective Zilla Parishads of project districts will be
responsible for calling tenders, selecting contractors and awarding contracts. The
buildings to be constructed in a year in"the district will form a package. The valuation
will be done and payment vouchers made by the Asst Engineer . Zilla Parishad after
completion of each stage of construction.
1
Ml I Lilli
61
The Executive Engineer, Zilla Parishad will submit to the Engineering wing of
the Directorate, a statement of fund requirement for the payments falling due in the
next 12 months. The Joint Director Area project will on the recommendation of the
Engineering wing will release the amount to the Executive Engineer. Zilla Parishad.
The Executive Engineer. Zilla Parishad will submit each quarter a report on the
progress of work and statement of expenditure for the quarter.
The requirement of office furniture is valued at Rs. 15,000 for each of the four
executives and at Rs. 10.000 for 12 other staff. Two vehicles costing Rs. 3,90.000 are
required for the Engineering wing.
Table 7.2 Capital &. Revenue Expenditure by Year on Engineering Wing
Million Rupees
94-95
95-96
96-97
97-98
98-99
99-00
00-011
Total
Oll'ice tiimnurc
O..28O
0.000
0.000
0.000
0.000
0.000'
0 (XX)
0.280
Vehicles
0 400
0.000
0.000
0.000
0 000
0.000 ’
0 000
0.400
Total capital cxpuuliture
0.6X0
0.000
0.000
0000
0.000
0.000 '
oooo
0.680
0.531
0.531
0.531
3.717
Capital expoidilure
Revenue expaiditure
p
Salaries ot stall
0.531
0.531
0 531
0.531
Staticxiary
0.360
0.360
0.360
0.360
0.360
0.360
0.360
2.520
0.891
0.X91
0.891
0.891
0.891
0.891
0 891
6.2.37
supplies
1 <Xal of revenue expenditure
7.3.
MIES
7.3.1. Present Status
The Population Centre was assigned the task of developing Management
Information and Evaluation System (MIES), as part of India Population Project - I.
After a study of the existing system, the Population Centre designed and implemented
a new system for providing information to management on performance of various
components of FW and MCH programme, staff sanctioned, in position, vacant and
leave record
p
ni
The salient feature of the new system were:
1. Substantial reduction in the number of records to be maintained and reports
submitted by the field staff
2. Simplification of information to be collected.
3. Streamlining of the recording system.
4. Strengthening feed back
5. Facilitating effective evaluation by the programme administrators.
ne
i
r
In this system each field worker prepares only one report at the end of each
month and submits to his/her supervisor. The supervisor consolidates the reports
received from her/his subordinates and submits to the M.O. of the PHC. The District
Health Officer consolidates the reports from PHCs and forwards to the Directorate of
Health and Family Welfare. There is a computer wing at the Directorate which
62
consolidates the reports received from the districts. Chart 1 presents the information
flow for the system designed by the Population Centre.
Chart 1
Flow of Health Service Statistics
Sub-Centres
Outreach
Ddeaicn ami Lracmcnt of Malana. TB.
Detection and lracmcnt of Malana. I B.
Ixprosy. Maternal & Child Care. FP.
Leprosy. Maternal & Child Care. M’.
Infant. Child A: Maternal deaths and
Infant. Child & Maternal deaths and
Stocks of Dntg3 & Supplies
lamninnental Sanitation
Monthly Reports of Health Assistants Male & Female
Primary Health Centre
Consolidation of Monthly Reports
of Jr. Health assistants
by Sr. Health Assistants
Plus
Services Rendered at PHC
I xprnsx. Maternal Ac Child Caic. FP
Dctectidi and lracmcnt of Malana. TB.
Infant. Child Ac Maternal deaths.
Morbiditx. Stocks of I )nigs mid Supplies
CHCs and Govt. Hospitals
Fvt. Nursing Homes
Monthly Repons on
Services Render under National
Programmes on MCH, FW. Malaria.
TB, Leprosy & Blindness
Monthly Reports on
Services Render under National
Programmes on MCH, FW, Malaria,
TB, Leprosy & Blindness
District Health Office
Statistical Cell
Consoldation of Monthly Reports
from PHCs, CHCs etc.
J
Directorate of Health
MCH & FW
Consoldation of Monthly Repons
from Districts
Coverage of HMIS Version 2.0
Currently information on infrastructure facilities and their condition which is
essential for planning of health and family welfare services is not readily available.
63
COnS°,idatIOn °f
in^a^S^eD-th" 7•
only a subset of information being compiled at PHCs
,nfOrmat,°n ,0 be covered is
demographic eh.rac.eriaties of aceep.ors of FP meihoda'sZ’o'v^r1”"' S“C" “
7.3.2. Proposed Information System
It is now planned to develop a comprehensive database
•
encompassing:
Demographic features of the territories covered bv CHCs PHCs and SC.
Fac.ht.es at health centres - Building, equipment, and staff
'
.»s£xxre by "ead of a“°“ *' '"e Me “ -
-p
Personnel information - date of joining, date of birth, academic qualification
details of pre and in-service
■” tra,nlng Provided’ se™ce record and current place of
posting.
Stock on hand and consumption of drugs and supplies
M»S,y '’erf°n""" ”fofFW & MCH programme, and
•
•
enhancenZL7edrdeq^L^TmZ POi"‘ f°r
MIES but substantial
System outlined above and presented in Chart 1
COmpO"e,,,S °f Healt1' Information
Family Welfare'offiters'"^"u^rade d.Vf^ff °ftl,e,°fficeS of District Health and
continually update the database. "
are:
‘le St3te ’eVel t0 create and
Hie benefits that will accrue by implementing the
proposed information system
•’ time
Xt
s„Xe,7fiXa,,re faci'ities ”d ""■ia'i"8
617 ldentlfication of areas "ith Poor performance
—
and take necessary steps in
•
•
Proper planning for personnel development
through identification of trainins needs
and scheduling training programmes,
Freeing supervisory staff from the
drudgery of compiling monthly reports and
improving quality of supervision, and
X^lies^ S>StemS f°r pr0CUrement’ stocki»g and distribution of drugs and
deveioped HM S dZr “»
S.ndv he nequ « Z
Direc^e. k “1^
'"‘J ,''e N,,i°"i"
C“- ««=h h.s
" ■'"
""*« NIC “ "■»»"* 1°
’/ HM,S
......... .
- He- - F.^ We,fare „d
I
64
I
Directorate, are better placed to brief NIC on information needs. NIC is also willing to
train the staff and implement the information system.
Chart 2
Proposed Integrated Management Information System
Census Reports
Facility Survey
Demographic Profile
of SC, PHC, CHC
Details of buildings.
Furniture & Fixtures
Equipment, & Staff
at each centre
Monthly Reports
From
Jr. Health Assistants
PHCs, CHCs, Com.
and Pvt. Hospitals
District Health Office £ Mciil'nly RcptTri'x
Computer Centre
Personnel
Training
Facilities
Training Courses Conducted
Particulars ofTrainnes
Directorate
IEC
Inventory of materials
Media Schedules
~
Date of joining. Qualifications
Pre & Inservice training.
Postings & Promotions
Present grade, salary. Date of
Next Increament
Computer
Centre
Central Stores
Stocks on hand, on Order
Receipts and Issues
during the month
___ 7
Engineering
Construction Schedule and
Progress Reports: Physical
and Financial information
-------------- - ----------------- /
Finance
Budget & Expenditure
by Cost Centre
Project Coordinator
The system presented in Chart 2 is oriented towards aiding the management at
various levels and in different areas of activity of the Directorate of Health and Family
welfare. At the Lowest level of management .namely the Sr. Health Assistant, he or
•’.s’'
J
65
she can monitor the perfonnance of Jr. Health Assistants tinder her or him and nav
• en mn to poor performers to improve them. The Medical officer of the PHC will be
able to monitor the perfonnance of the PHC as well as the suh-eentrpc
h
i •
junsdiction At the next higher level, the ADHO who is in-charee of rf
.he (heihdes .laihble a, each PHC and ns peZ^Ta.^et'Zed^
llieDHO gn|H ’
faC,''tieS a,’d °r 'mpr0Ve the performance °f those la-ine behind
Hie DHO vmII have necessary information to review' the perfonnance of eVchADHO's
temtory as well as interact with the Joint Directors and /uperintendin, E^eer “tl
Directorate to obtain necessary inputs to achieve the goals set for his district.
At the Directorate, each functionary will have direct access to infonnation
squired for monitonng of activities falling under his jurisdiction.
he en ?,a?ieVe/ ful'il,te"ration of M,S ^th operational activities, workshops will
onducted to identify the information needs at each level and parameters^o he
PronXd • f
PerS°nnel ,n'char?e of operational activity will be briefed on the
1 od.y an™es“"
”,‘i b°W
l’ar,iCipate "‘l ™k'
Hie three most important areas which require high priority are Facilities
Direcn,Ct,On’ CrSOi"nel ,nfonnatl0n 0,1 these is ”ot rei>d'ly available either at the
c a Xit onL"'
f
leVeL Infonnation on these areas is necessan' for
u'
MK eXISt,n^ei,t^- ^editing construction activity and plannina for
could T
S VerS,On ; C° d e lm'’lemcnted in parallel. Enhancements to HMDS
. aktn UP after completing implementation of systems for Facilities
Construction and Personnel.
'
rauimies.
7.3.3. Staffing MJES
I he additional staff requirement is presented in Table 7.3.3 1
fable 7.3.3.1 Staff Requirement
Location
Designation
Grade
Directorate
Dy. Director_____
Sr. Systems
Analyst_____
Hardware Engineer
FDA____________
FDA____________
Asst. Director
3300-5300
2150-4,200
_1_
2
2150-4,200
1280-2375
1190-2200
3300-5300
1
3
20
1
Districts
S1HFW ,
Total
Number
Annual
salary
103.020
152,400
76,200
131,580
877,200
103,020
1.442.800
I
66
7.3.4. Capital Equipment for MIES
r'
7
The computer systems and equipment to be procured for the districts and the
Directorate are as presented in Table 7.3.4.1
P
r
Table 7.3.4.1 Capital Equipment for MIES
Location
Computers
i Equipment
Districts
IBM Compatible PC 386 with 4 MB Memory, 100 MB
Hard
disk.one 3.5 " Floppy drives. Dot matrix Printer and
---------software
IBM Compatible PC 486 with 8 MB Memory, 100 MB
Hard disk, one each of 5’/i" and 3.5 " Floppy drives. Laser
Printer and software
Minicomputer with 16 MB memory,
2.x 1.2 Giga Bytes Hard disk. 3.5’' and 5 25 " floppy
drive. Cartridge Tape.. six terminals, 600 1pm printer, laser
printer, and software
IBM Compatible PC 486 with 8 MB Memory'. 2 x 200
MB Hard disk, one each of 3.5 ” and 5.25 " Floppy drives.
Laser printer, four terminals and software.
20
3.500.000
2
500,000
1
800.000
1
350.000
Air conditioner. Voltage stabilizer. Spike buster
Air conditioners (4), UPS (3). Photo copiers (2). Fax
machines (2)
20
1
800.000
900.000
Directorate
Directorate
SIHFW
Other Equipment
Districts
Directorate
Number |
Cost Rs.
The requirement of office furniture is estimated at Rs. 75.000
7.3.5. Stationary' & Office Supplies
C
\
Table 7.3.5.1 Presents estimated cost of stationary for implementing MIES.
Table 7.3.5.1 Cost of Stationary' and Office Supplies
Item
Annual Diary' for Junior Health .Assistants
Monthly Report of Junior Health Assistants
Monthly Report of PHC
_CHCs, Govt Hospitals, Pvt. Nursing Homes
Monthly Feed back Reports to Senior Health
Staff__________ ,
Monthly Feed back Reports to PHCs
District Reports _________
Computer Stationary
Diskettes
_______ •
T otal
Wastage @ 10%
Total cost of stationary and supplies
Rate/Unit
Rs.
Annual
Requirement
Cost Per
Annum
Million Rs.
20
1.62
4,05
2.88
15.000
216,000
20,000
20.000
0.300
________ 0.350
_______ 0.081
_____ 0.058
2,40
4.00
4.00
0.40
8.50
40,000
20,000
300
720,000
400
0.096
0.080
0.001
0.288
0.004
1.255
0.125
1.380
f
67
7.3.6 Computer Systems for Special Applications
Engineering wing. Health Education and Training, and EEC will each be
provided with a computer and their staff trained in use of special application in their
respective areas.
Table 7.4.1. Computer Systems for Special Applications
Department
Purpose
Configuration
Civil Engineering
Construction
Monitoring and
Costing
IBM Compatible PC 486 with 8 MB Memory.
300 MB Hard disk, one each of 3.5 " and 5.25
" Floppy drives. Dot Matrix printer. Plotter
CAD and Project Management software
Health Education
& Training
Production of
Training
Materials
Production of
IEC Materials
IBM Compatible PC 486 with 8 MB Memory.
300 MB Hard disk, one each of 3.5 " and 5.25
" Floppy drives. Laser printer and software.
250.000
IBM Compatible PC 486 with 8 MB Memory'.
300 MB Hard disk, one each of 3.5 " and 5.25
" Floppy drives. Laser printer and software.
350.000
IEC
Cost
Million
Rs____
400.000
7.3.7 Selection of Vendors and Consultants
Hie Project Coordinator will float tenders for computers, other equipment and
consultancy services. I he offers will be scrutinized by the steering committee and
vendors and consultants selected for each application. Their decisions will be
forwarded to PGB for ratification.
7.3.8 Budget for MIES
The budget for MIES is presented in Table 7.3.8.
Table 7.3 7 Capital & Revenue Expenditure by Year on MIES
Millid) Rupees
94-951
95-96
96-97
97-98
98-99
Computers
6.150
0.000
0.000
0.000
Other equipment
1.669
0.000
0.000
0.000
Spares lor Cnuputers
1.476
0.000
bees to ecwisuhants
2.100
Total capital expenditure
1 1.395
1.443
99-00
00-01
Total
0.000
0.000
0.000
6.150
0.000
0.000
0 000
1.669
0 000
0.000
0.000
1.476
Capital expenditure
0.000
0.000
0.750
0.750
0.000
0.000
0.000
o.ooo
3.600
0.750
0.750
0.000
0.000
0.000
0.000
12.895
1.44.3
1 443
1.443
1.44.3
1 443
1.443
10.101
Revenue expenditure
Salaries of stall
SlutKnarv
supplies
Total of revenue expenditure
z.i
0.690
1.380
1.380
1.380
1.380
1.380
1.380
8.970
2.133
2.823
2.82.3
2.823
2.823
2.82.3
2.823
19.071
68
7.4
Evaluation Studies
The Project Coordinator will initiate with the proposed State Institute of
Health and Family Welfare, Baseline, Mid-term and End-line studies. The Baseline
studies will help in refining the project components besides providing baseline data for
evaluating the impact of the programme. Provision for other studies is made for
operational research in-service delivery, evaluating the pilot schemes and the end-line
study at the end of the project for evaluating the impact of the project.
7.5
Flow of Funds
The Project Coordinator will have under him an accounts wing headed by a
Chief Accounts Officer. Separate accounts will be maintained for the project and at the
end of each quarter an expenditure statement will be prepared and submitted to the
Government of India for reimbursement and forwarding to the World Bank. The
Government of India will reimburse the State Government the amount within fifteen
days of receipt of the expenditure statement.
The Accounts will be audited at the end of each year by the Accountant
General, Karnataka, and Audited Accounts and Certificate will be submitted to the
Government of India.
Budget for Project Management
7.6
Table 7.6 Capital
Revenue Expenditure by Year on Project Management
Millicn Rupees
94-95
95-96
96-97
97-98
98-99
99-00
00-01
Tolal
6.150
0.000
0.000
0.000
0.000
0.000
0.000
6.150
1.520
0.000
0.000
0.000
0.000
0.000
0.000
1.520
0.000
0.000
Capital expenditure
Computers
Other equipment
1.476
0.000
0.000
0.000
oTooo
1.476
Office furniture
0.280
0.000
0.000
0.000
0.000
0.000
0.000
0.280
Vehicles
0.400
0.000
0.000
o.ooo-
0.000
0.000
Kooo
0.400
Fees to consultants
2 100
0.750
0.750
0.000
0.000
0.000
3.000
3.600
11.926
0.750
0.750
0.000
0.000
0.000
0.000
13.426
4.000
0.400
0.400
0.400
0.400
0.400
4.000
10.000
2.090
2.090
2.090
3.090
14.630
Spares for Computers
Total capital expenditure
Revenue expenditure
Baseline. Mid-term and end-line studies
Sal ones of staff
Stationarx’ &. supplies
Total of revalue cxpaiditurc
2.090
2.090
2.090
1.050
1.740
1.740
1.740
1.740
1.740
T.740
T1.490
4.230
4.230
4.230
4.230
7830
36.120
7.140
4.230
69
Chapter 8
Innovative Schemes
j9,"""'1’1’''*1,0 s“PPlemem the efforts of
.he departmeiuh
8.1
Sub-centre Health Advisory Committee
Chap Jl‘“e±3
“VT' ”
and if extended in the third vear to all h" m '
period will be Rs. 27.768 million.
Sub-Centres-
8.2
A“
— a/d b“X“Xs™edt^
.... .
”
"
tU°
exPenmental period
total cost dunng the project
Involvement of PVOs and PMPs
l22'9.V°l'‘'“a.ry 0r?’"t=i.'0"S having good rcpulaiion for condoning social
welfare activities will be selected
- ---j tor supplementing the efforts of the Directorate in
promoting and / or jprovi mg .
and MCH services. The potential PVOs will be
identified by the MO of the PHC
311 p\e
se^ect’on will be made by the DUO in
... ........ Cl,i«r Score,ar, „fllle zfl,a
Where PVOs arc not
3t present, the MO of the PHC will
promote formation of
Mahila Swasthya Sanghas
Heal,I, & Famijy Welfare Sochl'welf-Jr' 7p?“ 'ei“i'rS
f'“le work'” of
expeced a,.a ,„e scale .f fiaaac,.! .ss,s,a„ceXr
services
Type of Organization
Services rendered
Number
for
100
PVO ( Hospital / Clinic)
Motivation
FW & MCH
Motivation
delivery
services
&
of
20
Mahila Swasthya
Sangh
in a village
Motivation
FW & MCH
for
1000
PVO
.his scl,eAm“Se,"T l’r°ViSim Of
-••
•
59 786
Financial Support to be
extended Rs per annum
per village covered
Rs. 2,500
Sterilization :Rs. 300
IUD Insertion. Rs 100
Primary Immunization
per child: Rs. 25
Rs. 2,500
» .he prcjec. proposal for
-—--------- —
I
70
8.3
Special Programme for Tribal Areas
Currently one sub-centre is provided for 3000 population in hilly areas. Some
of the hamlets of tribal population are scattered and located in the interior of forests
where wild animals abound. It is difficult for an ANM to cover these inaccessible
hamlets. Further, cultural difference also make it difficult to promote and provide
health sendees.
It is proposed to select girls from tribal hamlets and provide them ANM
training and post them in tribal hamlets and assign them an area with 500 population.
The emphasis would be on health and nutrition rather than on family planning. The
minimum educational qualifications for ANM training will be relaxed if suitable
candidates are not available. In all 100 tribal girls (20 each year) will be trained and
posted as ANMs in tribal hamlets and provided midwifery' kit and sub-centre
equipment.
There are some voluntary' organizations working in tribal areas and providing
medical services. Their experience and services will be utilized in planning and
implementing this scheme. The Directorate of Health and FW sendees will support
such organizations by providing equipment and drugs.
A budget provision of Rs. 16.1 million is made in the project cost for this
scheme.
8.4
Involvement of Industrial Houses in IEC
Leading industrial houses both in the private and public sectors promote and
support sports and other social activities. It is proposed to conduct workshops to get
them involved in health and family welfare education by developing IEC materials
and/or hiring time slots on DD and AIR at prime time. Leading personalities from film
industry' and advertising who are interested in social welfare will also be invited for
these workshops.
8.5
Non-Formal Education For Girls and Young Women
The Education Department is having programmes to achieve 100 percent
literacy in all districts of the State. The programme contemplated under IPP-IX
Project is aimed at school dropout girls in the ages 11-14 and neo-literate young
women in the ages 15-29 years.
The curriculum for non-fomial education will include modules on personal
hygiene, environmental sanitation, late age at marriage, aseptic deliveries, limiting and
spacing of children etc.
71
8.6
Clubs for Newly Married Couples
8.7
Community Incentives
benefitiSeS
hi§heSt CPR Vvi11 be gk'en c°™ity incentives
enefiting the community such as bore well, additional class rooms etc.
8.8
Marketing of Nirodh
Hie shoos will h
a7
Nir°dh thr°Ugh the PubIic distribution system
to e T
u g’Ven St°CkS °f N,rOdh fr£e °f C0St °r at
price and pennhud
Nirodh
P006 "C
Pr°fitS- ThiS VVi11 be in addition t0 ™rketirm of
Nirodh by voluntary workers appointed in the villages.
g
8.9
Monitoring of Innovative Schemes
A sub-committee consisting of the following persons will be formed to monitor
and tf necessary modify each of the innovative schemes to achieve maZmimpae"
Tlie Director Population Centre
The Project Coordinator
£h “
The Joint Director, Area Projects
Deputy Secretary. Department of Health and Family welfare Member Sectary
J
J
72
Chapter 9
Tribal Population of Karnataka
9.1
Scheduled Tribes of Karnataka
The term Scheduled Caste and Scheduled Tribe is the expression standardized
in the Constitution of India. Contrary to usual practice, the constitution has not given
any definition of the terms Scheduled Castes and Scheduled Tribes. Articles 341 and
342 of the Constitution empower the President of India after consulting the head of a
particular State to notify by an order the castes, races or tribes or parts or groups
within castes, races or tribes which shall for the purpose of the constitution be deemed
to be Scheduled Castes / Scheduled Tribes in relation to that State.
The Scheduled Tribes are popularly believed to constitute the aboriginal
elements of the Indian Society. They are generally concentrated in the hill and forest
areas and until recently the political system of the different tribes enjoyed a certain
degree of autonomy. Today however, it is difficult to define tribal peoples of India by
any single set of formal criteria. The elements that should normally be taken into
account in such a situation are the ecological isolation of the tribal people, the relative
autonomy of their political and cultural systems, and the antiquity' of their association
with their present habitat.
The difficulty of applying a uniform set of criteria in Scheduled Tribes arises
from the fact that the tribes have been for quite some time tribes-in-transition. The
political boundaries of most tribal systems have collapsed well before the beginning of
the present century. A certain amount of cultural interaction between the tribal people
and outside world existed for centuries. Large segments of tribal population have
tended to get absorbed into Hindu society. In many cases it is difficult to say whether a
particular social unit is a tribe or caste. The lists of scheduled Tribes have been drawn
up after a careful consideration of individual cases.
In Karnataka, the list of Scheduled Castes and Scheduled Tribes lists
(Modification) Order 1956 .notified by Government of India, Ministry of Home affairs
Notification No. SRO -2477A dated 29 th October 1956, formed the basis of 1961 and
1971 Censuses. The lists were amended under Scheduled Castes and Scheduled Tribes
Order (Amendment) Act 1976 (No. 108 of 1976 dated 18 th September 1976). The
only difference between the original order and the amended one has been that the
castes and tribes so notified are applicable to the whole of the State rather than to
certain fixed areas of a State. The amended order formed the basis for 1981 and 1991
Censuses. The Scheduled Tribes as per Order of 1956 is presented in Table 9.1.1.
■
r
73
Table 9 1.1 List of Scheduled Tribes in Karnataka as Per Scheduled Castes and
Scheduled Tribes (Modification) Order, 1956
Districts_____
Tribes
Bangalore,
Beliary,
Chikmagalur, Chitradurga,
Hassan. Kolar Mandya,
Mysore (except Kollegal
taluk),
Shimoga
and
Tumkur
1. Gowdalu
2. Hakkipikki •*
3. Hasalaru
4.1ruliga
5. Jenu Kuruba
6. Kadu Kuruba
7 Malaikudi
S.Maieru
9.Soligaru
1. Barda
2. Bavcha or Bamcha
3. Bhil, including Bhil Garsia. Dholi Bhil, Dungn Bhil. Dungri
Garasia,
Mewasi Bhil, Rawal Bhil. Tadvi Bhil. Bhagalia Bhilala. Pav,Ta.
Vasava and Vasave
4 Chodhara
5. Dhanka including Tadvi. Tetaria and Valvi
Belgaum. Bijapur. Dharwad
and Uttar Kannad
6. Dhodia
7. Dhubla, including Talavia or Halapati
8. Gamit, or Gamta or Gavit including Mavchi. Padvi.
Vasava, Vasave and Valvi.
9 Gond or Rajgond
10 Kathodi or Katkari including Dhor Kathodi or Dhor Katkan and
Son Kathodi or Son Katkari
11. Kokna, Kokni. Kukna
12. Koli Dhor, Tokre Kodi, Kolcha or Kolgha
13. Naikda or Nayaka. including Cholivala Nayaka, Kapadia Nayaka,
Mota Nayaka and Nana Nayaka
M.Pardhi. Including Advichincher and Phanse Phardhi
15. Patelia
16. Pomla
17. Rathwa
18. Varli
Gulbarga,
Raichur
Bidar
and
Dakshin Kannad and
Kollegal Taluk of Mysore
19 Vitolia, Kotwalia, or Barodia
1. Bhil “————---------------- ------------------2. Chenchu or Chenchwar
3. Gond (including Naikpod and Rajgond)
4. Koya (including Bhine Koya and Rajkoya)
5. Thoti
1 Adiyan
2. Arandan
3. Imlar
Kollegal taluk of Mysore
Dakshin Kannad______
Kodagu
4. Kadar
5. Kammara
6 Kattunayakan
7 Konda Kapus
8. Konda Redd is
9. Koraga
10. Kota
11. Kudiya or Melakudi
1. Kaniyan or Kanyan
1 Marati
12. Kurichachan
13. Kurumans
14. Maha Malasar
15. Malsar
16. Malayekandi
17. Mudugar or Muduvan
18. Palliyan
19. Paniyan
20. Pulayan
21. Sholaga
22. Toda
1. Korama
4. Maratha
2. Kudiya
3. Kuruba
5. Meda
6. Yerava
?
.
...
■
1
74
The Tribal Population by district as per Censuses of 1961 to 1991 is presented
in Table 9.1.2
Table 9.1.2 Scheduled Tribe Population by District 1961-1991
Number and Percent Within District (State)
District
Bangalore
Belgaum
Bellary
Bidar
Bijapur
Chikmagalur
Chitradurga
Dakshin Kannad
Dharwad
Gulbarga
Hassan
Kodagu
Kolar
Mandya
Mysore
Raichur
Shimoga
Tumkur
Uttar Kannad
Karnataka State
1991
1981
1971
1961
Number 'Percent Number 1Percent Number :Percent Number Percent
75627
1.53 102936
L58
10287
0.31
4638
0.19
51673
647
1055
9405
7176
152
48678
10665
1352
924
27102
367
552
16805
45
6240
402
4218
2.60
0,07
0.16
0.57
1.20
0.01
3.11
0.55
0.10
0.10
8,40
0.03
0.06
0.01
0.00
0.61
0.03
0.61
53150
4246
699
6524
10092
762
63596
14632
1871
1606
26596
1921
2795
19547
1 148
7540
2081
2175
2,19
0.38
0.08
0.33
1.37
0.05
3,28
0,62
0.11
0.15
7,03
0.13
0.24
0.94
0.08
0.58
013
0.26
59111
164582
43150
115239
15320
252009
88403
137461
97627
10811
36877
113839
1 1653
166649
177307
52426
140117
9753
3.90
11.05
4,33
4.80
1,68
14.18
3.72
4,67
4,69
0,80
7,98
5,97
0.82
6.42
9,94
3.16
7.08
0.91
83076
166693
104215
39535
26534
318381
106159
105099
106935
16581
40312
153019
11936
102102
180272
74106
2,32
8.82
8.30
1.35
2.61
14.60
3.94
3.00
4.14
1.06
8,25
6.90
167632
192096
0.80
231268
0.79
1767961
4 91
1915691
7,27
0.83
4.26
10168
0.73
3.23
7 80
3~88
The Registrar General of India commented on 1981 Census of Tribal
Population Karnataka that the ’’Scheduled Tribe figures would appear to include high
returns relating to certain communities with nomenclature similar to those included in
the list of Scheduled Tribes consequent on the removal of area restrictions", for
Karnataka in 1981 Census. The population of Scheduled Tribes of Karnataka in 1981
was higher than the 1971 population by 689.2 percent as against 41.8 percent at the
National level.
According to 1981 Census, 19 tribes accounted for 99.1 percent of all
Scheduled Tribes in Karnataka. Out of these tribes, sixteen tribes accounted for 90
percent of the Scheduled Tribe population in the 1971 Census. The sixteen tribes and
the districts where they reside are presented in Table 9.1.3.
The seven tribes whose numbers have increased several fold and accounted for
98.1 percent of increase in population of Scheduled Tribes in the decade 1971-81 are
presented in Table 9.1.4.
Naik, Nayak, Beda, Bedar and Valmiki tribes have been recognized as
Scheduled Tribes vide The Constitution (Scheduled Tribes) Orders (Amendment)
Ordinance, No. 3 of 1991 dated 19 th April 1991 (issued subsequent to Census of
1991).
75
Table 9.1.3 Major Tribes of Karnataka by Place of Residence - 1971 Census
Scheduled Tribe
Naikda
Marat i
Yerava
Hasalaru
Soligaru
Kuruba
Kadu Kuruba
Koraga
Kudiya
Jenu Kuruba
Gowdalu
Iruliga
Sholaga
Hakkipikki
Gond
Marat ha
I
District
_ Belgaum, Bijapur, Dharwad, and Uttar Kannad
Dakshin Kannad
Kodagu
"—
Chikmagalur and Shimo
Bangalore, Mandya, Mysore and Tumkur
Kodagu
~
Bangalore, Bellary, Mysore
Dakshin Kannad and Mysore
Kodagu
—————— --------
Bangalore, Bellary, Mysore
Bangalore and Chikmagalur
Bangalore
---------Dakshin Kannad and Mysore
Bangalore. Mandya, Mysore, Shimoga and
Gulbarga, Bidar and Raichur
'
Kodagu
"
'
Percent Cumulativ
of State e Percent
29.68
29.68
21.12,
50,79
5,94
56,74
4.85
61.59
4,75
66.33
3,83
70.16
3,54
73.71
3,29
77.00
2.89'
79,89
2 88 '
82,77
2.23 ~
85,00
1.32“
86.32
1.14~
87.46
1.11 ~
88,57
0.75
89.32
0.70
90.02
from
14,848
........ ' i
featured in 1981
1.44,610 in 1981.
Table 9.1.4 Increase in Population of Selected Tribes
Community
Naikda
Kadu Kuruba
Gond
Koli Dhor
Koya
Jenu Kuruba
Meda
Total
9.2
Census Popu 1 ation
1971
1981
68632
1260158
8192
209677,
1746
60730
1404
39135
___ 30
27807
6656
34747
325
18684
86985 ’
1650938'
Increase in 81 over 71
Number
Percent
~1191526
1736,
201485
2460
58984
3378
37731
2687
27777'
92590
28091'
422
18359'
5649
1563953 ’
1798
Tribal Development in Karnataka
LL
? ™ka 3re dlsPersed 311 over Ae State. Their concentration is
found in 1the districts of Chikmagalur, Dakshin Kannad, Kodagu and Mysore where
tribes are" TT
< n0™Cfal!y’,S,0C.lalI-V..and educationally backward. Although the four
districts had sizable Scheduled Trib
--.oe population, the State could not declare the tribal
areas as ScheduledcAreas since
v the scheduled tribe population in any area is less than
50 percent norm fixed by the Government of India. This norm was subsequently
76
relaxed to the extent that pockets of scheduled tribes of any concurrent administrative .
area should have at least 10,000 persons belonging to Scheduled Tribes so that
Integrated Tribal Development Project could be formed.
On this Basis, five Integrated Tribal Development Projects were launched in the four
districts. The jurisdiction of Tribal Sub-Plan was limited to 398 tribal colonies in 23
taluks in the four districts — Chikmagalur, Dakshin Kannad, Kodagu and Mysore
where primitive tribes live in hilly areas.
The Tribal Sub-Plan has been implemented in the State during the year 1976-77
and some work of poverty removal has been done. However, systematic efforts with a
definite target to uplift 50 percent of the target groups in I.T.D.P areas above poverty
line were mounted from 1980-81.
The ob jectives of the Tribal Sub-Plan are:
1. To enable families to overcome the rigours of poverty through provision of
package of viable economic benefits.
2. To lay down policies which will protect tribal culture and promote tribal
welfare.
3. To provide tribal habitats with basic minimum infrastructure facilities.
The Government of Karnataka has spent on an average Rs. 116.3 million per
annum on Integrated Tribal Development Projects during the period 1985-1992 and
proposes to spend Rs. 211.5 million per annum during the Eighth Five Year Plan.
The existing health facilities and proposed outlay on Health and Nutrition
component of (ITDP) during the Eighth Five Year Plan are as under.
Table 9.2.1 Health and Nutritional Facilities: Tribal Sub-Plan - 8 th Plan 1992-97
Existing
Eighth Five Year Plan 1992-97
Units
PHCs___________________________
Mobile Dispensary / Health Unit_____
ANM Sub-Centres_________________
Drugs___________________________
Assistance to PVOs________________
Midday Meals Energy food for
Standards I to VII_________________
Special Nutrition Programme:
Children and Expectant Mothers_____
Total
30
10
31
Additional
Units
_______ 10
_______14
10
Outlay
Million Rs,
10,0
14.9
______ 2,5
______ 5,0
______ Z5_
2.1
5.3
42.3
The Government of India Suggested certain norms be fixed for covering the
tribes living outside I.T.D.P areas:
77
Pockets of tribal <concentrations can be identified within one administrative unit
satisfying the conditions prescribed for
_
Modified Area Development Approach
namely:
1.' A maximum tribal population of 10,000 in a pocket.
2. Percent of the population in the pocket should be that of tribes
3. Hie villages in the pockets should be contiguous.
Pockets of
tribal cconcentration be identified within an administrative mrit in a
~r t~b_l
block,
taluk
district. ’
administrative or
unit^t.^
" the
•
•
are contiguous.
Villages with predominantly tribal population can be identified. Such small grouns
of villages are interspersed in villages where tribal population is less than 50
percent.
Pockets can be identified where tribes are living in hamlets and predominantly in
non-tribal areas. Those hamlets can be
taken1 as a unit.
---------
•
of these
—ts Chi the
thebasis
districts
ofrevised
Ban^^'
the districts of Bangalore,
ogrammes suiting to the felt needs of these tribes are being prepared.
■ • niu “reCtOrate of Social Wclfa^ has decided to initiate survey in all
the 1 st of SI a 77 7 '0Cate tnba‘ P°ckets/],amlets in view of the recent additions to
list of Scheduled tubes and earmarked Rs. 4 million in the 1993-94 budset.
9.3
Ethnographic Survey of Scheduled Tribes
The Anthropological Survey of India, Mysore has conducted an ethnographic
sun
suney
ey of Scheduled Tribes of Karnataka and prepared a repoU " The People of India
—M
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Descri’’tive D"'’ -
on Ethnographic
Survey
85-90'’. ThisX
report is
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and
1993 However^
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<1 i“
be rel“s'd
'Vend of
1993. However,
the T
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Welfare
access ,'
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»«>«™e of Health and Family
Welfare access to the manuscupt. Steps have been initiated to copy relevant
»19
.f=
9.4 Socio-Economic and Demographic Studies of Tribes in Karnataka
The literacy level among the tribal population is less than total population but
Sche'dded TathamOnS Scheduled Castes- I" 1981, 30.0 percent of males among
chedukd Tubes were literate as compared to 29.4 percent among Scheduled Caste
males. Only 10 percent of females of scheduled tribes were literate as compared to
11.6 percent among Scheduled Caste females.
78
Table 9.4.1 Literacy of Total, SC and ST Population,
Total
Population
Year
Persons
Males
Females
Scheduled
Castes
Scheduled
Tribes
14,85
20.14
21.71
29.96
7,67
10.03
1971
1981
38.46
1971
1981
48.81
13.89
20.59
20.73
29.35
27.71
6.74
11.55
1971
1981
Several scholars have studied the socio-economic and demographic
characteristics of important Scheduled Tribes in the districts of Dakshin Kannad,
Kodagu and Mysore. Reddy P.H., Bhattacharya P.J. and Venugopala Rao M.R.45have
studied Soligas in B.R. Hills of Mysore (1983) and Koragas (1988) of Dakshin Kannad
districts. Nanjunda Rao .L. has studied the Jenu Kuruba and Kadu Kuruba Tribes of
H.D. Kote6 Taluka of Mysore district (1988). Muthharayappa, K, Lingaraju M. and
Prakasha Rao A78 have studied the tribes of Kodagu district (1986-87) and the Marati,
Malekudiya and Koraga tribes of Dakshin Kannad (1992). The findings of these studies
are summarized in the following Table.
Table 9.4.2 Infrastructure Provided for Scheduled Tribe Settlements
Tribes
Amenities
Households Surveyed_______
Infrastructure____________
1. Health Facility (distance)
Within village
1-5 Km.
>5 Km.___________________
2. Primary School (distance)
Within village
1-3 Km.
>3Km.___________________
3. Anganwadi Centre
Within village
1-3 Km.
>3 Km.___________________
4. Market Facility
Within village
1-3 Km.
>3 Km. .___________
5. Protected Water Supply
6. Electricity in the household
Koraga
Malekudiya
Soligas
Jenu
Kuruba
Kadu
Kuruba
645
61*
7*
170
170
1983
569
1991
164
4.3
39.1
56.6
3.3
24.6
72.1
14.3
85.7
0.0
2.3
65.3
32.4
0.0
63.0
37.0
21.0
43 0
36.0
6.7
87.7
5.5
65.2
34.2
0.0
34.4
36.1
14.7
57.1
28.6
0.0
11.2
85.9
2.9
19.4
56.6
23.0
68.0
32.0
00
14.6
82.9
2.5
13.5
84.1
2.4
15 9
47.6
36.5
29.3
65.8
.9
13.5
80.0
6.5
14.1
17.1
15.0
58.2
25.8
5.9
12.9
16.4
74.4
9.2
64.0
23.3
4.3
39.1
56.6
82.6
8.7
95.1
8.20
100.0
0.0
Marti
* Villages
x'-
91.0
21.0
79
Table 9.4.3 Demographic Characteristics of Selected Scheduled Tribes
Demographic Characteristic
Jenu
Kuruba
Soligas
1 Sex Ratio: Females / 1000 males
2 Average household Size
969
4. Literacy*
20.7
Male
Female
4. School Enrollment
6-9 Years:
Bovs
Girls
10-14 'i ears: Bovs
___________ Girls
5. Labour Participation
10-14 Years
Male
Female
15-59 Years
Male
Female
60
Male
Female____
6. Practice of Contraception
7 Mean Living Children
8 °/o of Married Women in ages
15-29______________
9. Aware of Immunization
"lO.ANC
Tribes
Marti
Malekudiya
1983
1004
5.0
1991
954
65.2
48.2
66.2
90.7
90.9
85.7
77.9
87.7
80.0
87.0
80.0
3.9
16.2
12.5
10.6
8.3
92.7
81.9
92.6
61.2
32.3
78.6
43.7
_2-8_
88.9
86.2
53.3
15.6
45.7
3,5
24.4
56.7
31.1
51.1
46
29.8
83.5
48.8
75.3
42.9
77.4
55.5
77.1
74.6
70.4
81.6
74.6
6.8
81.6
1.5
91.7
75.0
75.0
18.9
4.8
11.5
17,0
DPT 3 doses
OPV 3 doses
Measles
12. Vital Rates
6.1
56.5
45.0
18.5
138
39.0
31.0
924
5.4
48.4
31.5
91.0
65.9
77.2
65.8
92.1
35.0
2.4
59.4
42.3
3.8
26.4
36.0
11.3
79
Maternal and Child Care
Awareness of Child Immunization
%__________________
Ante Natal Care Received %
Percent Children below 5 Years
Immunized
BCG
DPT 3 Doses
Partial
OPV 3 Doses
Partial
Measles
Koraga
1027
6.2
1 1 immunization of Children
BCG
CBR
CDR
1MR
Radu
Kuruba
83.5
75.3
77.4
48.8
42.9
55.5
88.1
74.6
17.8
74.6
16.1
70.4
81.6
11.4
81.6
11.4
1.5
91.7
75.0
16.7
75.0
16.7
18.9
_____________________________
6.8
* Literacy for all ages for Soligas and 7+ for others
9.5 Beneficiary and Communication Needs Assessment Studies
Rapid BNA and CNA studies among'general population were conducted in 80
villages - 8 from each of the ten project districts. In each sampled village one
community leader and one or two married women aged 15 and over were interviewed
'
■
........................................................................
80
using a structured questionnaire. In all 74 community' leaders and 120 women were
interviewed for BNA as well as CNA studies.
Similar studies were conducted in among Scheduled Tribes in 32 xtllages with
predominantly Scheduled Tribe population in the four districts of Chitradurga. Dakshin
Kannad, Kodagu and Mysore. The CNA study is based on interviews with 30
community leaders and 155 married women aged 15 and over. The BNA study
covered a much larger sample 33 community leaders, 314 married women and 70
voluntary workers.
Age at Marriage : Around 58 percent of tribal respondents are not aware of
the Act as compared to 33 percent of non-tribal respondents. Significantly more tribal
respondents prefer early marriage for boys and girls than non tribal respondents.
Table 9.5.1 Ideal age at Marriage for Girls and Boys
____ Girls
Age
Tribal Non-Tribal
Age
Respondents Respondents
______ 25.4 _______ 1_1_9 <21
<15
18____ ______ 36,2 ______ 55.2 21___
______ 29,2 ______ 23_7_ 22-24
19-21
9.3 >25
9.2
>22
I
_____ Boys
Non-Tribal
Tribal
Respondents Respondents
______ 20.5 _______ 5.2
_______ 5.4 _______ 16.5
_______ [6_8 _______ 17,5
60.8
57.3
Ideal number of Children : Over three fourths of non-tribal respondents
stated that ideal number of children is two as compared to 44.3 percent of tribal
respondents. One in two non-tribal respondents stated three or more children as ideal
while one in two tribal respondents hold similar opinion.
Awareness of MCH Components : There is no difference between tribal and
non tribal population in the awareness of immunization for children or growth
monitoring. However when it comes to maternal care the awareness of various
components is low among tribal population as compared to non-tribal population.
Table 9.5.2 Awareness of MCH Components
MCH Component
Immunization of Children_______
Growth Monitoring of Children
Immunization of Expectant Mothers
Ante Natal Care___________
Delivery by Trained Personnel____
Post Natal Care
Percent in Community
____ Unaware
Non-Tribal
Tribal
Respondents Respondents
_______ 2.4 __________ 1.0
25,9 ______ 26.2
______ 25.9 _______ 2,4
______ 34 1 _______ 49
______ 50.6 _______ 9,5
12.9
61.2
Awareness of Contraceptive Methods: Awareness of contraceptive methods
is lower among tribal respondents as compared to non-tribal respondents.
J
81
Table 9.5.3 Aw areness of Contraceptive Methods
Method
Vasectomy
T ubectomv
IUCD
Condom
Oral Pill
Withdrawal
Rhythm
Abstinence
Percent Aware_____
Tribal
Non tribal
Respondents
Respondents
_______ 56 2
_______ 820
90.3
_______ 990
_______ 48.2
_______ 91,9
41 1
_______ 814
44.3
_______ 83,8
_______ 1 1 4
34,3
13 0
33.8
20 7
51 4
Attitude to- Contraception: The respondents have been asked as to the
attitude of the members of their community towards adoption of contraception
Nearly
a quarter of the respondents from tribal population indicated that few or none favour
adoption of contraception as compared to one in twenty non-tribal respondents.
Table 9.5.4 Attitude to Adoption of Contraception
All favour
Majority favour
Many favour
Few favour
None Favours
Percent of Respondents
Tribal Non-Tnbal
areas _____ Areas
24,1
21 4
24,1
35,5
28,5
37.0
23,4
5,9
0.0
0.5
Adoptmn of Contraception: The level of adoption of terminal methods
appears to be the same among tribal and non-tribal populations as per impressions of
the respondents. On the other hand adoption of spacing methods is more in non-tribal
areas.
Table 9.5.5 Adoption of Contraceptive Methods
I
!
Method
Vasectomy________
Tubectomy_______
IUCD________
Condom______
Oral Pill
Traditional Methods
Percent of respondents
indicating that "Majority" or
"Many" are adopting the
________ Method
________ 7,6
81
88.6
95.7
_______ 16.2
39,5
_______ 13.0
17,6
_______ 15,1
18.6
8.6
3.4
Attendance at School: There is no significant difference between sirls and
boys m the age group 5-10 in school attendance both in tribal and non-tribal areas.
7
~~
82
However in the age group 11-15 years, the school attendance among girls is lower
than that among boys in tribal and non-tribal areas. The difference is more in tribal
areas than non-tribal areas.
Table 9.5.6 Percent of Children Attending School
Boys
Girls
Age Group
Tribal
Respondent
Non-Tribal
Respondent
Tribal
5-10 Years
11-15 Years
82,7_______
65.9
89,2_______
711
82.7
75.1
Respondent
Non-Tribal
Respondent
~ 90,7
76.8
Promotion of MCH and FVV: The Coverage by Female Health Worker is the
same for tribal and non-tribal population. On the other hand, the coverage by Male
Health Workers is better in tribal areas than in non-tribal areas.
Table 9.5.7 Promotional Efforts by Health Workers in Tribal and Non-tribal Areas for
’ MCH and EW
(a) Inteq)crsonal Communication
Category of
Worker
Child Care
Maternal Care
Family Planning
I
Tribal
Respondent
ANM/Anganwadi
Worker_______
Health worker
Others________
None_________
No Response
Non-Tribal
Respondent
Non-Tribal
Respondent
Tribal
Respondent
Tribal
Respondent
Non-Tribal
Respondent
i
56.2
21.6
1.6
1,6
3.2
58.6
4,3
7,6
22.9
6.9
55.7
20.5
1.6
2.7
3.2
58,6
4,3
6,2
22,9
6.2
56.8
20.5
1 6
2,7
2.7
61.0
3.3
4,8
24 8
6.2
While around one in two non-tribal villages are covered by special proportional
programmes, less than one in ten tribal villages are covered.
(b) Special Promotional Programmes in the Village
Programmes arranged on
Sanitation_____________
Personal Hygiene______
Family Planning______ ‘
Family Planning Methods
Maternal Care________
Child Care
Percent of Villages
Tribal .Areas
Non-Tribal
Areas
5,9
36,8
5,4
42.9
8.1
54,8
8,1
55.2
8,6
53,3
8.6
51.9
Mass Media: One in six non-tribal villages have community TV and Radio sets
while one in twenty-five tribal villages have such facility.
MU
83
infrastructure: Tribal villages have fewer facilities as compared to non-tribal
\ illages.
Table 9.5 8 Facilities Available in Tribal and Non-Tribal Villages
Facilitv
i
1. Type of Access Road
Mud Road
Red Gravel / Metal Road
Tar Road
Not Reported___________
2 Water Source
Bore Well
Open Well
Other
Not Reported__________
3. Electrified Villages
4 Type of Health facility
Health Guide
TBA
Sub-Centre
PHC
PMP
None
Percent of Villages______
Tribal
Non-Tnbal
Villages
Villages
71 4
24.0
24
51.5
12.4
36.1
0.0
39.1
53.0
7.2
0 7
36.2
69.6
18.0
12.3
0.0
94.8
51 3
10.3
14.9
2.6
4.8
34 5
19.0
63.3
49.5
13.3
31.5
13.8
House Visits by Paramedical Staff: Tribal households and non-tribal
households receive the same level of service from paramedical staff. ANM is the one
who provides all types of services at outreach.
Fable 9.5.9 Level of Outreach Services ITovided to Tribal and non-Tribal Households
Service Provided
Check if any member has fever______________
Provide medicines_________________________
Advise on Family planning_________________
Advise on FP methods_____________________
Distribute FP aids_________________________
Provide Care to Pregnant women____________
Conduct Deliveries at home________________
Advise on care of mother and new born______
Immunization of pregnant w'omen___________
Immumza'tion of children__________________
Educate mothers on nutritious food__________
Educate mothers on management of diarrhoea
Percent of Villages______
Non-Tribal
Tribal
Villages______
Villages
So,7
_________ 81,3
_________ 811
64,3
_________ 83,2
85.2
_________ 83.5
80.5
75.7
_________ 77,0
82 3
_________ 80,8
__________74.1
68.6
85,7
__________81.8
86,7
__________83,2
S3 8
83.0
82.9
__________ 8J_8_
78.6
75.1
Utilization of Medical Facilities: Tribal population is mostly dependent on
medical facilities set up by the Government as few tribal settlements have private
medical practitioners. The non tribal population utilizes the sendees of private medical
...... -
84
practitioners for treatment of sickness but for all other needs utilize the services
provided by health centres and hospitals set up by the State.
Table 9.5.10 Where People go for Medical Services
Purpose
Area
Treatment of Sickness
Tribal
Non-Tribal
Tribal
Non-Tribal
Tribal
Non-Tribal
Tribal
Non-Tribal
Tribal
Non-Tribal
Tribal
Non-Tribal
Tribal
Non-Tribal
Immunization of .Child
Immunization of Mothers
Monitoring Pregnancy
Delivery
ANC/PNC
FP Services
Percent of Respondents
Pvt.
Sub
PHC
CHC
/Govt.
Doctor
Centre
Hospital
16.8
7.4
37.4
41.5
55,8
5.7
28,1
47,6
1 1.5
30.2
28.8
28.5
2,8
42,4
21,0
381
28.1
29.0
11.5
28.1
42,4
19
310
38.1
11.2
28.1
28.1
26.1
36,2
20,0
290
0.0
28.1
11.5
28.1
29.0
9.5
34,3
26,7
47.6
12.0
27.6
28.1
28.5
36,2
19,0
34.8
4.3
1 1.5
28.3
28.3
29.7
1.4
22.4
24.3
35.2
I
9.6
Proposed Studies
The 1991 Census data on total population, SC and ST population by village in
each district will be obtained to identify tribal pockets as per norms set out by the
planning commission.
It is planned to conduct Baseline Survey, Beneficiary' and Communication
Needs Surveys covering the urban and rural areas of all the districts in the state as
soon as the Project Proposal is appraised and approved. Adequate representation will
be given to tribal pockets in the sample. This study is expected to help in refining and if
necessary modifying the project components to meet the needs of target groups among
Tribal as well as non-tribal population. The cost of such studies is included in the
Project Cost.
85
Chapter 10
Project Cost
10.1
Project Cost by Activity
Table 10.1 Presents the Project Base cost by Activity. The basis for
detennining the various elements of project cost and phasing of expenditure is
presented in Table 10.3.
Table 10.1 Project Base Cost by Activity
Activity
Type of Cost
Strengthening Delivery of Services
Capital
Revenue
Total
Capital
Revenue
Total
Capital
Revenue
Total
Capital
Revenue
Total
Capital
Capital
Revenue
Total
Improving Quality of Services
1EC
Project Management
Innovative Schemes
Total Project Cost
Amount
Million Rs.
700 843
119.591
820.434
91.675
80.915
172.590
58.008
44.209
102.217
13.575
36.120
49.695
75.886
940.087
280 835
1220 922
Percent of
Total
57 40
9.80
67,20
7.51
6.63
14 14
4.75
3 62
8 37
1 11
2 96
___ _4_07
6.22
77.00
23 00
100 00
86
10.2 Expenditure by Category
Table 10.2 presents expenditure by category
Table 10.2 Expenditure by Category
Item of cost
Capital Expenditure
Civil Works
Consultancy Charges_____
Equipment
Furniture
Innovative Schemes
Library Books
Pre-testing of IEC Materials
Production of 1EC Materials
Revolving Fund
Spares for Computers
TA/DA for Others
Training in MIS and Applications
Training Material Dcvclopment
Foreign Fellowships
Vehicles
Sub-Total
Revenue expenditure
Baseline and Other Evaluation Studies]
Building Maintenance
Delivery Kits
Hire Charges for Video Vans
Incentive to Voluntary Workers
Media Hire Charges
Office Expenses
Million Rs.
Percent of
Total
530.859
3.000,
83.377
69,907
75.986
0.540
1.056
43,48
0.25
6,83
5,73
6,22
004
0.09
3,08
8,60
0.12
1.36
0.05
0.02
0.41
0.72
77.00
37.610
105 000
1476
16,624
0.600
0.252'
5,000'
8,800
040.087'
U”
i
Clj
10.000
22.876
13.295
36.000
87.998
5.500
7.980
6.912
0.82
L87
L09
Z95
72?
Rent
Staff Salaries
Stationary & Office Supplies
TA/DA for Staff
Training Materials
Sub-Total
26.354
8.260
280.835
045
0.65
0.57
3.62
0.94
2.16
0.68
23.00
Total Base Cost
1220.922
100.00
44.170
11.490
L.
cn
c
■
10.3
Phasing and Costing of Activities
Table 10.3 presents the phasing of activities and costing of each element.
Table 10.3 Phasing of Project Activities and Cost Estimates
Item of cost
Cost in Million Rupees
Number of Units
Unit Cost
Rs. 000's
94-95 95-96 96-97 97-98 98-99 99-00 00-01
Total
94-95
95-96
96-97
97-98
98-99
99-00
00-01
Total
1. Strengthening Service Delivery
I
1
1
I- '
New Constructions
Sub-Centre buildings
PHC Buildings
Mo Staff Quarters______________
Rehabilitation
CMC
PHC
SC__________________________
Equipment for solid waste
CHC
PHC
SC__________________________
Furniture
New SC Buildings
Other Sub-centres______________
Equipment
New SC Buildings
Other Sub-Centres______________
Laproscopes new
Laproscopes repairs
Suction Apparatus______________
Kits for ANM
230
780
300
87
24
30
350
25
87
349
25
87
253
20
67
0
0
0
0
0
0
0
0
0
1039
94
271
20.010
18 720
9.000
80 500
19.500
26 100
80 270
19.500
26.100
58 190
15.600
20 100
0.000
0 000
0.000
0 000
0.000
0.000
0.000
0.000
0.000
238.970
73.320
81.300
120.2
73.2
20.4
10
45
71
20
100
500
18
100
500
0
82
500
0
0
500
0
0
0
0
0
0
48
327
2071
I 202
3 294
1.448
2 404 • 2 164
7.320
7.320
10.200 •10.200
0 000
6 002
10.200
0 000
0.000
10.200
0 000
0 000
0.000
0 000
0 000
0.000
5 770
23 936
42.248
14
6
0.25
127
871
5560
0
0
0
0
0
ol
0
0
0
0
0
0
0
0
0
0
0
0
127
871
5660
1 778
5 226
1 390
0 000
0 000
0.000
0.000
0 000
0.000
0.000
0 000
0.000
0.000
0.000
0.000
0 000
0 000
0.000
0.000
0 000
0.000
1.778
5 226
1.390
22.5
9
87
2260
350
2261
350
0
252
0
0
0
0
0
0
0
786
4521
1.958
20.340
7.875
20.349
7.852
0.000
5.693
0.000
0.000
0.000
0.000
0.000
0.000
0.000
23.378
40.689
5
87
___ 5 2260
250
13
39
6
___ 10 __ 25
2,000 1,000
350
349
2261 ___ 0
0
0
36
0
___ 0 ___ 0
1,000 1.000
253
0
0
0
0
0
0
0
0
0
0
0
0
0.435
11.300
3.250
0.234
0.250
2.000
1.750
11.305
0 000
1 404
0.000
2.000
1.745
0.000
0.000
0.000
0.000
2.000
1 265
0.000
0 000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0 000
0.000
0.000
0 000
0.000
0.000
0.000
0.000
0.000
0.000
5.195
22.605
3.250
1.638
0.250
6.000
Revolving fund for 2 Whelrs.
12,500
720
1,920
1.920
1,920
1.920
Upgrading CHCs to FRUs
350
18
18
18
0
0
714 p.a.
804
Incentive: Volunteer workers
Delivery Kits (thousands)
Maintenance of Buildings
(
Total revenue expenditure
Total Expenditure
12 31.75
@2%
47.7
0
£
£
0
0
0
0
0
0
786
4521
13
42
__ 25
3,000
0
0
8.400
9.000
24.000
24.000
24.000
24.000
0.000
0.000
105.000
0
0
54
6.300
6.300
6.300
0.000
o.opo
0.000
0.000
18.900
117.135 221.007 187.451 141 050
34.201*
0.000
0.000
700.843
804 13514 27028 27028 27028 27028
27028
0.574
19.300
19.300
1.9.300
87.998
206.0 901 20
0.381
1.127
1.935
2 436
2.472
2.472
2.472
13.295
0.000
0.000
0.000
0.955
3.477
5.994
7.872
18.298
0 955
1.701
11.585
22 691
25.249
27 766
29.644
119 SQI
I 18 090 222.708 199.036 163 741
59.449
27.766
29.644
820.434
93.92 161 25
2
0
203.0 206.0 206.0
173.8 299.7 393.6 393.6 393.6 393.6
299.7
0.574
9.650
19 300
87
V
iH-
Item of cost
Unit Cost
Rs. 000's
Number of Units
94-95 95-96
96-97 97-98
Cost in Million Rupees
98-99 99-00 00-01
Total
94-95
95-96
96-97
97-98
98-99
99-00
00-01
Total
2. Improving Quality of Service
District Trng.Centres
Civil works
1600
Furniture:
Class rooms
Hostel
____________
Equipment
Class Rooms
1 lostel
90
160
7
0
0
12
0
0
0
0
0
0
0
0
22
19
7
20
19
J6
_7
£
10
19
0
Library Books (lump sum)
0
0
0
19
11.200
0.000
0.000
19.200
0.000
0.000
0.000
30.400
0
12
0
0
0
0
0
0
19
19
1.710
1.120
0.000
0.000
0.000
0.000
0.000
1.920
0.000
0.000,
0.000
0.000
0.000
0.000
1.710
3.040
0
0
0
0
0
0
0
0
19
2
J9
0.380
0.112
0.190
14.712
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.192
0.000
0.000
0.000
0.000
0.000
0.000,
0.000
0.000
0.000
0.000
0.380
0.304
0.190
0.000
0.000
21.312
0.000
0.000
0.000
36 024
0.840
0
0
Sub-total Capital Expenditure
Training Material
0.2
” 0.52
TA / DA 1
Staff Salaries
116.7
Office Expenses
60
Rent >
144
Building Maintenance
@2%
2,100
4,200
2,100
4,200: 4,200
19 ~19
19
19
19
12
12
"11.20
11.20
4,200
4,200
4,200
4,200
4,200
14,693
0.420
0.840
T200 7.200
~l9 ~ 19
~T9 ~T9 ~T9
12 —12
0
11.20 30.40 30.40
0.840
0.840
0.840
0.840
4.200
4,200
14,693
1.092
2.184
2.184
2.184
2.184
~19
~79
2.184
5.460
”14.196
~T9
~19
2.217
2.217
2.217
2.217
—19
2.217
15.519
19
1.140
2.217
1.140
7.184
2.217
~6
1.140
1.140
1.140
1.140
7.980
0
12
1.728
1.728
1.728
1.140
”1.728
0.000
0.000
0.000
30.40
30.40
7). 000
6.912
30.40
0.000
0.000
0.224
0.224
7.224
0.608
1.280
6.597
8.109
8.109
8.333
6.605
6.605
6.989
51.347
0.456
0.000
0.000
0.000
0.000
0.000
0.000
0.000
77o7
0.456
0.125
7.000
0.000
0.000
Sub-total Revenue Expenditure
HFWTCs
■
Ramanagaram
Building Extension
456
1
0
0
0
0
7
7
0
750
T
T
T
0
Furniture (lumpsum)
1
"o
0
7
7
7
7
7
7
7
7
7
T
T
T
0.000
0.125
0.075
0.000
7.000
7.000
0.000
0.000
0.000
0.075
0.450
0 000
0.000
0.000
0.000
0 000
0.000
7.450
0
0
i
0.000
5.909
0.000
0.000
0.000
0.000
0.000
0 000
0.000
0 000
0.000
5.909
’ 0.325
0.000
0.000
7.ooo
0.000
"”0 075
7100
0.000
0.000
0.000
0 000
0.100
1.998
5.315|
0.000
7.000
1.998
7.000
7.000
7.000
0 000
7.000
0 325
7^075
5315
0.000
1.998
16.624
Equipment
~75
Mini Bus (Replacement)
450
o
o
7
7
Mysore
Civil works
5909
~325
Fumiture(lump sum)
Equipment
75
~25
Library Books
T.A./ D.A. for Others at PHCs
0
~0
1
4
T
~7
o
57.10
151.9
0
o
0
0
~6
0
~o
o
0
~7
~~0
o
~o
o 57.10 1519
7
0
r
7 ~o
i
~4
7
0
7 57.10 208.96
88
j Iteir
st
!
°st I
oer o
5
in
Rup
t.
Item of cost
Cost in Million Rupees
Number of Units
Unit Cost
Rs. 000's
T.A./D.A Medical Officers
T.A./D.A. Spervisory Staff
Training Materials
Maintenance of Buildings
0.9
1080
1080
1080
1080
1080
1080
920
2000
2000
2000
2000
2000
02 2000 2000
5.365
@ 2 % 0.456 5.365 5.365 5.365 5.365 5.365
076
920
920
920
920
920
99-00
00-01
l ota I
1.998
5.315
1.998
0.972
0.972
0.699
24.139
6 804
96-97
3.204
0.000
0.972
0.972
0.972
0.699
0.699
0.699
3205
2000
0.699
0.400
0.400
0.400
0.400
5.365
0.000
0.000
0.000
0.009
0.400
0 127
0.000
0.972
0.699
0 400
07127
2.071
2.071
2.071
2.080
2.198
0.000
21.000
0.000
0.000
Sub-total Capital Exp.
1080
920
98-99
97-98
95-96
11.624'
94-95
Total
00-01
95-96 96-97 97-98 98-99 99-00
94-95
3781
Sub-total Revenue Exp.
0.972
0.400
0.12?
4.893
2.800
0 390
2.198
2.198
14.887
0.000
0.000
0.000
21.000
0.000
0.000
1.600
22.600
0.699
ANM/LHV Training Schools
Civil Works
ANM Training Schools
LHV Prom. Tmg. School
3000
1600
0
7
0
1
0
0
0
0
0
0
0
0
0
0
7
1
Sub-total Capital Exp.
Maintenance of Buildings
@2%
1.600
21.00
22.60
22.60
22.60
22.60 22.600
22.60
Sub-total Revenue Exp.
1.600
0.000
0.000
0.000
0.000
1.600
21.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.032
0.452
0.452
0.000
0.452’
0.000
0.000
0.000
0.032
0.4,52
0.452
0.452
t
Institute of Health & FW
Building for office
Furniture: Sr. Staff
;_________ Jr. Staff__________
Video Projector
Library Books (lump sum)
Trang Materials Developmen
Initial Course
Referesher Course___________
Vehicles:
Cars
Jeeps______________________
Foreign Fellowships
1.388
1.388'
1900
1
0
0
0
0
0
0
1
0.000
0.000
0.000
1.900
0.000
0.000
0.000
0.000
0.000
0.000
0.300
0.060
0.200
1
0.000
0.000
0.000
0.000
0.000
0.000
T
0.125
0.125
0.000
0.000
0.000
0.000
0.000
0.250
0
0
168
168
0.168
0.084
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.168
0.084
0
0
2
2
0.400
0.550
0.000
0.000
0.000
1.000
0.000
0.000
1.000
0.000
0.000
1.000
0.000
0.000
1.000
0.000
0.000
1.000
0.000
0.000
0.000
0.400
0.550
5.000
3.787
1.125
1.000
1.000
1.000
1.000
0 000
8 912
1.616
11.312
0.000
0.000
0.000
0.021
0.175
0.266
0
0
0
12
4
0
0
0
0
0.4
0.4
0.2
0
0
0
o"
0.5
168
168
0
0
0
0
0
0
0
0
0
0
200
275
2
2
0
0
0
0
0
0
0
0
0
0
1
0.000
0.000
0.000
0.000
0
0
0
250,000
0.000
0.300
0.060
0.200
0
0
0
£
0.000
0.000
0.000
0.000
0
0
Q4
0
L2
4
1
25
_____ 15
200
1.900
Sub-total Capital Exp.
Staff Salaries
1616
1
1
1
1
1
1
1
1
1.616
1.616
1.616
1.616
1.616
1.616
TA/DA for Staff:
6 days
13 days
26 days
0.51
1.04
2.08
0
40
128
0
0
0
0
0
0
0
128
0
40
0
0
0
0
0
0
0
0
40
168
128
0.000
0.042
0.266
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.133
0.000
0..021
0.000
0.000
0.000
0.000
0.000
■!
89
Item of cost
Maintenance of Buildings
Unit Cost
Rs. 000's
Number of Units
Cost in Million Rupees
94-95 95-96 96-97 97-98 98-99 99-00 00-01
19.00 19.00 79.00 19.00 19 00
@2% 19.00 79.00
Total
94-95
19.00
0.000
Sub-total Revenue Exp.
Total Capital Expenditure
Total Revenue Expenditure
Total Expenditure.
3. IEC:
95-96
96-97
97-98
98-99
99-00
00-01
Total
0 000
1.924 —1.616
0.000
0.380
0.380
0.380
0.380
1.616
2.129
2.017
1.996
1.996
1.520
73.294
1.998
91.675
23.303
33.749
7.000
24.310
6.315
1.000
10.592
11.796
11.796
12.574
11.271
11 251
11 635
80 915
33.895
45.545
12.796
36.884
17.586
12.251
13.633
172.590
0.000
0.000
12.342
0.000
6.240
0.000
Equipment
Video projectors
Slide Projectors
240
~20
Overhead Projectors
~7o
T.V. / V.C.R.
”32
Radio cum Cassette player
~2
26
~2T
”77
177
Too
0
T)
"o
0,
~0
0
—0
”~0
Cinema slides
Audio Cassettes
Copies of cassette
Flip Charts 7 Types
Exhibition Panels
Hoardings
Wall Paintings
Pretesting of IEC Materials
Vehicles
7
0
350
350
0
”T’
~o’
0.000
0.000
~ 21
0.420
0.000
0.000
0.000
0.000
0.000 ”0.000
21
0.210
0.000
0.000
0.000
0.000
0
50
3.872
0.000
0.000
0.000
0
TToo
0.200
0.000
0.700
0.700
10.908
7.066
0.000 ' 7.000
0.900
1.600
0.000
0.000
1.500 ' 0.000
1.500
2.000
2.000
0.000
1.500' 1.500 ' 1.500'
0.120
0.120
0.120
1.500' 1.500 ’ 1.500'
0.250
0.250
0.250
"o
0
350' ” 20 ’ ~0 ~
0.000
0.000
7
7
7
7
~0
"To' 100'
0
~o'
o'
~7o' 25 ' 25 ' 25 ' ~25 '
To' IOOO' 1000 ' 1000 1000 '
T' 77” 72 " 64’ ~57'
0.700
0.000
0
0
4
o
0
0
400 _____ 01 ____ 0 ___ 0.
10
io
0
0
1000 1000 ___ q ___ 0
12
12
12
0
600
600
600
0
50
50
50
50
0.1
2500 2500 2500 2500
300
1
I
0
0
”77 500 ~ 500
~0
500
750
T ~0
T
.05
200 ____ 0 5800 2000
.06' 20000 ’ 30000 20000’
o'
0.700
6.240
0
0
~0
225
___ 4
150
___ 2
125
0.2
30
0.000.
30
0
Production of IEC Materials
J 5 minute 35mm films
Prints of films
______
3-4 minute quickies
35 mm prints_______
Tele Films 15-20 mts
VHS prints__________ _____
TV Spots
VHS prints__________________
TV Serial
10.942
0
23.988
0
_0
0
_0
0
_0
0
_0
0
0
_0
0
_0
0
_0
0
_0
0
7)
7)
”o
"o’
_0.
0
_0
"o’
’o'
o'
o
0
0.000
0.420
—b.210
0.000
0 000
0.000
0.000
3.872
0.000
0.000
0.000
1.600
3.704
0.000
0.000
0.000
45.666
0.000
0.000
O.OOO’
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.900
1.600
4
400
20
2000
36
1800
200
10,000
2
0.300 '
0 300 ’
O.OOO’
”o
1,500
0 150’ 7.150’
0.150 ’
"o’
T
0.150 ’
0.000 ’
8000
70000
0.010
1.200 ’
0.000
1.800
0.300' 0.150' 7.000’
0.290
0.100
0.000
1.200’ 0.000' 0.000 ’
100
4.000 ’
0.000 ’ 7.000'
0
_0
0
_0
0
_0
0
_0
0
"o’
’o'
T)’
7’
o’
o'
7'
7'
7'
7'
o’
o’
7’
0.000
0.000'
0.000
1.500'
0.250
O.OOO’
o.ooo"
0.000
0.000’
0.000
0.000'
0.000'
7.000'
0.450
”0.000
0.000'
0.000
o.ooo'
0.600
0.400
4.200
0.000’
4.000
0.000
0.000
0 000’
’TTod" 0.000 ' 7.000’
0.500 " 0 500 ~ 0.500 ”0.500’ 0 000 ' 0.000 ' 0 000'
4000 7.000 ’ 7.000” 7.000
1.000’ 0.000 ’ TToo' 0.000'
264 ’ 7.308 ” 7288 ” 7.256
0.204’ 0.000 ’ 0.000' 0.000'
100
20'
7 000 ” 7 000 ”
0.000,
0.000’ 0.000 ”
4.000
4.500
0.360
6.000
1.000
0 600
o.ooo" o.ooo" o.ooo'
0.000
0.000
O.OOO' 7.000 ’
3.000
0.000’
0.000'
2.000
4.000
1.056
7.000
90
Ite
ost
Cost
I Rs. 000's I
uber
its
st in K 4:i,;"in Ri.... ..
I
Item of cost
Unit Cost
Rs. 000's
Number of Units
94-95
95-96
96-97 97-98
98-99
Cost in Million Rupees
99-00 00-01
Total
■
i
Total Capital Expenditure
Hire charges for video vans
Staff salaries (8 persons)
5
360
387
5
I
10
20
20
20
20
120
1
1
1
1
I
*1
1
Media Hire charges
Total Revenue Expenditure
Total Expenditure
94-95
95-96
96-97
97-98
98-99
99-00
00-01
34 930
10 908
7 766
4.404
0 000
0 000
0.000
58 008
1.800
1 800
3.600
7.200
7.200
7 200
7.200
36.000
Total
0.387
0 387
0.387
0 387
0.387
0 387
0.387
2.709
0 250
0 500
0 750
1 000
1 000
1 000
1.000
5 500
2.437
2.687
4.737
8.587
8.587
8 587
8 587
44 209
37.367
13 595
12.503
12.991
8.587
8.587
8.587
102 217
0 116
0.1 16
0 812
4. Administration & MIES
Administration
Staff Salaries
0.116
1
1
1
1
1
1
1
1
Baselineand Evaluation studies
Sub-total Revenue Exp.
0.116
0.116
0 116
0.116
0 116
4 000
0 400
0.400
0.400
0 400
0 400
4 000
10 000
4 116
0 516
0 5lo
0 516
0.516
0 516
4 116
10 812
0.280
0.100
0.180
0 400
0 000
0.000
0.000
0 000
0.000
0.000
0.000
0 000
0.000
0 000
0.000
0 000
0.000
0 000
0 000
0 000
0 000
0 000
0 000
0.000
0.000
0.000
0.000
0.000
0.280
0 100
0 180
0 400
0.680
0.000
0.000
0.000
0.000
0.000
0.000
0.680
0.531
0.531
0.531
0.531
0.531
0.531
0.531
3.717
Civil Engineering
Furniture
Sr. Staff
Jr.Staff
Vehicles
25
15
200
4
12
2
531
1
0
£
0
0
£
£
£
£
£
0
0
0
0
0
0
4
12
2
1
1
1
1
1
1
1
1
1
1
1
1
0
0
0
Sub-total Capital Exp.
Staff Salaries
Stationary & Supplies
360
1
1
1
Sub-total Revenue Exp.
0.360
0.360
0.360
0.360
0 360
0.360
0.360
2.520
0.891
0.891
0.891
0.891
0.891
0.891
0.891
6.237
6.150
0 800
0.400
0.250
0.350
0.500
0.350
3 500
I 229
0.229
1.000
1.476’
0 000
0.000
0 000
0 000
0 000
0 000
0 000
0 000
0 000
0 000
0.000
0.000 ’
0.000
0.000
0.000
0 000
0.000
0.000
0.000
0 000
0 000
0.000
0.000
0.000'
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0 000
0 000
0.000
0 000
0.000'
o.oon
0.000
0.000
0.000
0.000
0 000
0.000
0 000
0 000
0.000
0.000
0.000
0 000
0.000
0.000
0.000
0 000
0 000
0 000
0 ()()()
0 000
0.000
0.000
0 000'
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0 000
0 000
0.000
0.000
0.000 ’
6 150
0.800
0.400
0.250
0.350
0.500
0.350
3 500
1 229
0.229
1.000
1.476
MIES
|
Computers
Directorate
Engineering
HE&T
IEC
Department
S1HFW
Districts_________
Site prqiaration
Directorate
Districts______
Spares for Computers
800
400
250
350
250
350
175
I
1
1
1
2
1
20
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
220
_____50
@ 24%
1
0
0,
0
0
0
0
0
20
1
£
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
I
I
1
2
1
20
0
0
£
0
£
1
20,
I
91
I
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Item of cost
Unit Cost
Rs. 000‘s
Total
94-95
95-96
96-97
97-98
98-99
99-00
00-01
Total
■>
0 360
0.080
0.000
0.000
0 000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.360
0.080
-M00
0 600
0.100
0.500
1 1.395
0 750
0 000
0.000
0.000
0.750
0 750
0 000
0.000
0.000
0 750
0 000
0 000
0.000
0.000
0.000
0 000
0.000
0.000
0.000
0.000
0 000
0.000
0.000
0.000
0 000
0.000
0.000
0.000
0 000
3.000
0 600
0.100
0.500
12.895
1 443
0.463
0 103
0 877
1.380
0.226
1 443
0.463
0 103
0.877
1.380
0.226
1.154
2 823
1.443
0.463
0 103
0 877
1.380
0.226
1.154
2.823
1 443
0.463
0 103
0.877
1.380
0.226
1.154
2.823
I 443
0.463
0 103
0.877
1 380
0.226
1.154
2 823
1 443
0 463
0 103
0.877
1.380
Sub-total Revenue Exp.
1.443
0.463
0 103
0.877
0 690
0 113
0.577
2 133
10 101
3.241
0.721
6.139
8.970
1.469
7.501
19.071
Total Capital Expenditure
12.075
0.750
0.750
0.000
0.000
0.000
0.000
13.575
Total Revenue Expenditure
7.140
4.230
4.230
4.230
4.230
4.230
7.830
36.120
Total Expenditure
19.215
4.980
4.980
4.230
4.230
4.230
7.830
49.695
3.768 10.850 12.900 14.950
2.018
0.500
1.000
1.500
2.000
2.500
0.500
0.250
0.750
1.000
1.250
1 500
0 500
1 000
2.000
2.500
0 768
0 768
5 400
5 400
5.400
1.700
0.000
0.500
2.500
3.300
189.461 270.182 207.817 182.664' 55.465
15.750
2.500
1.250
2 500
5 400
4.100
16 750
15.750
2.500
1.250
2.500
5.400
4.100
75.986
12.500
6.250
12.500
28.536
16.200
17 748
942.087
280.835
94-95
Photo Copier
fax machines_______________
Consultancy Charges:
MIS________________________
MIS Training
Directorate
Districts__________________
Sub-total Capital Exp.
■
-
Cost in Million Rupees
Number of Units
Staff Salaries
Directorate
IHFW
Districts__________________
Stationary
Directorate
Districts___________________
Innovative Schemes (Capital)
PVOs
PM PS
Mahila Sanghas
HAC Members TA/DA
Tribal AN Ms________________
95-96 96-97 97-98
98-99 99-00 00-01
180
40
2
2
0
0
0
0
0
0
0
0
0
0
0
0
2
3,000
0.50
0.25
0.25
0
0
0
0
I
100
500
1
1
0
0
0
0
0
0
0
0
0
0
0
0
I
1
0.463
0 103
0.877
1
I
1
1
1
1
1
1
1
1
1
1
1
I
1
1
1
1
1
1
1
I
1
I
0.226
1.154
0.5
0.5
1
1
I
1
1
1
1
1
1
1
1
1
1
1
25
1
2.5
0.1
20
250
200
7680
40
60
80
100
100
100
500
750 1000 1250 1250 1250
400
600
800 1000 1000 1000
7680 54000 54000 54000 54000 54000
Total Capital Cost of Project
100
1250
1000
54000
1 154
2 823
o.ooo1
0.226
1 154
2 823
Total Recurring Cost
21.124
49.337
51 834
57.696
Total Project Base Cost
210,585 290.596 240.165 230.746 104 803
68 584
75.444 1220.922
20.414
32.348
48.082
Physical Contingency
15.721
24.369
17.877
15.460
2.863
1 828
2.154
80.273
Price Contingency
14.741
40.553
49.936
61914
34.767
27 319
35 326
264.554
Total Project Cost
241 047 355.5 18 307.978 308.119 142.433
97.731 112.924 1565.749
Provision for physical contingency is made at 10 percent for physical quantities and 5 percent for salaries, O & M, consultancy and honorarium and that for price
contingency at , 7.5% for 1994-95, 6.5% for 1995-96, 6.0 for 1996-97 and 5% for 1997-2000.
92
I
93
10.4
Project Sustainability
'flie revenue expenditure of Karnataka on Health and Family Welfare, formed
4.44 percent of total expenditure of the state in 1983-84 and rose to 4.66 percent by
1993-94. The expenditure on Health and Family welfare has been growing at a
compound rate of 14.4 percent per annum. The non-plan expenditure which is borne
by the state is nearly two thirds of the total expenditure. The Total Expenditure for the
year 1999-2000 is projected at Rs. 9737.857 million of which non-plan expenditure
will be Rs. 6538.830 million or 2.3 times the level of expenditure in 1993-94.
The increase in annual recurring expenditure by Rs. 55.818 million at the end of
the project period will’be 0.85 percent of the non-plan expenditure. *This increase is
insignificant compared to anticipated increase in total non-plan expenditure or even
current level of expenditure. The following Table presents the trend in Expenditure
during the period 1983-84 to 1993-94 and projection for 1999-2000.
Table 10.4 Actual and Projected Expenditure on
Health and Family Welfare
Million Rupees
Year
1983-84
1984-85
1985-86
1986-87
1987-88
1989-90
1990-91
1991-92
1992-93
1993-94
1999-2000
Projected
Plan
Non-plan
Total
Plan
expenditure expenditure expenditure expenditure
as percent of
______ Total
407.951
712.972
1120.923
36.39
611.889
804.244
1416.133
43.21
503 684
1044,915
1548.599
32.53
539.014
1155.926
1694.940
31.80
656.917
1285.620
1942.537
33.82
821.459
1653.554
2475.013
33.19
927.389
1779.598
2706.987
34.26
1035.134
2155.153
3190.287
32,45
1204 949
2482.818
3687.767
32.67
1477.717
2848.326
4326.043
34.16
3198.757
6538.830
9737.587
32.85
94
References
'Reddy PH and Gopal Y.S, “India Population Project—I II, Karnataka Gaps in Knowledge, Skills and
Practices of Health and Family Planning Personnel”, Population Centre, Bangalore and Directorate of
Health and Family Welfare Sendees, Karnataka, P90.
2‘Training Needs of Medical and Paramedical Staff’"— Report prepared by STEM based on Training
Needs Assessment study conducted by Directorate of Health and Family Welfare, Karnataka.
3Bhaskara Rao N Family Planning Communication in Retrospect, Centre for Media Studies, New
Delhi
4Reddy P.H., Bhattacharya P.J., Venugopala Rao M.R Tribes in Karnataka - A study of Socio
economic and Demographic Characteristics of the Soligas, Population Centre, Bangalore. 1983
5Reddy P H., Bhattacharya P.J., Venugopala Rao M.R. Tribes in Karnataka - A study of Socio
economic and Demographic Characteristics of the Soligas, Population Centre, Bangalore, 1984.
p
F '
GNajunda Rao L. Tribals in Heggadadevanakote taluk. Foundation for Educational Innovations in
Asia (FENIDA), Bangalore, 1988.
7Hanumantarayappa P. Issues in Tribal development, (A Study of Selected Tribes in Dakshina
Kannada District of Karnataka). Population Research Centre, Institute of Social and Economic
Change, Bangalore 1992.
8Muthurayappa R, Lingaraju M, Prakasha Rao A. Evaluation Study of Health and Family Welfare
Programme Among Scheduled Tribes in Dakshin Kannad District of Karnataka, Population Research
Centre, Institute of Social and Economic Change, Bangalore 1992.
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Annexure 3
Locations for Construction of Sub-Centres
During First Year of Project
Sites in eighty seven villages have been located for the first year programme .
However, additional 29 villages have been identified as standby for the first vear and if
not used will be carried over for the second year.
District
1. Bellary
Taluk
Village
1 Singuppa
1. Konchigen
2. M.Sugur
3. Buduguppa
4. Baiakundi
5. Nittur_____________
6. Shivapura
7. Doopadhahalli______
8. Metnki____________
9. Udghatta Doddathandi
10, Madlagiri__________
11, Danapura
12, Nagalapura_________
1. Channagondanahally
2. Ambale____________
3. Nagenahally
4. Somanahally
5. S.Madapura
6. Hogarehally_________
7. Ballavara
8. Kuncthinamadu______
9. Madaburu__________
10. Kumbarakoppa
11. Gunavanthy
12. Hosur______________
13. Honavalli
14. Hearur_____________
15. Kotigehara
16. Shibira_____________
2. Kudligi
3. Sandur
4. Haranahalli
5. Hospet
2. Chikmagalur
1. Chikmagalur
2. Kadur
3 Tarikere
4, Narasimharajapura
5. Koppa
6. Sringeri
7. Mudigere
3. Chitadurga
1. Chitradurga
2, Hiriyur
3. Hosadurga
4, Mallakalamuru
5, Harihara_____
6, Challakere
1.
Doddasiddawahanahally
2, Mallapura__________
3, Palavanahally________
4, Allaghatta
5, Devanagere_________
6, Chikkarahalli________
7 Belasanna___________
8. Rangavanahally
9. Ganjijunte
Site
Selected
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
”X
99
District
Taluk
Village
4. Dakshin Kannad
1 Mangalore
1. Bajpe
2. Permude
3. Natekal______
4. Hejamadi
5. Tenka_______
6. Kodapadavu
7 Mangilapadavu
2. Udupi
3. Buntwal
District
Taluk
Village
5. Hassan
1. Hassan
3. Chennarayapatna
1. Dasarakoppalu
2. Bijamaranahally
3. Maralekatte
4. Maratagere
5. Obalapura
Site
Selected
Yes
Yes
Yes
Yes
Yes
4. Arakalagudu
5. Sakalshapura
6. Ragimarur
7. Halebelur
Yes
Yes
8. Parasadihalli
Yes
Yes
2. Arasikere
6. Belur___________
7. Alur____________
8. Holenarasapura
6. Kodagu
Virajpet
Hebbele________
7. Mandya
1. Srirangapatna
2. Pandavapura
3. Nagamangala
8. Mysore
1. Gundulpet
2. Chamarajanagar
•4
Site
Selected
Yes
Yes
Yes
Yes
Yes
9. Byrapura
10. Chittanahally
Yes
Kannagala
Kutta B__________
Thorenoor
Yes
Yes
Yes
1. Belagola
2. Ganjam
3. Kirangur
4. Acchappanakoppalu
5. Balenahally
6. Arakere
7. Neralakere
8. Doddapalya
9. Gamanahally
10. Tadagawwadi_____
11. Jakkanahalli
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
12. Kalingnahalli
13. Chinchanahalli
14. Arni
15. Lakshmipura
16. Nelligere
17. Bommenahalli
18. Agachahalli
19. Ancheetinhanahalli
20. Doddajutaka
21. Kelagere_________
1. Kadsoge
2. Terakanainbi______
3. Honganur
4. Rachanballi
5. Nagaval li
6. Nallur
7. Daddahalli
8. V.Chatra
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
I® .1
IMHI IIIill I
.■■■BBIRII ...II.
laiiiji. •.•-it;.11-,*! -IL... JHEL.
100
District
Taluk
| Village
Mysore
3. H.D.Kote
o. Saragur
10. Hampapura
11. Bettadapura
12. Ravan dur_____
| 13. Hanur
4. Periapatna
5, Kollegal
6. T. Narsipura
9. Shimoga
1. Honnali
2. Channageri
3. Shimoga
4. Bhadravathi
5. Sliikaripura
6. Sorab
7. Tirthahalli
8. Hosanagar
10. Uttar Kannad
1, Kumta
2. Kanvar
3. Mun dago d
i 14. Somnathapura
I 15, Musuvinakoplu
1. Kumbalpur
2. Muktahanhalli
3. Hodalipura
4. Bellagere_____
! 5. Mandaghatta
6 Thadasa______
7. Nimbegundi
Site
Selected
Yes
Yes
\’es
Yes
^j'es
Yes
Yes
Yes
Yes
Yes
Yes
8. Haragari
9. Jogihalli
! 10. Hiramagadi
; 11. Chikkababbur
| 12. Ubbur
13. Kukkur
14 Mallimukke
15. Bettabasavami
16. Meekari______
17. Maverikoppa
18. Nittur________
| 1. Bankikodla
Yes
2. Binaga
3. Kodara_______
4. Nandigatta
5. Kusura
Yes
Yes
Yes
Yes
104
Annexure 7
Status of Buildings for PHCs
District
PHC
Sanctioned
PHCs with
Own
Building
Bangalore_____
Bangalore Rural
Belgaum______
Bellary________
Bidar_________
Bijapur_______
Chikmagalur
Chitradurga
Dak shin Kann ad
Dhans ad______
Gulbarga______
Hassan_______
Kodagu_______
Kolar________
Mandya_______
Mysore_______
Raichur_______
Shimoga______
Tumkur______
Uttar Kannad_
Karnataka____
IBP IX Districts
Other Districts
25
54 '
107
46
35 '
77 '
39 '
66 '
110 ~
85 '
74 "
61
27 '
69 '
55 ~
117
62
61
77 '
50 '
1297
632
665
PHCs
Building
Under
Const metion
________ 1__
________ 8__
20
32
65 ~ _________ 29_’
30 ~ ________ 0__
28 | ________0__
69 !
5
34 |
0~~
36 I
9
80 I
14 ~
61
________
0_~
46 ~
____________
0_’
45 ~
13 ____________ 2_’
9
60 j
43 I __________
83 ' _______ 16__
o'
51
’____________9_
20
7
20
28 ' __________
864 I _______ 119 '
412 | _______ 46 '
73j
452 |
PHCs
without
Buildings
4
14
13
16
7
—6~
30
21
10
28
16
12
0
11
18
11
32
50
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II
INDIA POPULATION PROJECT IX
KARNATAKA INDIA
PROPOSED P.H.C. SU1LDING (TYPE DESIGN)
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9UilO»K,
'0 Bt ct moi i s^eo
PROPOSED ADDITION A ALTIRAT10NS TO THE
EXISTING PRIMARY HEALTH CENTRE (TYPE DESIGN)
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108
Annexure 9
Furniture and Equipment for Sub-centres
1 (a). Furniture for new buildings
Sri
No.
Item Description
1.
2
Examination table
Foot step
Wash basin with stand
Stool
Cot with mattress
Bench for visitors
Cupboards for equipment and supplies
Office table
Side rack
Chairs
Container for water storage
Bucket with lid
Total
3.
4.
5.
6.
7.
8.
9.
10.
1 1.
12
Quantity
Cost Rs.
1
1
1,375
200
175
250
2,975
3.000
9,000
3,500
500
1
1
1
2
2
1
1
2
I
2
1.000
350
120
22,445
Say Rs. 22,500
I (a). Furniture for other sub-centres
Furniture worth Rs. 9,000 on an average is provided for other sub-centres
.....
■■ ■ ..■c.cC.W-.- ■
...
1
100
2. Equipment for all Sub-centres
Sri
No
1.
■>
4
5
6.
7.
8.
9.
10
11.
12.
13
14
15
16
18
19
20
21
22
23
24
26
27
Item Description
Quantity
Cost Rs.
I
350
Scale Bathroom Metric/A\ oirdupois:
120 KG 280 LB
Scale infant Metric 16 KGs x 20 Ci
1
Colour coded weighing scale (baby)
Basin Kidney enamel 825 ml
Basin solution deep enamel 6 litres
Tray instrument / dressing with cover:
310 x 195 x 631 mm S.S^
5
2
1.200
500
200
1
I
100
100
Sheeting plastic clear vinyl 910 mm wide
Brush surgeon4s white nylon bristles
Lancet ( Hedgedom Suture Needle) straight 75 mm
Tape measure 1.5 M / 60" wide vinyl coated
Flash light pre focused - 2 cell
Sphygmomanometer aneroid 300 mm with cuff
Stethoscope Bianural
Forceps dressing spring tvpe 1 50 mm stainless steel
Forceps hemostat straight Kelly 140 mm stainless
steel
Forceps sterilizer (utility) 200 mm Vaughn Crim
Jar dressing w/cover 0.945 litre stainless steel
Forceps uterine vulsellum straight J and above 250
mm
Scissors surgical straight 140 mm S / B stainless steel
Speculum vaginal Bi-valve Cusco's medium stainless
steel
Reagent strips for urine test (albumen and sugar)
Rack Blood sedimentation Westergren 6-3/4 unit
C usco’s & Sims vaginal speculum
Anterior vaginal wall retractor
Measure 1/2 and 1 litre
Uterine sound
Haemoglobinmeter set salti type complete set
Total
2
2
1
60
30
30
1
1
1
10
50
200
150
1
I
2
30
60
1
50
50
1
100
1
80
1
100
100
200
500
80
80
1
1
1
1
1
1
1
100
100
500
5.010
Say Rs. 5.000
T
1 10
Annexure 10
Equipment for ANM Kit
Sri
No.
1.
2.
4
5.
6
7.
8.
9.
10
11
12.
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Item Description
Sphygmomanometer aneroid 300 mm with cuff
Colour coded weighing scale (baby)
Instrument sterilizer SS 222 x 22 x 41 mm
Spring type dressing forceps - stainless steel
Basin Kidney enamel 825 ml
Sponge bowl - stainless steel - 600 ml
Urethral catheter (12 ft) runner
Sheeting plastic clear vinyl 910 mm wide
Enema can with tubing
Clinical thermometer oral (dual Celsius '
Fahrenheit scale)
Clinical thermometer rectal (dual Celsius /
Fahrenheit scale)
Brush surgeoifs white nylon bristles
Mucus extractor
Artery Forceps
Cord cutting scissors
Cord ties /rubber band packet
Nail clipper
Foethoscope (stethescope Foetal)
Surgical scissors straight stainless steel 150 mm
Spirit lamp with screw cap : metal (60 ml)
Aluminum shield for sprit lamp
Poly urethane self sealing bag (125 x 200 mm)
Ann circumference scale
Rack Blood sedimentation Westergen 6-3/4 unit
Adhesive zinc oxide tape (25 mm x 0.9 m) roll
Tape measure 1.5 M / 60" wide vinyl coated
Flash light pre focused - 2 cell
Kit bag
Total
Quantity
Cost Rs.
1
1
1
1
1
200
2
1
2
100
1
1
100
80
80
50
25
60
60
20
20
1
1
2
1
1
1
1
1
1
1
12
1
1
1
1
1
1
15
50
70
60
20
20
20
80
50
20
30
20
20
80
10
50
500
1.910
Say Rs. 2.000
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113
Annexure 12
Furniture and Equipment for each District Training Centre
1. Furniture:
Item
A. Class Room
1. Table and Chair for Faculty
2. TraineesWork bench and 2 chairs: 15 (a Rs. 3.200 each
3. White Board 6' x 4'
Total
Rs.
2.800
48,000
3,200
54.000
B. Office Rooms
1. Sr. Staff: Table and 3 Chairs: 4 Sets (cr Rs. 5,400
2. Jr. Staff: Table and 2 Chairs: 2 sets
^s- 4,200
3. Cupboards: 2 Nos. @ Rs. 3.000 each
4. Slotted angle rack: one
Total
21,600
8,400
6,000
1,000
36,000
1. Cots with Mattress: 30 @ Rs. 2.500 each
2. Work bench and Chair: 30
Rs. 1.200 each
Total
75.000
36,000
1.11.000
C. Hostel Rooms
D. Dining Hall
1. Tables : 9 @ Rs. 2,400 each
2. Chairs: 36 @ Rs 750 each
1
Total
21,600
27,000
48,600
1. Overhead Projector with Screen and accessories
2. 35 mm Slide Projector with accessories
Total
8,640
16,200
24,840
Equipment
A. Class Room
B. Kitchen
1. Cooking Range
2. Kitchen utensils
3. Dining plate, 3, Katoris one cup , glass Stainless Steel:
36 sets @ Rs. 200
Total
2,500
3,000
7,200
12,700
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8i
Annexure 16
Furniture and Equipment for HFWTCs
(a) Furniture Required for HFWTC Mysore
Item
I. Principal's Room
1. Steel Officers Table 1.83m 1 x 0.91m wx 0.76m h
2. Executive Revolving Chair with full high back
with head rest
3. "S" Type continuous arm chair with full cushion
4. Steel Telephone Stand
II Office Room
1. Superintendent Table
2. Typist Table (Teak wood)
3. Typist chair
III Faculty Room
1. Officers T.W.Table 1.22m 1 x 0.61 m w x 0.76 m h
2. Executive Revolving Chair with cane seat & back
IV Hostel Room
1. Steel Cot 1.90m 1 x 0.78m w x 0.60m h 14Gg
2. Mosquito Curtain Pole 1.90 1 x 0.79 b x 1.22m h
3. Beds 1.98m I x 0.91m w
4. Mosquito Curtain
V General
1. Steel Trays Size P 40 x 0.27 0.10 M at top and
0.38m x 0.25m at bottom using 24G
2. Steel Dust Bin size 27.94 cms sqare at top and
20.32cms square at bottom with a height of
30.48 cms
3. News Paper Stand
4. Steel Almirah Size 1.83m 0.915m x D.O 48m
glass doors fitted with four shelves making 5
compartments
5. Steel AlmirahSize 1.83m 0.915m x D.O 48m
fitted with four shelves making
6 Folding Chair Steel
7. "S" Type Continuous arm chair
VI Lecture Hall
1. Black Board Size 152.4 x 91.44 x 76 cm
2. Teak Wood Office Table
Size 152.4 x 91.44 x 76 cm
3 Teak Wood Office Chairs with arm
4 Teak Wood Chair with writing pad on right hand
side
Qty
Rate
Amount Rs.
2
2
3,699
3,696
7,398
7,392
10+3
1
750
945
9,750
945
3
1
1
3,080
2,704
905
9,240
2,704
905
6
6
2,860
1,680
17,160
10,080
30
30
30
30
1,650
236
750
450
49,500
7,080
22,500
13,500
20
99
1,980
12
110
1,320
1
5
2,340
4290
2,340
23,450
20
3712
74,240
25
25
157
600
3,925
15,000
1
1
1,144
1,092
1,144
3,016
1
30
1,092
1,066
1,092
31,980
Total
KST @ 4%
Total with Tax
3,15,641
12,626
3,28,267
f
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I
*
125
(b) Furniture Required for HFWTC Ramanagaram
i
i
Item
1. Steel Officers Table
1.83m 1 x 0.91m w x 0.76m h
2. Executive Revolving Chair
with full high back with head rest
3. Steel Al mi rah
Size 1 83m 0.915m x D O 48m
fitted with four shelves making
4 Steel Cot
1.90m 1 x 0.78m wx 0.60m h 14Gg
5. Mosquito Curtain Pole
1.90 lx 0.79 bx 1.22m h
6. "S" Type continuous arm chair
7. "S" Type continuous arm chair with full
cushion
8. Steel Almirah Size
1.83m 0.915m x D O 48 glass doors
fitted with four shelves making
5 compartments
9. Steel Table with Laminated Top
10. "S" Type Chair without arms
Qty
n
Rate
3,699
Amount Rs.
7,398
2
3,696
7,392
6
3712
22,272
20
1.650
33,000
20
236
4,720
30
15
600
750
18,000
11,250
4,290
12,870
1,925
476
Total
KST @ 4%
Total with Tax
19,250
5,712
1,50,165
6,006
1,56,171
10
12
(c) Equipment Requirement for HFWTC Mysore and Ramanagaram
Each of the HFWTCs at Ramanagaram and Mysore will be provided with the
following equipment.
1. I V. and VCR
2. Oxerhead Projector with Screen and accessories
3. 35 nun Slide Projector with accessories
4. PC for presentations
Total
Rs. 32,000
Rs. 8,640
Rs. 16,200
Rs. 18,000
74,840
126
Annexure 17
<
Furniture and Equipment for SIHFW
Furniture Required for SIHFW
Item
Sr. Staff (per member)
1. Steel Officers Table 1.83m 1 x 0.91m wx 0.76m h
2. Executive Revolving Chair with full high back
with head rest
3. "S" Type continuous arm chair with full cushion
4. Steel Telephone Stand
5 Steel Almirah Size 1.83m 0.915m x D.O 48m
glass doors fitted with four shelves making 5
compartments
6 Steel Almirah Size 1.83m 0.915m x D.O 48m
fitted with four shelves making
Qty
Rate
Amount Rs.
1
1
3,699
3.696
3,699
3.696
6
1
1
750
945
4,290
4.500
045
4,290
2
3,712
7.424
Total
24,554
25.536
Total with Tax
Jr. Staff (per member)
1 ..Superintendent Table
2. Executive Revolving Chair with cane seat & back
3. "S" Type continuous arm chair with full cushion
4 Steel Almirah Size 1.83m 0.915m x D.O 48m
glass doors fitted with four shelves making 5
compartments
5 Steel Almirah Size 1.83m 0.915m x D.O 48m
fitted with four shelves making
1
1
2
1
3.080
1.680
750
4,290
3.080
1,680
1.500
4.290
1
3,712
3.712
Total
Total with Tax
14,262
14,832
I
Equipment
SIHFW will be provided with video projector costing Rs. 200,000.
I
Position: 4700 (1 views)