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ohftT{ whfNzr w[Zy wzsoh ih d/ Bkb f;js ns/ gfotko GbkJh ftGkr gzikp 4-9-2009 HEALTH DEPARTMENT Wings – • Director Health Services • PHSC – Secondary level hospitals • Drug Controller • Food Safety – PFA • Employee State Insurance • Ayurveda & Homeopathy • NRHM • PSACS Health Institutions -f;js ;z;EktK ;z;EktK frDsh ;p ;?ANo (jo fJZe 5000 dh nkpkdh fgZS/) 2950 w[ZYbk f;js e/Ado (jo fJZe 30000 dh nkpkdh fgS/) 394 pbke b?tb T[s/ ns/ j'o efwT{fBNh f;js e/Ado (jo fJZe 120000 dh nkpkdh fgS/) ghHn?uHn?;H;ha (PHSC) tZb'A ubkJhnK ik ojhnK vhHn?uHn?;H tZb'A ubkJhnK ik ojhnK 41 353 129 114 15 fdjksh j;gskb 45 ;p vthiBb j;gskb 36 fibQk j;gskb 21 ôfjoh fv;g?A;ohnK$;e{b j?bE $NhHphH ebhfBe 134 j'o ;z;EktK JhHn?;HnkJhH j;gskb 6 JhHn?;HnkJhH fv;g?A;oh 70 BUDGET FY (2009-10) Amount in Crores PLAN DHS DFW PHSC AYURVEDA 38.29 43.00 0.20 NON GOI/CSS OTHERS PLAN 576.98 6.70 22.78 17.38 15.40 7.50 20.00 35.82 6.98 - 0.13 9.21 1.02 - ESI - 47.50 - - AIDS - - 18.15 - 32.71 - 218.05 2.14 114.33 707.69 275.78 22.14 HOMOEPATHY NRHM TOTAL Total 621.97 40.16 85.90 43.00 10.36 47.50 18.15 252.90 1119.94 . HSE (Excluding Medical Education) is 0.79% of the GDP against desired 2 – 3% Per Capita Public Expenditure of Health – Rs. 448/- per year. SUMMARY STAFF Sr. No Category Sanction Filled Vacant 3864 3272 592 45 42 3 1 Medical 2 Drug and Food 3 Nursing 3104 2502 602 4 Laboratory 1065 840 225 5 Paramedical 9810 9331 1324 6 IEC 207 104 103 Remarks Diminishing Cadre for Pharmacists SUMMARY STAFF Sr. No Category Sanction Filled Vacant 7 Malaria Section 254 149 105 8 Technician 202 122 80 9 Statistical 387 272 115 10 Ministerial /Class IV Paramedical (TB and 11 Leprosy) Total 9451 8547 904 28 16 12 28427 25197 4065 Remarks Diminishing Cadre for Class IV STAFF (Medical) Sr. No Category Sanction Filled Vacant Director Additional Director 3 2 1 2 0 2 Joint Director Deputy Director Deputy Director (Dental) Senior Medical Officer Medical Officer 1 1 0 34 24 10 18 14 4 379 321 58 3142 2752 390 285 158 127 Medical 1 2 3 4 5 6 7 8 Medical Officer (Dental) STAFF Sr. No 1 2 3 (Drug and Food) Category Assistant Drug Controller Drug Inspector Food Inspector Sanction Filled Vacant 3 3 0 19 16 3 23 23 - STAFF (Nursing) Sr. No Category Sanction Filled Vacant 1 Superintendent Punjab Health School Amritsar at Mohali 1 - 1 2 Nursing Superintendent 5 - 5 3 Principal Tutor 10 8 2 4 Matron 44 28 16 5 District Public Health Nurse 12 - 12 6 Public Health Nurse (Teaching) 42 34 8 7 Sister Tutor 50 37 13 8 Nursing Sister 410 370 40 9 Staff Nurse 2506 2010 496 10 Lady House Keeper 24 15 9 STAFF (Laboratory- Food & Chemical) Sr. No Category Sanction Filled Vacant 1 Bio Chemist 1 1 - 2 Junior Analytical Assistant 5 - 5 3 Senior Analytical Assistant 3 - 3 4 Analyst 31 29 2 5 Public Analyst 1 - 1 6 Deputy District Public Analyst 3 2 1 7 Deputy Chemical Examiner 2 - 2 8 Assistant Chemical Examiner 3 2 1 9 Government Analyst 1 - 1 1 1 0 57 43 14 512 477 35 445 285 160 10 Bio Chemist Senior Medical Laboratory 11 Technician Senior Medical Laboratory 12 Technician Grade-1 Medical Laboratory Technician 13 Grade-2 STAFF (Paramedical) Sr. No Category Sanction Multipurpose Health 1 Worker (Female) 3631 Multipurpose Health 2 Worker (Male) 2958 Multipurpose Health 3 Supervisor (Female) 750 Filled Vacant 3559 72 2153 805 537 213 4 Trained Dai 376 233 143 5 Ophthalmic Officer 199 194 5 6 Senior Radiographer 40 33 7 7 220 143 77 8 Radiographer Radiographer (Contract Basis) 115 113 2 9 Pharmacist 1531 2390 0 STAFF (IEC) Sr. No Category State Mass Media 1 Information Officer District Mass Media 2 Information Officer Sanction Filled Vacant 1 - 1 18 16 2 and and 3 Deputy MEIO 42 29 13 4 Assistant Editor 1 - 1 5 B.E.E 142 56 86 6 1 1 0 7 Photographer Technical Officer/ Audio Visual 1 1 0 8 Publicity Supervisor 1 1 0 STAFF (Malaria Section) Sr. No Category Assistant Malaria 1 Officer Sanction Filled Vacant 14 - 14 39 10 29 1 - 1 4 Assistant Unit Officer Entomologist-cumParasitamologist Entomologist Assistant 5 1 4 5 Insect Setter 1 1 - 6 Insect Collector 29 18 11 7 1 1 - 8 Draftsman Superior Field Worker 151 118 33 9 Biologist 13 - 13 2 3 STAFF (Technician) Sr. No Category Refrigerator 1 Mechanic Assistant Dental 2 Mechanic Sanction Filled Vacant 16 15 1 8 3 5 3 Dental Mechanic 18 2 16 4 Dental Hygienist 20 15 5 5 Dental Electrician Dark Room Assistant 1 0 1 21 18 3 13 9 4 8 E.C.G. Technician Operation Theatre Assistant 41 34 7 9 Pump Mechanic 12 8 4 10 Field Assistant 1 1 - 6 7 STAFF Cont.. (Technician) Sr. No Category Sanitary Supervisor 11 (Health Core) Microscope 12 Mechanic Sanction Filled Vacant 11 5 6 1 1 - 13 Artist 13 7 6 14 Projectionist 17 1 16 15 Developer 1 0 1 16 1 0 1 17 Machine Operator Tradonal Machine Operator 1 0 1 18 Senior Compositor 1 0 1 19 Compositor 1 0 1 20 Copy Holder 1 1 0 21 1 1 0 22 Proof Assistant Manager off-set Press 1 0 1 23 Cold Chain Officer 1 1 0 STAFF (Statistical) Sr. No Category Joint 1 Director(Evaluation) Deputy 2 Director(Statistics) Senior Research 3 Officer Sanction Filled Vacant 1 0 1 1 0 1 2 1 1 11 2 9 22 19 3 61 25 36 7 Statistical Assistant Junior Statistical Assistant 25 25 0 8 Computor 264 200 64 4 5 6 Statistical Officer Superintendent (Statistics) STAFF (Ministerial) Sr. No Category Sanction Filled Vacant 1 0 1 2 Administrative Officer Registrar (Budget) DRME 1 0 1 3 Superintendent Grade-1 18 15 3 4 Superintendent Grade-2 14 14 - 5 Senior Assistant 135 135 - 6 Junior Assistant/Clerk 129 96 33 7 Personal Assistant Junior Scale Stenographer Senior Scale Stenographer Steno-Typist (Head Quarter) 4 2 2 4 4 - 6 6 - 9 9 0 1 8 9 10 STAFF Cont.. (Ministerial) Sr. No Category Sanction Filled Vacant 11 Steno-Typist (Field) 231 166 65 12 Superintendent Grade-2 68 59 9 13 Senior Assistant 298 292 6 14 Clerk 1110 1033 110 15 Librarian 1 1 - 16 Home Science Assistant 1 - 1 17 Senior Scale Stenographer 16 13 3 18 Junior Scale Stenographer 2 2 - 19 Packer / Sweeper 5 4 1 20 Class IV ( Head Quarter) 86 84 2 21 Sweeper (Head Quarter) 5 5 - 22 23 Chowkidar Class IV (Field) (Total Posts) 8 7299 8 6599 1193 Requirement of New Health Institutions – Sub Centers 2950 Sub- centers are functioning. Shortage of 289 Sub Centers as per census 2001 and 687 Sub Centers as per estimates of 2011 population , as per norm of 1 sub centre for every 5000 population. Cost of new Sub Center is Rs. 7 lac. Year Existing Required as per Additions Norms Required Fund Required (Rs. in Crore) 2001 2950 3239 289 20.00 2011 2950 3637 687 48.00 Requirement of New Health Institutions – PHCs 394 PHCs are functioning. Shortage of 146 as per census 2001 and 212 PHC’c as per 2011 estimated population . Rs. 1 crore per PHC. Year Existing Required as per Additions Norms Required Fund Required (Rs. in Crore) 2001 394 540 146 146.00 2011 394 606 212 212.00 Requirement of New Health Institutions – CHCs 142 Administrative Blocks in the State. One CHC is to be provided in each block. Number of Administrative Block 142 Number of CHC Required as per norms(1 per block +2 for Block with population more than 1.50 lac) 165 Number of CHCs already functioning under PHSC 114 No of blocks were no CHC Exists (108 out of 142 ok) 34 Number of CHCs more required (6 double) (165-114+6) 57 Number of CHCs under DHS which needs to be strengthen 15 Number of CHCs to be constructed at new places 42 Funds Required for 57 CHCs including CHCs under DHS (Rs. in Crores) (In the first phase 34 CHCs would suffice) 171 Staff and Building for New Districts Posts - 8 New districts i.e. Mansa, Moga, Muktsar, SBS Nagar, SAS Nagar, Barnala, F.G.Sahib and Tarn Taran were created after 1992 but all the required posts for the office of Civil Surgeons have not been sanctioned. In all 274 new posts of other than Class-IV are required. Office - There is no office accommodation for the office of Civil Surgeons in these 8 districts. The office of Civil Surgeon at Amritsar, Ludhiana, Patiala, Gurdaspur and Hoshiarpur required to be constructed at proper place. The total requirement of funds would be about Rs. 26 crore. Residence - Civil Surgeons of districts Amritsar, Barnala, F.G.Sahib, Hoshiarpur, Kapurthala, Mansa, Moga & SBS Nagar do not have residential accommodation earmarked. They are staying in the premises of Senior Medical Officers or in Private Accommodation. Details of posts required at Newly created districts Sr. Name of Post No. 1 District Immunization Officer Shortage of Staff Contd.. Scale 10025-15100 Requirement of Posts 5 2 District Dental Health Officer 10025-15100 3 3 4 Epidemiologist Deputy Medical Commissioner 7880-13500 10025-15100 5 5 5 Distt. Mass Media & Information Officer Deputy Mass Media & Information Officer Artist Cum Photographer District Public Health Nurse Food Inspector Assistant Malaria Officer Multipurpose Health Worker(M) Superintendent Grade-II Superintendent Statistics Senior Assistant Statistical Assistant 6400-10640 6 5800-9200 6 6 7 8 9 10 11 12 13 14 15 5800-9200 6400-10640 4550-7220 5800-9200 4550-7200 6400-10640 6400-10640 5800-9200 5800-9200 8 8 6 6 48 12 8 22 11 Remarks Shortage of Staff Contd.. Details of posts required at Newly created districts Contd.. Sr. No. Name of Post Scale Requirement of Posts 16 Steno Typist 3330-6200 16 17 Clerk 3120-5160 60 18 19 20 Computer/ Statistical Clerk 3120-5160 Multi Purpose Supervisor (M)/ Health 4550-7220 Supervisor Driver 3330-6200 21 Senior Lab. Technician 5000-8100 8 22 Medical Laboratory Technician Grade II 3330-6200 8 23 24 25 Lab. Attendant District TB Officer Medical Laboratory Technician Grade I 3120-5160 7880-13500 4020-6200 8 8 8 26 27 28 29 Medical Officers Medical Officer (Dental) Public Health Nurse Class IV 7880-13500 7880-13500 5000-8100 2520-4140 8 8 8 128 16 (Helper/ Watchman/ Sweeper) Steno Typist 3330-6200 Remarks 6 5 64 16 For District Malaria Laboratory For TB Clinics For School Health Clinics Food and Drug Control Drug Inspectors 19 posts of Drug Inspectors are sanctioned in the state . 1 Inspector for 1 district. Present strength is grossly inadequate for about 22000 shops. 38 posts of Drug Inspectors are more required so as to have one Drug Inspector for every 600 chemist shop. Food and Drug Control Food Inspectors 23 Food Inspectors – sanctioned. Only 1 inspector for a district. There should be at least 1 Food Inspector in every Sub-Division. 53 more Posts of Food Inspectors are required. Requirement of funds for existing Health Institutions • Sub-Centres – Out of 2950 Sub-Centres 1030 are functioning from Dharmshalas etc. New buildings would require Rs. 60 crore. • PHCs - 80 PHCs out of 394 PHCs are similarly situated. A sum of Rs. 80 crore is required for these new buildings. Requirement of Medicines SN Institution Requirement (Cr.) Rs. Provision Source Gap 1 SHC (1187) 10.68 11.79 Non-Plan (RDP) Nil 2 SC (2950) 1.00 1.00 GoI in Kind Nil 3 PHC (394) 8.00 11.00 NRHM (1.00), Non-Plan (10.00) Nil 4 CHC/SDH/DH 19.00 14.00 NRHM (6.00), Non-Plan (2.50), User Charges (5.50) 5.00 38.68 37.79 TOTAL 5.00 Requirement of Equipments SN Institution Requirement Provision (Cr.) Rs(Cr.) Source Gap 1 SHC (1187) 11.87 Nil Non-Plan (RDP) 11.87 2 SC (2950) 2.90 2.90 NRHM Untied funds Nil 3 PHC (394) 10.00 5.58 NRHM (3.25), Non-Plan (2.33) 4.41 4 CHC/SDH/DH 80.00 14.24 NRHM (13.24), Plan (1.00) 65.76 104.77 22.72 TOTAL 82.04 Requirement for Infrastructure [As per 2011 Estimates] SN Institution Requirement Provision (Cr.) Rs(Cr.) Source Gap 1 SC (2950) 48.00 10.00 per year NRHM 18.00 2 PHC (394) 212.00 5.00 per year NRHM 200.00 3 CHC/SDH/DH 153.00 5.00 per year NRHM + 25.00 Cr. State Plan 113.00 413.00 60.00 25.00 328.00 TOTAL Shortage of Vehicles/ Ambulances Ambulances were procured more than 10 years back and majority of them are not road worthy. 172 vehicles (Ambassador (27), Gypsy(26), Trucks(10), Buses(39), Jeep(59) and Ambulances(11) were condemned and Rs.95.47 lacs was deposited in the State Treasury. Due to its condemnation and auction there is huge shortage of vehicles. More Vehicles Required Type of Vehicles Required Qty Place Ambulances 50 for district hospitals, sub division hospitals and community health centers Ambassadors 25 Tata Sumo, Gypsy etc 85 The offices of Civil Surgeons and Head Office district and state head quarters CANCER CONTROL India – 200- 250 cases per one lakh population. Punjab - As per survey conducted by Health Department in Districts Mukatsar, Bathinda , Faridkot and Mansa the prevalence of cancer patients is 52.2 per lakh population (2005 survey). SN District Population No. of cancer patients No. of cancer patients per lakh population 1 2 Muktsar Bathinda 8,27,906 12,00,736 453 711 56.6 59.3 3 4 Faridkot Mansa 5,85,500 7,31,535 164 420 28.0 57.5 CANCER CONTROL Contd.. • The number of deaths because of Cancer in 2007 in Bathinda, Faridkot, Mansa, Muktsar, Sangrur, Barnala, Patiala, Ludhiana and Ferozepur (Malwa districts) was 591. • The number of Cancer patients in whole of Punjab in Government Institutions was 2300. CANCER CONTROL . . .Contd.. Detection of Cancer Imaging: o X-Ray: CHC, SDH, DH and Medical College Hospitals. o Ultrasound: Sub-Divisional, District and Govt. Medical College Hospitals o CT Scan: All Govt. Medical College Hospitals. Biopsy: CH Jalandhar and Govt. Medical College Hospitals. Mammography: CH Bathinda and Mata Kaushalya Hospital, Patiala Laboratory : Fine Needle Aspiration Cytology, Peripheral Blood Smear examination available at District Hospitals and Medical College Hospitals Cancer Control .. Contd.. Treatment : Surgery : Sub-Divisional, District and Medical College Hospitals. Chemotherapy : Medical College Hospitals. Radiotherapy : Medical College Patiala. PGIMER, Chandigarh has been approved as Regional Cancer Centre for Punjab by Govt.of India. Regional Cancer Centre provides comprehensive cancer treatment services and training to Medical & Para-medical staff for detection & prevention of cancer and supportive care to patients. It is also a referral centre for other hospitals. Palliative Care: It is provided at all levels. It includes relief of pain and symptomatic treatment of terminally ill patients. It also includes provision of psychosocial support and aims at improving quality of life of patients. Cancer Control .. Contd.. Projects completed: • Mammography unit at Civil Hospital Bathinda and Mata Kaushalya Hospital Patiala. • Brachytherapy Machine costing Rs 70 lacs for the treatment of cancer patients has been installed at Govt. Medical College Patiala. • Cobalt Source for the treatment of cancer patients has been installed at Sri Guru Ram Dass Institute of Medical Sciences and Research with assistance of Rs. 25.00 Lac from Govt. of Punjab. Cancer Control .. Contd.. Ongoing Projects: • Multispecialty & Cancer Hospitals are being setup at Mohali and Bathinda in Public Private Partnership mode in collaboration with M/S Max Health Care India. • Regional Cancer Centre at Medical College Amritsar: Government of India has provided Rs. 2.00 Crore for machinery and equipment. • Simulator and Treatment Planning system for Govt. Medical College Patiala. Government of India has provided Rs. 2.00 Crore for this purpose. • Mammography unit is to be installed at Medical College Patiala. Rs. 30 lacs have been provided for this. • Radiotherapy unit at Sri Guru Gobind Singh Medical College Faridkot. Rs. 3.00 Crore have been provided by Govt. of India for machinery and equipment and construction. Cancer Control .. Contd.. Projects under consideration of Govt. of India : • Onconet Service- A Tele Medicine Service is to be established by Govt. of India. Regional Cancer Centre PGI will be connected to four district Hospitals namely Hoshiarpur, Sangrur, Bathinda and Muktsar for this service. • Setting up of a Cancer Registry in Districts Bathinda & Muktsar. • District Cancer Control Programme for districts Hoshiarpur and Patiala. This programme is to be implemented by PGI Chandigarh. Cancer Control .. Contd.. Other facilities to cancer patients: • Financial assistance under State Illness fund to cancer patients belong in to below poverty line families up to the tune of Rs. 1.5 Lacs. • School children suffering from cancer are provided free treatment by Punjab Government. • Punjab Government provides free travel facility to cancer patient and one attendant. • Health Education activities are under taken to make people aware about the causes signs and symptoms and prevention of cancer. Preparedness to Combat Drug Abuse In The State • There are 12 De-addiction Centers functional, 3 in State medical Colleges i.e. Patiala, Amritsar and Faridkot and 9 in Govt. Hospitals Tarn Taran, Pathankot, Kapurthala, Jullandhar, Bathinda, Faridkot, Muktsar, Hoshiarpur and Badal. 2 De- Addiction Centers at Civil Hospitals Talwandi Saboo and Ferozpur are in the process of being established. A state level 50 bedded Drug Dependence Treatment Center is being set up at Government Medical College, Amritsar. • 22 De-addiction Centers/Counseling Centers in Punjab are being run under the control of Ministry of Social Welfare, Govt. of India. Out of this 13 centres are run by Indian Red Cross Society and 09 by Non-Govt. Organizations. 37 such centers in Punjab (33 functional and 4 under construction) is insufficient to handle the drug abuse problem in the State. In 33 functional DDTCs there are 142 beds out of which 30 beds are with State Medical Colleges and 112 are with the Department of Health and Family Welfare, Punjab in various Civil Hospitals. Preparedness to Combat Drug Abuse In The State.. Contd.. • • • • There are 26 Psychiatrists within the department working at different health institutions of the state and are providing services in drug abuse prevention at their place of postings. All of them can be judiciously and optimally utilized to manage/advisor to DDDAC/any drug de-addiction centers in every district.) The NDDTC, AIIMS has already trained 20 psychiatrists as Master Trainers in Drug Abuse Prevention. It has also trained 10 health personnel from four districts of the state (4 psychiatrists, 3 staff nurses, 3 laboratory technicians) for Opioid Substitution Clinics which are going to be established by GOI to prevent IDU in collaboration with NACO. Health department has already commissioned a study on “Drug abuse in the border districts of Punjab” funded by National Rural Health Mission, (NRHM), Punjab at the cost of Rs. 5.0 lakh in 2009. The study will be completed by March 2010. There are many steps being taken to establish de-addiction centers like DHS (16):- Annual Plan 2009-10- Rs. 200.0 lakh, Total Plan Outlay =Rs. 330.0 lakh DHS (17) State Level Drug Dependence Treatment Center (SDDTC), Govt. Medical College, Amritsar (Swami Viveka Nand Drug Dependence Treatment Center ):-Annual Plan2009-10 Rs. 200.0 lakh, Total Plan Outlay =Rs. 334.0 lakh, Preparedness to Combat Drug Abuse In The State.. Contd.. • Trained Manpower: - S.No. Item Total Districts 1 Psychiatrist in State Health Services 2 Districts with a Psychiatrist 3 Districts without a Psychiatrist 4 5 6 Number 20 26 18 02 (Fatehgarh Sahib, SBS Nagar) Psychiatrists Trained as Master Trainer 20 Health employees Trained in Opioid Substitution Therapy 10 Drug De-Addiction Program Contd.. Drug Menace: During the year 2008, 617 Joint raids were conducted by the Drug Inspectors with the help of police department to check the menace of drug addiction. 37 licenses of chemist shops have been cancelled and licenses of 294 chemists were suspended due to various contraventions of drug and cosmetics Act. Drugs worth Rs. 3.18 crore have been seized during the year 2008 and action taken against the defaulters. Drugs worth Rs. 1.34 crore have been seized during the year 2009 (upto July) and action taken against the defaulters. 329 Joint raids were conducted and 119 licenses of chemist shops have been cancelled and 244 chemist's licences were suspended during 2009(upto July). Prevention of Food Adulteration During 2008, 290 samples out of 3520 samples were found to be adulterated. During 2009 (upto July) 183 samples out of 1981 samples were found to be adulterated. Scheme Wise Outlay & Expenditure Code No. DHS 1 DHS 2 DHS 3 DHS 4 DHS 5 DHS 9 DHS 10 DHS 11 DHS 12 Sub-Head/Name of the Scheme DIRECTORATE OF HEALTH SERVICES(DHS) Department of Health and Family Welfare Centrally Sponsored/Funded Schemes National Malaria Eradication Programme (Rural)- (50:50) National Malaria Eradication Programme (Urban) - (50:50) Punjab Nirogi Yojana- (33:67) Integrated Disease Surveillance Project(IDSP), Punjab -(70:30) State Funded Schemes Implementation of Tele-medicine Application in the State of Punjab Balri Rakshak Yojana Construction of new hospitals (PAP Jalandhar and Nangal) Upgradation and expansion of existing Health Institutions National Rural Health Mission (NRHM) (85:15) Annual Plan 11th Plan Annual Plan (2008-09) Annual Plan (2009-10) (2007-12) (2007-08) Approved Approved Revised Approved Expenditure Expenditure Outlay Outlay Outlay Outlay 200.00 29.66 40.00 40.00 21.19 45.00 100.00 3.34 20.00 20.00 15.72 25.00 200.00 100.00 100.00 100.00 100.00 200.00 57.52 0.00 34.50 34.50 0.00 34.50 147.00 0.00 150.00 150.00 150.00 0.00 300.00 8.72 100.00 50.00 26.04 60.00 1000.00 0.00 837.00 837.00 500.00 300.00 0.00 0.00 0.00 250.00 0.00 2500.00 19567.10 0.00 3000.00 2884.00 2884.00 4125.00 0.00 0.00 0.00 0.00 0.00 100.00 New Scheme DHS 12(i) National Urban Health Mission (NUHM) (85:15) Scheme Wise Outlay & Expenditure Code No. DHS 13 DHS 15 DHS 16 DHS 17 DHS 18 DHS 19 DHS 20 Sub-Head/Name of the Scheme State Funded Schemes Medical Equipment/Diagnostic Services in the hospitals Setting up of Urban Healthcare Centres in Muncipal Corporation Town, Bathinda (ACA2008-09) Establishment of De-addiction Centres in the State Establishment of State Level Drug Dependence Treatment Centre Specialized Healthcare Services in the Rural areas of the State and Continuing Medical Education through tele-medicine Assistance to NGOs/District Administration for enforcement of PNDT Act, monitoring of pregnancies, helpline etc. Centrally Sponsored/Funded Scheme Rashtriya Swasthya Bima Yojana for workers covered under BPL (75:25) Annual Plan 11th Plan Annual Plan (2008-09) Annual Plan (2009-10) (2007-12) (2007-08) Approved Approved Revised Approved Expenditure Expenditure Outlay Outlay Outlay Outlay 500.00 13.16 165.00 210.00 206.15 100.00 5000.00 0.00 1000.00 1000.00 0.00 500.00 330.00 0.00 165.00 40.00 0.00 200.00 383.00 0.00 200.00 0.10 0.00 200.00 1000.00 0.00 0.10 0.00 0.00 0.00 500.00 0.00 100.00 0.00 0.00 0.00 0.00 0.00 200.00 100.00 100.00 200.00 0.00 0.00 0.00 0.00 0.00 100.00 New Schemes State Funded Scheme DHS 21 Implementation of Emergency Response Services in the State Scheme Wise Outlay & Expenditure Code No. DHS 22 DHS 23 DHS 24 DHS 25 AY 1 HM 1 Sub-Head/Name of the Scheme Annual Plan 11th Plan Annual Plan (2008-09) Annual Plan (2009-10) (2007-12) (2007-08) Approved Approved Revised Approved Expenditure Expenditure Outlay Outlay Outlay Outlay Assistance for Institutional deliveries to poor 0.00 families Providing hotline facilities in the district as well as sub-divisional hospitals (more than 100 beds) 0.00 for maintaining emergency services. Setting up of mobile cancer detection units in 0.00 the State. Setting up of Urban Healthcare Centres in Jalandhar, Ludhiana and Malerkotla for urban 0.00 poor and slum dwellers Total (DHS) 29284.62 AYURVEDA Department of Health & Family Welfare State Funded Schemes Upgradation and Extension of Govt. Ayurvedic 50.00 Pharmacy and Stores, Patiala Total(Ayurveda) 50.00 HOMOEOPATHY Department of Health & Family Welfare State Funded Schemes Strengthening of Existing Govt. Homoeopathic 65.00 Dispensaries Total (Homoeopathy) 65.00 Grand Total (Medical & Public Health) 40621.00 0.00 0.00 0.00 0.00 1000.00 0.00 0.00 0.00 0.00 200.00 0.00 0.00 0.00 0.00 1.00 0.00 0.00 0.00 0.00 1500.00 154.88 6111.60 5715.60 4003.10 11390.50 0.00 20.00 20.00 9.00 10.00 0.00 20.00 20.00 9.00 10.00 0.00 13.00 13.00 11.98 13.00 0.00 324.40 13.00 9544.60 13.00 9614.97 11.98 4423.74 13.00 16938.92 Summary – Issues and Challenges 1. 2. 3. Food Adulteration – Significant seizures but requirement for extra enforcement staff – 53 Food Inspectors (One per SubDivision). Drug Menace – Campaign launched and habit forming drugs worth more than Rs. 6.00 Cr. seized during last 2½ years. Need for increasing the strength of Drug Inspectors from 19 to 57 so as to have 1 Drug Inspector per every 600 Chemist Shops. Sex Ratio – Latest data shows an improvement from 796 in 2001 to 838 in 2006 as per SRS 2007. Need for strengthening the schemes for girl child. Some States are depositing upto Rs. 30,000/- per girl child at birth to enable her to receive staggered payment through academic career. Summary – Issues and Challenges 4. Access to Health Care – Free delivery, free referral for school students, free treatment for BPL families in Govt. Hospitals. Implementation of RSBY for BPL families in all the districts for cashless treatment upto Rs. 30,000/-. Implementation of Bhai Kanhaya by Cooperation Deptt. for cashless treatment upto Rs. 2,00,000/- for members of Co-op. Societies. State illness fund for BPL families. Need – Definition of BPL families restrictive and need for enlarging the scope of insurance scheme for greater number of poor people. Supply of free medicines – more medicines should be added. Summary – Issues and Challenges 5. Telemedicine – Made functional but needs to be strengthened. Greater involvement of medical colleges. 6. PPP Projects – Two Hospitals awarded. Case of 3 Hospitals – Mother and Child Hospital, FGH Sahib, SDH Nangal and Nabha being referred to PIDB. 7. Jan Aushadhi Stores – 8 opened and remaining 12 would be opened by 30-11-2009 for sale of cheaper generic medicines manufactured mostly by CPSUs. Summary – Issues and Challenges 8. EMRI – Emergency Medical Response System needs to be made functional. 16 States have already undertaken this work and GoI is encouraging it under NRHM. 9. Recruitment of Staff – After many years Govt. has allowed recruitment of MOs, MO Dental and Specialists which needs to be continued on regular basis. 191 more Ayurvedic Doctors needs to be recruited. 10. ESI – Recruitment of Doctors on contract basis. ESI willing to set up a Medical College provided State Govt. arranges 30 acres of land. Summary – Issues and Challenges 11. Institutional Deliveries – Significant increase but still deliveries in Govt. Institutions account for about 15% of all births and 23% of total institutional deliveries. (5 lakh birth, 62% institutional deliveries and 70000 deliveries in Govt. Hospitals). Need for more incentives for poor people. Provision of delivery kit of Rs. 1500/- per child during 2009-10. Need for strengthening the community monitoring system specially at PHCs and SCs level. Involvement of private parties in under served pockets. Summary – Issues and Challenges 12. Work of ANMs – Hardly any vacancy of ANMs in 2950 SCs. Bigger SCs have 2 ANMs. They are being provided mobiles and an application based on mobiles for online monitoring of their performance. 13. ASHAs – Proper selection and weeding out of nonperformers. 14. Community Monitoring – Payment of allowances and incentives to ANMs/Staff Nurses and other Doctors enganged under NRHM through the Planning and Monitoring Committees. Summary – Issues and Challenges 15. Monitoring of Staff – A website of NRHM, Computerization of service particulars and administrative maps by PRSC, Ludhiana. Involvement of District Administration and PRIs in District Health Societies and Missions. Need for greater accountability on the part of the staff in the field. 16. Staff and Buildings in New Districts – New 24 Health Blocks. 17. Upgradation of DH/SDH/CHCs and new constructions as per norms. Summary – Issues and Challenges 18. Funds for equipments for PHSC. 19. HMIS in all Hospitals for monitoring of service delivery. effective Summary – Issues and Challenges 20. Rationalization of postings and transfers – End to irrational deployment of Doctors and Other Paramedical Staff for the first time. Need to continue this. Deputation- 82 doctors on deputation with UT and many for more than 25 years. Doctors should return after completion of their tenure of 3-5 years after replacement. Similarly about 45 doctors are with Medical Colleges. These doctors did not return after completion of SR and PG and were adjusted in an irregular manner by the Medical Education Department against the post of Teaching faculty.