| Part
A : Status of Health Infrastructure |
|
Numbers at the end
of the Quarters |
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Details for Public
Sector Health Institutions |
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| Q1 |
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Total number of
Hospitals(District Hospitals, Medical Colleges) |
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| Q2 |
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Total number of Sub-divisional
Hospitals |
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| Q3 |
Details of
Community Health Centres (CHCs) |
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| 3.1 |
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Total
number of CHCs |
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(a) |
Number
of CHCs having less than 30 beds |
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(b) |
Number
of CHCs having 30 or more beds |
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| 3.2 |
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Number
of CHCs functioning as per IPHS |
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| 3.3 |
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Number
of CHCs having operational CEmONC sevices 24 hrs * 7 days |
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| 3.4 |
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Number
od CHCs having all Specialists (7) in position |
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| 3.5 |
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Number
of CHCs having established a Rogi Kalyan Samiti-as on date |
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| 3.6 |
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Number
of CHCs reporting at least onr meeting of Rogi Kalyan Samiti
during the Quarter |
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| 3.7 |
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Number
of CHCs where Citizen's Charter has been established and
available |
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| Q4 |
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Details of Primary Health
Centres(PHCs) |
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| 4.1 |
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Total
number of PHCs |
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(a) |
Number
of PHCs functioning as 24 hour RCH Centres |
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(b) |
Number
of other PHCs |
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| 4.2 |
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Number
of PHCs equipped to provide Basic Obstetric services |
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| 4.3 |
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Number
of PHCs having AYUSH doctor-in-position |
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| 4.4 |
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Number
of PHCs having functional Rogi Kalyan Samiti |
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| 4.5 |
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Number
of PHCs reporting at least one meeting of Rogi Kalyan Samiti
during the quarter |
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| Q5 |
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Details of Sub-Centres: |
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| 5.1 |
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Total
number of Sub-Centres |
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| 5.2 |
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Total
number of functional Sub-Centres (ANM is available and
working out of the facility) |
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| 5.3 |
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Number
of Sub-Centres reporting use of untied grant during the
quarter |
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| Q6 |
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Anganwadi Centres: |
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| 6.1 |
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Total
number of Anganwadi Centres |
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| 6.2 |
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Number
of Anganwadi centres reported to have conducted at least one
Health Day (divas) |
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| Q7 |
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Reproductive Tract Infection (RTI)/Sexually
Transmitted Infection (STI) Clinics: |
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| 7.1 |
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Total
number of RTI/STI Clinics |
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| 7.2 |
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Total
number of CHCs upgraded as FRUs, CHCs and 24 hr PHCs
offering RTI/STI services |
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| Part B |
Status of Human Resource Availability - Staffing status of
selected positions |
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Sanctioned positions (at the
end of the quarter) |
In-position (at the end of the
quarter) |
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| Q8 |
Programme
Management Units |
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| 8.1 |
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State Programme Management Unit (SPMU) |
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(a) |
State
Programme Manager |
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(b) |
State
Finance Manager |
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(c) |
State
Data Manager |
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(d) |
Others
(Specify) |
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| 8.2 |
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District Programme Management Unit (DPMU) |
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(a) |
District
Programme Manager |
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(b) |
District
Finance Manager |
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(c) |
District
Data Manager |
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(d) |
Others
(Specify) |
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| 8.3 |
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Block Programme Management Unit (BPMU) |
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(a) |
Block
Programme Manager |
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(b) |
Block
Finance Manager |
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(c) |
Block
Data Assistant |
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(d) |
Others
(Specify) |
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| Q9 |
Medical Officers |
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| 9.1 |
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CMO's |
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| 9.2 |
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Deputy
CMOs |
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| 9.3 |
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District
Immunization Officer |
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| 9.4 |
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DHEIO |
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| Q10 |
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Staff in CHC: |
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| 10.1 |
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Surgeon |
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| 10.2 |
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Anesthetists |
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| 10.3 |
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Gynecologists |
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| 10.4 |
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Pediatricians |
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| 10.5 |
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Pathologists |
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| 10.6 |
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General
Physician |
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| 10.7 |
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Pharmacist |
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| 10.8 |
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Radiologist |
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| 10.9 |
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Staff
Nurse-Regular |
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| 10.10 |
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Staff
Nurse-Contractual |
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| 10.11 |
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Public
Health Nurse (PHN) |
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| 10.12 |
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Lab
Technician |
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| 10.13 |
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Lab
Assistant |
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| 10.14 |
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Statistical Assistant |
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| Q11 |
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Staff in PHC: |
|
Sanctioned positions (at end
of quarter) |
In-position (at end of
quarter) |
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| 11.1 |
|
Medical
Officer - Allopathic |
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| 11.2 |
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Medical
Officer - AYUSH |
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(a) |
Staff
Nurse -Regular |
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(b) |
Staff
Nurse - Contractual |
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| 11.3 |
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Nurse
Mid-wife |
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| 11.4 |
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Lab
Assistant |
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| 11.5 |
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Lady
Health Visitor (LHV) |
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| 11.6 |
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Pharmacist |
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| 11.7 |
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BHEIO |
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| 11.8 |
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Statistical Assistant |
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| Q 12 |
|
Staff in Sub-centres |
|
Sanctioned positions (at end
of quarter) |
In-position (at end of
quarter) |
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| 12.1 |
|
ANMs |
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12.1 |
ANM
(Regular) |
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12.2 |
ANM
(Contractual) |
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| 12.2 |
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MPW -
Male |
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(a) |
MPW-Female
(Regular) |
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(b) |
MPW-Female
(Contractual) |
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| Part C: Training
Programmes |
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|
Type of Training Programmes |
|
Number of staff trained during
the quarter |
Mandays of training imparted |
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| Q13 |
|
Doctors |
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| 13.1 |
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Training
of MBBS Doctors in life saving Anesthesia skills |
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| 13.2 |
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Training
of MBBS Doctors in Obstetric Care |
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| 13.3 |
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Training
of MBBS Doctors as skilled Birth Attendant |
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| 13.4 |
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Training
of Doctors in NSVs |
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| 13.5 |
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Training
of Doctors in Minilap |
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| 13.6 |
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Training
of Doctors in Laproscopic |
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| 13.7 |
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Training
of Doctors in IUDs |
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| 13.8 |
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Others
(specify) |
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| Q14 |
|
ANM |
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| 14.1 |
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Training of Staff Nurses, ANMs and
LHV as SBAs |
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| 14.2 |
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Training of Staff Nurses, ANMs and
LHV in IUDs |
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| 14.3 |
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| Q15 |
|
Staff of Proframme Management
Units
(SPMU, DPMU,BPMU) |
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Staff Designation |
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| 15.1 |
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| 15.2 |
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| 15.3 |
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| Q16 |
|
Programme Managers (State
Officers/ CMO/ Dy. CMO) |
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Number of staff trained during
the quarter |
Mandays of training imparted |
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Staff Designation |
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| 16.1 |
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| 16.2 |
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| 16.3 |
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| Q17 |
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Other para-medical staff,
statistical officers/ assistants and AWW |
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Staff Designation |
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| 17.1 |
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| 17.2 |
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| 17.3 |
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| Q18 |
|
ASHA |
|
Number of staff trained during
the quarter |
Mandays of training imparted |
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| 18.1 |
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| 18.2 |
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| 18.3 |
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| Q21 |
|
PRI members |
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| 21.1 |
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| 21.2 |
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| 21.3 |
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| Q22 |
|
Village Health & Sanitation
Committee members |
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| 22.1 |
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| 22.2 |
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| 22.3 |
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| Q23 |
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Others (Specify)
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| 23.1 |
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IMNCI |
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| 23.2 |
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| 23.3 |
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| Part D: |
Details of Camps
Held |
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| Q24 |
|
Status of Camps held during
the quarter |
No. of Camps held |
Total number of persons that
attended |
Major Services provided |
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| |
|
Type of Camp held |
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| 24.1 |
|
RCH
Camps |
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| 24.2 |
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General
Health Camps |
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| 24.3 |
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Eye
Camps |
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| 24.4 |
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School
Health Camps |
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| 24.5 |
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NSV
Camps |
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| 24.6 |
|
Health
Melas |
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| 24.7 |
|
Blood
Donation Camps |
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| 24.8 |
|
Others
(Specify) |
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(a) |
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(b) |
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(c) |
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| Part E. |
Status of
Equipment |
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|
| Q25 |
|
Name of Equipment |
No. out of order |
No. out of order
since |
| Up to 15 Days |
15 days to 1 month |
Above 1 month |
| 25.1 |
|
ILR-300 |
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| 25.2 |
|
DFz-300 |
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| 25.3 |
|
ILR-300 |
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| 25.4 |
|
DFz-140 |
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| 25.5 |
|
Laproscope |
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| 25.6 |
|
Others
(Specify) |
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(a) |
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(b) |
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(c) |
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| Part F |
Additional NRHM
components |
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| Q26 |
|
State Health
Mission |
Status at end of Quarter |
|
| 26.1 |
|
State Health Mission functional after merger of societies
(Yes=1; No=0) |
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| 26.2 |
|
State has completed the State Health Plan (Yes=1; No=0) |
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| 26.3 |
|
Number of times the State Health Mission has met |
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| 26.4 |
|
Number of times Quality Assurance (QA) has met |
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| |
(a) |
Number of sites identified to provide QA services |
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| |
(b) |
Number of sites adhering to the prescribed QA norms |
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| Q27 |
|
District Health
Missions: |
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|
| 27.1 |
|
Number of District Health Mission functional afetr merger of
societies |
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| 27.2 |
|
Number of districts that have completed the District Health
Plans |
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| |
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| Q28 |
|
Status of
hospitals (District Hospitals and SDHs): |
|
|
| 28.1 |
|
Number of Hospitals selected for upgrading as per IPHS |
|
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| 28.2 |
|
Number of Hospitals where building work is in progress |
|
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| 28.3 |
|
Number of Hospitals where building work is completed |
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| 28.4 |
|
Number of Hospitals fully euipped as per IPHS |
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| |
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| Q29 |
|
Health Societies /
Rogi Kalyan Samitis (RKSs) |
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| 29.1 |
|
Number of Hospitals having functional Rogi Kalyan Samiti |
|
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| 29.2 |
|
Number of RKSs reported to have conducted at least one
meeting |
|
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| |
|
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|
| Q30 |
|
Number of
Hospitals where Citizen's Charter has beeen established and
displayed |
|
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| Q31 |
|
ASHAs and Functioning of VHCs: |
|
|
| 31.1 |
|
Total number of ASHSs recruited |
|
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| 31.2 |
|
Number of ASHSs in-position (after 7 day orientation
training and provision of drug kit) |
|
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| 31.3 |
|
Number of VHCs formed |
|
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| 31.4 |
|
Number of VHCs reported to have conduvted a least one
meeting |
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| 31.5 |
|
Number of such VHC meetings where ASHA and ANM were present
during the quarter |
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| 31.6 |
|
Number of joint sessions (ANM,AWW and ASHA) planned during
the quarter |
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| 31.7 |
|
Number of joint sessions actually conducted during the
quarter |
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|
