Chattisgarh

1.Korba district
Major observations of Field Survey Unit, Bhopal about the Evaluation
work in district Korba of Chattisgarh in July, 2010.
I. Details of the visited institutions:-

District DH, CHCs and PHCs visited SCs Visited

Visited
Korba Distt. Hospital: Korba Salora, Hunkra, Ranjna,
CHCs: Katghora and Pali Dipka, Nanbaka, Rajkamma,
PHCs:Chhurikala,Ranjna,Chetma Nunera & Tiwarta
& Hardi Bazar

II. Major Observations:-

1. Human resources:-
a) Acute shortage in the technical manpower was observed in the district. Most of the posts of
specialist were lying vacant in the District. More than 50% posts of medical officer were
lying vacant there. Overall in 463 posts of different categories were lying vacant as against
938 sanctioned posts in the district. Sanctioned strength & vacancy in key posts are given
below:

Particulars Sanctioned Vacant

Class- I Officers 37 26
Class -II Officers 105 53
Male Supervisor 49 22
Lab.Technician 32 23
Lady Health Visitor 55 20
MPW (M) 215 109
MPW (F) 251 115
Ophthalmic Assistant 37 33
Pharmacist Gr. II/Store Keeper 45 17

1
 Urgent necessary steps may be taken to fill up the vacant posts for providing smooth health
services in the District.

-1-

b) At CHC Katghora, 2 of 7 sanctioned posts of Medical Officers were vacant. Against 5

specialists required for CHC there was only 1 in position. Similarly, 1 MO against sanctioned
strength of 2 in each of the visited PHC was vacant.
2. Janani Suraksha Yojana (JSY):-
a) During visit to CHCs at Kathghora and Pali, it was observed that the funds are provided
regularly in time and the beneficiaries were having facilities as well as incentive under the
Scheme. JSY registers were maintained entering all relevant details of the beneficiaries in
these CHCs. Concerned MOs were checking the registers regularly.

b) In CHC Kathghora, total numbers of pregnant women identified under JSY were 8105 for the
last complete year and 1575 for the current year and incentive provided to 1473 and 567 JSY
beneficiaries during 2009-10 and 2010-11 respectively. An amount of Rs. 19,42,500 was
provided during 2009-10, against which expenditure incurred was to the tune of Rs.
18,16,700 and an amount of Rs. 10,00,000 was provided in the current financial year, out of it
Rs. 8,32,700 was spent..

c) In CHC Pali total numbers of pregnant women identified under JSY were 4421 for the last
complete year and 1376 for the current year. And the fund provided to 2442 and 591 for the
last and current year respectively. The fund allotted to the CHC Pali,was Rs. 38,70,600 for
the year 2009-10 and the expenditure incurred was Rs.26,99,600. An amount of Rs 10,00,000
was allotted to the CHC for the current year and out of it an expenditure of Rs.7,31,050 was
incurred.

d) The team contacted 32 beneficiaries in the areas of the visited centres out of 40 selected for
sample verification and observed that all of them received ANC services in time and also JSY
amount as per the norms. Contacted beneficiaries were mostly satisfied with the services
under the scheme,, but some of the mother had not received three post natal checkups.
e) Most of the beneficiaries were accompanied by ASHAs while going to the hospitals for
deliveries.
3. Untied Funds:-

2
a) Untied funds to the tune of Rs.5,00,000 was provided to the District Hospital and an
expenditure of Rs. 5,26,968 was incurred and excess amount was met from other funds.

b) All 4 CHCs were given untied funds of Rs.2,00,000 during 2009-10 and 85% of the funds
were utilised during the period. Similarly, for 37 PHCs, Rs. 9,25,000 @ 25,000 each PHC
was provided during the year 2009-10 and funds utilised upto 92% during the period.

c) All 211 Sub-Centres were given @10,000/- per centre during 2009-10 and 2010-11. It was
reported that 157 Sub-Centres out of 211 submitted their utilization certificate for both the
years i.e., 2009-10 and 2010-11.

d) No untied fund has been provided to CHCs and PHCs for 2010-11 till the month of visit.
-2-

4. Rogi Kalyan Samiti (RKS) and Village Health & Sanitation Committee
(VHSC):-
a) It was reported that Rogi Kalyan Samitis have been constituted at DH, 4 CHCs and 37 PHCs
in the district.

b) During 2009-10, 04 CHCs had received RKS funds @ Rs.1,00,000 for each CHC and utilized
85% of funds during the year.

c) In 2009-10, all the 37 PHCs had been provided RKS funds to the tune of Rs. 37,00,000 i.e.,
@ Rs.1,00,000 to each PHC and utilized about 92% of the funds.

d) RKS funds were not given to the institutions for the current year till the month of visit.

e) Block-wise report of the district shows that out of 795 villages, VHSCs have been formed in
716 villages in the district and all VHSCs were having ASHA as a member. Most of villages
in the visited Sub Centres were having VHSCs.

f) VHSCs were reported to have opened bank accounts for handling funds.

5. Functioning of ASHA Scheme:-

a) 2274 ASHAs have been selected in the district and all ASHAs have been trained up to IV th
module and provided with Drug Kit. In the visited centres, it was observed that ASHAs were
trained up to IV th module, having drug kits and working properly.

b) As informed by the ANMs, JSY beneficiaries and villagers of the visited Sub- Centres, the
role of ASHAs in the field was satisfactory.

3
c) At the time of ANCs and immunization, ASHAs were helping ANMs and also motivating
and accompanying mothers for Institutional deliveries.

6. 24 x 7 hour Delivery Care System:-

a) In the district there are 4 CHCs and 37 PHCs. All were functioning as 24 x 7 but delivery care
service is reported to be available on call. At PHC level, staff Nurse is providing services for
delivery on call.

b) The Sub-Centre Salora, under Chhuri PHC in Katghora CHC had been accredited for
institutional delivery.

-3-

7. Physical Infrastructure and position of supplies:-

i) CHC:

a) The Pali and Kathghora CHCs were functioning in government buildings. The premises of
both the CHCs were found neat & clean. The Kathghora CHC was having 30 & CHC Pali
was having 20 beds and all the beds were found to be in good condition during the visit. The
Water supply was regular but the electric supply was irregular in both the visited CHCs.

b) Though the norms for infrastructure and equipments were not as per IPHS, necessary
equipments like BP Apparatus, Weighing Machine (Adult & Infant), Microscope & Lab
Equipments, Auto clave, Oxygen Cylinder, Resuscitation Equipment, Neo natal Resuscitation
Equipment Labour room, Labour room table & Equipments, Examination table and IUD
insertion kits were available at both the visited CHCs.
c) Anaesthesia equipments were not available in CHC Katghora and surgical equipments were
not available in CHC Pali. The license for Blood storage unit is awaited at the visited
CHCs.

d) Vital, Essential and desirable drugs were available in both the CHCs visited.

ii) PHC:

4
a) PHCs viz., Chhurikala, Ranjna, Chetma & Hardi Bazar, visited in the district were
functioning in Govt. Building. Electricity and water supply were available at all the PHCs. BP
Apparatus, Weighing Machine (Adult & Infant), Auto clave, minor surgical equipments IUD
insertions kit, Labour room with the table & Equipments etc. were available in the visited
PHCs except PHC at Chetma.

b) Functional Operation Theatre with OT table was not available at visited PHCs. There was no
vehicle in any of the 4 visited PHCs. The Cold Chain equipments were found only in 2 PHCs
out of 4 visited PHCs.

c) AYUSH Medical Officers were not available at 3 out of 4 visited PHCs. There was no
residential quarter at PHC Hardi Bazar.

iii) Sub-centre:

a) Out of 08 visited Sub-Centres, 05 were functioning in Govt. buildings and the sub centres at
Nanbaka, Nunera and Tiwarta were functioning in rental building. The sub-centres Ranjana,
Nanbaka, Nunera and Tiwarta were not having sufficient space for conducting deliveries and
cleanliness was not up to the satisfactory level at Nunera and Tiwarta Sub-Centres.

-4-

b) Essential furniture, weighing machine, IUD insertion kit and Ambu bag etc. were available in
the SCs functioning under CHC Katghora i.e., Sub Centres at Salora, Hunkra, Ranjna and
Dipka.

c) BP apparatus in working condition, steam sterilizer, blood slides, ORS and vitamin “A” etc.
were lacking one or other visited centres.

d) Drugs like Tab. Chloroquine, Metronidazole, Paracetamole, Oxytocin and Ampicillin, lnj.
Gentamicin and Antisaptic solution etc. were not available at most of the centres. Short
Supply of Condom since Feb.2010 was observed in the centres visited.

8. Knowledge and opinion of the Community on health Services:-

a) To assess the knowledge and opinion on health services provided by the ANMs, 25
mothers having child up to one year old were interviewed in the areas of 8 visited sub centres
and mothers reported that ANMs were available as and when needed.

5
b) 10(40%) mothers replied that the ANM visited them within three days of the delivery.
13(52%) intimated the ANM visited on 7th day of delivery. In 2 cases there was no home
visit. 19(76%) mothers put their babies to breast within 1 hour of delivery and only 10 (40%)
mothers received three post natal checks up.

c) 14 (56%) mothers knew about danger sign of ARI. 17 (68%) mothers knew the use of ORS.

d) All the mothers knew the schedule of child immunization and use of contraceptive.

e) The posts of male workers found vacant at 4 out of 8 visited sub-centres. MPW was there at
SCs Dipka, Nunera, Nanbaka and Rajkamma and they were collecting blood slides regularly
and also looking after immunization programmes. The villagers were satisfied with the
services and behaviour of the MPWs.

e) During the course of visit to PHCs, as intimated by the service acceptors and other villagers
they were satisfied with the staff and the Health services provided by PHCs. Almost all the
Medical Officers of the visited PHCs used to stay at Head Quarters and all the emergency
medicine and drugs were available in the visited PHCs.

9. Sample verification of FW acceptors:-

a) Out of selected 214 acceptors of Family planning methods, 177 (82.7%) acceptors
could be contacted for sample verification in the district. While examining the data of the
selected acceptors from the service registers, it was noticed that age of acceptors, age of
spouse, total number of children, number of male/female children and age of the youngest
child were not recorded in 29 (14%), 62 (29%), 23 (11%), 29 (14%) and 98 (46%) cases
respectively.

-5-

b) Similarly, discrepancies in the age of accepters in 32 cases, in the age of spouse in 27

cases and in the number of male child in 19 cases were observed during sample check of the
F.W acceptors.

c) There were 143 acceptors of spacing method and out of that 113 (79%) cases were found to
the reported fake/false i.e., IUD 29, Oral Pills 38 and Nirodh 46.

d) 6 OP users and 2 Nirodh users were facing difficulty due to irregular supply.

6
e) The follow-up services were confirmed by 55 (86%), out of 64 genuine contacted acceptors.
All 34 contacted Sterilization cases got the incentive amount.
10. Maintenance of records and Registers:-
a) Maintenance of records and registers for F.W. services was found very poor in the
visited sub-centres except in SCs at Hunkra, Dipka and Nanbaka.

b) EC registers were not maintained properly at most of the SCs.

c) Non-printed registers in respect of F.W. Services were being used at CHC, PHC and Sub
Centres level.

d) Monthly progressive performance for F.W. Services for the Year 2009-10 and 2010-11 was
not readily available at district office.

e) Due to absence of IUD record at CHC Head Quarter, the IUD figures could not be verified.

11. Observation and Suggestions:-

a) Due to lack of proper supervision by Block Medical Officers, the maintenance of records and
registers was poor. The monitoring and supervision needs to be strengthened at periphery
level.

b) During ANC/PNC surveillance, it was ascertained that 3 PNC, visits to mother were not
being given at village level.

c) SC Salora which is under the jurisdiction of PHC Chhurikala & Katghora CHC was
accredited for institutional deliveries from December, 2009 and only 3 deliveries were
conducted upto the time of visit.

7
 -6-

2.Rajnandgaon district
Major observations of Regional Evaluation Team, Bhopal about the Evaluation work in
District Rajnandgaon in Chattisgarh State in September , 2010

I. Details of the visited Institutions:

District Visited DH , CHCs and PHC s visited SCs Visited

Rajnand Gaon District Hospital Rajnandgaon, Udaypur, Ghirgholi, Birutola,

CHCs: Dongargaon, Chhuikhadan Tilai, Khujji, Atariyaroad,
and Gumka. Gopalpur and Rudgaon.
PHCs: Pendarwani, Badgaon,
Charbhata, Gandai, Asra, and
Dumardih.

II. Major Observations:-

1. Health Human Resource

a) The following table shows the vacancy position of key Health personnel against the
sanctioned strength in the district.

Post Sanctioned Strength Vacant

Specialist 33 29

Medical Officer 97 56

Lab Technicians 28 27

8
 MPW (Male) 314 91

LHV 67 29

ANM 355 10

Apart from the above, 12 out of 48 sanctioned posts of Contractual Staff nurse (BE MOC)
filled on contractual basis are also lying vacant.

a) 13 posts of Causality Doctors GDPO out of 24 sanctioned , all 2 posts of Anesthetist, all 2
posts of Medical specialists, and 1 out of 2 posts of OB & G, Pediatrics and 4 out of posts
of Pharmacists were lying vacant in District Hospital, Rajnandgaon. There was only one
post each of Psychiatrist and Dental Surgeon which were presently lying vacant in the
Hospital.

b) In CHC visited at Chhuikhadan, Ghumka and Dongargaon, few posts of Specialists, BEE,
Account Assiststs, Computers, Staff Nurse, MPWs and Radiographer ets are lying vacant .

c) . Necessary action is required to be taken to fill up these posts for providing proper health
care delivery in the district..

2. Services of Janani Suraksha Yojana (JSY) :

a) To assess the client satisfaction and availability, of services under JSY as many as 28 JSY
beneficiaries were contacted by the team in the district and all of them were found satisfied
with the services provided under JSY.
b) All the mothers received TT and IFA tablets during ANC checkups and also had the
checkups during the ANCs. Most of them were accompanied by ASHA/Dai/ ANM while
going to the hospital for delivery.
c) However, Only 12 ( 42%) beneficiaries got three post natal checkup and 6 (21%) mothers
received their cheques for JSY cash incentive within 3 days of the delivery.
d) Proper registers were being maintained containing list of beneficiaries to whom cheques were
issued and the MOs of the visited centres were checking the registers on monthly basis.

3. Utilization of Untied Funds:

a) As reported CHCs @ Rs 50,000 each, PHCs @ Rs 25,000 each and HSCs @ Rs10,000 each
were provided as united funds during 2009-10 in the district. Utilization certificate (UC) for
the financial year 2009-10 was not submitted by the CHCs and PHCs and hence funds for
2010-11 were been released to them till the visit of the team. However, all the HSCs
submitted UCs for the funds provided in 2009-10.

No. of centres provided Untied funds in 2009-10 Submitted UC in 2009-10

9
 Untied unds
9 CHCs (@ Rs. 50,000 9 CHCs NIL
39 PHCs @ Rs 25,000 39 PHCs NIL
305 HSCs @ 10,000 305 HSCs 305 HSCs

b) In the visited sub-centres, untied funds were found to have been provided and utilized as per
norms.

4. Implementation of Rogi Kalyan Samiti (RKS)

a) Rogi Kalyan Samitis has been set up in District Hospital, 9 CHCs, and 39 PHCs . RKS at
CHC level had been provided the funds @ Rs. 1,00,000 during 2009-10. In 9 CHCs which
were provided funds, reported complete utilization but Utilization certificates were not
submitted. Hence, these CHCs were not provided funds for 2010-11 till visit of the RET.
During 2010-11 3 CHCs namely Chhuikhandan, chouki and Mohala incurred 100%
expenditure and have submitted Utilization Certificates.

b) At PHC level, funds had been provided @ Rs. 1,00,000 during 2009-10. In 39 PHCs out of
43 PHCs which were provided funds, reported complete utilization but Utilisation
certificates were not produced. Hence, these PHCs were not provided funds for 2010-11
till visit of the RET. During 2010-11 4 PHCs namely Salhewara, Udaipur, Tumdibod and
Charbhata incurred 100% expenditure and have submitted Utilisation Certficate.

c) During 2008-09 and 2009-10 the RKS of the District Hospital Rajanandgaon, was provided
funds @ Rs. 5 Lakhs per RKS. Though occasionally executive committee meetings were
convened but general body meeting was not convened since last two years. The district
collector wants the proposal for incurring expenditure to be submitted to in General Body
meeting . Since, this was not done, expenditure was not incurred as there was no expenditure
in previous year funds were not provided in 2010-11.

5. Village Health Sanitation Committee (VHSCs):

a) Village Heath & Sanitation Committees have been formed in all 1603 villages and VHSCs
were having ASHA as a member. All the 1603 VHSCs have been reported to have opened
joint Bank accounts as per norms for handling the funds.

b) As per the details available , the district was in reeipt of Rs. 37,40,000 as VHSC fund for 374
VHSC during 2010-11 and out which an amount of Rs. 15,12,279 was spent.

6. Functioning of ASHA Scheme:

a) As per the information received from DPMU, 3740 ASHAs were selected and trained and
equipped with drug kits.

10
 b) During visit to the sub-centres, it was observed that most of the ASHAs were taking active
part in providing the services of ANC, Immunization and other JSY activities, and also
motivating cases for sterilisation.

7. 24 X 7 hours Delivery Care System:

a) 32 institutions i.e District hospital, 8 CHCs, and 23 PHCs were providing 24X7 delivery care
in the district. Visited CHCs,and PHCs were providing 24X7 Delivery care services.

8. Physical Infrastructure:

i. CHCs:

a) CHC Dongargaon, Chhuikhada and Ghumka were functioning in Govt. buildings. . CHC
Dongargaon and Chhuikhada were having 30 beded facility and CHC Ghumka had 10
beds. The premises of visited CHCs were found neat & clean.
b) Medical waste disposing system Incinerator and Blood storage facility were not available at
any CHC visited.
c) X-Ray facility was available in all visited CHC, but it was non functional in CHC Ghumka
as there was no x-ray technician posted there.. Anesthesia equipments were non –functional
at Dongargaon CHC.
d) Infrastructure and equipments were in the CHCs were not as per IPHS standard.

ii. PHC:

a) PHCs at Badgaon Charbhata, Gandai, Dumardih and Asra were functioning in government
building having capacity of 4,10,2,& 20 beds respectively. PHC Pandarvani, was running
in rent free building and had no bed facility.
b) Most of the essential facility Like water supply electricity, toilet and telephone, etc. were
found available in all the visited PHCs except PHC Pandarvani.
c) Microscops was found unused in Dumardhi and Asra PHC.
d) Cold chain equipments were available in the visited PHCs expect at PHC Padarvani. The
same was was not in working condition in PHCs at Badgaon Charbhata..
e) Residential quarters for MO are avaliable in Badagaon, Charghata, Gandgi and Dumarih
PHCs but not in Asra and Pandarvani.
f) AYUSH MO was not available in the visited PHCs.

iii. Sub-centre:

a) 8 visited Sub-Centres were Viz. Khuji, Raudgaon, Ataria road, Gopalpur, Udaipur, Ghirgholi,
Birutola and Tilai . Except Bitrutola and Gopalpur SCs all were having Govt
accommodations. ANMs of Bitrutola and Gopalpur sub centers were not residing in sub

11
 center villages. Deliveries were being conducted in the centers except SC Udaipur and
Birutola. At Tilai SC, deliveries being conducted even though there was no labor room.

b) Examination table, Cup board, for drugs, Delivery kit, Gloves, weighing machines etc were
found in all the sub-centres except one or two places. Ambu bag was available in 2 sub
centers out of 8 SCs visited.

c) DDK, Emergency Contraceptive Pills, tab. Misofrostol, Injection Gentamicin and Oxitocin
etc were not available at some of the visited sub centers, Cap. Ampicillin was not available at
any of the SCs visited.

d) Torch, Stove, BP apparatus were available at some of the Centers and they were not in
working conditions in a few other centers.

9. Knowledge and opinion of community on health services:

a) 44 mothers having child upto one-year age were interviewed for assessing the services being
rendered by the ANM working in the visited sub-centres.
b) Only 39 mothers replied that the ANMs visited them within three days of their delivery.
c) 14 ( 32% ) mothers had three post natal checkups.
d) Of the 44 contacted, mothers15 mothers knew danger sign of ARI and 27 knew the schedule
of child immunization.
e) 11(25%) mothers were aware about advantages and side effects of contraceptives use.
f) During the course of visit to PHCs at Asra, Badgaon Charbhata and Gandai, it was observed
that the community was mostly satisfied with the services of PHC staffs.
g) Performance of MPW(M) for 2009-10 could not be assessed as the performance report and
registers could not be produced by workers.

10. Sample Verification of Family Welfare Acceptors:

a) Out of selected 141 Family Planning acceptors (Sterilisation, IUD, OP and Nirodh) 87 (61%)
could be contacted for sample verification in the district.
b) While examining records of selected acceptors from service registers, age of spouse was
found not recorded in 10 (8%) cases and age of youngest child in 66 (47%) cases. 14 (21%)
cases out of 87 contacted acceptors reported to have not been visited by the Health Personnel
for follow up services.
c) Out of 57 contacted cases of spacing methods i,e., IUD, OP and Nirodh 21 (24%) found
to be false reported in the in the district.
d) Out of selected 192 beneficiaries of child immunization, 167 (87%) children could be
contacted and confirmed received the vaccination. It was also found that as many as 104
(62%) beneficiaries were not provided with the follow-up services.
12
.11. Maintenance of records and Registers:

a) EC Register was neither maintained nor updated at most of the visited centers in the district.
b) Service registers for OP and Nirodh were not maintained properly in most of the visited sub
centers. Some of these registers were lacking the required data of accepters.
c) MCH service Registers were mostly updated.
d) Service registers for Sterilization, was maintained properly at CHC Dongargaon and PHC
Chhuikhadan but not in CHC Ghumka.
e) Lack of supervision and monitoring was noticed at all the centers at periphery level which
should be strengthened.

********

13
3.Janjgir district
Major observations of Field Survey Unit (FSU) and Regional
Evaluation Team (RET), Bhopal about the Evaluation work in
district Janjgir of Chattisgarh State in the month of March, 2011.

I. Details of the visited Institutions:

District PHCs /CHCs/District HSCs Visited

Visited Hospital Visited

Janjgir District Hospital: Janjgir Nagarda, Dhanpur,

Deragarh,
CHCs: Sakti and Akaltara
Lavsara, Parsahibana,
PHCs: Kurda, Baradwar,
Kapan and Tilai, Pauna and Taraud
Nariyara

II. Major Observations :-

1. Human Resources:
a) There was acute shortage of manpower in the district against the sanctioned strength. 54 (83%) of
the sanctioned posts of Specialist, 78 (57%) of the sanctioned posts of Medical Officer, 15 (29%) of the
sanctioned posts of Staff Nurse, 25 (71%) of the sanctioned posts of Lab Technician, 22 (35%) of the
sanctioned posts of the LHV, 24 (44%) of the sanctioned posts of Multi Purpose Supervisor, 87 (26%) of
the sanctioned posts of ANM and 116 (43%) of the sanctioned posts of MPW (Male) were lying vacant
in the district.

b) As regards, contractual staff under RCH, all 12 posts of Staff Nurse CEmOC, 34 (77%) posts
out of 44 Staff Nurse BEmOC and 39 (65%) of the 60 posts of ANM were lying vacant.

14
c) In the visited District Hospital, posts of Hospital Superintendent, Medical Specialist,
Psychiatrists, Ophthalmologist, Orthopedician and Radiologist were lying vacant. Further under
para-medical category, 6 out of 18 sanctioned posts of Staff Nurse, one post out of 02
Ophthalmic Assistant and post of Lab Technician were vacant in the hospital.
d) At the CHC level, 2 out of 4 posts of PGMOs each at CHC Sakti and and CHC Akaltara were
lying vacant. Post of Block Programme Manager, BEE and Computer were lying vacant at both
the CHCs. In CHC Akaltara, the only post of the AIDS Counselor and the Technician were
lying vacant.
e) In the visited PHC Kurda, one post each of the post of Staff Nurse, Lab. Technician and Ward
Boy and all 2 sanctioned posts of ANM were lying vacant. The post of Medical Officer, one of
the 2 sanctioned posts of Staff Nurse and only sanctioned post of Lab. Technician were lying
vacant at PHC- Paradwar. All the sanctioned posts were found filled up at Kapan PHC, except
one post of Staff Nurse. Each of the sanctioned post of Lab. Technician, Radiographer and ANM
and both sanctioned posts Staff Nurse were lying vacant at PHC, Nariyara.
2. Functioning of Rogi Kalyan Samiti (RKS) and Village Health & Sanitation
Committee (VHSC):
a) Rogi Kalyan Samiti known as Jeewan Deep Samiti (JDS) in the State was reported to be set
up at the PHCs, CHCs and District Hospital (DH) in the district. Jeewan Deep Samiti (JDS)
have been registered in DH, 8 CHCs and 37 PHCs.
b) JDS have been provided funds at CHC @ Rs.1,00,000 and at PHC @ Rs.50,000 in the year
2009-10. There were 11 PHCs out of 37 to whom RKS funds@ Rs. 1,00,000 had been provided
in the year 2009-10. It was observed that most of the amount was utilized at the CHC and PHC
level in the year 2009-10. No fund was released to PHC Tilai, Portha, Jarve and Lavsara in
financial year 2009-10 and PHC Baradwar in current year.
c) RKS funds for the CHCs were not received during 2010-11 by the district from the State till
the month of February, 2011 and RKS funds at PHCs were provided @ Rs.50,000 each.
d) As per the VHSC scheme, 898 villages out of total 915 villages in the district were covered
under the scheme and all 898 VHSCs were functioning with ASHA as a member in the district.
Block Dabhara is the only block in the district in which all 126 villages were having VHSC. It

15
was reported that 886 of the 898 VHSCs have opened their bank account for handling the funds
for sanitation work.
3. 24X7 hour Delivery Care System:

a) Nine institutions including DH, Janjgir, Civil Hospital Champa, 6 CHCs and one PHC were providing 24
x7 hours delivery care service in the district. Mostly this service was being provided on telephonic call in
the institutions.

b) In this connection, the performance and other facilities were checked in some of the PHCs. It was
observed that 213 deliveries were conducted at Bardwar PHC in the year 2010-11, which showed
improvement in comparison to 161 deliveries in the year 2009-10. PHCs visited at Kurda, Kapan and
Nariyara could not achieve the stipulated minimum 10 deliveries per month. PHC Kapan conducted only
3 deliveries in 2009-10 and 2 deliveries in 2010-11. It was informed that PHCs were not improving their
performance because delivery of mother in the areas of PHCs Kurda, Kapan and Nariyara were also
being conducted in CHCs Sakti and Akaltar.

c) There was no Blood Storage Unit in the visited centres.

4. Janani Suraksha Yojana (JSY):

a) The district spent Rs.1,06,55,150 out of Rs.2,29,37,308 provided in the year 2009-10.
Similarly, An amount of Rs.90,41,850 was spent up to February, 2011 out of total funds of Rs.
2,35,26,253 allotted to the district during 2010-11 under the scheme.
b) Performance under JSY in the district as a whole and visited institutions is reported as under:
Sr. Particulars District DH Janjgir CHCs
No. Sakti Akaltara
2009-10 2010-11 2009-10 2010-11 2009-10 2010-11 2009-10 2010-11
upto Feb.
2011

1 Total no. of 38481 32173 - - - - - -

deliveries
conducted
2 Total no. of Instt. 10246 11121 303 283 781 794 404 705
Delivery conducted
3 No. of beneficiaries 10246 11121 303 283 781 784 404 705
to whom incentive
was paid

16
c) During visit to PHCs, it was observed that there were no separate funds provided to these
centres under JSY. All the expenditure earmarked under FLEXIPOOL (NRHM).The JSY funds
were received in time in all the four visited PHCs and the payment were made timely to all the
beneficiaries.
d) 50 (71%) JSY beneficiaries were contacted out of 64 selected in the area of 8 Sub Centres
for field verification. All beneficiaries were satisfied with the services. 46 (92%) beneficiaries
were accompanied by ASHA/Dai. 10 beneficiaries used Janani Express to go to hospital. All
beneficiaries got three Ante Natal Checkups (ANC) and 44 (88%) beneficiaries got three Post
Natal Checkups (PNC).
5. Implementation of ASHA Scheme:

a) Targeted no. of 3611 ASHAs were in position in the district, Of these, 3586 ASHAs reported to have
been provided with drug kits.

b) As informed, 3611 ASHAs were working in 915 villages in the district. Almost all blocks were having
more than two ASHAs in each village.

c) During visit to the villages, it was observed that ASHAs were accompanying the mothers for delivery
purpose and helping ANMs during immunization, assisting them in ANC/PNC. The ASHAs were also
motivating the cases for sterilization operations.

6. Untied Funds:
a) Untied funds were being given regularly to the CHCs, PHCs and HSCs in the district but its
utilization was observed to have not been done fully during last two years.
b) It was reported that no expenditure was incurred under this head out of the funds to Rs.
63,73,274 in the district during financial year 2009-10. The same amount carried forward to the
current financial year 2010-11, but only Rs.8,56,651 spent up to Feb. 2011during the current
year.
c) It was also observed that no amount under Untied Fund has been provided at CHC, PHC and
Sub Centre level in the year 2010-11 (up to Feb. 2011) in the district.
7. Physical infrastructure:
i) CHCs:

17
a) CHCs visited at Sakti and Akaltara were functioning in govt. buildings having 30 beds each.
The premises of CHCs were found neat and clean. Water supply and electricity with power
back-up were available at all visited CHCs.
b) Anesthesia equipment was not available at Akaltara CHC. Blood storage unit and Waste
Disposal Management System were not available in both the CHCs. Infrastructure was not as per
IPHS in the CHCs.
c) Posts of Specialists and Gynecologist were not available in the CHCs. Neonatal resuscitation
suction machine and baby incubator were not available.
ii) PHCs:
a) Visited PHCs Kurda, Bardwar, Kapan and Nariyara were functioning in Government
building. Water supply was available in all the visited PHCs. Electricity connection was not
available in Kapan PHC and Power backup was not available at Nariyara PHC. Telephone
facilities were available in Kapan and Nariyara PHCs. Ambulance/Jeep was not available in all
the visited PHCs.
b) BP Apparatus and facility of Labour room was not available at Kapan PHC. The Microscope
was available only at Kurda PHC. Microscope was unused as post of Lab Technician was laying
vacant at Baradwar and Nariyara PHC. The Resuscitation equipments available only at Kurda
and Baradwar PHCs.
c) Operation Theatres were not in functional condition at the visited PHCs.
e) The Stock of IUD, OP and Nirodh pieces was not available in all the visited PHCs except
Kurda PHC. The stocks of vaccines (BCG, DPT, OPV, Measles, DT and TT) was available at
Kurda and Baradwar PHC. The Prophylactic drugs-IFA large were not available in all the
visited PHCs except Kapan PHC and IFA small was available at Baradwar PHC, IFA syrup and
Vitamin A Tab. were available in Baradwar and Nariyara PHC. Vitamin A syrup was available
in all PHCs except Kapan.
f) Medical Officers (AYUSH) was posted only at Kurda and Nariyara PHCs.
g) Residential quarters for Medical officers were available in all the PHCs except Baradwar.
iii) Sub Centres:
a) All the visited sub centers were functioning in Govt. building. ANMs of the sub centres
Nagarda, Dhanpur, Deragarh and Lavsara were residing in Sub-centre building. ANM of

18
Parsahibana and Tilai SC were residing in sub centre village and ANM of Taraud SC was not
residing at SC building or village.
b) Water supply facility was not available at Nagarda, Dhanpur, Deragarh and Taraud SCs.
Electricity connection was available in all the visited sub centres except Taraud SC. Labour
rooms was available and deliveries were not conducting in Dhanpur and Taraud SCs.
c) Examination table was available in all the visited sub centres except Dhanpur, Tiali and
Taraud SCs. Delivery table was available in all the visited sub canters except Dhanpur,
Parsahibana and Pauna SCs. McIntosh sheet was not available at Dhanpur, Deragarh,
Parsahibana and Pauna SCs. Ambubag /suction was available in all the visited sub centres except
Dhanpur, Parsahibana and Tilai SCs.
d) ORS packets and Tab. Paracetamole, Kits A and B were available in all the visited Sub
Centres except Deragarh SC. DDKs were not available in 4 SCs i.e. Nagar, Dhanpur,
Parsahibana and Tilai SCs. Kerosene oil/gas was not available in all the visited sub centres
except Nagarda and Dhanpur SCs. Vitamin A solution was available in all the visited sub
centres except Taraud SCs.
e) Sanitary Napkins, Emergency Contraceptive Pills, Tab. Oxytocin, Cap Ampicillin were not
available in all the visited Sub Centres. Antiseptic Solution was available in all the visited Sub
Centres except Deragarh, Tilai, Pauna and Taraud SCs. Chlorine Solution / Bleaching Powder
was not available in Taraud SC. Inj. Gentamycin was not available in all the visited Sub Centres
except Lavsara and Parsahibana SCs.
f) The posters for public awareness were not displayed at the sub-centres Nagarda, Dhanpur,
Parsahibana and Tilai SCs.
g) SBA training was not received by the ANMs at Dhanpur, Parsahibana, Tilai and Taraud SCs
visited.
h) ANMs of 7 Sub Centres did not receive training of Integrated Management of Neonatal and
childhood infection (IMNCI) except ANM at Pauna SC.
8. Opinion and Knowledge of Community on Health Services:
a) As many as 43 mothers having child up to one year of age were interviewed in the area of the visited
Sub Centres for assessing the work of ANM and Knowledge & Opinion of mothers.

b) 41 (95%) mothers informed that ANM is available when needed. 7 (16.3%) mothers knew the
danger sign of ARI. 22(51.2%) mothers received three post natal checkups. and 30(69.77%) mothers

19
knew about use of ORS packets during diarrhoea. 34 (79.1% ) mothers reported that immunization are
held regularly in the village. All the mothers were aware of contraceptive methods and All the mothers
were aware of the government facilities where they can get all health facilities.

c) During the course of visit to PHC Kurda, Baradwar, Kapan and Nariyara it was observed that the
community was satisfied with the services received from staff and Medical Officers of the PHCs.
However, Medical officers of PHC Kurda and Nariyara were not residing at their head quarter.

9. Sample Verification of F.W. beneficiaries:

a) 252 Family Welfare beneficiaries were selected in the visited Centres for sample verification and out
of them 179 (71.03%) could be contacted in the district. Minor discrepancies in the age of acceptors,
spouse, total no. of children and no. of Male children were found during field verification. In cases of 19
(10.6%) acceptors, proper age of youngest child was not recorded. Demographic data of the acceptors
should be recorded properly.

b) Out of contacted 128 of the selected 175 spacing methods acceptors, 26(20%) were found to be
reported false in the district.

c) 33 (21.6%) beneficiaries didn’t get follow up services.

d) All 128 contacted beneficiaries of child immunization confirmed receipt of proper doses of
vaccination and there was no complication after receiving the services.
10. Maintenance of Records and Registers:

a) EC, IUD, CC and OP registers were not maintained in all the visited CHCs.

b) MCH registers were not maintained in visited CHC, Akaltara but the ANC & PNC registers were
maintained in CHC, Sakti.

c) Stock registers were maintained in all the visited CHCs.

d) Printed registers for eligible couple were not available at visited sub centres Pauna and Taraud SC.
Printed register for family planning services were available at Nagarda, Dhanpur, Parsahibana and Tilai
SC. Printed stock register and formats for monthly reporting were not available at Sub Centres
Deragarh, Lavsara and Pauna SCs.

20
e) OP and Nirodh registers were not printed but the same was maintained in most of the Sub Centres.

f) ANC, PNC and Immunisation service registers were maintained in all the visited Sub Centres.

g) JSY register was maintained properly in most of the Sub-Centres, but JSY Registration Cards not
available at Dhanpur and Pauna SCs.

h) Mother and child tracking formats were not available at Sub Centres Deragarh and Lavsara SC.

11. Other Observations and Suggestions:

a) During the visit to the district, counselor on HIV/AIDS was not observed to be available in visited
CHCs Sakti, Akaltara and District Hospital.

b) Lack of supervision was noticed at all levels which need to be strengthened.

c). Not a single case was motivated at Dhanpur SC for sterilization during 2009-10 & 2010-11 till the
date of visit. EC Pills were not supplied in 04 Sub Centres, i.e. Dhanpur, Deragarh, Lavsara and Pauna
during 2009-10 & 2010-11.

*********

21
4. Kawardha District
Major observations of Field Survey Unit (FSU) and Regional
Evaluation Team (RET), Bhopal about the Evaluation work in
district Kawardha of Chattisgarh State in the month of March,
2011.

I. Details of the visited Institutions:

District PHCs /CHCs/District HSCs Visited

Visited Hospital Visited

Kawardha District Hospital: Kawardha. Maharatola,

Bamhantola,
CHCs: Sahaspur Lohara,
Singhanpuri Jangal,
Bodla and
Udiyakala,
Pipariya Khairbankala, Rochan,
Khairbankhurd,
PHCs: Bhimbhori, Indori, Bhonda, Rajanawagaon,
Rengakhar and Indori and Bamhani
Chilpi

II. Major Observations :-

1. Human resources:
a) The staff position in the district was not satisfactory. 22 (71%) of the sanctioned posts of Specialist,
39 (57%) of the sanctioned posts of Medical Officer, 18 (53%) of the sanctioned posts of Staff Nurse, 10
(77%) of the sanctioned posts of Lab Technician, 23 (72%) of the sanctioned posts of the LHV, 44 (26%)
of the sanctioned posts of ANM and 69 (46%) of the sanctioned posts of MPW (Male) were lying vacant

22
in the district. Urgent steps need to be taken to fill up the above vacant posts in the district for providing
effective health care delivery to the people.

b) In the visited District Hospital, one post each of Hospital Superintendent, OB & Gyne,
Anesthetist, Ophthalmologist, Dental Surgeon and 11 out of 15 sanctioned posts of Casualty
Doctors/GDMO were lying vacant. Under paramedical category, 4 of the 18 sanctioned posts of
Staff Nurse,1 out of 2 posts each of Lab Attendant, Radiographer and only post of Matron were
vacant.
2. Functioning of Rogi Kalyan Samiti( RKS) and Village Health & Sanitation
Committee(VHSC) :
a) Rogi Kalyan Samiti is known as Jeewan Deep Samitis (JDS) in the State were reported to
have been registered in DH, 4 CHCs and 9 PHCs. Meetings of JDS in the visited CHCs and
PHCs were being conducted, However, no information was available about JDS at PHCs Indori
and Chilpi.
c) It was reported that JDS funds for the years 2008-09 and 2009-10 were provided to the block
head quarters during January, 2010. There are 13 CHCs/PHCs located in 4 blocks in the district
and funds @ Rs.2,00,000 to each JDS at CHC/PHC level and @ Rs.10,00,000 to DH were
provided. During financial year 2010-11 funds were not provided to any JDS.
c) The VHSCs were constituted in all 956 villages and all the VHSCs were having ASHAs as a
member and also opened bank account for handling the funds.
3. 24X7 hour Delivery Care System:

a) All CHCs and 10 PHCs were identified to provide 24 X 7 hours services in the district. Most of the
PHCs were having Medical Officer except PHCs Indori, Ranveerpur and Kisungarh and three PHCs viz.
Rengakhar, Ranveerpur and Kisungarh did not have Staff Nurse.

b) Two PHCs were functioning in Sub Centre building.

c) In Visited 24x7 hours Health Institutions, no CHC/PHC was having Blood Storage facility.

d) Most of CHCs and PHCs were not having adequate facilities for caring Mothers and New born child
except at CHC Sahaspur Lohara.

4. Janani Suraksha Yojana (JSY):

23
a) The district spent Rs.1,82,87,190 out of funds of Rs.2,67,11,780 provided in the year 2009-
10, but no figure was available for the current year.
b) JSY physical performance in the whole district and visited institutions is reported as under:
Sr. Particulars District CHCs
No. Pipariya Sakti Akaltara

2009-10 20010-11 2009-10 2010-11 2009-10 2010-11 2009-10 2010-11

up to Feb
2011

1 Total no. of 20827 20306 6766 4882 4812 4443 2641 3694
deliveries
conducted ( Home
+ Institutional)
2 Total no. of Instt. 4812 6660 1284 1141 688 1285 1318 1999
Deliveries
conducted
3 No. of beneficiaries 8860 7975 3273 1772 1111 1658 2152 2107
to whom JSY
incentive was paid

c) During visit to 11 HSCs, it was observed that all the HSCs were conducting deliveries, JSY
fund received in time and the payment were made timely to all the beneficiaries.
d) Registers were being maintained properly containing list of beneficiaries to whom cheques
were issued. Proper columns have been found filled up in that register in the visited institutions.
e) Total 38 (90%) JSY beneficiaries were contacted out of 42 selected in the area of 7 visited
sub centre for on the spot verification. All beneficiaries were accompanied by ASHA/Dai. 37
(97%) beneficiaries had received cheques within three days after delivery. 29 (76%)
beneficiaries got three Ante Natal Check (ANC) ups by ANM and 25 (66%) beneficiaries got
three Post Natal Check ( PNC) ups by ASHA and ANM.
5. Implementation of ASHA Scheme:

a) 1675 ASHAs were in position out of selected 1705 ASHAs in the district. All the ASHAs were trained
upto 5th module and also provided with drug kits.

b) During visit to the centres, it was observed that most of ASHAs were working, trained and
participating in the activities of VHSCs. It was also observed that ASHAs were accompanying the
mothers for delivery purpose to the hospital and helping ANMs during immunization and in ANC/PNC.
The ASHAs were also motivating the cases for sterilization operations.

24
c) ASHAs were receiving performance based remuneration on an average Rs. 800-1200 per month.

6. Untied Funds:
a) It was reported that in November, 2009 Untied Funds were provided to 04 CHCs and in
December, 2010 funds provided to 24 PHCs but the whole amount was taken back from CHCs
& PHCs and returned to State Health authorities. Till date, no untied funds provided to any of
the CHCs & PHCs in the district. No proper explanation in this regard was available from the
district.
7. Physical infrastructure and Stock Position:
i) CHCs:
a) CHCs visited at Sahaspur Lohara, Pipariya and Bodla were functioning in Govt. buildings.
The premises of CHCs were found neat & clean. Water supply and electricity were available at
all visited CHCs. Power backup was not available in the visited CHCs except Sahaspur Lohara
CHC.
b) X-ray facilities and Anesthesia equipment were not available at Pipariya CHC. Blood storage
unit, Incinerator and Sick new born care unit were not available in all the visited CHCs. Waste
Disposal Management System was not available in all the visited CHCs except Pipariya CHC.
Resuscitation equipments were not available at Sahaspur Lohara CHC. Neonatal Resuscitation
equipments were not available in all the visited CHCs except Bodla CHC. Quinine injections
and Arteether injections were not available in all the visited CHCs.
c) Residential quarters for para medical staff were available in all the visited CHCs except
Bodla CHC.
d) Norms for infrastructure and equipments were not as per IPHS.
ii) PHCs:
a) PHC Bhimbhori, Indori and Rengakhar were functioning in Government building and PHC
Chilpi was functioning in a school building. Regular water supply was available in all the visited
PHCs except Chilpi CHC. Power backup was not available in all the visited PHCs except in
Rengakhar PHC . Telephone facility was not available in Bhimbhori and Indori PHCs. Toilet
facility was available in all the visited PHCs except in Chilpi PHC.
b) Ambulance/Jeep was not available in all the visited PHCs except in Rengakhar PHC. The
cold chain equipments were not available at Bhimbhori and Indori PHCs.

25
c) Autoclave/Steam Sterilizer, Oxygen cylinder and Minor surgical equipments were available
in all the visited PHCs except in Chilpi PHC. Resuscitation equipments were available in all the
visited PHCs except in Indori PHC. Microscope was available only in Rengakhar PHC.
Functional Operation Theatre with OT table was available only in Rengakhar PHC.
d) AYUSH Medical Officers were not available in all the visited PHCs. Residential quarters
for Medical officers were not available at Indori and Chilpi PHCs.
iii) Sub Centres:
a) All the visited sub centers were functioning in Govt. buildings. Additional ANM under
NRHM was not posted at the visited SCs. Post of MPW(M) was vacant in all the visited SCs
except at Rochan and Bamhani SCs.Water facility was not available at Khairbankala Sub Centre.
b) DDKs, Kerosene oil/Gas cylinder, Sanitary Napkins, Emergency Contraceptive Pills, Tab
Oxytocin and Injection Gentamycin were not available in all the visited SCs. Nishchay
Pregnancy test kit was not available at Maharatola, Udiyakala and Khairbankal since 3-4
months. Rapid Diagnosis Kit for Malaria was not available at Bamantola, Rajanawagaon and
Indori SCs.
c) Though deliveries were being conducted by all the visited HSCs, Delivery table was not
available at Maharatola, Khairbankala, Rochan, Bhonda, Rajanawagaon, Indori and Bamhani
SCs. Ambubag/suction was available in all the visited SCs except the Indori SC. Kit A and Kit
B were not received by most of the visited SCs during the year 2010-11.
d) SBA training was not received by the ANM at Rochan SC.
.8. Opinion and Knowledge of Community on Health Services:

a) 60 mothers having child up to one year of age were interviewed in the area of the visited sub
centres for assessing the work of ANMs and knowledge & opinion of mothers.

b) 52 (86.7%) mothers replied that ANM is available when needed. 32 (53.3%) mothers knew the
danger sign of ARI. 34 (56.7%) mothers received three post natal checkups and 41(68.3%) mothers
knew about use of ORS during diarrhoea. All mother informed that immunization session for children
were being held regularly in their villages. 41(68.3%) mothers were aware of contraceptive methods.
59(98.3% ) mothers had been counselled for exclusive breast feeding and complementary feeds.

c) All the mothers were aware of the government health facilities where they can get health facilities.

26
d) 2 of 11 visited Sub Centres were having the post of health worker (M). The MPW (M) were not
present at their Sub Centre head quarter at Rochan and Bamhari. Though, villagers were apparently
observed satisfied with the services of MPW (M), their visit to the villages was irregular.

e) During the course of visit to PHCs Bhimbhori, Indori and Chilpi, it was observed that the community
was satisfied with the services received from staff and Medical Officers of the PHCs though M.Os was
not present regularly in the at PHCs Bhimbari and Chilpi as they were looking after the work of other
hospitals also.

9. Sample Verification of F.W. Acceptors:

a) Out of 201 Family Welfare acceptors selected for sample verification, 146 (73%) could be contacted
in the district. While examining records of selected acceptors from service registers, age of acceptors
was found not recorded in 9 (4%) cases, age of spouse was not recorded in 98 (48.76%) cases and age of
youngest child was not recorded in 153 (76%) cases. No. of Male/female children was found not
recorded in 100 (50%) cases.

b) 16 (19%) beneficiaries were not provided follow up services.

c) Out of contacted 102 of the selected 131 spacing methods acceptors, 63(48%) were found to be
false cases in the district.

d) All 70 contacted beneficiaries of child immunization confirmed receipt of proper doses of

the vaccinations and there was no case of complication after receiving the services.
10. Maintenance of records and registers:

a) EC, Sterilization, IUD, CC and OP registers were not maintained in all the visited CHCs.

b) Printed registers for eligible couple were neither maintained nor updated at most of the visited Sub
Centres.

c) MCH service Registers were mostly updated.

d) JSY registers were not printed but maintained properly in all the visited SCs.

e) Stock registers were not printed but were maintained and updated in all the visited SCs.

27
11. Other Observations and Suggestions:

a) Lack of supervision was noticed at all levels which need to be strengthened.

b) It was observed that the specialist services viz. Medicine, OBG, Paediatrics and Blood Storage facility
were not available in the visited CHCs at Bodla, Sahaspur Lohara and Pipariya.

******

28
 No.Q-11015/1/2011-Stats (E.V.)
Ministry of Health & Family Welfare
Statistics Division
Nirman Bhawan,New Delhi,
Dated:
To,
The Secretary / Commissioner (H& FW)
Dept. of Health & Family Welfare,
Government of Chhattisgarh,
Room No. 164, D.K.S. Bhavan,
Mantralaya, Raipur- 492001
Chhattisgarh

Subject: Major observations of sample verification conducted by Regional Evaluation Team

(RET) and Field Survey Unit (FSU), Bhopal.
Sir,
The Regional Evaluation Team (RET) and the Field Survey Unit (FSU) located in the
Regional Office of the Ministry of Health & Family Welfare at Bhopal had undertaken sample
checks in Janjgir and Kawardha districts of Chhattisgarh State during the month of March, 2011.
The major observations of the team regarding the availability of man power, equipments etc.,
at health facilities, health care services etc. are annexed. You are requested to kindly examine the
same and forward your valuable comments along with the action taken in this regard urgently.

Yours
faithfully,

(Biswajit Das)
Director (Stats)
Phone: (011)23062647
E mail:jdstat2-mohfw@nic.in
Copy for information and necessary action to :

1. The Mission Director (NRHM), D.K.S. Bhavan Campus, Old Nursing Hostel, Raipur,
Chhattisgarh.
2. The Sr. Regional Director (H & FW), Regional office for Health & Family Welfare, 32 Purzor
House Press Complex, Maharana Pratap Nagar, Zone-1, Bhopal 462011, Madhya Pradesh.
3. Regional Director I/C, RO for Health & Family Welfare, RLTRI P.O. Lalpur, Raipur – 492001,
Chhattisgarh.
4. DC(MH)/DC(FP)/DC(CH)/DC(TRG)/DC(Imm).
5. DDG (Dr. Dharmashaktu) Dte. GHS, Niman Bhawan, New Delhi.
Director (Stats)
Copy to :-

1. PPS/PS to SS & MD (NRHM)

2. JS (P) / JS (PH) / JS (RCH) / DDG (Stats).

29