Ministry of Health & Family Welfare

(Monitoring & Evaluation Division)

Monthly Return under NRHM

Name of District/Block : BHOPAL/FANDA

Reporting Month: AUGST Year 2009

Part A. REPRODUCTIVE HEALTH Numbers

reported
during the
month
M1 Ante Natal Care Services (ANC)
1.1 MÑüsÉ mÉÇeÉÏ¢üiÉ qÉÌWûsÉÉrÉÉåÇ MüÐ xÉÇZrÉÉ

1.1.1 izFke frekgh esa iathd`r xHkZorh efgyk,sa

1.2 bl ekg esa tuuh lqj{kk ;kstuk esa iathd`r efgyk,W

1.3 xHkZorh efgyk,W ftudh 3 tkWp gqbZ gSA

1.4 xHkZorh efgykvksa dh la[;k ftUgs fuEu lqfo/kk nh xbZ
1.4.1 TT1
1.4.2 TT2 ;k Booster

1.5 dqy xHkZorh efgyk,W ftUgsa 100 IFA tablets nh

1.6 mPp jDrpki okyh xHkZorh efgyk,W (BP>140/90)

1.6.1 laLFkk esa bl ekg ntZ u, dsl
1.6.2 ,DysfE'k;k izca/ku ds dsl dh la[;k
1.7 [kwu dh deh okyh xHkZorh efgyk,W
1.7.1 ftudk Lrj Hb 11 ls de gS ¼tkWp ds ckn½

1.7.2 vfr xzHkhj ,uhfe;k ¼7 th-,e-½ ds dsl ftudk mipkj laLFkk esa gqvk
M2 Deliveries
2.1 x`g izlo
2.1.1 ?kj ij izlo fdlds }kjk djok, x,

(a) ,l-ch-,- izf'kf{kr O;fDr }kjk

(b) vizf'kf{kr O;fDr }kjk By Non SBA (Trained TBA/Relatives/etc.)

Total {(a) to (b)}
2.1.2 uotkr f'k'kqvks dh la[;k ftUgsa 24 ?kUVs ds vUnj x`g HksV dh xbZ

2.1.3 ilwrh efgykvksa dh la[;k ftUgsa ?kj ij izlo ds ckn tuuh lqj{kk ;kstuk dh jkf'k nh xbZ

2.2 laLFkk es gq, izlo Deliveries conducted at Public Institutions

(a) SHC

(b) PHC

(c ) CHC
 (d) Sub-divisional hospital/District Hospital

(e) At Other State Owned Public Institutions

Total {(a) to (e)}

2.2.1 izloks dh la[;k tks 48 /kaVs rd laLFkk es jgs

#REF!
2.2.2 tuuh lqj{kk ;kstuk jkf'k dk Hkqxrku fd;k
(a) izlwrk efgyk dks #REF!
(b) vk'kk dks #REF!
(c) ,-,u-,e-@vkaxuckMh dk;ZdrkZ dks ¼dsoy ,p-ih-,l- jkT;ksa esa ½ #REF!
2.3 Number of Deliveries at accredited Private Institutions

2.3.1 laLFkkxr izlo ftUgs tuuh lqj{kk ;kstuk jkf'k dk Hkqxrku fd;k Number of institutional delivery cases
where JSY incentive paid to
(a) izlwrk efgyk dks
(b) vk'kk dks
(c) ,-,u-,e-@vkaxuckMh dk;ZdrkZ dks ¼dsoy ,p-ih-,l- jkT;ksa esa ½

M3 Number of Caesarean (C-Section) deliveries performed at

3.1 Public facilities
3.1.1 PHC #REF!
3.1.2 CHC
3.1.3 Sub-divisional hospital/District Hospital
3.1.4 At Other State Owned Public Institutions
Total {(3.1.1) to (3.1.4)}
3.2 Private facilities
M4 xHkkZoLFkk dk ifj.kke o uotkr f'k'k tkudkjh
4.1 xHkkZoLFkk ifj.kke ¼la[;k½
4.1.1 Live Birth
(a) Male
(b) Female
Total ({a} + {b})
4.1.2 e`r tUe
4.1.3 xHkZikr Abortion (spontaneous/induced)
4.2 otu fy, x, uotkr f'k'kq dh tkudkjh
4.2.1 uotkr f'k'kq dh la[;k ftudk tUe ds le; out fy;k
4.2.2 2-5 fdyks ls de otu dh uotkr f'k'kqvks dh la[;k
4.2.3 1-8 fdyks ls de otu dh uotkr f'k'kqvks dh la[;k
4.3 uotkr f'k'kqvks dh la[;k ftUgs 1 ?k.Vs ds vUnj Lruiku djk;k x;k
M5 tfVy izlo

5.1 laLFkk ij tkap dh xbZ xHkZorh efgyk,Wa ftUgsa tfVyrk Fk Number of cases of pregnant women
with Obstetric Complications and attended at Public facilities
5.1.1 PHC
5.1.2 CHC
 5.1.3 Sub-divisional hospital/District Hospital
5.1.4 At Other State Owned Public Institutions
Total {(5.1.1) to (5.1.4)}
5.2
Number of cases of pregnant women with Obstetric Complications and attended at Private
facilities
5.3 tfVy izlo dk izca/ku fd;k
5.3.1 vkbZ-Ogh- ,UVhck;ksfVDl
5.3.2 vkbZ-Ogh- ,Uvhgk;ijVsfUlo@esxlYQ batsD'ku IV antihypertensive/Magsulph injection
5.3.3 vkbZ-Ogh- vkWDlhVksfDll IV Oxytocis
5.3.4 Blood Transfusion
M6 Post - Natal Care
6.1 izlwrk efgyk ftUgsa 48 ?k.Vs ds vanj izlo Ik'pkr lqfo/kk feyh

6.2 izlwrk efgyk ftUgsa 48 ?k.Vs o 14 fnu ds vanj izlo Ik'pkr lqfo/kk feyh
6.3 izlo Ik'pkr tfVyrk izca/ku dh la[;k PNC maternal complications attended
M7 xHkZikr Medical Termination of Pregnancy (MTP)
7.1 laLFkk esa fd, x, xHkZikr dh la[;k
7.1.1 xHkkZoLFkk ds 12 g¶rs rd
7.1.2 xHkkZoLFkk ds 12 g¶rs ls vf/kd More than 12 weeks of pregnancy
Total {(7.1.1) to (7.1.2)}
7.2 futh laLFkkvksa esa fd, x, xHkZikr dh la[;k Number of MTPs conducted at Private Facilities
M8 RTI/STI Cases
8.1 u;s dslksa dh la[;k ftudk mipkj 'kq: fd;k
(a) Male
(b) Female
Total {(8.1.1) to (8.1.2)}
8.2 bl ekg fd;s x;s osV ekmUV tkap dh la[;k
M9 Family Planning
9.01 laLFkk esa dh xbZ NSV/iq:"k ulcanh dh la[;k
9.1.1 At Public facilities

(a) At PHCs

(b) At CHCs

(c) At Sub-divisional hospitals/ District Hospitals

(d) At Other State Owned Public Institutions
Total {(a) to (d)}
9.1.2 At Private facilities
9.02 laLFkk esa dh xbZ LTT dh la[;k Number of Laparoscopic sterilizations conducted
9.2.1 At Public facilities
(a) At PHCs
(b) At CHCs
 (c) At Sub-divisional hospitals/ District Hospitals

(d) At Other State Owned Public Institutions

Total {(a) to (d)}

9.2.2 At Private facilities
9.03 laLFkk esa fd;s x;s feuhysi ulcUnh dh la[;k Number of Mini-lap sterilizations conducted
9.3.1 At Public facilities
(a) At PHCs
(b) At CHCs
(c) At Sub-divisional hospitals/ District Hospitals

(d) At Other State Owned Public Institutions

Total {(a) to (d)}

9.3.2 At Private facilities
9.04 laLFkk esa fd;s x,s izlo Ik'pkr ulcUnh dh la[;k Number of Post-Partum sterilizations conducted
9.4.1 Public facilities
(a) At PHCs

(b) At CHCs
(c) At Sub-divisional hospitals/ District Hospitals
(d) At Other State Owned Public Institutions
Total {(a) to (d)}
9.4.2 Private facilities
9.05 bl ekg laLFkk esa fd, x, ywi fuos'ku dh la[;k Number of IUD Insertions
9.5.1 Public facilities
(a) At Sub-Centres
(b) At PHCs
(c) At CHCs
(d) At Sub-divisional hospitals/ District Hospitals

(e) At Other State Owned Public Institutions

Total {(a) to (e)}
9.5.2 Private facilities
9.06 ywi dh la[;k fudkys x, Number of IUD removals
9.07 forfjr vksjy fiy pØ dh la[;k Number of Oral Pills cycles distributed

9.08 forfjr fd, x, fujks/k dh la[;k Number of Condom pieces distributed

9.09 forfjr lkIrkfgd xksyh ¼lsUVØkseku½ dh la[;k Number of Centchroman (weekly) pills given

9.10 forfjr vkikrdkyhu xHkZfujks/kd dh la[;k Number of Emergency Contraceptive Pills distributed
9.11 ulcanh lsokvksa dh xq.koRrk Quality in sterilization services
9.11.1 ulcanh ds dkj.k mith tfVyrk Number of complications following sterilization
(a) Male
(b) Female
 9.11.2 vlQy ulcUnh Number of failures following sterilization
(a) Male
(b) Female
9.11.3 ulcUnh ds ckn e`R;q Number of deaths following sterilization
(a) Male
(b) Female
9.12 laLFkk esa NSV izf'kf{kr fpfdRld gSa ¼gkW@ugh½
M10 CHILD IMMUNIZATION
10.1 Number of Infants 0 to 11 months old who received the following:

10.1.01 ch-lh-th-
10.1.02 Mh-ih-Vh- 1
10.1.03 Mh-ih-Vh- 2
10.1.04 Mh-ih-Vh- 3 #REF!
10.1.05 iksfy;ks 0 ¼tUe ds le;½
10.1.06 iksfy;ks 1
10.1.07 iksfy;ks 2
10.1.08 iksfy;ks 3
10.1.09 fgi ch 1
10.1.10 fgi ch 2
10.1.11 fgi ch 3
10.1.12 ehtYl

10.1.13
Total number of children aged between 9 and 11 months who have been fully immunized
(BCG+DPT123+OPV123+Measles) during the month
(a) Male
(b) Female
Total {(a) to (b)}

10.2 Number of children more than 16 months who received the following

10.2.1 DPT Booster

10.2.2 OPV Booster
10.2.3 Measles, Mumps, Rubella (MMR) Vaccine
10.3 Immunization Status

10.3.1
Total number of children aged between 12 and 23 months who have been fully immunized
(BCG+DPT123+OPV123+Measles) during the month

(a) Male

(b) Female

Total {(a) to (b)}

10.3.2 5 o"kZ rd ds cPps ftUg DT5 fn;kA

10.3.3 10 o"kZ ls vf/kd cPps ftUgsa TT10 fn;k

 10.3.4 16 o"kZ ls vf/kd cPps ftUgsa TT16 fn;k

10.3.5 Vhdkdj.k Ik'pkr~ izfrdwy izHkko Adverse Event Following Immunisation (AEFI)

(a) TüÉåQûÉ

(b) qÉëirÉÑ

(c) AlrÉ

10.4 ekg esa Vhdkdj.k l= dh la[;k Number of Immunization sessions during the month

10.4.1 ÌlÉrÉÉåÎeÉiÉ xɧÉ

10.4.2 AÉrÉÉåÎeÉiÉ xɧÉ

10.4.3 xÉ§É eÉWûÉÇ AÉzÉÉ EmÉÎxjÉiÉ jÉÏÇ

10.5 vU; ¼tsiuhl budsQsykbfVl½

10.5.1

10.5.2

10.5.3

M11 foVkfeu , [kqjkd dh la[;k Number of Vitamin A doses

11.1 9 ekg ls 5 o"kZ ds chp nh xbZ [kqjkd Administered between 9 months and 5 years

11.1.1 Dose-1
11.1.2 Dose-5
11.1.3 Dose-9
M12 Number of cases of Childhood Diseases reported during the month (0-5 years)

12.1 ÌQûmjÉåËUrÉÉ

12.2 mÉUšÔÍxÉxÉ

12.3 ÌOûOûlÉåxÉ (lÉuÉeÉÉiÉ ÍzÉzÉÔ qÉåÇ)

12.4 ÌOûOûlÉåxÉ ( AlrÉåÇ)

12.5 mÉÉåÍsÉrÉÉå

12.6 ÍqÉeÉsxÉ

12.7 SxiÉ uÉ ÌlÉeÉïsÉÏMüUhÉ

12.8 qÉsÉåËUrÉÉ

12.9 NûÉiÉÏ qÉåÇ xÉÇ¢üqÉhÉ Måü pÉiÉÏï qÉUÏeÉ

Part B. Other Programmes

M13 vU/kRo fuokj.k dk;Øe Blindness Control Programme

13.1 qÉÉåÌiÉrÉÉÌoÉlS Måü AÉmÉUåzÉlÉ WÒûL UÉåaÉÏrÉÉåÇ MüÐ xÉÇZrÉÉ

13.2 UÉåaÉÏ ÎeÉlÉqÉåÇ IOL sÉaÉÉrÉå aÉrÉå

13.3 ËUTåüYOûUÏ LUU MüÐ mÉWûcÉÉlÉ ÌMüL aÉrÉå xMÔüsÉÏ oÉŠÉåÇ MüÐ xÉÇZrÉÉ

13.4 oÉŠÉåÇ MüÐ xÉÇZrÉÉ ÎeÉlWåÇû qÉÑniÉ qÉåÇ cÉxqÉåÇ ÌuÉiÉËUiÉ ÌMüL

13.5 lÉå§É SÉlÉ WåûiÉÑ lÉå§É eÉqÉÉ lÉÑL

 13.6 lÉå§É SÉlÉ xÉå qÉUÏeÉÉåÇ qÉåÇ lÉå§É sÉaÉÉrÉå aÉrÉå

Part C. Health Facility Services

M14 Patient Services

14.01 Number of CHC/ SDH/ DH functioning as an FRU

14.02 Number of PHCs functioning 24X7 (3 Staff Nurses)

14.03 Number of Anganwadi centres reported to have conducted VHNDs

14.04 Number of facilities having a Rogi Kalyan Samiti

14.05 Number of RKS meetings held during the month

14.06 Number of facilities having Ambulance services (Assured Referral Services) available

14.07 Total Number of times the Ambulance was used for transporting patients during the month

14.08 Number of Institutions having operational Sick New Born and Child Care Units

14.09 Number of functional Laparoscopes in CHC/SDH/DH

14.10 Inpatients
Children
14.10.1 HkrhZ Admissions (< 19 yrs)
Adults

(a) Male 0 50
(b) Female 6 84
Total {(a) to (b)} 6 134
14.10.2 e`R;q Deaths

(a) Male
(b) Female
Total {(a) to (b)}
14.11 jkr esa fdrus ejht laLFkk esa HkrhZ Fks In-Patient Head Count at midnight
14.12 ckg~; jksxh Outpatients
14.12.1 dqy ckg~; jksxh OPD attendance (All)
14.13 vkWijs'ku fFk;sVj Operation Theatre
14.13.1 cM+h 'kY; fØ;k ¼tujy@LikbZuy ,usLFksfl;k fn;k½

14.13.2 NksVh 'kY; fØ;k ¼yksdy ,usLFksfl;k fn;k½

14.14 vU; ¼nar fpfdRlk us= jksx] vk;q"k vkfn½

14.14.1 AÉrÉÑwÉ

14.14.2 SliÉ ÍcÉÌMüixÉÉ

14.14.3 ÌMüzÉÉåUÉåÇ MüÉå mÉUÉqÉzÉï xÉÑÌuÉkÉÉ

14.14.4

14.14.5

M15 iz;ksx'kkyk esa tkap Laboratory Testing

15.1 foLr`r tkudkjh Laboratory Test Details
15.1.1 Hb Tests conducted
 (a) fd, x, Hb VsLV dh la[;k (No. of Hb tests conducted)
(b) VsLV fd, x, esa ls 7 gm ls de Hb (Of which numbers having Hb < 7 mg)

15.1.2 HIV tests conducted Number Numbers

tested Positive
(a) mÉÑÃwÉ

(b) qÉÌWûsÉÉ(aÉpÉïuÉÌiÉ qÉÌWûsÉÉ lÉWûÏ)

(c) aÉpÉïuÉÌiÉ qÉÌWûsÉÉ

Total {(a) to (c)}

15.2 foMky VsLV dh la[;k Widal tests conducted
Number Numbers
15.3 VDRL VsLV dh la[;k VDRL tests conducted tested Positive
(a) mÉÑÃwÉ

(b) qÉÌWûsÉÉ(aÉpÉïuÉÌiÉ qÉÌWûsÉÉ lÉWûÏ)

(c) aÉpÉïuÉÌiÉ qÉÌWûsÉÉ

Total {(a) to (c)}

15.4 qÉsÉåËUrÉÉ OåûxOû Numbers
15.4.1 U£ü mɏûÏ MüÐ eÉÉÇcÉ
15.4.2 Plasmodium Vivax mÉÉrÉå aÉrÉå

15.4.3 Plasmodium Falciparum mÉÉrÉå aÉrÉå

Part D. Monthly Inventory Status
M16 Stock Position (During the month)
Balance from Previous
Stocks received Unusable stock
Stock
month
Distributed
16.1 Vaccines
16.1.1 DPT

16.1.2 OPV
16.1.3 TT
16.1.4 DT
16.1.5 BCG
16.1.6 Measles
16.1.7 JE
16.1.8 Hepatitis B
16.2 Family Planning
16.2.1 IUD 380 A
16.2.2 Condoms
16.2.3 Oral Contraceptive
16.2.4 Emergency Contraceptive Pills
16.2.5 Tubal rings
16.3 Other Items
16.3.01 Injection Oxytocin

16.3.02 Gloves
16.3.03 MVA Syringes
16.3.04 Tab. Fluconazole
16.3.05 Blood Transfusion sets
16.3.06 Gluteraldehyde 2%
16.3.07 IFA tablets
 16.3.08 IFA Syrup (Pediatric)

16.3.09
Pediatrics Antibiotics (Cotrimaxozole and
Injectable Gentamicin)
16.3.10 Vitamin A solution
16.3.11 ORS (New WHO)
16.4 Syringes
16.4.1 0.1 ml (AD)
16.4.2 0.5 ml (AD)
16.4.3 5.0 ml (Disposable)
Part E. Mortality Details
M17 Details of deaths reported during the month with probable causes: Male Female
17.1 tUe ds 24 ?kaVs ds vUnj gqbZ uotkr f'k'kq dh e`R;q Infant deaths within 24 hrs of birth
Between 1 week & 4
17.2 Infant Deaths up to 4 weeks by cause Up to 1 Weeks of Birth Total
weeks of birth

Male Female Male Female Total Male Female

17.2.1 xÉÇ¢üqÉhÉ
17.2.2 xÉÉxÉ sÉålÉå qÉåÇ iÉMüsÉÏTü
17.2.3 MüqÉ uÉeÉlÉ
17.2.4 AlrÉ
Between 1 month and Between 1 year & 5
17.3 Infant/Child Deaths up to 5 years by cause Total
11 months years

Male Female Male Female Total Male Female

17.3.1 ÌlÉqÉÉåÌlÉrÉÉ
17.3.2 SxiÉ
17.3.3 oÉÑZÉÉU
17.3.4 ÍqÉeÉsxÉ
17.3.5 AlrÉ
Above 55
17.4 Adolescent/Adult deaths by cause 6-14 yrs 15-55 yrs.
yrs. Total
male Female male Female male Female

17.4.1 SèxiÉ
17.4.2 ¤ÉçrÉ UÉåaÉ

17.4.3
xÉÉxÉ MüÐ ÌoÉqÉÉUÏ (¤ÉrÉ UÉåaÉ
Måü AÉsÉÉuÉÉ)
17.4.4 qÉsÉåËUrÉÉ
17.4.5 AlrÉ oÉÑZÉÉU xÉÇoÉÇÍkÉiÉ
17.4.6 LcÉ.AÉrÉ.uWûÏ./LQûxÉ
17.4.7 ÌSsÉ/EŠ U£ü cÉÉmÉ MüÐ ÌoÉqÉÉUÏ

17.4.8 iÉÇ̧ÉMüÉ/SÉæUÉ
17.4.9 Maternal Deaths
(a) aÉpÉïmÉÉiÉ
(b) AuÉî/ÌuÉsÉÇÌoÉiÉ mÉëxÉuÉ
(c ) EŠ U£ü cÉÉmÉ/fÉOûMåü
(d) U£ü x§ÉÉuÉ
(e) iÉåeÉoÉÑZÉÉU
 (f) AlrÉ MüÉUhÉ
17.4.10 cÉÉåOû/SÒkÉïOûlÉÉ/eÉsÉeÉÉlÉå Måü MüÉUhÉ
17.4.11 AÉiqÉWûirÉÉ
17.4.12 mÉzÉÔ/ÌMüQåû Måü MüÉOûlÉå xÉå
17.4.13 AlrÉ oÉÏqÉÉUÏ
(a) aÉÇpÉÏU oÉÏqÉÉUÏ
(b) sÉqoÉÏ oÉÏqÉÉUÏ
(c ) MüÉUhÉ mÉiÉÉ lÉWûÏ