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District Attock
Three Years Rolling Plan (2010-2013) District Attock
Table of Contents
Acronyms.................................................................................................... 5
Executive Summary .................................................................................... 7
SECTION 1: DISTRICT HEALTH PROFILE ................................................... 9
I. Vision of the District.............................................................................. 9
II. Background of the District.................................................................. 9
III. Map of the District............................................................................ 10
IV. Demography ..................................................................................... 10
V. Socio-Economic Indicators ............................................................... 12
1) Education and Literacy ........................................................................ 12
2) Per capita income ................................................................................. 12
3) Housing ............................................................................................... 12
4) Water and Sanitation ........................................................................... 12
VI. Health Indicators .............................................................................. 12
VII. Organizational Structure of District Health Administration ............... 13
VIII. Health Resources........................................................................... 14
1) Health Facilities ............................................................................... 14
a) Public ............................................................................................ 14
b) Private ........................................................................................... 15
2) Human Resource .............................................................................. 15
a) Administrative ............................................................................... 15
b) Facility Based ................................................................................ 16
c) Outreach ........................................................................................ 21
d) Training Institutions ....................................................................... 22
3) Health Financing .............................................................................. 24
IX. Disease Pattern ................................................................................ 25
X. Status of Vertical Programs .............................................................. 27
1) National Program for FP & PHC ........................................................ 27
2) EPI ................................................................................................... 27
3) MNCH Program ................................................................................ 28
4) TB Control Program .......................................................................... 28
5) Malaria Control Program .................................................................. 28
6) HIV/AIDS Control Program............................................................... 28
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Three Years Rolling Plan (2010-2013) District Attock
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Acronyms
3YRP Three Years Rolling plan
ADB Asian Development Bank
APMO Additional Principal Medical Officer
ARI Acute Respiratory Infections
BHU Basic Health Center
BoD Burden of Disease
CDC Communicable Disease Control
CDR Case Detection Rate
CPR Contraceptive Prevalence Rate
DHIS District Health Information System
DHQH District Head Quarter Hospital
DoH Department of Health
DR Default Rate
EDO(H) Executive District Officer Health
EPI Expended Program on Immunization
HSRP Health Sector Reforms Program
IMR Infant Mortality Rate
IPC Interpersonal Communication
M&E Monitoring and Evaluation
M&E Maintenance and Repair
MCH Maternal Child Health
MMR Maternal Mortality Ratio
MNCH Maternal Newborn and Child Health
MO Medical Officer
MoV Means of Verification
MSDS Minimum Service Delivery Standards
PDSSP Punjab Devolved Social Services Program
PHC Primary Health Care
PMO Principal Medial Officer
POL Petrol, Oil and Lubricant
RHC Rural Health Center
SCR Sputum Conversion Rate
SHC Secondary Health Care
SMO Senior Medical Officer
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Executive Summary
Prior to devolution, planning process was carried out at provincial level. Districts
were supposed to implement plans and programs developed/designed at provincial
and federal levels. Devolution brought a paradigm shift where planning became a
district responsibility. This change provided an opportunity to the district at one
hand and challenge on other due to their limited capacity in planning and
budgeting. Planning focus also changed from short term to medium term planning
recognizing the flexibility /adaptability it provided. Government envisions that
medium term plan .i.e. 3YRP will be instrumental in using health resources
effectively and efficiently through adapting Minimum Service Delivery Standards
(MSDS) as the strategy to achieve objectives of MDGs.
Districts have been preparing 3YRP (medium term plan) for last few years under
the auspices/patronage of Department of Health (DoH) Government of Punjab
through technical assistance of Punjab Devolved Program Social Services
Programme (PDSSP). This year government of the Punjab through Health Sector
Reforms Program (HSRP) with the technical assistance from a team of consultants
(SP09) and wide consultations/inputs from all key stake holders has established a
bench mark in standardization of the format of 3YRP. Capacity building of the
districts has been done on the standardized format.
Current 3 Years Rolling Plan (3YRP) plan is first attempt by the district on that
agreed format. First section of the format (District Health Profile) contains all
relevant information on Geography, Demographic, Socioeconomic and Health
indicators of the district. It also takes stock of health resources in terms of human
resource, infrastructure and others. District diseases pattern compiled from DHIS
Primary and Secondary Health Care reports and current status of vertical /national
programs is part of the profile. In fact district profile is a health related fact sheet of
the district and depicts the true picture of health status and health
resources/services of the district. An accurate district health profile provides a
sound basis for evidence-based planning.
3YRP plan has been developed by following the standard planning cycle approach.
3YRP details the current year activities, physical targets and fiscal targets.
Projections of second and third year physical and financial targets are given.
Section Two includes problems identification from various perspectives, and their
prioritization by applying WHO prioritization criteria. This section also contains
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underlying causes of the prioritized problems. Section Three of the plan relates to
developing best possible interventions/activities and setting physical targets for
each year. Section Four consists of costing based on additional requirements taking
account of implementation of current status of activities. Best available estimates
have been used to accurately cost the activities. The detailed activity based costing
of the Health and Service Delivery problems has been developed on automated
Excel sheets, and annexed for details as ready reference. Last section of the 3YRP
consists of Monitoring and Evaluation of plan to gauge the progress of different
activities and targets of the plan using reliable district data sources. This permits
timely remedial action for smooth implementation of planned activities.
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DISTRICT ATTOCK
The District Attock owes its name from famous Attock fort situated on the left bank
of Indus River. Name of the fort was accorded by Emperor Akbar. District Attock
was constituted in 1904. The District was initially named as Campbellpur after the
name of Sir Campbell. Attock is located in the North West of Punjab; Daton north
west River Indus separates it from the NWFP. Towards east it is bordered by
District Rawalpindi and in south by Chakwal District.
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S
er I
Riv
FATEHJANG
HA
KO
JAND
I
D
PIN
PINDIGHEB AL
AW
R
River Soan
MIANWALI
MIANWALI
DISTRICT CHAKWAL
IV. Demography
o Total Population 1661225
1) Area-wise population
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2) Gender-wise population
3) Population groups
Standard Estimated
Population Groups
Demographic (%) Population
Under 1 year of age 2.7 44853
Under 5 years 13.4 222604
Under 15 years 44 730939
Women in child bearing 22 365469
age (15-49 years)
Married Child Bearing 16 265796
age Women
Expected pregnancies 3.4 56481
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V. Socio-Economic Indicators
1) Education and Literacy
Literacy rate Male Female
Urban 85.8% 66.4%
Rural 73.6% 45.7%
Overall District 76% 49.9%
Age Literacy Rate
10+yrs 63%
15+yrs 59%
15-24yrs 81%
Sources: MICS 2007
3) Housing
Ownership of house 93%
Mean household size 5.8
Mean number of persons per room 3.0
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There exists a three-tier system in the health sector in the country. At federal level,
Federal Secretary of Health is responsible to administer and supervise the health
related activities and programs. Major function of federal tier is to provide policy
guidelines and ensure quality of health care standards through federal legislation.
After the 18th amendment in the constitution, and announcement of National
Finance Award, most of the existing federal level programs will be transferred to the
provincial level. At provincial level, provincial Secretary of Health along with
Director General Health Services is responsible for managing and supervising
health care services. The district is still an administrative entity in the system and
EDO (Health) acts as head of the district health department, under overall
supervision of DCO. The organizational structure at district level is as under:
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DOH
MCHC GRDs
DDOH AE DSV RHCs BHUs SHCs
(8) (24)
(5) (5) (58) (2)
No. of
Number of
Facility Type Bed Strength Functional Remarks
Facility
Beds
THQ Hospital
1. Fateh Jang
2. Pindi Ghep
5 280 280 -------
3. Jand
4. Hazro
5. Hasan Abdal
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Government Rural
24 0 0 -------
Dispensaries
b) Private
Private sector is also contributing in provision of health services in the district. In
absence of any registration and regulatory mechanism, actual situation of private
sector is not known. According to available information total number of private
hospitals and clinics are 50. With the passage of time, role of private health care
providers will expand and there is a need to develop an effective coordination
between public and private sector. Detailed list of private sector health facilities is
attached as Annex-I.
2) Human Resource
The Human resource of district health department has been placed in
following categories:
a) Administrative
b) Facility based
c) Outreach
d) Training institutions
a) Administrative
Sr. Name of Post Sanctioned Filled
1 Executive District Officer Health 1 1
2 District Officer Health 1 1
3 Deputy District Officer Health 5 3
4 Program Director DHDC 1 0
5 District Sanitary Inspector 1 0
6 CDC Officer 1 0
7 CDC Inspector 4 3
8 Drug Inspector 2 0
9 District Superintendent Vaccination 1 1
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b) Facility Based
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Sr.
Post Sanctioned Filled Vacant
No.
10 Health Technician 8 5 3
11 Lady Health Visitor 10 9 1
12 Lady Health Visitor (MNCH) 2 2 0
13 Senior Clerk 5 1 4
14 Lab Technician 5 5 0
15 Junior Clerk 5 4 1
16 Dispenser 20 15 5
17 Dresser 3 0 3
18 X-ray Assistant 3 0 3
19 Libratory Assistant 5 3 2
20 Homeo Dispenser 5 3 2
21 OTA 5 0 5
22 Driver 6 5 1
23 RHI 5 0 5
24 Midwife/Dia 20 8 12
25 Tube Well Operator 5 5 0
26 Ward Servant M/F 10 9 1
27 Sanitary Patrol 20 12 8
28 Naib Qasid 10 8 2
29 Homeo Naib Qasid 4 3 1
30 Water Carrier 5 3 2
31 Mali 5 5 0
32 Cook 5 4 1
33 Chowkidar 10 8 2
34 Sanitary Worker 20 9 11
35 Radiographer 2 2 0
36 Dawasaz 2 2 0
37 Dawa Khob 2 2 0
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c) Outreach
This information is about outreach program workers such as Vaccinators, CDC
Supervisors and Sanitary Inspectors which are not part of above mentioned
health facilities.
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d) Training Institutions
A number of training institutions are working in the district, which include the
following:
Midwifery school 1
i. DHDC
Post Sanctioned Filled Vacant
Program Director
1 0 1
DHDC
Medical Officer (Multi
1 0 1
Purpose)
LHV Trainer 1 1 0
Assistant 1 1 0
Driver 1 1 0
Naib Qasid 1 1 0
Chowkidar 2 2 0
Sweeper 1 1 0
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Principal 1 0 1
P.T.O/WMO 1 0 1
Woman Medical
1 0 1
Officer
Nursing Instructor 2 0 2
Health education
1 0 1
officer
Public Health
Midwifery 1 0 1
Supervisor
Public Health
1 0 1
Nursing Supervisor
Domiciliary
Midwifery 1 0 1
Supervisor
Assistant Nursing
1 0 1
Supervisor
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Stenographer 1 0 1
Tutor (LHV) 2 2 0
House Keeper 2 1 1
Accountant 1 0 1
Senior Clerk 1 1 0
Junior Clerk 2 0 2
Store Keeper 1 0 1
Driver 2 2 0
Dai 2 1 1
Aya 2 2 0
Naib Qasid 3 3 0
Mali 1 1 0
Chowkidar 3 3 0
Cook 2 2 0
Barrier 3 3 0
Sweeper 2 2 0
3) Health Financing
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Rs. Million
Year
Source of funding 2007-08 2008-09 2009-10
Allocation Exp. Allocation Exp. Allocation Exp.
District Health
Budget
24.812 19.625 6.450 6.332 - -
Developmental
Non-
Developmental 302.908 242.216 378.807 297.051 390.557 183.330
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Respiratory Disease
1 Acute upper respiratory infection 15.75
2 Pneumonia < 5years 0.81
3 Pneumonia < 5years 0.61
4 TB Suspects 0.90
5 Chronic Obstructive Pulmonary 0.39
Disease
6 Asthma 1.34
Gastro Intestinal Disease
7 Diarrhea / Dysentery < 5 years 2.72
8 Diarrhea / Dysentery < 5 years 2.44
9 Enteric / Typhoid Fever 0.26
10 Worm infestations 1.41
11 Peptic Ulcer 4.31
12 Cirrhosis of Liver 0.007
Urinary Tract Disease
13 Urinary Tract infection 2.04
14 Nephritis / Nephrosis 0.06
15 Sexually Transmitted Infections 0.040
16 Benign Enlargement of Prostrate 0.049
Other Communicable Disease
17 Suspected Malaria 1.006
18 Suspected Meningitis 0.015
19 Fever due to other causes 2.72
Vaccine Preventable Disease
20 Suspected Measles 0.06
21 Suspected Viral Hepatitis 0.06
22 Suspected Neo-natal Tetanus 0.003
Cardiovascular Disease
23 Ischemic Heart disease 0.13
24 Hypertension 1.86
Skin Disease
25 Scabies 4.63
26 Dermatitis 1.54
27 Cutaneous Leishmaniasis 0.02
Endocrine Disease
28 Diabetes Mellitus 1.13
Neuro- Psychiatric Disease
29 Depression 0.74
30 Drug Dependence 0.079
31 Epilepsy 0.021
Eye & ENT
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32 Cataract 0.023
33 Trachoma 0.14
34 Glaucoma 0.03
35 Otitis Media 0.67
Oral Disease
36 Dental Caries 2.20
Injuries / Poisoning
37 Road Traffic Accidents 0.77
38 Fractures 0.12
39 Burns 0.16
40 Dog Bites 0.15
41 Snake Bites ( with sign/symptoms 0.024
of poisoning
Miscellaneous Disease
42 Acute Flaccid Paralysis 0.002
43 Suspected HIV/AIDS 0
44 Any other unusual disease ( 0
specify )
Source: DHIS Reports
2) EPI
EPI Coverage rate of the district
Fully immunized children 0-23 months 103%
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3) MNCH Program
CMW Students Admitted 13
Passed 25
Fresh CMWs batch 32
4) TB Control Program
CDR all types 96%
CDR NSS positive 78%
SCR 99%
TSR 96%
DR 02%
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The Health sector in Punjab is facing enormous health and service delivery
problems. Common health problems are communicable, non communicable, MNCH
related diseases and accident/ trauma. The society is passing through
demographic and epidemiological transition. This is due to changing life style,
urbanization, ecological and other factors. Disease pattern is changing where non
communicable diseases are gradually increasing and the communicable diseases
are still posing serious threat. Punjab is practically facing Double Burden of
Disease (BOD). Besides, health problems service delivery/ managerial issues are
also hindering the access and quality of health services to the population. The
service delivery/management problems are diverse in nature, and include shortage
of technical human resource, capacity issues, lack of infrastructure and
equipment.
Devolution was introduced during 2001 affecting the administrative and financial
set up of the districts. The devolution also brought political culture in the decision
making of the districts in the shape of Nazims, Naib-Nazims and Councilors. This
system is now in the phase of reshaping and it is not clear what will be future
structure and managerial shape when new local bodies system is put in place. The
District Manager and functionaries are in the state of uncertainty and confusion in
this scenario. However, one thing is clear that the district shall remain a hub of all
primary and secondary health services delivery. Despite the source of funding in
the future, either from provincial or district government, health planning at district
level shall continue to play a pivotal role in provision of quality health services.
In view of the above situation the district considers following objectives for
developing three year rolling plan.
I. Objectives
Improve health status of the population
Meeting the requirements of national and provincial health policies
Achievement of MDGs through MSDS
Introducing evidence-based planning culture by addressing district specific
problems/issues
Addressing emerging health needs or re-emergence of health problems (e.g.
H1N1, HIV-AIDS, Polio, T.B)
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Plan development has been a systematic and consultative process. A core planning
team consisting of EDO (H), DOH, MS DHQ and THQs, Statistical officer, and
Budget and Accounts Officer, was designated by Director General Health Services
Punjab. This team received three days customized training from SP-09 team at
divisional headquarters. The main components of the trainings were: (i) developing
a three-year rolling health sector plan using the standard three year rolling plan
format; (ii) costing of the plan; (iii) preparing related budget projections; (iv)
accounting procedures; (v) preparing adequate financial reports on the use of
funds.
The district planning team adopted the following steps for the preparation of three
years rolling plan:
Problem identification
Prioritization of identified problems
Identifying underlying causes of prioritized problems
Developing interventions and activities
Setting targets
Determining resource requirements, costing and budgeting
Preparing action plans
Preparing monitoring plan
1. Problem Identification
This step involved assessment of the current situation from various perspectives to
establish the actual health situation in terms of health and service
delivery/management problems. Problem identification is based on the district
health profile, review of previous plans, MIS (DHIS, Program reports and periodic
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reports etc.), District specific surveys (MICS), MSDS, and national and provincial
policy guidelines.
The district planning team held meetings and started with identification of problem
using the training received from SP-09 team and consulting the above mentioned
documents. The problems identified were broadly divided into two categories i.e.
a) Health Problems
b) Health Service Delivery or Management Problems
A. Health Problems
2. Diarrhoea
3. Scabies
5. Dental Caries
8. Diabetes
9. Hepatitis
10. Malnutrition
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2. Problem Prioritization
WHO has developed standard criteria for prioritization of health problems;
which is based on the following five elements:
Magnitude
Severity/danger
Vulnerability to intervention (feasibility)
Cost-effectiveness of the intervention
Political expediency
Diarrhoea 3 3 2 3 1 12 2
Scabies 3 1 2 2 1 9 7
Injuries & 2 2 2 2 2 10 5
Accidents
Dental 2 1 2 2 1 8 9
Caries
UTIs 1 1 1 1 1 6 10
CVDs 2 3 1 2 1 9 8
Diabetes 1 1 1 2 1 6 10
Hepatitis 3 3 2 1 3 11 3
Malnutrition 3 2 2 2 1 10 6
Complication 3 3 2 2 1 11 4
of
pregnancies
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3. Shortage of vehicles
6. Ineffective supervision/monitoring
9. Political interference
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The government is committed to achieve the MDGs targets. For this purpose, the
government of Punjab has decided to adopt Minimum Service Delivery Standards
(MSDS) as strategy to achieve the MDGs within the province. Health Department of
Punjab is especially focusing on MNCH related component of MSDS for which
substantial resources are coming from Asian Development Program funded Punjab
Millennium Development Goal Program (PMDGP). MSDS entails a level-specific
service delivery package (for primary and secondary health care) along with their
standards and system specifications including human, infrastructure, equipment,
medical supplies, medicine and other consumables.
In order to achieve the MDGs, the government of Punjab has adopted MSDS as
strategic framework. During the development of three years rolling plans, gaps
under MSDS focusing on MNCH interventions have been identified. Most essential
areas for which gaps have been identified are human resource and equipment of
DHQ and THQ hospitals, as per lists notified by the government in accordance with
MSDS standards.
1) Human Resource
With regard to MSDS gap analysis for human resource, the difference
between the standards proposed in MSDS and existing sanctioned strength is
calculated as ‘Vacancy Gap in relation to Sanctioned Positions’ and difference
between existing sanctioned posts and filled posts has been calculated as the
‘Vacancy Gap in relation to Filled Positions’.
The hospitals have been categorized based on their bed strength as follows:
C Up to 250 Beds
A Above 60 Beds
C Up to 40 Beds
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in relation In
to relation
Sanctione of Filled
C B A
d Positions
Positions
1 Gynaecologist 2 2 3 8 0 2 10
2 Paediatricians 2 2 3 5 3 5 7
3 Anesthetists 3 3 4 4 1 11 14
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in relation In
to relation
Sanctione of Filled
C B A
d Positions
Positions
4 Medical
Officers
including 16 19 22 52 21 43 74
SMO,APMO &
PMOs
5 Women
Medical
Officers
including 9 10 11 19 6 31 44
SWMO
APWMO &
PMOs
6 Lady Health
8 8 8 5 4 35 36
Visitors
7 Nurses 15 24 30 64 40 56 80
a) Equipment
Government of Punjab has notified a standard list as yard-stick of MNCH related
equipment to provide comprehensive EmONC services in the DHQ and THQ
hospitals. Provision of comprehensive EmONC services is essentially required to
decrease the high MMR and IMR prevailing in the province.
Gaps in relation to the MNCH related equipment have been identified taking into
account the equipment purchased or under process of purchase from all funds
including PMDGP funds allocated/sanctioned to the district. The cost of equipment
gap has been included in the equipment portion of the Management/Service
delivery problems; the detail is attached as Annex-II.
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Three Years Rolling Plan (2010-2013) District Attock
(Qty.)
C B A
20 Examination light 3 3 6 2 1
21 Suction Curette 1 2 2 2 0
22 Infant Resuscitation Trolley
(with life saving medicines,
baby laryngoscope, Endo- 1 1 2 0 1
tracheal tube, Infant BP
Apparatus, Chargeable Light)
23 Mother Resuscitation Trolley
(with life saving medicines,
Laryngoscope, Endo-tracheal 1 1 2 0 1
tube, BP Apparatus,
Chargeable light)
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Three Years Rolling Plan (2010-2013) District Attock
(Qty.)
C B A
24 Cardiac Monitor 1 1 2 1 0
25 Pump Breast Electronic 1 1 1 0 1
26 Vaginal Hysterectomy Set
26.1 Toothed Tissue Forceps (8”) 2 2 4 4 0
26.2 Non-Tooted Tissue Forceps
2 2 4 2 0
(8”)
26.3 Dissection Scissors (Curved
2 2 4 1 1
7”)
26.4 Dissection Scissors (Straight
2 2 4 1 1
7”)
26.5 Hysterectomy Clamps
8 8 16 6 2
(Straight)
26.6 Hysterectomy Clamps
8 8 16 6 2
(Curved)
26.7 Uterine Sound 2 2 4 2 0
26.8 Needle Holder (7”) 2 2 4 2 0
26.9 Needle Holder (10”) 2 2 4 2 0
26.10 Artery Forceps (Straight 6”) 16 16 32 16 0
26.11 Artery Forceps (Curved 6”) 16 16 32 16 0
26.12 Allis Forceps 8 8 16 8 0
26.13 Towel Clamps 8 8 16 8 0
26.14 Single blade Sims speculum 4 4 8 4 0
26.15 Double blade Sims speculum 4 4 8 4 0
26.16 Sponge holding forceps 8 8 16 4 4
26.17 Volselum forceps 4 4 8 2 2
26.18 Uterine Sound 2 2 4 1 1
26.19 Bladder Sound 2 2 4 1 1
27 Delivery Sets
27.1 Episiotomy Scissors 10 10 15 6 4
27.2 Straight Scissors 10 10 15 6 4
27.3 Needle holder 10 10 15 2 8
27.4 Non-toothed tissue forceps 8
10 10 15 2 8
inches
27.5 Toothed tissue forceps 8
10 10 15 2 8
inches
27.6 Sims Speculum single blade 20 20 30 6 14
27.7 Sims Speculum double blade 20 20 30 6 14
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(Qty.)
C B A
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(Qty.)
C B A
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(Qty.)
C B A
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After enlisting the vital causes of prioritized health problems, team proposed appropriate interventions to tackle the problems. Once
interventions and activities had been identified, next task the planning team performed was to set the number and quality of specific activities
(targets) that have to be carried out. It is pertinent to mention over here that the plan envisages additional activities along with routine
activities under regular budget.
Health Problems
Plan
Activities Target for Target for Target for
Causes Intervention Activities Unit
Targets 2010-11 2011-12 2012-13
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Plan
Activities Target for Target for Target for
Causes Intervention Activities Unit
Targets 2010-11 2011-12 2012-13
· Seasonal variation
Oral Medicine
450000 150000 150000 150000
Package
Procurement of
drugs
· Lack of awareness
related to winter season Injectable 75000 25000 25000 25000
and hygienic practices
Procurement of
Drug 75000 25000 25000 25000
nebulizing drugs
2. Diarrhoea
Poor Hygiene & · Coordination with TMA · Quarterly co-
sanitation for improvement of water ordination meetings
Meetings 12 4 4 4
supply and sanitation with TMA and other
agencies
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Three Years Rolling Plan (2010-2013) District Attock
Plan
Activities Target for Target for Target for
Causes Intervention Activities Unit
Targets 2010-11 2011-12 2012-13
· Training of medics
and paramedics in Batch 24 10 10 4
IMCI
·Procurement and
distribution of ORS ORS packets 3,900,000 1,300,000 1,300,000 1,300,000
and Zinc Sulphate
3. Hepatitis
· Quarterly co-
· Health Education/ ordination meetings
· Poor sanitation Meetings 12 4 4 4
Promotion with TMA and other
agencies
Page 72
Three Years Rolling Plan (2010-2013) District Attock
Plan
Activities Target for Target for Target for
Causes Intervention Activities Unit
Targets 2010-11 2011-12 2012-13
· Printing and
· Strengthening blood
· Sharing of used distribution of IPC
transfusion services for Brochure 300,000 100,000 100,000 100,000
syringes and hepatitis
safe transfusions
awareness material
· Transfusion of
· Procurement and
unsafe/unscreened · Campaign against drug
supply of screening Kits 300,000 100,000 100,000 100,000
blood and blood addiction
kits
products
· Regulatory mechanism to
ensure use of safe · Procurement of
· Unsafe sexual practices Syringe cutter 1,000 500 250 250
instruments by dentists, safety boxes
barbers etc.
· Procurement of
· Ear piercing and drugs for treatment of Cost per course
6,000 2,000 2,000 2,000
tattooing Hepatitis patients per patient
(Interferon)
· Develop and
· Use of unsterilized
implement SOPs for
equipment by dentists -
sterilization of
and barbers
equipment
Page 73
Three Years Rolling Plan (2010-2013) District Attock
Plan
Activities Target for Target for Target for
Causes Intervention Activities Unit
Targets 2010-11 2011-12 2012-13
4. Complications of pregnancy
· Low access to
· Behaviour Change · Messages on local
appropriate health Monthly Package 36 12 12 12
Communication (BCC) cable network
services
· Training of TBAs
Batch of 25 TBAs
· Lack of skilled birth · Refresher courses for with specific focus on
for 2 days 20 10 5 5
attendants TBAs safe delivery and
Training
danger signs
Page 74
Three Years Rolling Plan (2010-2013) District Attock
Plan
Activities Target for Target for Target for
Causes Intervention Activities Unit
Targets 2010-11 2011-12 2012-13
· Replacement of non
functional
ambulances for Ambulance 4 2 1 1
timely transportation
of pregnant mothers
· Purchase of MNCH
related equipments
Equipment
for DHQ And THQ
Hospitals
Page 75
Three Years Rolling Plan (2010-2013) District Attock
Plan
Activities Target for Target for Target for
Causes Intervention Activities Unit
Targets 2010-11 2011-12 2012-13
Page 76
Three Years Rolling Plan (2010-2013) District Attock
Plan
Activities Target for Target for Target for
Causes Intervention Activities Unit
Targets 2010-11 2011-12 2012-13
6. Malnutrition
· Infections Coordination
· Assistant of poor
· Diagnosis and treatment with Bait-ul-Maal
family through Bait ul - - - -
of infections and Social
Maal and Zakat Fund
Welfare Deptt.
· Purchase of Folic
Acid and Ferrous
Drug
sulphate tablet
(Packs)
Page 77
Three Years Rolling Plan (2010-2013) District Attock
Plan
Activities Target for Target for Target for
Causes Intervention Activities Unit
Targets 2010-11 2011-12 2012-13
7. Scabies
Printing &
· Low socio-economic
· Provision of medicines Distribution of IPC Brochure 150000 50000 50000 50000
conditions
Material
8. Cardiovascular Diseases
Health educational
Health Education campaign
· Sedentary Life Style sessions in Seminar 50 20 15 15
regarding healthy life style
community
Page 78
Three Years Rolling Plan (2010-2013) District Attock
Plan
Activities Target for Target for Target for
Causes Intervention Activities Unit
Targets 2010-11 2011-12 2012-13
Demand generation
and request
submission for
· Excess smoking Genetic counseling approval of
establishing CCU at
district and tehsil
level
Temporary
Establishment and positioning of
· Genetics Strengthening of coronary qualified medical and
care unit paramedical staffs in
the specialty
· Stressful life
Page 79
Three Years Rolling Plan (2010-2013) District Attock
Page 80
Three Years Rolling Plan (2010-2013) District Attock
Management Problems
Human Resource Plan to bridge gap between proposed MSDS posts and Sanctioned posts
Physical Targets
Page 81
Three Years Rolling Plan (2010-2013) District Attock
Plan
Activities Target for Target for Target for
Causes Intervention Activities Unit
Targets 2010-11 2011-12 2012-13
Temporary filling of
· Non-sanctioning of · Sanctioning of trained
vacant positions on Recruitment - - -
staff according to MSDS staffs according to MSDS
contract
· Demand
generation and
request to the
· Lack of permanent · Incentivized pay Department of Health Demand
- - - -
postings package at all levels by the districts for submission
recruitment through
PSC against vacant
posts
Page 82
Three Years Rolling Plan (2010-2013) District Attock
Plan
Activities Target for Target for Target for
Causes Intervention Activities Unit
Targets 2010-11 2011-12 2012-13
· Consensus
building between the
districts for uniform
· Frequent transfer
incentivized pay Coordination
postings
package for all
· High level political categories and levels
commitment for providing staff
protection to staff
working in health facilities · Request to the
Provincial
Government for
· Job insecurity Request
approval and
implementation of
agreed pay packages
· Lack of conducive
· Filling of Human
environment including
Resource gaps as per Posts 229 113 58 58
insecurity and transport
MSDS
of children for education
Page 83
Three Years Rolling Plan (2010-2013) District Attock
Plan
Activities Target for Target for Target for
Causes Intervention Activities Unit
Targets 2010-11 2011-12 2012-13
· Prepare training
programs for
providing higher
Plan
professional
education based on
TNA
Perform supervision
Lack of training /monitoring visits for
Capacity gap assessment Plan - - - -
opportunities performance gap
assessment
Conduct training of
Coordination with training
Lack of performance health manager at Batch 5 3 2 1
institutions
DHDC
Page 84
Three Years Rolling Plan (2010-2013) District Attock
Plan
Activities Target for Target for Target for
Causes Intervention Activities Unit
Targets 2010-11 2011-12 2012-13
· Preparation and
· Ban on · Seeking exemptions for submission of
Demand
procurement of vehicles procurement of specific demand for
Submission
by the government vehicle replacement five
ambulances at RHC
· Complicated
· Expedite the · Procurement of
procedure for purchase Ambulance 5 3 2 1
procurement procedure ambulances
of new vehicles
· Demand
· Demand sufficient funds
submission for
for repair and maintenance Demand
replacement four
of vehicles and expedite the submission
supervisory vehicles
repair
at HQ AND THQ
· Procurement of
four supervisory
vehicles 4 2 1 1
vehicles at HQ AND
THQ
Page 85
Three Years Rolling Plan (2010-2013) District Attock
Plan
Activities Target for Target for Target for
Causes Intervention Activities Unit
Targets 2010-11 2011-12 2012-13
· Repair of the
vehicles 3 3
vehicles
Costing and
· Less budget Demand
submission of
allocation submission
additional demand
· Provision of POL
· Frequent increase 4800 Litre per
budget for 30 10 10 10
in prices month
supervisory vehicles
· Provision of POL
1400 litre per
budget for EPI 240 80 80 80
month
vehicles
5. Inadequate Equipment
Procurement of
· Deficient
equipments for THQ
equipment to cater basic Provision of the equipment
and DHQ hospitals Addressed in
and comprehensive in accordance with the
based on the gaps Health Problems
EmONC at primary and notified equipment list
between MSDS and
secondary level of care
existing available
Page 86
Three Years Rolling Plan (2010-2013) District Attock
Plan
Activities Target for Target for Target for
Causes Intervention Activities Unit
Targets 2010-11 2011-12 2012-13
Training of district
Development of
managers in Already
No monitoring policy supervision/ monitoring Batch
supervision and addressed
policy
monitoring
Procurement of
Capacity building of
Lack of skills transport for Vehicles 6 4 1 1
mangers
supervision
Page 87
Three Years Rolling Plan (2010-2013) District Attock
a) Health Problems
Define Financial Targets
Total Cost
Activity
Unit Rate Quantity Year I Year II Year III
1. ARI (under 5)
· Printing and
Brochure &
distribution of IPC - - - - Integrated activity
Poster
material
Page 88
Three Years Rolling Plan (2010-2013) District Attock
· Training of medics
and para-medics in Batch 75000 50 1,500,000 1,650,000 907,500 4,057,500
IMCI
Oral Medicine
70 450000 10,500,000 11,550,000 12,705,000 34,755,000
Package
· Procurement of
drugs
Total 107,495,000
2. Diarrhoea
Page 89
Three Years Rolling Plan (2010-2013) District Attock
Total 134,577,920
3. Hepatitis
· Quarterly co-
ordination meetings
Meetings - - - - - Integrated activity
with TMA and other
agencies
Page 90
Three Years Rolling Plan (2010-2013) District Attock
· Printing and
distribution of IPC and
Brochure 5 300,000 500,000 550,000 605,000 1,655,000
hepatitis awareness
material
· Procurement and
Kits 50 300,000 5,000,000 5,500,000 6,050,000 16,550,000
supply of screening kits
· Procurement of
Syringe cutter 500 1,000 250,000 137,500 151,250 538,750
safety boxes
· Procurement of drugs
Cost per
for treatment of
course per 12,000 6,000 24,000,000 26,400,000 29,040,000 79,440,000
Hepatitis patients
patient
(Interferon)
· Develop and
implement SOPs for
SOPs - - - - -
sterilization of
equipment
Total 99,573,950
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Three Years Rolling Plan (2010-2013) District Attock
4. Complications of
pregnancy
· Printing and
distribution of IPC Brochure 5 200,000 500,000 275,000 302,500 1,077,500
material
· Training of TBAs
Batch of 25
with specific focus on
TBAs for 2 50,000 20 500,000 275,000 302,500 1,077,500
safe delivery and
days Training
danger signs
· Placement of mid-
wives in their Plan - - - - - -
catchment area
· Repair of non
functional ambulances
Repair and
for timely 50,000 20 500,000 275,000 302,500 1,077,500
maintenance
transportation of
pregnant mothers
Page 92
Three Years Rolling Plan (2010-2013) District Attock
· Replacement of non
functional ambulances
for timely Ambulance 1,500,000 4 3,000,000 1,650,000 1,815,000 6,465,000
transportation of
pregnant mothers
Total 10,094,700
5. Accidents and
Injuries
· Quarterly co-
ordination meetings
Meetings 5,000 12 20,000 22,000 24,200 66,200
with Traffic Police
department
· Quarterly co-
ordination meetings
Meetings 5,000 12 20,000 22,000 24,200 66,200
with Highway
department
Page 93
Three Years Rolling Plan (2010-2013) District Attock
· Preparation of
Disaster Management
Plan including the Plan - - - - -
Patient Management
protocols
· Provision of
emergency kits for Kits 3,000 3,000 3,000,000 3,300,000 3,630,000 9,930,000
victims
· Procurement of
equipments /
Plan - - - - - -
instruments / various
splints and Plaster casts
· Disaster management
- - - -
plan Plan
Total 77,524,400
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Three Years Rolling Plan (2010-2013) District Attock
6. Malnutrition
· Printing and
distribution of IPC Meeting 5 150,000 250,000 275,000 302,500 827,500
material
· Short refresher
trainings of LHWs about
balanced diet and Batch 75,000 40 1,500,000 825,000 907,500 3,232,500
provision of micro-
nutrients
· Distribution of foods
supplement through Plan - - - - - -
LHW & CMW
Coordination
· Assistance of poor with Bait-ul-
family through Bait ul Maal and - - - - -
Maal and Zakat Fund Social Welfare
Deptt.
· Purchase of Folic
Acid and Ferrus Drug 40 -
sulphate tablet (Packs)
Page 95
Three Years Rolling Plan (2010-2013) District Attock
8,032,000
Total
7. Scabies
Community health
HE session 2,000 1500 1,000,000 1,100,000 1,210,000 3,310,000
education sessions
20,687,500
Total
8. Cardiovascular
Diseases
Health educational
Seminar 10,000 50 200,000 165,000 181,500 546,500
sessions in community
Page 96
Three Years Rolling Plan (2010-2013) District Attock
Printing and
distribution of Health Brochure 5 150,000 250,000 275,000 302,500 827,500
Education material
Temporary positioning
of qualified medical and
Plan - - - -
paramedical staffs in
the specialty
Total 1,374,000
Page 97
Three Years Rolling Plan (2010-2013) District Attock
b) Management Problems
Human Resource plan to bridge gap between proposed MSDS posts and sanctioned posts
Financial Targets
Page 98
Three Years Rolling Plan (2010-2013) District Attock
1. Shortage of
skilled staff
Temporary filling of
vacant positions on Plan - - - - - -
contract
· Demand generation
and request to the
Department of Health by Demand
- - - - - -
the districts for generation
recruitment through PSC
against vacant posts
· Orientation trainings
Batch 350,500 9 1,402,000 1,156,650 848,210 3,406,860
of the recruited staffs
Page 99
Three Years Rolling Plan (2010-2013) District Attock
· Consensus building
between the districts for
uniform incentivized pay Coordination - - - -
package for all categories
and levels staff
· Request to the
Provincial Government
Request for
for approval and - - - -
approval
implementation of agreed
pay packages
Page 100
Three Years Rolling Plan (2010-2013) District Attock
· Prepare training
programs for providing
Plan - - - -
higher professional
education based on TNA
144,125,854
Total
2. Deficient staff
capacity
Perform supervision
/monitoring visits for
Plan - - - -
performance gap
assessment
Total 115,380
3. Shortage of
functional vehicles
and POL
· Condemnation of the
Plan - - - -
old and off-road vehicles
Page 101
Three Years Rolling Plan (2010-2013) District Attock
· Preparation and
submission of demand for Demand
- - - -
replacement five submission
ambulances at RHC
· Procurement of
Ambulance 3,800,000 5 11,400,000 8,360,000 4,598,000 24,358,000
ambulances
· Demand submission
for replacement four Demand
supervisory vehicles at submission
DHQ AND THQ
· Procurement of four
supervisory vehicles at vehicles 1,200,000 4 2,400,000 1,320,000 1,452,000 5,172,000
HQ AND THQ
Total 29,830,000
4. Inadequate district
health budget
Assessment of additional
Assessment - - - -
requirement
Page 102
Three Years Rolling Plan (2010-2013) District Attock
· Provision of POL
4800 Litre
budget for supervisory 4,377,600 30 43,776,000 48,153,600 52,968,960 144,898,560
per month
vehicles
· Provision of POL
budget for EPI vehicles 1400 litre per
1,276,800 240 102,144,000 112,358,400 123,594,240 338,096,640
month
Total 482,995,200
5. Inadequate
Equipment
Procurement of
equipments for THQ and
DHQ hospitals based on Equipment 83,350,275 - - 83,350,275
the gaps between MSDS
and existing available
Allocation of enhanced
amount for M&R of Plan - - - -
equipments
Orientation of staffs in
Orientation
maintenance of logs for - - - -
equipments sessions
Page 103
Three Years Rolling Plan (2010-2013) District Attock
Total 83,350,257
6. Inadequate
supervision/
monitoring
Training of district
managers in supervision Batch - - - -
and monitoring
Procurement of transport
Vehicles 1,200,000 6 4,800,000 1,320,000 1,452,000 7,572,000
for supervision
10,882,000
Total
Page 104
Three Years Rolling Plan (2010-2013) District Attock
a) Health Problems
Object 2010-2011 2011-2012 2012-2013
Classification
Regular Additional Total Regular Additional Total Regular Additional Total
A03907 313,000 960,000 1,273,000 359,950 1,056,000 1,415,950 413,943 1,161,600 1,575,543
A03902 260,000 5,250,000 5,510,000 299,000 3,025,000 3,324,000 343,850 3,025,000 3,368,850
A03820 - 1,552,000 1,552,000 - 1,707,200 1,707,200 - 970,420 970,420
A03927 41,500,000 128,350,000 169,850,000 47,725,000 141,185,000 188,910,000 54,883,750 155,303,500 210,187,250
A13101 358,000 500,000 858,000 411,700 275,000 686,700 473,455 302,500 775,955
A09501 - 3,000,000 3,000,000 - 1,650,000 1,650,000 - 1,815,000 1,815,000
A09601 - - - - - - - - -
A03903 - 3,200,000 3,200,000 - 2,365,000 2,365,000 - 2,601,500 2,601,500
A03801 - 3,550,000 3,550,000 - 2,145,000 2,145,000 - 1,815,000 1,815,000
A09601 - 250,000 250,000 - 137,500 137,500 - 151,250 151,250
Page 105
Three Years Rolling Plan (2010-2013) District Attock
b) Management Problems
Page 106
Three Years Rolling Plan (2010-2013) District Attock
III. Summaries
1. Problem-wise Costing
a) Health Problem
FY I FY II FY III Total Cost Rs.
Sr.
Problem
No.
Amount (Rs.) Amount (Rs.) Amount (Rs.) Amount (Rs.)
b) Management Problems
FY I FY II FY III Total Cost Rs.
Sr.
Problem Amount Amount Amount
No. Amount (Rs.)
(Rs.) (Rs.) (Rs.)
1 Shortage of skilled 28,929,892 46,937,854 68,258,109 144,125,854
staffs
2 Deficent capacity of 54,000 39,600 21,780 115,380
Staff
3 Shortage of 14,100,000 9,680,000 6,050,000 29,830,000
functional vehicles
4 Inadequate budget 145,920,000 160,512,000 176,563,200 482,995,200
POL and M & R
5 Inadequate 83,350,275 - - 83,350,275
equipments- MNCH
Related
6 Ineffective 5,800,000 2,420,000 2,662,000 10,882,000
supervision /
monitoring
Total 751,298,709
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Three Years Rolling Plan (2010-2013) District Attock
2. Activity-wise Costing
a) Health Problems
Sr. Costing (Rs.)
No. Health Problem Activity FY-I FY-II FY-III Total
ARI Children under 5 Messages on local cable networks - - - -
1 years
Messages through FM radio channels - - - -
Printing and distribution of IPC material - - - -
Training of medics and para-medics in IMCI 1500000 1650000 907500 4057500
Procurement of drugs 30500000 33550000 36905000 100955000
Procurement of nebbulizing drugs 750000 825000 907500 2482500
Quarterly co-ordination meetings with TMA
2 Diarrhoeal diseases and other agencies 12000 13200 14520 39720
Messages on local cable network 420000 462000 508200 1390200
Printing and distribution of IPC material 3500000 1375000 1210000 6085000
Conduction of HES in the community 2000000 1100000 1210000 4310000
Training of medics and paramedics in IMCI 750000 825000 363000 1938000
Procurement and distribution of ORS and
Zinc Sulphate 6500000 7150000 7865000 21515000
Procurement and distribution of Zinc
Sulphate 30000000 33000000 36300000 99300000
Quarterly co-ordination meetings with TMA
3 Hepatitis B & C and other agencies - - - -
Messages on local cable network 420000 462000 508200 1390200
Printing and distribution of IPC and hepatitis
awareness material 500000 550000 605000 1655000
Procurement and supply of screening kits 5000000 5500000 6050000 16550000
Procurement of safety boxes 250000 137500 151250 538750
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Three Years Rolling Plan (2010-2013) District Attock
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Three Years Rolling Plan (2010-2013) District Attock
Page 110
Three Years Rolling Plan (2010-2013) District Attock
b) Management Problems
Sr. Management Costing (Rs.)
No. Problems Activity FY-I FY-II FY-III Total
1 · Filling of the vacant posts of medics and
Shortage of skilled the paramedics through existing recruitment
staffs committees - - - -
Temporary filling of vacant positions on
contract - - - -
· Demand generation and request to the
Department of Health by the districts for
recruitment through PSC against vacant
posts - - - -
· Orientation trainings of the recruited
staffs 1402000 1156650 848210 3406860
· Consensus building between the districts
for uniform incentivized pay package for all
categories and levels staff - - - -
· Request to the Provincial Government for
approval and implementation of agreed pay
packages
- - - -
· Review and revise the career structure of
medics and paramedics - - - -
Page 111
Three Years Rolling Plan (2010-2013) District Attock
Page 112
Three Years Rolling Plan (2010-2013) District Attock
Page 113
Three Years Rolling Plan (2010-2013) District Attock
The monitoring and evaluation targets and indicators mentioned below will be
used to gauge the progress of implementation of the plan. Monitoring and
evaluation of the three years rolling plan would be carried out through the
proposed indicators, targets and means of verifications, by the district health
authorities.
M&E of Plan
Frequency
%
Indicators Target MoV Responsibility of
Achievement
monitoring
Page 114
Three Years Rolling Plan (2010-2013) District Attock
Frequency
%
Indicators Target MoV Responsibility of
Achievement
monitoring
(30000
during 1st
year)
(30000
during 1st
year)
Page 115
Three Years Rolling Plan (2010-2013) District Attock
Frequency
%
Indicators Target MoV Responsibility of
Achievement
monitoring
Page 116
Three Years Rolling Plan (2010-2013) District Attock
Annex-I
Private Health Facilities in District Attock
Page 118
Three Years Rolling Plan (2010-2013) District Attock
Annex-II
Costing of Equipment Gaps for DHQ and THQ
Hospitals
Page 119
Three Years Rolling Plan (2010-2013) District Attock
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Three Years Rolling Plan (2010-2013) District Attock
Page 121
Three Years Rolling Plan (2010-2013) District Attock
Page 122
Three Years Rolling Plan (2010-2013) District Attock
32 Blood Bank 0 0
32.1 Blood storage 1 1 2 0 0 0
cabinet (100 bag
capacity) 1
32.2 Packed cell machine 1 1 1 0 1 600000 600000
32.3 Cell Separator 1 1 1 0 1 5225000 5225000
32.4 Freezer for Fresh 1 1 1 1 1150000 1150000
Frozen Plasma 0
32.5 Blood bag shaker 1 1 2 1 0 0 0
32.6 RH view box 2 2 4 1 1 1000 1000
32.7 Water bath 2 2 2 1 1 3000 3000
32.8 Micro0pipette 4 6 8 0 4 8000 32000
32.9 Blood grouping tiles 3 3 6 2 1 3000 3000
32.1 Plasma Extractor 1 1 1 2 0 0 0
32.11 Platelets agitator 1 1 1 1 1000000 1000000
32.12 Blood thawing bath 1 1 1 1 3000 3000
32.13 Microscopes 1 1 2 1 0 0 0
33 Gynae & Labour 0 0
Room Related
Laboratory
Equipment
33.1 Hematology Analyzer 1 1 1 1 0 0 0
33.2 Electrolyte Analyzer 1 1 1 1 0 0 0
33.3 Analyzer 1 1 1 0 0 0
Bio0chemistry
Semi0automatic 1
33.4 Glucometer 2 2 2 1 1 2500 2500
33.5 Haemoglobino0meter 2 2 4 2 0 0 0
33.6 Centrifuge 1 1 2 2 0 0 0
14203980
Grand Total=
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Three Years Rolling Plan (2010-2013) District Attock
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Three Years Rolling Plan (2010-2013) District Attock
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Three Years Rolling Plan (2010-2013) District Attock
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Three Years Rolling Plan (2010-2013) District Attock
30 MNCH Related 0
Paediatrics
Equipments 0
30.1 Paediatric Ventilator 1 2 2 1 1200000 1200000
30.2 Incubator 1 1 2 1 0 1500000 0
30.3 Photo Therapy Unit 1 1 1 1 0 22000 0
30.4 Over-head Radiant 1 1 1 1 910000
Warmer 0 910000
30.5 Infant Length 2 2 2 1 5000
Measuring Scale 1 5000
30.6 Infant Weighing 2 2 2 1 3100
Machine 1 3100
30.7 Nebulizer 1 1 2 1 0 22000 0
30.8 Billiubino-meter 1 1 2 1 0
30.9 Exchange Blood 1 1 2 1 2000
Transfusion Set 2000
30.1 Nasal Probe Paed 2 2 4 1 7000
size 1 7000
31 Anaesthesia/ICU 0 0
31.1 Anaesthesia 1 1 2 0 321000
Machine 1 0
31.2 Ventilators 1 1 1 1 0 525000 0
31.3 Nebulizer 1 1 1 1 0 165000 0
31.4 Pulse Oximetry 1 1 1 1 0 21000 0
31.5 Defibrillator 1 1 1 1 500000 500000
31.6 Airway Oral and 2 3 4 0 500
Nasal 6 0
31.7 Tracheostomy tube 2 2 4 1 1 1000
(adult and paeds) 1000
31.8 Face mask of all 2 2 4 4 0 1000
sizes 0
31.9 Double Cuff 1 2 2 1 320
Tourniquet (for
regional block) 320
31.1 AMBO bag adult 2 2 4 1 1 2450 2450
31.11 AMBO Bag paeds 2 2 4 1 1 3000 3000
31.12 Red Rubber Nasal 4 4 8 1 3 1000
tubes all sizes
without cuff 3000
32 Blood Bank 0 0
32.1 Blood storage 1 1 2 1 0 812000
cabinet (100 bag
capacity) 0
32.2 Packed cell machine 1 1 1 0 1 600000 600000
32.3 Cell Separator 1 1 1 0 1 5225000 5225000
32.4 Freezer for Fresh 1 1 1 0 1 1150000
Frozen Plasma 1150000
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Three Years Rolling Plan (2010-2013) District Attock
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Three Years Rolling Plan (2010-2013) District Attock
Page 137
Three Years Rolling Plan (2010-2013) District Attock
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Three Years Rolling Plan (2010-2013) District Attock
15 Vaginal 10 10 10 350
Retractors 4 6 2100
16 Polypectomy 2 2 2 750
forceps 1 1 750
17 Sponge holder 10 15 20 6 14 300 4200
18 Uterine elevator 1 1 1 1 0 150 0
19 CosCo Speculum 6 10 10 1 9 550 4950
20 Examination light 3 3 6 1 5 18000 90000
21 Suction Curette 1 2 2 1 1 95 95
22 Infant 1 1 2 95000
Resuscitation
Trolley (with life
saving medicines,
baby
laryngoscope,
Endo-tracheal
tube, Infant BP
Apparatus,
Chargeable Light) 0 2 190000
23 Mother 1 1 2 110000
Resuscitation
Trolley (with life
saving medicines,
Laryngoscope,
Endo-tracheal
tube, BP
Apparatus,
Chargeable light) 0 2 220000
24 Cardiac Monitor 1 1 2 1 1 500000 500000
25 Pump Breast 1 1 1 250000
Electronic 0 1 250000
26 Vaginal 2 2 4 30000
Hysterectomy
Set 4 120000
26.1 Toothed Tissue 2 2 4 55
Forceps (8”) 8 0 0
26.2 Non-Tooted 2 2 4 55
Tissue Forceps
(8”) 8 0 0
26.3 Dissection 2 2 4 150
Scissors (Curved
7”) 5 0 0
26.4 Dissection 2 2 4 150
Scissors (Straight
7”) 6 0 0
26.5 Hysterectomy 8 8 16 150
Clamps (Straight) 8 8 1200
26.6 Hysterectomy 8 8 16 175
Clamps (Curved) 8 8 1400
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26.2 Non-Tooted 2 2 4 1 55 55
Tissue Forceps
(8”) 1
26.3 Dissection 2 2 4 0 150 0
Scissors
(Curved 7”) 2
26.4 Dissection 2 2 4 0 150 0
Scissors
(Straight 7”) 6
26.5 Hysterectomy 8 8 16 2 150 300
Clamps
(Straight) 6
26.6 Hysterectomy 8 8 16 6 175 1050
Clamps
(Curved) 2
26.7 Uterine Sound 2 2 4 1 1 90 90
26.8 Needle Holder 2 2 4 0 150 0
(7”) 2
26.9 Needle Holder 2 2 4 0 300 0
(10”) 2
26.1 Artery Forceps 16 16 32 10 110 1100
(Straight 6”) 6
26.11 Artery Forceps 16 16 32 10 125 1250
(Curved 6”) 6
26.12 Allis Forceps 8 8 16 3 5 230 1150
26.13 Towel Clamps 8 8 16 2 6 125 750
26.14 Single blade 4 4 8 3 275 825
Sims speculum 1
26.15 Double blade 4 4 8 3 250 750
Sims speculum 1
26.16 Sponge holding 8 8 16 7 200 1400
forceps 1
26.17 Volselum 4 4 8 3 250 750
forceps 1
26.18 Uterine Sound 2 2 4 1 1 1500 1500
26.19 Bladder Sound 2 2 4 1 1 1500 1500
27 Delivery Sets 10 10 15 10 0
27.1 Episiotomy 10 10 15 9 125 1125
Scissors 1
27.2 Straight 10 10 15 9 360 3240
Scissors 1
27.3 Needle holder 10 10 15 1 9 135 1215
27.4 Non-toothed 10 10 15 8 100 800
tissue forceps 8
inches 2
27.5 Toothed tissue 10 10 15 8 100 800
forceps 8
inches 2
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33 Gynae & 0 0
Labour Room
Related
Laboratory
Equipment
33.1 Hematology 1 1 1 0 425000 0
Analyzer 1
33.2 Electrolyte 1 1 1 0 625000 0
Analyzer 1
33.3 Analyzer Bio- 1 1 1 0 690000 0
chemistry
Semi-
automatic 1
33.4 Glucometer 2 2 2 1 1 2500 2500
33.5 Haemoglobino- 2 2 4 1 1000 1000
meter 1
33.6 Centrifuge 1 1 2 1 0 133000 0
Total 1476988
0
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