Professional Documents
Culture Documents
District
Session
: Day &
Date
Name of HRA
25/4/13
Govindpur,
Giripur,
Mohinipur
26/4/13
3
4
S
No
Name &
mobile no of
Mobilizer
Designation
of Mobilizer
(ASHA/ AWW/
Other)
Jhadeswar
Mandir
Sudesha
Bhoi
103
Mukhi Sahi
AW Center
113
48
No of
houses
in HRA
Address of
session site
102
Mukhi Sahi
(Hatisal)
27/4/13
Patrapali
Janghi Kudar
29/4/13
Rajamunda
Munda Sahi
Category
of HRA#
JE Introduced
Pentavalent Introduced
Name &
mobile no
of AVD
person
Estimated
beneficiaries
0-2
yrs
Pregna
nt
Women
TT
BCG &
diluent
AWW
39
22
02
Rukmini
Behera
AWW
40
22
Patrapali
AW Center
Sanjukta
Dei
AWW
33
Munda Sahi
AW Center
Fulmanikrip
a Toppo
AWW
14
Pentavalent
Syringes
0.1
ml
AD
0.5 ml
AD
5 ml
Reconstit
ution
10
22
68
14
03
10
22
68
14
04
03
09
19
57
12
01
01
02
08
24
10
DPT
HepB
tOPV
Measles
& diluent
03
05
04
03
02
03
05
04
18
02
02
04
08
01
01
01
JE &
diluen
t
#1- Slums with migration; 2- Nomads; 3- Brick kiln; 4- Construction site; 5- Others (fisherman villages, riverine areas with shifting populations etc), 6- non migratory (settled population) & hard to reach areas
* In Pentavalent states, only a booster dose of DPT will be required
Signature of Supervisor
Signature of MOIC
Annex-1: Ready Reckoner for estimating the requirement of vaccines and logistics
BC
G
via
ls
&
Dil
ue
nts
OP
V
vial
s
0.1 ml
AD
syringe
HR
A
Hou
seh
old
s
HR
A
pop
ulat
ion
0-1
yea
r
02
ye
ars
PW
TT
vials
25
0
50
0
15
15
30
10
f=
(e
x1.3
3) /
10
50
10
0
Mea
sles
vials
&
Dilu
ents
DPT
vials
Pent
a
vials
JE
via
ls
&
Dil
ue
nts
0.5 ml
AD
syringe
5 ml
Reconstit
ution
syringe
DPT
vial
s
Pe
nt
a
via
ls
0.5 ml AD
syringe
5 ml
Reconst
itution
syringe
DPT
vial
s
Hep
B
vial
s
0.5 ml
AD
syringe
5 ml
Reconstit
ution
syringe
v
41
W
5
j
3
44
33
u
1
17
87
14
66
82
g=
(cx
1.3
3)/
10
h=
(dx1
.33)
/20
i=(c*1
.11)
j=
[(1.2
5 X c)
X1.3
3]/5
takin
g
agegrou
p9
comp
leted
mont
hs to
2
years
k=
[(dc)x1.
33]/1
0
l=
(cx1.
33)/1
0
m
=
[(1.
25
X
c)
X1.
33]
/5
n=[d
+e+(
1.25*c
)*2]*1
.11;
o=[1.1
1*(g+j
+m)]
p=
[(dc)x1
.33]
/10
q=
(cx
1.3
3)/
10
r=[d+e
+(1.25
*c)]*1.
11
s=[1.
11*(g
+j)]
t=
(dx1
.33)
/10
u=
(cx1
.33)
/10
v=[d+
c+e+(
1.25*c
)]*1.1
1
w=[1.1
1*(g+j)
]
Aver
age
no.
of
pers
ons
per
hou
seh
old
=5
1. No. of
infants =
3% of
total
populatio
n
2.
All
children
are
unimmuni
zed.
1.
Cumul
ative
no. of
pregna
nt
women
eligible
for TT
injectio
n in a
period
of 6
months
2.
Pregna
ncy
wastag
e is
10%
102
608
20
39
22
02
03
03
22
10
05
68
14
103
667
20
40
22
02
03
03
22
10
05
68
14
Assumptions/Calculations
113
550
17
33
18
02
02
03
19
09
04
57
12
48
230
07
14
08
01
01
02
08
02
01
24
10
366
2105 64
126 70
07
09
11
71
31
15
217
50
Date of activity
Place of session
Name of HRA:
Number of
children
vaccinated
BCG
DPT1
DPT2
DPT3
DPT-B
HepB1
HepB2
HepB3
Penta-1
Penta-2
Penta-3
OPV-0
OPV1
OPV2
OPV3
OPV-B
Measles1
Measles2
JE-1
JE-2
Women
Pregnant women
Tally marks
Number of pregnant
women vaccinated
TT1
TT2
TT
Booster
issued
AD Syringes
consumed
issued
consumed
Names of staff
1. ANM
BCG Vials
Disposable
Syringes
Measles Vials
BCG Diluents
DPT Vials
Measles Diluents
JE Vials
3.AWW
4. Volunteer
HepB vials
Penta Vials
OPV Vials
JE Diluents
TT Vials
Signatures of ANM
2. ASHA
#1- Slums with migration; 2- Nomads; 3- Brick kiln; 4- Construction site; 5- Others (fisherman villages, riverine areas with shifting populations etc),
6- non migratory (settled population) & hard to reach areas
Annex -3:
Annex -4:
Annex -5: