1.5.

7 Essential Health Care Programme

Based on the basic philosophy and components of primary health care approach, BRAC Health Program provides an integrated package of preventive, promotional and basic curative care and referral services, all aimed at improving the health and nutritional status of the poor and ultra-poor, particularly women and children. In this respect, BRACs health sector envisions to ensure more access by the poor to government health care services by raising public awareness about the available services. Efforts are also being made to address the ultra-poor and poor women health problems and advocate government and other health care service providers to ensure service that reaches the target population. The health issues that BRAC gives priority to, are: health care for women and children, communicable and infectious diseases, illness due to environmental hazards.

(a)

Expected Outcome:

The community has access to basic health services. BRACs health programme is complementary to that of GOB and other organizations both at the extension and at policy level. Specially targeted ultra poor have access to free basic health services and the provision of selected heath products ensured at subsidy or cost price. Mortality and morbidity reduced. (b)
(i)

Proposed activities: Pushing Down Strategies:

As per the proposal, the following Health Interventions are tailored for Specially Targeted Ultra Poor beneficiaries: Health and Nutrition education

Pregnancy related care Family planning Immunization Water and sanitation Tuberculosis Basic curative services Community based management of ARI Promotion of safe delivery practices First Strategy: Social mobilization, health awareness, and basic health care. Second Strategy: Financial assistance for the provision of medical care for mild and severe morbidity.

(ii)

Pushing Out:

The overall goal of the EHC programme is to reduce the vulnerability of the poor to sudden health shocks and to prevent them form sliding back into the vicious cycle of extreme poverty. EHC strives to increase access to health services, through demand-based strategies and by providing a package of basic health services to the whole community. The specific objectives of the EHC component are to: Provide equitable and accessible health services for the poor. Reduce the vulnerability of the people especially the poor and ultra poor to common diseases Positively influence maternal and child morbidity and mortality. Control the spread of infectious diseases.

The pushing out strategy in the health care means ensuring the right to health services for programme participants and the wider community. BRAC takes these services to the doorsteps at community through its community health volunteers and workers (Shasthya Shebikas and Shasthya Kormis ). The referral linkages with different government and private health facilities are also being strengthened. There is also a partnership programme with government and other NGOs.

1.6 Structure of the Work Plan

Project work plans have been prepared at two levels. One is a Perspective or 5-year Implementation Plan that gives an overall view of the work to be done over the full duration of the project. This plan is intended to show how BRAC proposes to meet the targets listed in the project LFA. It also provides the context in which the Annual Plans for each year of the project can be formulated. The Perspective Plan for the project is set out in Chapter 2. The second level of project is the Annual Work Plan. The plan for 2009 is set out separately in Chapter 3. This plan provides a comprehensive picture of such things as the activities are to be taken under each project component outcome. Such as the number of staff required, the training required for staff and beneficiaries in order to fulfil the project objectives, the number of workshops to be held and with whom etc. plus, where possible, details of the budgeted costs for each of these activities.

CHAPTER 2: FIVE-YEAR PERSPECTIVE PLAN

An Implementation or Perspective Plan has been prepared covering the five years of the CFPR project from 2007 to 2011. This document shows the planned annual progression under each activity listed in the project LFA in order to meet the various project Outcome and objectives. As such it provides an overview of the project plus a framework and guide for the formulation of work plans for the individual project years. It also serves as a basis for the several external and internal monitoring/evaluation reviews that are scheduled to take place during the course of the project. Wherever possible, the information is given in numerical form as measuring performance in quantifiable terms often provides the easiest and surest way of assessing the progress of a project.

2.1

Outcomes

Outcome 3: Health Item 2007

2008

2009

2010

2011 58%

End of Programme 58%

EHC services ensured for 4 million ultra poor and 14 million poor/community households 3.1 58% of 50% 52% 54% 56% eligible couple

using modern contraceptives 3.2 80% of households using slab latrines 3.3 85% of children aged 01 years fully vaccinated 3.4 70% detection rate for TB; cure rate kept at over 90% 4.6 All victims of acid, rape, & other forms of violence reported to BRAC receive medical care

45%

55%

65%

75%

80%

80%

73% Detection Rate 70% Cure Rate 85% Victims of acid, rape, & other forms of violence reported to BRAC will receive medical care

78% Detection Rate 70% Cure Rate 87%

79% Detection Rate 70% Cure Rate 89%

82% Detection Rate 70% Cure Rate 90%

85% Detection Rate 70% Cure Rate 90%

85% Detection Rate 70% Cure Rate 90%

Victims will continue to receive medical care

Victims will continue to receive medical care

Victims will continue to receive medical care

Victims will continue to receive medical care

All victims of acid, rape, & other forms of violence receive medical care

2.2

Activities
2007 STUP I RHC: 25 Panel Doctors: 190 2008 STUP I RHC: 30 Panel Doctors: 2009 STUP I RHC: 30 (includes 5 new recruit in year 3) 2010 STUP I RHC: 30 Panel Doctors: 2011 STUP I RHC: 30 Panel Doctors:

Items 3. Essential Health Care: 3.1 Staff recruitment and employment

Items

2007 SK: 190

STUP II RHC: 15 Panel Doctors: 110 SK: 110

VO members and Community RHC: 40 PO: 650 PO (trainer): 80 SK: 938 PO (Quality Assurance): 20 PO (ARI): 80

2008 200 (includes 10 new recruit in year 2) SK: 200 (includes 10 new recruit in year 2) STUP II RHC: 25 (includes 10 new recruits in year 2) Panel Doctors: 120 (includes 10 new recruits in year 2) SK: 120 (includes 10 new recruits in year 2) VO members and Community RHC: 40 PO: 775 (includes 125 new recruits in year 2) PO (trainer): 100 (includes 20 new recruits in year 3) SK: 1,563 (includes 625 new recruits in year 2) PO (Quality Assurance): 25 (includes 5 new recruits in year 2) PO (ARI): 300 (includes 220 new

2009 Panel Doctors: 200 SK: 200

2010 200 SK: 200

2011 200 SK: 200

STUP II RHC: 25 Panel Doctors: 120 SK: 120

STUP II RHC: 25 Panel Doctors: 120 SK: 120

STUP II RHC: 25 Panel Doctors: 120 SK: 120

VO members and Community RHC: 40 PO: 800 PO (trainer): 100 SK: 3,938 (includes 2,375 new recruits in year 2) PO (Quality Assurance): 25 PO (ARI): 350 (includes 50 new recruits in year 2)

VO members and Community RHC: 40 PO: 800 PO (trainer): 100 SK: 4,250 (includes 312 new recruits in year 2) PO (Quality Assurance): 25 PO (ARI): 350

VO members and Community RHC: 40 PO: 800 PO (trainer): 100 SK: 5,063 (includes 813 new recruits in year 2) PO (Quality Assurance): 25 PO (ARI): 350

Items 3.2 Training of staff, health workers and community health

2007 STUP I Orientation in panel doctors (twice a year): 10

2008 recruits in year 2) STUP I Orientation for panel doctors (twice a year): 10

2009 STUP I Orientation for panel doctors (twice a year): 10

2010 STUP I Orientation for panel doctors (twice a year): 10

2011 STUP I Orientation for panel doctors (twice a year): 10

STUP II Orientation for panel doctors (twice a year): 6 VO members and community SK basic training (4 weeks): 438 SS basic training (2 weeks): 2,500 ARI basic training for POs (quarterly): 160 ARI basic training for SKs (2 weeks): 1,600 ARI basic training for SSs (2 weeks): 16,000 Midwifery training of SKs (6 month): 125 Monthly refresher training: 125 SK refresher training (1 day each month): 938

STUP II Orientation for panel doctors (twice a year): 6 VO members and community SK basic training (4 weeks): 500 SS basic training (2 weeks): 2,500 ARI basic training for POs (quarterly): 300 ARI basic training for SKs (2 weeks): 2,400 ARI basic training for SSs (2 weeks): 24,000 Midwifery training of SKs (6 month): 150 Monthly refresher training: 275 SK refresher training (1 day

STUP II Orientation for panel doctors (twice a year): 6 VO members and community SK basic training (4 weeks): 500 SS basic training (2 weeks): 3,000 ARI basic training for POs (quarterly): 300 ARI basic training for SKs ( 2 weeks):2,400 ARI basic training for SSs ( 2 weeks): 24,000 Midwifery training of SKs ( 6 month): 150 Monthly refresher training: 425 SK refresher training (1 day each month): 3,938 SS refresher training (1 day each month): 50,000

STUP II Orientation for panel doctors (twice a year): 6 VO members and community SK basic training (4 weeks): 500 SS basic training (2 weeks): 3,000 Monthly refresher training: 425 SK refresher training (1 day each month): 4250 SS refresher training (1 day each month): 52,500

STUP II Orientation for panel doctors (twice a year): 6 VO members and community Monthly refresher training: 425 SK refresher training (1 day each month): 5,063 SS refresher training (1 day each month): 52,500

Items

2007 SS refresher training (1 day each month): 45,000

3.3 Develop IEC materials

3.4 Provide health/nutrition education

3,125 Health and Nutrition education will be provided through monthly health education meetings at the community level

2008 each month): 1,563 SS refresher training (1 day each month): 47,500 3,500 Health and Nutrition education will continue to be provided STUP I Panel doctors: 200 (includes 10 new recruits in year 2) Orientations: 10 STUP II Panel doctors: 120 (includes 10 new recruits in year 2) Orientations: 6 Panel doctors will continue to provide consultations

2009

2010

2011

3,500

3,500 Health and Nutrition education will continue to be provided

3,500 Health and Nutrition education will continue to be provided

Health and Nutrition education will continue to be provided

STUP I Panel doctors: 190 Orientations: 10 3.5 Deployment/orientation of panel doctors STUP II Panel doctors: 110 Orientations: 6 3.6 Provision of health care services: (family planning, antenatal care, immunization, basic curative treatment, TB) Panel doctors will provide outpatient consultations in BRACs area offices at scheduled dates to provide both preventative and curative health care

STUP I Panel doctors: 200 Orientations: 10

STUP I Panel doctors: 200 Orientations: 10 STUP II Panel doctors: 120 Orientations: 6 Panel doctors will continue to provide consultations

STUP I Panel doctors: 200 Orientations: 10 STUP II Panel doctors: 120 Orientations: 6 Provision of health care services: (family planning, antenatal care, immunization, basic curative treatment, TB)

STUP II Panel doctors: 120 Orientations: 6 Panel doctors will continue to provide consultations

Items

3.7 Community based treatment of ARI for children under 5

3.8 Eye and ENT-camp, linkages with GoB and other health organizations

3.9 Referral linkage with GoB and other private facilities

3.10 Financial assistance to ultra poor for mild and severe morbidity

2007 services SK and SS will diagnose and provide ARI treatment, and educate the mothers of children under 5 on the prevention and management of ARI, danger signs of ARI , and referral of cases to facility level Eye camps will be organized in collaboration with SSI, and BSNB eye hospital. ENT camps will be organized in collaboration with SAHIC The SS and SK will refer patients requiring specialized care to different health facilities. A health subsidy of Tk 300 per person per year for all STUP members, and up to 50 per cent of the OTUP members will be provided.

2008

2009

2010

2011

The SKs and SSs will continue to help diagnose and provide ARI treatment

The SKs and SSs will continue to help diagnose and provide ARI treatmen

The SKs and SSs will continue to help diagnose and provide ARI treatmen

The SKs and SSs will continue to help diagnose and provide ARI treatmen

Eye and ENT camps will continue to operate The SS and SK will refer patients requiring specialized care to different health facilities A health subsidy of Tk 300 per person per year for all STUP members, and up to 50 per cent of the OTUP members will be

Eye and ENT camps will continue to operate

Eye and ENT camps will continue to operate The SS and SK will refer patients requiring specialized care to different health facilities A health subsidy of Tk 300 per person per year for all STUP members, and up to 50 per cent of the OTUP members will be

Eye and ENTcamp linkages with GoB and other health organizations The SS and SK will refer patients requiring specialized care to different health facilities Financial assistance to ultra poor for mild and severe morbidity

The SS and SK will refer patients requiring specialized care to different health facilities A health subsidy of Tk 300 per person per year for all STUP members, and up to 50 per cent of the OTUP members will be provided

Items

2007 Existing partnerships established in phase I will be continued and strengthened in with Government and other organizations in the field of TB control, ARI control, Immunization, Family Planning, Vitamin A, Sanitation, Eye Care, and ENT services. Facilitation support will be provided to donor review missions

2008 provided

2009

2010 provided

2011

3.11 Strengthen partnership with GoB and other organizations

BRAC will continue to maintain and strengthen partnership

BRAC will continue to maintain and strengthen partnership

BRAC will continue to maintain and strengthen partnership

Strengthen partnership with GoB and other organizations

8.4 Facilitation of donor review mission

Facilitation will continue

Facilitation will continue

Facilitation will continue

Facilitation will continue

2.3

Budgeted Expenditure 2007 296,282,947 2008 346,601,435 2009 420,299,692 2010 335,056,858 2011 340,428,498

Item Outcome 2: Health Care Activity 3: Essential Health Care

10

CHAPTER 3: ANNUAL WORK PLAN 2009

3.4 Essential Health Care Programme

Based on the basic philosophy and components of primary health care approach, BRAC Health Program provides an integrated package of preventive, promotional and basic curative care and referral services, all aimed at improving the health and nutritional status of the poor and ultra-poor, particularly women and children. In this respect, BRACs health sector envisions to ensure more access by the poor to government health care services by raising public awareness about the available services. Efforts are being made to develop pro-poor and pro-women health policies and to sensitise the providers to ensure quality service provision that reaches the target population. Also address the ultra-poor and poor women health problems and advocate government and other health care service providers to ensure service that reaches the target population. The health issues that BRAC gives priority to, are: health care for women and children, communicable and infectious diseases, illness due to environmental hazards.

3.4.1

Essential Health Care Services for the Ultra Poor

Health interventions tailored for the Specially Targeted Ultra Poor First strategy Social mobilization, health awareness, and basic health care: Health and Nutrition education Pregnancy related care Family planning Immunization Water / sanitation Tuberculosis Basic curative services Health commodities Community mobilization for the ultra poor Second strategy: Financial assistance for the provision of medical care for mild and severe morbidity: Activity As per PP (At the end of programme)
Annual Target 2009 as per revised PP after adding AusAID funds 114,000

Operation Plan for 2009 Jan-June July-Dec. 2009 2009

Health and nutrition education Health care

Provide health and nutrition education Ante natal care

45,000

69,000

5,130 pregnant

2,025

3,105

11

Activity

As per PP (At the end of programme)

services

increased to 75% Modern contraceptives method acceptor increased to 58% Immunization coverage under -1 year increased to 85% Immunization coverage of pregnant women increased to 90% Using of slab latrines increased to 80% Vitamin A capsule distribution among 1-5 yrs. children increased to 95% TB case detection increased to 70% and cure rate 91% 85% of identified ARI patients treated.

Annual Target 2009 as per revised PP after adding AusAID funds women 55%

Operation Plan for 2009 Jan-June July-Dec. 2009 2009

55%

55%

80%

80%

80%

85%

85%

85%

76%

75%

76%

95%

95%

95%

TB case detection increased to 70% and cure rate 85% 85% of identified cases

TB case detection increased to 70% and cure rate 85%

TB case detection increased to 70% and cure rate 85%

85% of identified cases

85% of identified cases

Note: Services for 60,000 Specially targeted ultra poor selected in 2008 will be carried forward to 2009.

12

Health care subsidy for the STUP and OTUP:

Activity

Annual Target for 2009 as per PP

Treatment of mild morbidity Treatment of severe morbidity Tube-well Installation Slab Latrine Installation

67,125 22,375 1,200 68,400

Annual Target 2009 as per revised PP after adding AusAID funds 67,125 22,375 1,200 68,400

Operation Plan for 2009 Jan-June Jul-Dec 2009 2009

26,497 8,832 400 27,000

40,628 13,543 800 41,400

Budget (Taka): Essential Health Care Services for Ultra Poor

Operational Budget for 2009 Jan.July-Dec. Annual June 2009 Target 2009 2009 as per revised PP after adding AusAID funds Special Health Care Subsidy to (STUP I) 16,641,00 7,107,0 14,214,188 7,107,094 Special Health Care Subsidy 0 94 Salaries and benefits of Regional Health 3,449,7 5,373,656 6,999,552 3,449,776 coordinator 76 3,466,8 6,587,063 6,933,750 3,466,875 Honorarium of Panel Doctor 75 Incentives for Female Medical Doctors 114,000 120,000 60,000 60,000 Orientation cost for Panel Doctor 462,250 462,250 277,350 184,900 Resource person's cost in Orientation 138,675 138,675 83,205 55,470 Equipment for Panel Doctors Furniture & Fixture Prescriptions 526,965 554,700 277,350 277,350 Honorarium of Shasthya Karmi (SK) 2,529,432 2,662,560 1,331,2 1,331,280 Description Annual Target for 2009 as per PP

13

Description

Annual Target for 2009 as per PP

Fuel and maintenance cost of motorcycle Communication & Telephone Management and Logistics Expenses

693,375 346,688 2,338,917

35,752,0 Total Health care to STUP I 20 Special Health Care Subsidy Special Health Care Subsidy Salaries and benefits of Regional Health coordinator Honorarium of Panel Doctor Orientation cost for Panel Doctor Resource person's cost in Orientation Prescriptions Honorarium of Shastho Karmi (SK) Incentives for Female Medical Doctors Fuel and maintenance cost of motorcycle Communication & Telephone Management and Logistics Expenses Total Health care to STUP II 7,280,438 3,224,194 3,813,563 277,350 83,205 305,085 1,464,408 66,000 416,025 208,013 1,199,680 18,337,9 59

Operational Budget for 2009 Jan.July-Dec. Annual June 2009 Target 2009 2009 as per revised PP after adding AusAID funds 80 832,050 416,025 416,025 416,025 208,013 208,013 1,170,8 2,333,362 1,162,475 88 35,667,11 17,297, 17,169,25 2 855 7 to (STUP II) 5,460,3 12,134,063 6,673,734 28 2,916,4 5,832,960 2,916,480 80 2,080,1 4,160,250 2,080,125 25 277,350 138,675 138,675 83,205 41,603 41,603 332,820 166,410 166,410 1,597,536 798,768 798,768 72,000 36,000 36,000 693,375 346,688 346,688 346,688 173,344 173,344 1,787,117 851,089 936,028 27,317,36 13,009, 14,307,85 3 509 4

Budget (Taka): Essential Health Care Services for Other Targeted Ultra Poor
Operational Budget for 2009 Jan.-June July-Dec. Annual 2009 2009 Target 2009 as per revised PP after adding AusAID funds Special Health Care Subsidy to (OTUP I) Special Health Care Subsidy 8,667,188 8,667,188 4,333,594 4,333,594 Management and Logistics Expenses 606,703 606,703 303,352 303,352 9,273,89 9,273,891 4,636,945 4,636,945 Total Health Care to OTUP I 1 Special Health Care Subsidy to (OTUP II) Special Health Care Subsidy 13,867,50 13,867,500 5,547,000 8,320,500 Description Annual Target for 2009 as per PP

14

0 Salaries and benefits of Regional Health coordinator Total Health care to OTUP II 970,725 14,838,2 25 970,725 14,838,22 5 388,290 5,935,290 582,435 8,902,935

The programme appointed panel doctors for the ultra poor so they can have access to both preventive and curative health services. The purpose of appointing panel doctors was to make health services easily available to the rural people specially the ultra poor in BRAC working areas and reduce the level of income erosion resulting from the common and water borne diseases. In 2009, 320 panel doctors will be deployed and oriented. Orientations will be designed to inculcate BRACs value of serving the poor as well as to enhance their technical skills. In phase II, BRAC will also attempt a larger number of female doctors for the panel, in order to meet the requirements of ultra poor women. The panel doctors will provide two-hour consultation/treatment to the patients anytime within 3:00 pm to 5:00 pm at BRAC area office. They will provide counselling and treat all the patients enlisted by the area office. Each of the doctors will get Tk. 2,889 as honorarium on a monthly basis. There will also be one Shastho Karmi assisting one panel doctor in each area. Therefore in 2009, there will be 320 Shastho karmis assisting the 320 panel doctors. The Shastho Karmis will receive honorarium for their service of 1,109 per month. The panel doctors will also receive a prescription fee with a unit cost of Tk. 200 per prescription. In the year 2009, the health care subsidy will be provided to 41,000 STUP I women (includes 38,000 new members of STUP I, and 3,000 second round support members of previous cohorts), and 35,000 STUP II women (including 1,000 second round support beneficiaries). Health care subsidy will also be provided to 12,500 OTUP I members (50% of OTUP I members), and 40,000 OTUP II members (50% of OTUP II members).

3. 4. 2 Members

Essential Health Care Services for VO/Community

Pushing out in the context of health programme means that BRAC will extend its services to many more of the poor who lack basic health care. The primary objective of the regular EHC programme is to provide an essential package of health services mainly through the Shastho Shebika (health Volunteer) at peoples doorstep. The components are: Health and nutrition education planning Immunization Basic curative services Pregnancy related care Water and sanitation Health commodities 15 Family

Tuberculosis control

Table 10: Essential Health Care for VO/Community Members Activity As per PP Target for 2009 Annual (At the end Jan-June July-Dec. Target 2009 of 2009 2009 as per programme)
revised PP after adding AusAID funds 24,000

Training of Shasthya Shebikas Training of Shasthya Karmis Refreshers Training

Provide training to Shasthya Shebikas Provide training to Shasthya Karmi Refreshers training to Shasthya Shebikas Ante natal care increased to 75% Modern contraceptive s method acceptor increased to58% Using of slab latrines increased to 80% Immunization coverage under -1 year

12,000

12,000

2,400

1,200

1,200

50,000

50,000

50,000

Basic health care services

70%

70%

70%

55%

55%

55%

65%

60%

65%

80%

80%

80%

16

Activity

As per PP (At the end of programme)

Annual Target 2009 as per revised PP after adding AusAID funds

Target for 2009 Jan-June July-Dec. 2009 2009

increased to 85%
84% Immunization 85% coverage of pregnant women increased to90% 95% 95% Vitamin A capsule distribution among 1-5 yrs. children increased to 95% TB case detection TB case detection TB case increased to 70% increased to 70% detection and cure rate 85% and cure rate 85% increased to 70% and cure rate 91% 85% of identified 85% of identified 85% of cases identified ARI cases patients treated. Linkage with Government and other Health facilities 70% referred cases 70% referred cases Referral Mobilize, link received health received health linkage with and refer care services from care services from government community government and government and and other members to other health care other health care health government facilities facilities facilities health service facilities and other organizations Develop and Develop and Partnership Develop and continue continue program with continue partnership partnership government partnership program with program with and other program with government and government and organizations government other organizations other organizations and other (such as TB, (such as TB, organizations Immunization, Immunization, (such as TB, Family planning, Family planning, 85%

95%

TB case detection increased to 70% and cure rate 85%

85% of identified cases

70% referred cases received health care services from government and other health care facilities

Develop and continue partnership program with government and other organizations (such as TB, Immunization, Family planning,

17

Activity

As per PP (At the end of programme)

Immunization, Family planning, Vitamin A, Sanitation, Eye care and ENT services).

Annual Target 2009 as per revised PP after adding AusAID funds Vitamin A, Sanitation, Eye care and ENT services).

Target for 2009 Jan-June July-Dec. 2009 2009

Vitamin A, Sanitation, Eye care and ENT services).

Vitamin A, Sanitation, Eye care and ENT services).

Budget (Taka): Essential Health Care Services for VO members and community
Description Annual Target for 2009 as per PP Operational Budget for 2009 Jan.-June July-Dec. Annual 2009 2009 Target 2009 as per revised PP after adding AusAID funds 10,657,382 96,337,920 16,558,080 65,532,258 4,139,520 1,109,400 1,271,188 4,680,281 55,331,325 970,725 462,250 5,547,000 47,149,500 13,266,575 878,275 14,000,000 9,984,600 5,328,691 48,168,960 8,279,040 32,766,129 2,069,760 554,700 610,170 2,246,535 27,665,663 417,412 198,768 2,939,910 24,989,235 6,898,619 456,703 7,000,000 4,992,300 5,328,691 48,168,960 8,279,040 32,766,129 2,069,760 554,700 661,018 2,433,746 27,665,663 553,313 263,483 2,607,090 22,160,265 6,367,956 421,572 7,000,000 4,992,300

Salaries and Benefits of Regional Health Coordinator Salaries and Benefits of Program organiser Salaries and Benefits of Program organiser Honorarium for Shastho Karmi Salaries and Benefits of Program Organiser Fuel and maintenance cost of motorcycle Shastho Karmis Basic Training Shastho Shebikas Basic Training Salary & benefits of ARI PO-VII ARI Basic Training of POs One day Refreshers training for ARI POs ARI Basic Training of SKs ARI Basic Training of SSs Materials for ARI SS Education Materials for ARI Procure Motorcycle for ARI Fuel & maintenance cost for ARI Staff

9,818,190 72,111,000 12,203,400 57,211,758 3,050,850 1,109,400 1,113,560 3,900,234 50,588,640 776,580 591,680 5,547,000 47,149,500 11,371,350 762,713 12,000,000 8,875,200

18

Operational Budget for 2009 Jan.-June July-Dec. Annual 2009 2009 Target 2009 as per revised PP after adding AusAID funds Midwifery Training of SKs 22,853,640 17,140,230 8,570,115 8,570,115 Monthly Refreshers Training 693,375 589,369 300,578 288,791 Mobile telephone bills 693,375 589,369 300,578 288,791 Miscellaneous Expenses 693,375 589,369 300,578 288,791 Capacity Development (Refreshers Training) Shastho Karmis Refreshers 496,630 568,856 295,805 273,051 training Shastho Shebikas Refreshers 17,334,375 17,334,375 9,013,875 8,320,500 Training Regional Health Coordinators 981,819 1,065,738 554,184 511,554 Training Program Organizers Training 8,431,440 11,289,600 5,870,668 2,991,386 Printing and Stationeries 5,119,188 6,232,055 3,240,668 2,991,,386 Communication & Telephone 554,700 554,700 277,350 277,350 Area Office staff accommodation 9,568,575 11,648,700 5,824,350 5,824,350 and utilities Travelling and Transportation 4,506,938 5,547,000 2,773,500 2,773,500 Health Education Materials IEC Materials 361,133 404,469 206,279 198,190 ANC materials 4,044,688 6,067,031 3,094,186 2,972,845 Training Centre rent & utilities 4,437,600 4,437,600 2,263,176 2,174,424 Training centre set-up cost Management and Logistics 26,526,639 30,235,438 15,292,789 14,942,649 Expenses 405,478,5 462,170,1 233,170,1 228,408,1 Total 44 77 77 97 Description

Annual Target for 2009 as per PP

19