Integrated HMIS Reporting Formats

NATIONAL RURAL HEALTH MISSION

Instructions - at a Glance
(Version 1.5)

July-2010

Ministry of Health
& Family Welfare
Government of India
 As on 8th July, 2010

Contents

INTRODUCTION 3

DATA FLOW 5

MONTHLY FORMAT 8

QUARTERLY FORMAT 52

ANNUAL FORMAT 59

FINANCIAL MANAGEMENT REPORT 76

GLOSSARY OF TERMS AND TERMINOLOGY 94

CONTACT DETAILS 101

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Introduction

1.1 Recognising the importance of health of its citizens in the process of economic and social
development and improving their quality of life, the Ministry of Health and Family Welfare,
launched the National Rural Health Mission (NRHM) to carry out necessary architectural correction
in the basic health care delivery system. The Mission adopts a synergistic approach by relating
health to determinants of good health viz. of nutrition, sanitation, hygiene and safe drinking water.
It also aims at mainstreaming the Indian systems of medicine to facilitate health care. The Plan of
Action includes increasing public expenditure on health, reducing regional imbalance in health
infrastructure, pooling resources, integration of organizational structures, optimization of health
manpower, decentralization and district management of health programmes, community
participation and ownership of assets, induction of management and financial personnel into district
health system, and operationalising Community Health Centres into functional hospitals meeting
Indian Public Health Standards in each Block of the country. These interventions have increased the
demand for disaggregated data on population and health for use in both micro-level planning and
program implementation. At the same time, understanding the synergy between availability of
services, cost involved in provision of public health care services, expenditure and pattern of
utilization among various sections of population, including vulnerable sections of the society, are
important aspects that influence decision making. A continuous flow of good quality information on
inputs, outputs and outcome indicators facilitates monitoring of the objectives of NRHM.

1.2 The Ministry had last revised the forms for data capturing during the year 2006 and several
States sent data on the new forms. Based on the feedback received from States and other users,
efforts were made to further simplify and rationalise the data capturing formats. The revised sets of
formats have been sent to the States in September, 2008 and the present Guidelines gives broad
instructions to the various users on how the forms are to be filled up. The Formats have been
compiled and bound in a separate volume titled “Health Management Information Systems
Formats- Version 1.0”.

1.3 In context to these formats, a dedicated Health Management Information System (HMIS)
web-portal has been established at the URL http://nrhm-hmis.nic.in, where the users at the
District level can log on and enter the physical and financial performance data directly onto the
portal. The HMIS portal facilitates data to be entered at the facility level also. The broad details of
how data is to be captured on the HMIS portal are explained in the “Operational Manual for
HMIS”.

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1.4 The broad objectives of these Guidelines are:

o To ensure uniformity and consistency in understanding of the formats and the data
items/elements to be captured on the forms.

o To facilitate standardized compilation and calculation of the various indicators at different

levels of the health care delivery system;

o To facilitate the programme managers and other stake-holders in tracking monitoring

indicators that would be generated through the web-based HMIS portal by use of
standardized definitions.

1.5 The explanation and suggestions given in this guideline will not only help in compiling
good and robust data but will also lead to better estimates of monitoring indicators and assist in
comparisons. The guidelines given in this manual are intended for those who are engaged in the
collection and compilation of data from the peripheral level onwards facilitating them to collect and
collate the information without any ambiguity. In case further clarifications are required for the
terms used in the HMIS formats, the user is requested to refer to the Ministry’s website
(http://mohfw.nic.in).

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Data Flow

2.1 The various types of forms that have been developed are as follows:

Sl Form No. Periodicity Submission Date Submission Remarks

No channel
REPORTING FORMS from State to GOI
A
{These Forms are to be sent to GOI}
1. NRHM/GOI/1/A Annual 30th April of the
reporting year
2. NRHM/GOI/2/Q Quarterly 10th of Month following
respective Quarter State Govt
th
3. NRHM/GOI/3/M Monthly 20 of following Month to GOI
REPORTING FORMS within State Government
B
{These Forms are NOT to be sent to GOI}
4. NRHM/SG/1/A Annual 15th April of the Internal for
reporting year State Govt
5. NRHM/SG/2/Q Quarterly 20th of Month following Internal for
respective Quarter State Govt
REPORTING FORMS within Districts
C {These Forms are to be sent to State Govt}
6. NRHM/DHQ/1/A Annual 5th April of the reporting
year
7. NRHM/DHQ/2/Q Quarterly 10th of Month following
respective Quarter District to
th
8. NRHM/DHQ/3/M Monthly 10 of following Month State Govt

FACILITY REPORTING FORMS within Districts

D {These Forms are to be sent to District HQ}
9. NRHM/DH-SDH- Monthly 5th of following Month District The forms
CHC/3/M Hospital to are the
District HQ same for
DH, SDH
and CHC
and can be
used
interchang
eably
10. NRHM/PHC/3/M Monthly 5th of following Month PHC to

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Sl Form No. Periodicity Submission Date Submission Remarks

No channel
District HQ
11. NRHM/HSC/3/M Monthly 5th of following Month Health Sub
Centre to
District HQ

2.2 The above forms would flow from the various facilities as indicated in the diagram below.
The figure is indicative of the flow of information from the facilities and is not an exact model of
the administrative hierarchies which may vary across States.

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2.3 A similar flow is valid for the Quarterly and Annual Forms. It may be noted that there are no
quarterly forms from the facilities. The information for the Quarterly Form (No. NRHM/DHQ/2/Q)
is to be captured from the District Headquarters only and similarly for the State Headquarters (Form
No. NRHM/SG/2/Q)

2.4 For the Web Based HMIS portal, before the facility level information can be entered, it is
necessary to create and update the Master files which contain information about the facility. After
the Master files have been completely updated, the user will be able to select the facility for
capturing the physical progress on the HMIS portal.

2.5 The instructions for filling up the various forms (Annual, Quarterly or Monthly) are linked
by the reference numbers of the corresponding data element in the consolidated formats, namely
NRHM/GOI/1/A, NRHM/GOI/2/Q, NRHM/GOI/3/M. In view of this referencing and linkage,
separate instructions for the facilities are not being provided.

2.6 Each of the facility level forms can be easily adapted to capture information from
corresponding or equivalent institutions in the Urban Sector as well as the Private Sector.

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Monthly Format

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Guidelines for Monthly Reporting Format

(Consolidated)

Introductory Notes

1. These are instructions at a glance for filling up information in the

format. For detailed information on any term or terminology, the user
may please refer to the corresponding technical or programme
guidelines/manuals. All information will relate to the
activities/events during the reporting month.

2. In the Instructions, the column “Applicable to” gives symbols that

signify from which institution or facility the information is to be
captured from. The symbols are self-explanatory as depicted below:
SC SC

PHC PHC

CHC
SDH DH SDH
CHC
DH
District HQ DHQ

State HQ SG

3. In a few places detailed explanation has been given for some of the
medical terms for better clarity.

4. The major shift in the present HMIS is towards Facility based

reporting, so that the health services/activities that take place at the
facility gets captured/ reported for that particular month. Thus
activities like home deliveries, say, would not get reported in the DH,
CHC or PHC format; this would in fact get reported by the
corresponding sub-centre format in the catchment area.

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5. The private healthcare institutions (<30 beds) will be required to use

[PHC] formats while the private healthcare institutions (>30 beds)
would have to fill [CHC] formats. The private institutions are to fill
up a separate format for each institution and uploaded on the portal.
This assumes importance especially when the state has initiated
facility based reporting. Accredited private institutes are required to
provide information on the services provided at their facility.

6. Suggestions for improvement of these Instructions are welcome and

may be sent by e-mail to: [email protected].

Part A: Reproductive and Child Health

Ref Data Element Applicable to

no.

M1 Ante Natal Care Services (ANC)

PHC DH SDH
1.1 Total number of pregnant women Registered for ANC SC
CHC
Total number of NEW pregnant women registered for ante
natal care during the reporting month.
First ANC & registration are better treated as
synonymous
Data Source – Antenatal Register(Pregnancy Register)

1.1.1 Of which Number registered within first trimester DH SDH

SC PHC
Out of the total number reported in 1.1 above, the number CHC
registered within 12 weeks of pregnancy.
A visit purely to take a pregnancy test should NOT be
counted as a first antenatal visit.
Data Source – Antenatal Register (Pregnancy Register)

1.2 New women registered under JSY PHC DH SDH

SC
CHC
Total number of NEW pregnant women registered under
the JSY scheme during the reporting month.
Under JSY scheme, incentive is paid to the mother. Only
BPL, SC, ST pregnant women would be registered in

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Ref Data Element Applicable to

no.
High Performing States (HPS). In low performing states,
all BPL, SC, ST pregnant women and all APL pregnant
women who come for ANC could be registered.
Data Source – JSY Register
PHC DH SDH
SC
1.3 Number of pregnant women received 3 check ups CHC
Number of pregnant women who received the 3rd check-
up in the reporting month as per RCH schedule (i.e. 1st
Visit: 20-24 weeks, 2nd Visit: 28-32 weeks, 3rd Visit: 34-
36 weeks).
Note: Only those pregnant women are to be
counted/reported who received their third (3rd) antenatal
check up during the reporting month.
Data Source – Antenatal Register(Pregnancy Register)

Number of pregnant women given PHC DH SDH

1.4 SC
CHC
1.4.1 TT1
Total number of pregnant women who have received the
first dose of TT Immunisation.
This is the first pregnancy or first time that she has
received TT while pregnant.
Data Source – Antenatal Register(Pregnancy Register)

PHC DH SDH
1.4.2 TT-2 or Booster SC
CHC
Sum of number of pregnant women who have either
received the second dose of TT immunisation or booster
during the reporting month. This indicates the number of
pregnant women who have completed TT immunization
for the current pregnancy.
Data Source – Antenatal Register (Pregnancy Register)
PHC DH SDH
1.5 Total number of pregnant women given 100 IFA tablets SC
CHC
Total number of pregnant women who have received at
least 100 IFA tablet (large) (equivalent to 200 Mcg of
elemental iron per tablet daily) during the reporting
period.
Note: The number of women are to be reported and NOT
the number of IFA tablets.
Data Source – Antenatal Register(Pregnancy Register)

PHC DH SDH
1.6 Pregnant women with Hypertension (BP>140/90) SC
CHC
1.6.1 New cases detected at institution
Number of new ante-natal cases who have been detected

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Ref Data Element Applicable to

no.
with hypertension (BP more than 140/90) during the
reporting month at the facility.
BP should be monitored during regular checkups and need
to be reported only when it crosses 140/90. Such high BP
cases detected at the sub-centres or higher facility are to
be counted and reported in the respective forms, and the
case referred to a higher facility for treatment. The cases
referred to a higher facility should be recorded separately
on the register.
Data Source – Antenatal Register(Pregnancy Register)

1.6.2 Number of Eclampsia cases managed during delivery

DH SDH
Number of Eclampsia cases managed during delivery in
CHC
the reporting month at the facility. This diagnosis is made
by the medical officer attending to patient at the facility.
These clients may be referred from sub-centres or from
home but treated at this facility. Even if it is partial
treatment before referral, it should be reported.
Data Source – Antenatal Register (Pregnancy Register)
and Hospital Admissions/In-patient register

1.7 Pregnant women with Anaemia DH SDH

SC PHC
1.7.1 Number having Hb level<11 g/dl (tested cases) CHC
Number of pregnant women tested and found with
Haemoglobin (Hb) less than 11 grams/dl during the
reporting month.
Only those cases are to be reported where the Hb was
measured by a Hemoglobinometer or any other laboratory
method. Cases identified only by examination of eyes are
not to be recorded.
Data Source – Antenatal Register(Pregnancy Register),
Laboratory Register

Number having severe anaemia (Hb<7g/dl) treated at DH SDH

1.7.2 PHC
institution CHC
Number of women having severe Anaemia i.e. Hb. less
than 7 grams/dl and treated at the reporting facility during
the reporting month.
Note: The ANC clients who have haemoglobin under 7
grams/dl (severe anaemia) and detected at sub-
centres/PHC or from home, are to be referred to a higher
facility for treatment. The higher facility would report the
treatment.
Data Source– Antenatal Register(Pregnancy Register),
Laboratory Register

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Ref Data Element Applicable to

no.

M2 Deliveries

2.1 Deliveries conducted at Home

2.1.1 Number of Home Deliveries attended by:
SC
2.1.1 SBA Trained (Doctor/Nurse/ANM)
(a)
Number of home deliveries attended by a Doctor, Nurse
(SBA trained) or an ANM (SBA trained) during the
reporting month.
Data Source – Labour Room Register

2.1.1 Non SBA (TBA/Relatives/etc.)

(b) SC
Total number of home deliveries NOT attended by a
Skilled Birth Attendant (Doctor/ SBA trained Nurse/SBA
trained ANM) during the reporting month (i.e. excluding
those cases reported in 2.1.1 (a)). Trained ‘dais’ will also
come under this sub-category.

2.1.2 Number of newborns visited within 24 hours of Home

SC
Delivery

Total number of newborns visited by health worker

(ANM/ ASHA/ Doctor/ Staff Nurse) within 24 hours of
home delivery, during the reporting month.

2.1.3 Number of mothers paid JSY incentive for Home

SC
deliveries

Number of mothers who have been paid JSY (Janani

Suraksha Yojana) incentives for home deliveries during
the reporting month.
Note: The number of mothers is to be reported and NOT
the amount paid.

PHC DH SDH
2.2 Deliveries conducted at Public Institutions SC
CHC
Total number of deliveries conducted at the facility during
the reporting month. This will include the number of
caesarean section deliveries reported under Item M 3.
Only those deliveries that have taken place at the facility
are to be reported. Home deliveries are to be reported in
Item 2.1.1.
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Ref Data Element Applicable to

no.
Data Source – Labour Room Register
PHC DH SDH
2.2.1 Of which Number discharged under 48 hours of delivery SC
CHC
Out of the total deliveries conducted (reported in 2.2
above) in the facility, the number of women discharged
within 48 hours of delivery, during the reporting month is
to be reported.
It is important that a client stays in the institution for at
least 48 hours to reduce maternal mortality.
Data Source – Labour Room Register

2.2.2 Number of cases where JSY incentive paid to

PHC DH SDH
2.2.2 Mothers SC
CHC
(a) Number of mothers who have delivered in the reporting
facility and have been paid JSY incentive money during
the reporting month.
Institutional deliveries are encouraged by paying JSY
incentives to mothers. Total number of mothers who have
delivered in facility and have been paid JSY incentives are
to be counted. Count only those who were paid during the
month, not those who are eligible and due for payment.
Data Source – Pregnancy Register & JSY Register

PHC DH SDH
SC
2.2.2 ASHAs CHC
(b) Number of ASHAs paid incentive money for facilitating
institutional delivery at the reporting facility during the
reporting month under the JSY Scheme.
Count only those who have received payment – do not
include those who are eligible.
Data Source – Pregnancy Register & JSY Register

PHC DH SDH
2.2.2 ANM or AWW (only for HPS States) SC
CHC
(c) Number of ANM/AWW paid incentive for facilitating
institutional delivery at the reporting facility during the
reporting month under the JSY Scheme (To be reported
only for High Performing States).
In High Performing States (HPS), this incentive is paid to
ANM or AWW for Institutional delivery for facilitating
institutional delivery at the facility.
Data Source – Pregnancy Register & JSY Register

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Ref Data Element Applicable to

no.
DH SDH
2.3 Number of Deliveries at accredited Private Institutions PHC
CHC
Total number of deliveries conducted at the reporting
accredited private facility during the reporting month.

2.3.1 Number of private institutional delivery cases where JSY

incentive paid to:

2.3.1 Mothers
(a)
Number of mothers who have delivered in the reporting
accredited private facility and have been paid JSY
incentive money during the reporting month.
Institutional deliveries are encouraged by paying JSY
incentives to mothers. Count only those who were paid,
not those who are eligible and due for payment.
Data Source – Pregnancy Register & JSY Register

2.3.1 ASHAs DH SDH

PHC
(b) Number of ASHAs paid incentive for facilitating CHC
institutional delivery at the reporting accredited private
facility during the reporting month under the JSY scheme.
Count only those who have received payment – do not
include those who are eligible.
Data Source – Pregnancy Register & JSY Register
DH SDH
2.3.1 ANM or AWW (only for HPS States) PHC
CHC
(c) Number of ANM/AWW paid incentive for facilitating
institutional delivery at the reporting accredited private
facility during the reporting month under the JSY scheme
(To be reported only for High Performing States).
In HPS, this incentive is paid to ANM or AWW for
facilitating institutional delivery at the facility.
Data Source – Pregnancy Register & JSY Register

M3 Number of Caesarean (C-Section) deliveries

performed at
Data Source – Pregnancy register, Labour Room
Register & OT Register

3.1 Public facilities

Total number of caesarean section deliveries conducted by
facility during the reporting month.
Note: The number of C-section deliveries would be added

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Ref Data Element Applicable to

no.
to the total number of Deliveries at public Institutions
(Item 2.2).

3.1.1 PHC PHC

DH SDH
3.1.2 CHC CHC

DH SDH
3.1.3 Sub-divisional hospital/District Hospital
CHC

DH SDH
3.1.4 At Other State Owned Public Institutions
CHC

3.2 Private facilities

PHC DH SDH
CHC
M4 Pregnancy outcome & details of new-born

4.1 Pregnancy Outcome (in number)

Note : Pregnancy outcome is the sum of live births+ still
births + Abortion (Spontaneous/Induced)

PHC DH SDH
4.1.1 Live Birth SC
CHC
Live birth is the complete expulsion or extraction from its
mother of a baby, irrespective of the duration of the
pregnancy, which, after such separation, breathes or shows
any evidence of life, beating of the heart, pulsation of the
cord, cry etc.
Total number of live births during the reporting month.
For sub-centres, this includes both home deliveries and
deliveries conducted in the sub centre.
4.1.1 Male
(a)
Number of male live births during the reporting month.
In case of difficulty in attributing gender, make a note of
the same and attribute it to the nearest category. Report
only on live births happening in the facility. For live births
happening in a home near the facility, it would be
recorded in the nearest sub-centre form. Line listing will
help in avoiding duplication easier – and if your software
supports it, this could be used.
Data Source – Pregnancy Register/Labour Room

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Ref Data Element Applicable to

no.
4.1.1. Female
(b)
Number of female live births during the reporting month.
In case of difficulty in attributing gender, make a note of
the same and attribute it to the nearest category. Report
only on live births happening in the facility. For live births
happening in a home near the facility, it would be
recorded in the nearest sub-centre form. Line listing will
help in avoiding duplication – and if your software
supports it, this could be used.
Data Source – Pregnancy Register/Labour Room
PHC DH SDH
SC
4.1.2. Still Birth CHC
Number of still births occurring at the facility during the
reporting month. For sub-centres, the number of still
births occurring at the facility or home in the sub-centre
area would be reported.
When a foetus dies in uterus after about 20 weeks, or
during delivery, it is termed "stillborn". The death is
indicated by the fact that the foetus does not breathe or
show any evidence of life, such as beating of the heart or a
cry or a movement of the limbs. A still birth can be caused
by complications during labour or delivery. Other causes
of stillbirth can be birth defects in the baby, problems with
the placenta or umbilical cord, maternal illnesses or
conditions which may sometimes affect pregnancy.

Data Source – Pregnancy register/Labour Room Register

PHC DH SDH
SC
4.1.3 Abortion (spontaneous/induced) CHC
An abortion can occur due to various reasons. A
spontaneous abortion or miscarriage is the spontaneous
end of a pregnancy. Induced abortion is the Medical
Termination of Pregnancy (MTP). In this data element, the
total number of abortions (both spontaneous and induced)
during the reporting month will be reported. For sub-
centres, the number of spontaneous abortions occurring at
home in the sub-centre area would be reported if it has
been attended to, even with a delay. Of these total
abortions, all MTPs would also be reported separately in
Item M 7, as is required under the MTP Act. To this
extent, there will be double counting.

Abortion– Spontaneous/induced expulsion of products of

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Ref Data Element Applicable to

no.
conception before the age of viability of foetus. A
complete expulsion or extraction of a product of
conception of a pregnant woman less than 20 weeks.
Spontaneous abortions (miscarriages) occur when an
embryo or foetus is lost due to natural causes before the
20th week of gestation.
Data Source – Pregnancy register/Labour Room
Register

4.2 Details of Newborn children weighed

Total number of newborns weighed during the reporting
month at the facility. In case of home deliveries, the
number of new borns weighed would be reported in the
Sub-Centre form.
Data Source – Labour Room Register
PHC DH SDH
4.2.1 Number of Newborns weighed at birth SC
CHC
Number of infants (live births) weighed within 24 hours of
birth (See definition of live birth)
Data Source – Labour Room Register
PHC DH SDH
SC
4.2.2 Number of Newborns having weight less than 2.5 kg CHC
Total Number of infants (live births) who were weighed
and found to be less than 2500g in this facility
Data Source – Labour Room Register
PHC DH SDH
SC
4.3 Number of Newborns breast fed within 1 hour CHC
Out of newborns reported at the facility in the reporting
month, those given breast milk within 1st hour of delivery.
For sub centre, this will include newborns delivered at
sub-centre and home deliveries.
Data Source – Labour Room Register

M5 Complicated pregnancies

5.1 Number of cases of pregnant women with Obstetric

Complications and attended at Public facilities
The number of cases of pregnant women with obstetric
complications who have been attended to at the facility in
the reporting month is to be recorded.
An obstetric complication would include obstructed
labour, post partum haemorrhage, ante partum
haemorrhage, eclampsia, puerperal sepsis etc.
Data Source – Labour Room Register/ IP Register

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Ref Data Element Applicable to

no.

5.1.1 PHC PHC

5.1.2 CHC DH SDH

CHC

5.1.3 Sub-divisional hospital/District Hospital DH SDH

CHC

5.1.4 At Other State Owned Public Institutions (These could be DH SDH

Medical colleges, speciality hospitals etc.) CHC

5.2 Number of cases of pregnant women with Obstetric PHC DH SDH

Complications and attended at Private facilities CHC
No. of cases of pregnant women with obstetric
complications who have attended at private institutions in
the reporting month.
Data Source – Labour Room Register/ IP Register

5.3 Number of Complicated pregnancies treated with

Total number of complicated pregnancy cases treated with
the following at the reporting facility during the reporting
month.
DH SDH
PHC
5.3.1 IV Antibiotics CHC
Total number of complicated deliveries where a woman is
given Intra-venous (IV) antibiotics to treat sepsis in this
facility this month is to be reported.
Data Source – Obstetric IP Register/ Obstetric OPD
Register
DH SDH
5.3.2 IV Antihypertensive/Magsulph injection PHC
CHC
Total number complicated deliveries in which the woman
is given Intra-venous (IV) anti-hypertensive/Magsulph
injection to treat high blood pressure or Eclampsia at this
facility in this month is to be reported.
Data Source – Obstetric IP Register/ Obstetric OPD
Register

PHC DH SDH
5.3.3 IV Oxytocics CHC
Use of oxytocics is to prevent or manage bleeding. Total
number of complicated deliveries in which the woman is
given injectable oxytocin at this facility in this month is to

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Ref Data Element Applicable to

no.
be reported
Data Source – Obstetric IP Register/ Obstetric OPD
Register

5.3.4 Blood Transfusion DH SDH

Include both blood transfusion for severe anaemia and for CHC
complications in delivery (normal/C section) or postnatal
period
Data Source – Obstetric IP Register/ Obstetric OPD
Register

M6 Post Natal Care

The first 6 weeks (42 days) after delivery is called as post
natal period. After the birth of baby, either by normal
vaginal delivery or by C-section, there are many changes
that take place to reconstitute to the non-pregnant state.
Women should get a post partum check-up within 48
hours after delivery whether at home or at facility.

6.1 Women receiving post partum check-up within 48 hours PHC DH SDH
SC
after delivery CHC
Total number of women who have received post partum
check-up within 48 hours of delivery (0-48 hours) during
the reporting month. For sub-centres, this would also
include those post partum visits which have been given at
home within 48 hours of deliveries. Also count visits to
this facility that can be said to be a follow-up for post
natal care. Visits by ANM or any other SBA or trained ASHA
to the home, even where the delivery took place in the facility,
would be reported in sub-centre form.
Data Source – IP register/pregnancy register

6.2 Women getting a post partum check up between 48 PHC DH SDH

SC
hours and 14 days CHC
Total number of women who have received post partum
check-up between 48 hours and 14 days after delivery (48
hours-14 days) during the reporting month. For sub-
centres, this would also include those post partum visits,
which have been given at home.
Data Source – Pregnancy register/OP register

6.3 PNC maternal complications attended PHC DH SDH

Total number of women seen and treated as a PNC CHC

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Ref Data Element Applicable to

no.
complication, either being a referral received at the facility
or having developed the complication as an inpatient in
the facility in this month is to be reported.
Data Source – Obstetric IP Register/ Obstetric OPD
Register

M7 Medical Termination of Pregnancy (MTP)

Medical Termination of Pregnancy (MTP), also called as
induced abortion, is the removal or expulsion of an
embryo or foetus from the uterus done medically. Count
each case ONLY in the facility where the operation is
actually performed.
Data Source – OT Register/IP register

7.1 Number of MTP Conducted at Public Institutions PHC DH SDH

Total number of MTPs conducted at the reporting facility CHC
during the reporting month
Data Source – OT Register/IP register

7.1.1 Up to 12 weeks of pregnancy

7.1.2 More than 12 weeks of pregnancy

DH SDH
PHC
7.2 Number of MTPs conducted at Private Facilities CHC
Total number of MTPs conducted during the reporting
month at the private facilities.
Data Source – OT Register/IP register

M8 RTI/ STI Cases

The number of cases diagnosed with specific reproductive
tract infection (RTI) or sexually transmitted infection
(STI) during the reporting month. RTI/STI includes–
Gonorrhoea, Chlamydia, Candidiasis, Chancroid, Genital
herpes, Genital warts etc. Patients suspected of having
RTI/STI usually present with one of the following
complaints – Vaginal or urethral discharge, genital ulcers,
inguinal bubo, lower abdominal and/or scrotal pain,
genital skin conditions etc.
Count ONLY the first visit for each episode. Note that
patients with HIV/AIDS are NOT counted. Only those
given treatment that conform to ‘Syndromic management
of RTI/STI’ or disease specific treatment is to be counted
Data Source – OPD Register/IP Register/STI Client
Register

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8.1 Number of new RTI/STI for which treatment initiated DH SDH

PHC
Total number of new RTI/ STI cases for which treatment CHC
was initiated during the reporting month. Separate figures
for males and females needs to be reported.
Count ONLY the first visit for each episode. Note that
patients with HIV/AIDS are NOT counted. Only those
given treatment that conform to “Syndromic management
of RTIs/STIs” or disease specific treatment is to be
counted
Data Source – OPD Register/IP Register/STI Client
Register
8.1 (a) Male
8.1 (b) Female

DH SDH
8.2 Number of wet mount tests conducted PHC
CHC
Total numbers of suspected RTI / STI Cases for whom
wet mount tests were conducted during the reporting
month.
Wet mount tests are conducted for the suspected case of
RTI/STI. Count only the ones for which the test has been
conducted in the laboratory that serves this facility.
Data Source – Laboratory Register

M9 Family Planning

9.01 Number of NSV/Conventional Vasectomy conducted

Total number of NSV (No Scalpel
Vasectomy)/Conventional Vasectomy conducted during
the reporting month separately at the public and private
health facilities.
Cases by both the procedures should be added together.
Only cases done at this facility should be reported. Do not
differentiate in reporting between camps held at the
facility and regular services. Camps held in this facility’s
area and not reported by other facility, is to be reported
here. Ensure same camp is not double counted. A camp
has to be counted at the nearest PHC in which or near
which it was held. The difference between the NSV
procedure and the conventional procedure is in the
surgical approach to the vas deferens, which is through a
small puncture in the scrotum rather than by a cut with a
scalpel. The surgical procedure of vas ligation is the same

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as in the conventional method. Long term clinical reports
have shown that NSV is less invasive than the
conventional technique, cause fewer complications, and
takes much less time.

9.01.1 At public facilities PHC

9.01.1 (a)At PHCs
DH SDH
9.01.1 (b)At CHCs CHC

9.01.1 (c)At Sub-divisional hospitals/ District Hospitals DH SDH

CHC

9.01.1 (d)At Other State Owned Public Institutions DH SDH

CHC

9.01.2 At Private facilities DH SDH

PHC
CHC
Data Source – FP Register/OT register

9.02 Number of Laparoscopic sterilizations/ conducted

Total number of female sterilisation acceptors of
laparoscopic sterilization conducted during the reporting
month at the facility.
Data Source – FP Register/OT register

9.02.1 At public facilities

PHC
9.02.1 At PHCs
(a) DH SDH
9.02.1 At CHCs CHC
(b)
DH SDH
9.02.1 At Sub-divisional hospitals/ District Hospitals CHC
(c)
DH SDH
9.02.1 At Other State Owned Public Institutions CHC
(d)

9.02.2 At Private facilities PHC DH SDH

CHC
Total number of laparoscopic sterilizations conducted
during the reporting month at the private facilities.
Laparoscopic sterilization is a planned operative
procedure that results in the woman being sterilised using

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laparoscopic method.
Data Source – FP Register/OT register

9.03 Number of Mini-lap sterilizations conducted

Total number of Mini-lap sterilizations conducted during
the reporting month at the facility.
Mini-Lap sterilisation is a way of performing operation
through a small abdominal incision—about 2–3 inches.
Data Source – FP Register/OT register

9.03.1 At public facilities

PHC
9.03.1 At PHCs
(a) DH SDH
9.03.1 At CHCs CHC
(b)
DH SDH
9.03.1 At Sub-divisional hospitals/ District Hospitals CHC
(c)
DH SDH
9.03.1 At Other State Owned Public Institutions CHC
(d)

9.03.2 At Private facilities

DH SDH
PHC
9.04 Number of Post-Partum sterilizations conducted CHC
Total number of females who have undergone post partum
sterilization during the reporting month at the facility.
Post partum sterilization here refers to any female
sterilization done within 7 days of delivery
Data Source – FP Register/OT register

9.04.1 At public facilities PHC

9.04.1 (a) At PHCs
DH SDH
9.04.1 (b) At CHCs CHC

DH SDH
9.04.1 (c) At Sub-divisional hospitals/ District Hospitals CHC

DH SDH
9.04.1 (d) At Other State Owned Public Institutions CHC

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9.04.2 At Private facilities PHC DH SDH

CHC

9.05 Number of IUD Insertions

Total number of cases of IUD Insertions during the
reporting month at the facility.
Intra Uterine Contraceptive Device (IUD) is inserted into
a woman between 15 and 49 years. Those that were
inserted in a sub-centre or PHC below this CHC would be
reported by that facility.
Data Source – FP Register/OT register

9.05.1 At public facilities

9.05.1 (a) At Sub- Centres
SC

9.05.1 (b) At PHCs

PHC
9.05.1 (c) At CHCs DH SDH
CHC

9.05.1 (d) At Sub-divisional hospitals/ District Hospitals DH SDH

CHC

9.05.1 (e) At Other State Owned Public Institutions DH SDH

CHC

9.05.2 At Private facilities PHC DH SDH

CHC

PHC DH SDH
9.06 Number of IUD removals SC
CHC
Total number of cases of IUD removals during the
reporting month.
Data Source – FP Register/OT Register
PHC DH SDH
SC
9.07 Number of Oral Pills cycles distributed CHC
Total number of oral pill packets distributed during the
reporting month, including those distributed through depot
holder/ASHA/ANM (Distribution would mean,
distribution to actual beneficiaries and NOT inventory
transfer from one facility to another). If the strips are
stocked with a drug depot or ASHA, the ANM would

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have to ascertain from them and report it.
Data Source – FP Register
PHC DH SDH
9.08 Number of Condom pieces distributed SC
CHC
Total number of condom pieces distributed during the
reporting month, including those distributed through depot
holder/ASHA/ANM
Condoms that has been given out by the facility in this
month or taken from distribution points in facilities or
elsewhere (including campaigns in streets, markets,
factories etc.) which were supplied directly from this
facility.
Data Source – FP Register
PHC DH SDH
SC
9.09 Number of Centchroman (weekly) pills given CHC
Total number of Centchroman (weekly) pills distributed
during the reporting month, including those distributed
through depot holder/ASHA/ANM.
Data Source – FP Register/Inventory Register
PHC DH SDH
SC
9.10 Number of Emergency Contraceptive Pills distributed CHC
Total number of emergency contraceptive pills distributed
during the reporting month, including those distributed
through depot holder/ASHA/ANM.
One client can receive more than one emergency
contraceptive pill per month. In such cases, count each
visit. For counting disbursal through depots, see above.
Data Source – FP Register/Inventory Register
DH SDH
9.11 Quality in Sterilization services PHC
CHC
9.11.1 Number of Complications following sterilization
Total number of cases of complications following NSV/
conventional vasectomy and female sterilization reported
in the facility during the reporting month
Data Source – FP Register/OPD Register

9.11.1 Male
(a) Any male sterilisation patient who reports with or is
diagnosed as having a complaint related to the sterilisation
procedure. Patients tend to over report and health care
providers tend to under diagnose complications. Specific
symptom list that qualify should be laid down and known,
but even a patient’s subjective report is acceptable.
Problems that might occur after male sterilisation include:

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Bleeding, infection, mild inflammatory reaction and
others.

9.11.1 Female
(b) Any woman having undergone any one of the above
sterilisations who reports at a facility for a complication of
sterilisation. Patients tend to over report and health care
providers tend to under diagnose complications. Specific
symptom list that qualify should be laid down and known,
but even a patient’s subjective report is acceptable.
Serious complications from female surgical sterilization
are rare and are most likely to occur with abdominal
procedures. They include bleeding, infection, reaction to
the anaesthetics, injury to the bowels or blood vessels
rarely and require major surgical repair
PHC DH SDH
SC
9.11.2 Number of Failures following sterilization CHC
Total number of cases of failures following NSV/
conventional vasectomy and female sterilization reported
in the facility during the reporting month.
The woman becomes pregnant despite the spouse/self
having had a sterilisation surgery, provided either of the
two or both claims this to be due to sterilisation failure.
This will come to notice only if the man or the woman
complains or if there is record. Data needs to be attended
with great tact and confidentially.
Data Source – FP Register/OPD Register

9.11.2 Male
(a) This will come to notice only if the man or the woman
complains or if there is record of failure of sterilization.

9.11.2 Female
(b) A sterilized woman who becomes pregnant.
Needs to be investigated, supported, offered the care of
her choice and compensated.

PHC DH SDH
SC
CHC
9.11.3 Number of Deaths following sterilization
Total number of cases of deaths following NSV/
Conventional vasectomy and female fertilization reported
in the facility during the reporting month.
A death due to sterilization is very rare and needs to be
investigated. A death may occur at home or at the facility.
If it occurs at the facility then the facility will report it. If
it occurs at home (even if the sterilization was done at the
facility) then it will be reported by the sub centre based on the

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ANM’s report. However, the medical officer should
oversee and ensure the record and investigation of the
case.
Data Source – FP Register/OPD Register/IP
Register/Death Register

9.11.3 (a) Male

9.11.3 (b) Female

9.12 Number of Institutions having NSV Trained Doctors DH SDH

PHC
Total number of institutions which have NSV trained CHC
doctors Number of institutions to be reported here and not
the number of doctors.
Data Source-FP training Register

M10 Child Immunisation

10.1 Number of Infants 0 to 11 months old who received the PHC DH SDH
SC
following: CHC
Infants who were immunized in this facility premise
should be entered. Those who were immunized in outreach
centres should be seen as part of a defined sub-centre. This is
to avoid duplication with reports from sub-centres and
PHCs.

The OPV doses given during Pulse Polio rounds are NOT
to be counted.
Data Source – Immunisation Register

PHC DH SDH
10.1.01 BCG SC
CHC
BCG (tuberculosis) vaccine given to infants, preferably
right after birth.
All infants under 1 year receiving BCG at this facility
should be counted, including babies/infants coming to
clinics after home deliveries and infants that got their
BCG later than usual due to for instance temporary
shortages of vaccine.
Data Source – Immunisation Register
PHC DH SDH
SC
10.1.02 DPT1 CHC
First dose of Diphtheria, pertussis and tetanus combined
vaccine given to infants, preferably at six weeks. All
infants under 1 year receiving DPT1 at this facility should
be counted, including babies/infants coming to clinics
after home deliveries and infants that got their DPT1 later

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than usual due to, for instance, temporary shortages of
vaccine.
Data Source – Immunisation Register
PHC DH SDH
SC
10.1.03 DPT2 CHC
DPT (Diphtheria, Pertussis, Tetanus) vaccine 2nd dose
given to a child under one year - preferably at around 10
weeks after birth. All infants under 1 year receiving DPT2
at this facility should be counted, including babies/infants
coming to clinics after home deliveries and infants that got
their DPT2 later than usual due to, for instance, temporary
shortages of vaccine.
Data Source – Immunisation Register
PHC DH SDH
10.1.04 DPT3 SC
CHC
DPT (Diphtheria, Pertussis, Tetanus) vaccine 3rd dose
given to a child under one year - preferably at around 14
weeks after birth. All infants under 1 year receiving DPT3
at this facility should be counted, including babies/infants
coming to clinics after home deliveries and infants that got
their DPT3 later than usual due to for instance temporary
shortages of vaccine.
Data Source – Immunisation Register
PHC DH SDH
SC
10.1.05 OPV 0 (Birth Dose) CHC
Total number of newborns who have been given OPV 0
during the reporting month. For sub-centres, this would
also include cases of home delivery given OPV0.
Data Source – Immunisation Register
PHC DH SDH
10.1.06 OPV1 SC
CHC
OPV first dose given to infants of under one year. All
infants under 1 year receiving OPV1 at this facility should
be counted, including babies/infants coming to clinics
after home deliveries and infants that got their OPV1 later
than usual due to, for instance, temporary shortages of the
stock. Note that OPV doses given during Pulse Polio
rounds are not to be counted.
Data Source – Immunisation Register
PHC DH SDH
SC
10.1.07 OPV2 CHC
OPV second dose given to infants of under one year old.
All infants under 1 year receiving OPV2 at this facility
should be counted, including babies/infants coming to

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clinics after home deliveries and infants that got their
OPV2 later than usual due to, for instance, temporary
shortages of the stock. Note that OPV doses given during
Pulse Polio rounds are not to be counted
Data Source – Immunisation Register
PHC DH SDH
SC
10.1.08 OPV3 CHC
All infants under 1 year receiving OPV3 at this facility
should be counted, including babies/infants coming to
clinics after home deliveries and infants that got their
OPV3 later than usual due to, for instance, temporary
shortages of the stock. Note that OPV doses given during
Pulse Polio rounds are not to be counted
Data Source – Immunisation Register

PHC DH SDH
10.1.09 Hepatitis-B1 SC
CHC
First Hepatitis vaccine given to infants, preferably with
DPT at six weeks. All infants under 1 year receiving
Hepatitis B1 at this facility should be counted, including
babies/infants coming to clinics after home deliveries and
infants that got their Hepatitis B1 later than usual due to,
for instance, temporary shortages of the stock. Note this is
applicable only in those states which have taken up this
activity.
Data Source – Immunisation register
PHC DH SDH
10.1.10 Hepatitis -B2 SC
CHC
Hepatitis B 2nd dose given to infants of under one year. It
should be counted, including babies/infants coming to
clinics after home deliveries and infants that got their
Hepatitis B2 later than usual due to for instance temporary
shortages of the stock. Note this is applicable only in those
states which have taken up this activity.
Data Source – Immunisation register
PHC DH SDH
SC
10.1.11 Hepatitis -B3 CHC
Hepatitis B vaccine 3rd dose given to a child under one
year - preferably at around 14 weeks after birth. All
infants under 1 year receiving Hepatitis B3 at this facility
should be counted, including babies/infants coming to
clinics after home deliveries and infants that got their
Hepatitis B3 later than usual due to, for instance,
temporary shortages of the stock. Note this is applicable
only in those states which have taken up this activity

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Data Source – Immunisation Register

PHC DH SDH
10.1.12 Measles SC
CHC
Measles vaccine 1st dose given to a child under one year
of age (preferably at 9 months after birth). 1st doses given
to children between 9 and 12 months at this facility should
be included. Other doses given to YOUNGER children
during an outbreak should NOT be counted here
Data Source – Immunisation Register

10.1.13 Total Number of children aged between 9 and 11 months PHC DH SDH
SC
CHC
who have been fully immunized (Child given one dose of
BCG, three dosages of DPT i.e. DPT 1,2,3; three dosages
of polio i.e. OPV 1,2,3 and a dosage of Measles)
Total number of infants 9-11 months old that have
completed routine immunisation during the reporting
month i.e. who have received BCG, all three doses of
DPT, OPV and measles. The OPV doses given during
Pulse Polio rounds are NOT to be counted. Separate break
ups for male and female has to be given.
Data Source – Immunisation Register

10.1.13 (a) Male

10.1.13 (b) Female

10.2 Number of children more than 16 months who received DH SDH

SC PHC
the following CHC
Total number of children more than 16 months of age who
have received the following doses during the reporting
month

10.2.1 DPT Booster

Data Source – Immunisation register

10.2.2 OPV Booster

The OPV doses given during pulse polio rounds are NOT
to be counted.
Data Source – Immunisation Register

10.2.3 Measles, Mumps, Rubella (MMR) Vaccine

Measles, Mumps, Rubella vaccine given to child more
than 16 months.
Data Source – Immunisation Register

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PHC DH SDH
10.3 Immunization Status SC
CHC
10.3.1 Total number of Children aged between 12 and 23 months
who have been fully immunised (Child given one dose of
BCG, three dosages of DPT i.e. DPT 1,2,3; three dosages
of polio i.e. OPV 1,2,3 and a dosage of Measles) during
the month
Total number of children 12-23 months who have
completed routine immunisation during the reporting
month i.e. who have received BCG, DPT 1,2 and 3, OPV
1,2 and 3 and measles. Children receiving measles through
MMR only will also be counted provided that they have
received other vaccines also. The OPV doses given during
Pulse Polio rounds are NOT to be counted. Separate break
up for male and female has to be reported.
10.3.1 (a) Male
10.3.1 (b) Female
PHC DH SDH
SC
10.3.2 Children more than 5 years given DT5 CHC
Total number of children more than 5 years of age who
have been given DT booster during the reporting month.
Data Source – Immunisation register
PHC DH SDH
SC
10.3.3 Children more than 10 years given TT10 CHC
Total number of children more than 10 years of age who
have been given TT booster during the reporting month
Data Source – Immunisation register
PHC DH SDH
SC
10.3.4 Children more than 16 years given TT16 CHC
Total number of children more than 16 years of age who
have been given TT booster during the reporting month
Data Source – Immunisation register
PHC DH SDH
SC
10.3.5 Adverse Event Following Immunisation (AEFI) CHC
An adverse event following immunization (AEFI) is
defined as a medical incident that takes place after an
immunization, and is believed to be caused by
immunization.
Data Source – Immunisation Register/OPD Register/IP
Register/DHQ records(FIR sent)

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SC PHC
10.3.5 (a)Abscess CHC
Total number of cases of abscess reported following
routine immunisation during the reporting month. An
abscess is a collection of pus that has accumulated in a
cavity formed by the tissue on the basis of an infectious
process. This calls for investigation on quality of syringe
supply and use. Since the reporting person is the most
likely person at fault, this could get under-reported unless
the facilities where children are coming for treatment,
report this well.
Data Source – Immunisation Register/OPD Register/IP
Register

PHC DH SDH
SC
10.3.5 (b) Death CHC
Total number of cases of deaths reported following routine
immunisation during the reporting month. This needs to
be investigated. Total number of children who were
reported to have died following routine immunization in
this month in the facility. If the immunization is at the
facility but the death occurs at home- it is still reported
here, as medical officer has to certify it. If the
immunization is at home, but death occurs at facility it is
still reported here.
Data Source – Immunisation Register/OPD Register/IP
Register
PHC DH SDH
SC
10.3.5 (c) Others CHC
Total number of cases of other complications reported
following routine immunisation during the reporting
month. Any of the following symptoms should be
reported: 1.Rash, 2. Fever, 3. Fainting, 4. Anaphylactic
shock, 5. Paralysis, 6. Weakness developing in any part of
limbs etc. Even if it does not conform to this pattern but
occurs within a week, it should be noted and action to be
taken after investigation

10.4 Number of Immunization sessions during the month: PHC DH SDH

SC
10.4.1 Planned CHC
Written number of immunisation sessions planned to be
held in the facility and not in the outreach areas under it,
during the reporting month. For sub centres, the sessions
planned in the outreach area shall also be included.
Data Source – Immunisation Planning register

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PHC DH SDH
10.4.2 Held SC
CHC
Total number of immunisation sessions held during the
reporting month. For sub centres, the sessions held in the
outreach area shall also be included.
Data Source – Immunisation Planning Register
PHC DH SDH
10.4.3 Number of sessions where ASHAs were present SC
CHC
Total number of immunisation sessions held during the
reporting month where ASHA was present. It measures
the involvement of ASHAs in the community
Immunisation activities. For sub centres, the sessions
held in the outreach area shall also be included.
Data Source – Immunisation Planning Register

PHC DH SDH
10.5 Others [Japanese Encephalitis (JE) etc. Please Specify] SC
CHC
Total number of cases of immunisation carried out with
vaccine other than those included in routine immunisation
such as japanese encephalitis, chicken pox, typhoid etc.
during the reporting month. These could be state specific.
Data Source – Immunisation Planning Register

M11 Number of Vitamin A doses

11.1 Administered between 9 months and 5 years
Total number of children between 9 months and 5 years of
age who were given Vitamin A dose during the reporting
month.
PHC DH SDH
11.1.1 Dose-1 SC
CHC
Total number of children over 6 months under 1 year
given vitamin A 1st dose in this facility during the
reporting month.
Data Source – Immunisation Register
PHC DH SDH
SC
11.1.2 Dose-5 CHC
The facility maintains a register that tracks each child
where every dose of vitamin A is given. When it crosses
5, only then does it need to be reported and this could be
used to estimate achievements in in-between dosages.
Total number of children under 3 years given vitamin A
5th dose in this facility during the reporting month.
Data Source – Immunisation Register

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PHC DH SDH
SC
11.1.3 Dose-9 CHC
Same as above. Total number of children under 5 years
given vitamin A, 9th dose (booster) in this facility during
the reporting month
Data Source – Immunisation Register

M12 Number of cases of Childhood Diseases reported

during the month (0-5 years)
Sub centres will only report those cases that report to SC
or are treated at home. All the facilities will include both
the inpatients as well as outpatients cases.

12.1 Diphtheria PHC DH SDH

Total Number of cases of diphtheria reported in children CHC
below five years during the reporting month
Diphtheria is a bacterial infection that spreads easily and
mainly affects the nose and throat. Children under 5 years
are particularly at risk for contracting the infection.
Total cases of diphtheria in a child under 5 years seen at
this facility during the reporting month. If a doctor from
the facility has gone and seen the case in the house, then it
may be recorded as seen at the facility. Otherwise all the
cases seen at home are screened, and recorded by the
ANM of the sub-centre and needs to be further referred.
Note that all cases of diphtheria need admission.
Data Source – OP register/IP register

PHC DH SDH
12.2 Pertussis
CHC
Total Number of cases of pertussis reported in children
under five years seen at this facility during the reporting
month.
Whooping cough or Pertussis is an infection of the
respiratory system caused by the bacterium Bordetella
pertussis. Medical sources describe the whoop as "high-
pitched"; this is generally the case with infected babies
and children. Children tend to catch it more than adults.
For home cases- same instruction as above.

Data Source – OP Register/IP register

12.3 Tetanus Neonatorum PHC DH SDH

Total Number of cases of Tetanus neonatorum reported CHC
during the reporting month.
Neonatal Tetanus occurs in newborns who are delivered

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in unsanitary conditions, especially if the umbilical cord
stump becomes contaminated.
Total cases of tetanus neonatorum in newborns seen at this
facility in this month. For home cases, same instructions
as above.
Data Source – OP register/IP register

PHC DH SDH
12.4 Tetanus others
CHC
Total Number of Tetanus cases others than neonatorum
reported in children below five years during the reporting
month.
Tetanus, also known as lockjaw, is a serious but
preventable disease that affects the body's muscles and
nerves. It typically arises from a skin wound that becomes
contaminated by a bacterium called Clostridium tetni,
which is often found in soil.
Total cases of Tetanus Others in children less than 5
years seen at this facility in this month. For home cases,
same instructions as above.
Data Source – OP Register/IP register.

PHC DH SDH
12.5 Polio
CHC
Total Number of cases of polio reported in children below
five years, according to WHO clinical criteria, reported at
this facility. Poliomyelitis (polio) is a highly infectious
viral disease, which mainly affects young children. Initial
symptoms of polio include fever, fatigue, headache,
vomiting, stiffness in the neck, and pain in the limbs. In a
small proportion of cases, the disease causes paralysis,
which is often permanent.
Data Source – OP Register/IP register

PHC DH SDH
12.6 Measles SC
CHC
Total Number of cases of Measles reported in children
below five years during the reporting month.
Measles, also called rubeola, is a respiratory infection
that's caused by a virus. It causes a total-body skin rash
and flu-like symptoms, including fever, cough, and
running nose. The initial symptoms of the infection are
usually a hacking cough, running nose, high fever, and
watery red eyes. Another marker of measles is Koplik's
spots, small red spots with blue-white centres that appear
inside the mouth.
Data Source – OP Register/IP register

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PHC DH SDH
12.7 Diarrhoea and dehydration SC
CHC
Total number of cases of Diarrhoea with dehydration
reported in children below five years during the reporting
month. Diagnosis is best made at a medical facility but
based on conformance to the case definition, a health
worker can also report it. If a doctor from health facility
visits and attends to patients or it is seen at the facility,
they would report it.

Diarrhoea — frequent runny or watery bowel movements

(poop) — is usually brought on by gastrointestinal (GI)
infections caused by viruses, bacteria, or parasites.
Dehydration is a condition that occurs when a person
loses more fluids than he or she takes in. Dehydration is a
serious problem for babies or young children.
Data Source – OP register/IP register
PHC DH SDH
12.8 Malaria SC
CHC
Total number of cases of malaria (Smear positive)
reported in children below five years during the reporting
month. Diagnosis is best made at a medical facility but
based on conformance to the case definition, a health
worker can also report it. If a doctor from health facility
visits and attends to patients or it is seen at the facility,
they would report it.
Data Source – OP register/IP register/Lab register

PHC DH SDH
12.9 Number admitted with Respiratory Infections CHC
Total number of children below 5 years admitted with
respiratory infections during the reporting month.
Data Source – OP register/IP register

Part B: Other Programmes

Ref no. Data Element Applicable to

M13 Blindness Control Programme

PHC DH SDH
13.1 Number of patients operated for cataract CHC
Total number of cases of cataract operated during the reporting
month, at this facility (which is equipped to do eye surgeries).

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Ref no. Data Element Applicable to

Data Source – OT register/ IP register/Ophthalmology
register DH SDH
PHC CHC
13.2 Number of Intraocular Lens (IOL) implantations
Total number of cases of cataract where IOL was implanted,
during the reporting month, at this facility (which is equipped
to do eye surgeries).
Data Source – OT Register/ IP Register/Ophthalmology
Register

PHC DH SDH
13.3 Number of school children detected with Refractive errors
CHC
Total number of school children detected with refractive errors,
during the reporting month.
This is usually done in schools by qualified doctors – where
doctors have gone from this facility, it needs to be included
here. If the school visit was made by doctors from more than
one facility- include it at the level of the facility nearest the
school. (this would help when we use GIS).
Data Source– OPD register/Ophthalmology register/School
Health doctor records/

PHC DH SDH
13.4 Number of children provided free glasses
CHC
Total number of children provided with free glasses during the
reporting month.
Include it along with the facility from which the glasses were
sent- which would be the same as above.
Data Source – OPD register/Ophthalmology Register/
School Health doctor records/
DH SDH
13.5 Number of eyes collected CHC
Total number of eyes collected through eye donation during the
reporting month.
Data Source –Ophthalmology register of collecting centres

DH SDH
13.6 Number of eyes utilised CHC
Total number of donated eyes used for corneal transplant
during the reporting month.
Data Source –Ophthalmology register of collecting centres

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Part C: Health Facility Services

Ref no. Data Element Applicable to

M14 Patient Services

DH SDH
14.01 Number of CHC/ SDH/ DH functioning as an FRU CHC
Is the CHC/SDH/ DH functioning as FRU. (Answer to be
given in Yes/ No) (At a minimum, FRU should have
facilities for caesarean section and blood transfusion on
24X7 basis).
All the CHCs, declared as 24x7, may be upgraded to First
Referral Units (FRUs). The minimum requirement of FRUs
including manpower, i.e. gynaecologist, anaesthetist,
paediatrician, and round the clock services of nurses and
general duty officers should be ensured. Blood storage
facility and other supportive services such as laboratory, X-
ray, OT, labour room, laundry, diet, waste management
system, referral transport etc. must be ensured. CHCs, as
FRU, will provide the 24 hours delivery services including
normal and assisted deliveries, emergency obstetric care
including surgical intervention like caesarean section and
other medical intervention, newborn care, emergency care of
sick children, full range of family planning services
including laparoscopic services, safe abortion services,
treatment of STI/RTI, availability of blood storage unit or
effective linkage facilities with blood banks, and referral
transport services.
Data source : IP register

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

Is the PHC functioning 24x7 i.e. it has 2 staff nurses posted
for 24x7 deliveries. (Answer to be given in Yes/ No)
NRHM envisages that all the Primary Health Centres
(20,000-30,000 population) should function as a 24x7 centre
in a phased manner to improve the availability of health care
services and also promotes the conduct of institutional
deliveries at these centres

14.03 Number of Anganwadi centres reported to have conducted SC

VHNDs
Number of Anganwadi centres reporting of having
conducted at least one health and nutrition day (divas) is to

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Ref no. Data Element Applicable to

be recorded. It has to be reported by sub centre only.

Village Health and Nutrition Days are organized every
month at the Anganwadi level in each village in which
immunization, ante / post natal checkups and services related
to mother and child health care including nutrition are being
provided.

14.04 Number of facilities having a Rogi Kalyan Samiti PHC DH SDH

The purpose is to provide sustainable quality care with CHC
accountability and people’s participation along with total
transparency. This requires the development of a proper
management structure which may be called as Rogi Kalyan
Samiti (RKS) (Patient Welfare Committee).
Data Source – RKS Register
DH SDH
14.05 Number of RKS meetings held during the month PHC
CHC
Total number of meetings of RKS held during the reporting
month. A meeting is recorded if it was held during the
reporting month and whose minutes are maintained.
The RKS meetings should be held at least once in a quarter.
It is to be reported only in the month in which it was held.
Data Source – RKS register/Proceedings of Meeting
register

Number of facilities having Ambulance services (Assured DH SDH

14.06 PHC
CHC
Referral Services) available
Does the Facility have Assured Ambulance Service (Answer
to be given in Yes/ No). Assured Ambulance Service would
mean that ambulance is available on 24x7 basis for the health
facility.
The ambulance need not be owned or run by the hospital.
Even if this is outsourced or available on call of a regular
basis, it would count here.

14.07 Total Number of times the Ambulance was used for PHC DH SDH
transporting patients during the month CHC
Total Number of times the ambulance was used for
transporting the patients during the reporting month. Each
trip to be counted as one, even if more than one patient is
transported.
Data Source – Assured Ambulance Service Register

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Ref no. Data Element Applicable to

14.08 Number of Institutions having operational Sick New Born DH SDH

Care Units CHC
Is the Facility having operational Sick New Born Care Unit
(SNCU)? (Answer to be given in Yes/ No)

14.09 Number of functional Laparoscopes in CHC/SDH/DH DH SDH

The total number of functional laparoscopes available in the CHC
reporting facility during the reporting month (Status on the
reporting day). This will indicate whether any faulty
instrument has been repaired or not.
It will not include the ones which are not operational
(faulty).
Data Source – Equipment Maintenance Register

14.10 Inpatients DH SDH

PHC
14.10.1 Admissions CHC
An admission must include at least a planned 24 hour or
overnight stay.
Data Source – IP Register

Total number of patients admitted during the reporting

month.
Separate figures for male and female to be reported.

Children < 19 Yrs

Total number of children below 19 years of age admitted
during the reporting month. Separate figures for males and
females to be reported.

Adults
Total number of adults of age 19 years and above admitted
during the reporting month. Separate figures for males and
females to be reported.
14.10.1(a) Male
14.10.1(b) Female
DH SDH
PHC
14.10.2 Deaths CHC
Data Source – IP register
Total number of deaths in the facility due to any cause,
during the reporting month. Separate figures for males and
females to be reported.
14.10.2(a) Male
14.10.2(b) Female

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Ref no. Data Element Applicable to

PHC DH SDH
14.11 In-Patient Head Count at midnight CHC
This ensures that day care admissions are not counted. But
one has to include deaths within 24 hours. Also one could
call the “the sum of midnight patient head count per month.”
In an in-patient register at midnight (or at 6.00 am) on each
day, the midnight total for that day would be entered. At the
end of the month the daily midnight totals are added up to
get the figure to fill up here.
Data Source – IP register

Mid-Night count - Total number of in-patients remaining

admitted in the facility at midnight. Total would be
calculated by adding daily count, at mid-night, for the month.

PH DH
14.12 Outpatients SC
SDH
14.12.1 OPD attendance (All)
Total number of patients seen in the OPD (all types) during
the reporting month.

Data Source – OPD Register

DH SDH
14.13 Operation Theatre PHC
CHC
If C-sections are being done, they would be double counted,
but since interpretation and use is different, it could be
allowed.
Data Source – OT Register

14.13.1 Operation major (General and spinal anaesthesia)

Total number of operations carried out using general or
spinal anaesthesia, during the reporting month.
Major surgeries/operations are a defined as surgeries
requiring spinal or general anaesthesia. (alternative definition
–surgeries that take more than 30 minutes to complete).

14.13.2 Operation minor (No or local anaesthesia)

Total number of operations carried out without anaesthesia
or local anaesthesia, during the reporting month.
This is a measure of minor surgical care and should be
available even where there is no surgeon. Draining
abscesses, stitching injuries, haemorrhoids management etc
would be counted here. Local anaesthesia in this month.
Please do not include dental procedures as they would be
counted separately.
Data Source – OT Register
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Ref no. Data Element Applicable to

DH SDH
PHC
14.14 Others (Include other services like dental, optho, AYUSH CHC
etc.)
14.14.1 AYUSH
Number of patients seen by AYUSH practitioners, in the
facility, during the reporting month.
Data Source – OPD (AYUSH) Register

14.14.2 Dental Procedures

Total number of dental procedures carried out during the
reporting month
Data Source – OT (Dental) Register

14.14.3 Adolescent counselling services

Total number of adolescents counselled during the reporting
month.

Data Source – Adolescent counselling Register/ School

Health doctor records/

14.14.4 Others
Other OPD/ procedures not covered may be reported here
with name of the procedure and corresponding number.

M15 Laboratory Testing

15.1 Laboratory Test Details

PH DH SDH
15.1.1 Hb Tests conducted SC
CHC
15.1.1 (a) Number of Hb tests conducted
Total number of Haemoglobin (Hb) tests carried out during
the reporting month.

PH DH SDH
15.1.1 (b) Of which number having Hb < 7 grams/dl SC
CHC
Out of the total number of Haemoglobin (Hb) tests done
(15.1.1(a)), number having Hb less than 7 grams/dl.

15.1.2 HIV tests conducted DH SDH

PHC
Number of cases tested for HIV during the reporting month. CHC
Separate figures for males, females, and females with ANC
have to be reported.
Information is not asked for those found positive. Sample
would be collected confidentially, and then at the block and
district level, the positivity rate would be computed.
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Ref no. Data Element Applicable to

Alternatively, one could calculate positivity rates for each

facility and then send these up.

Data Source –Laboratory Register

15.1.2 (a) Male
15.1.2 (b) Female-Non ANC
15.1.2 (c) Female with ANC

PHC DH SDH
15.2 Widal tests conducted
CHC
Number of WIDAL tests carried out during the reporting
month.
One could cross check positive cases with those reported in
IDSP and not being reported here. This would be useful for
denominator for a positivity rate.
Data Source –Laboratory Register

15.3 VDRL tests conducted PHC DH SDH

Number of VDRL tests carried out during the reporting CHC
month. Separate figures for male, females, and females with
ANC have to be reported.

Data Source –Laboratory Register

15.3 (a) Male
15.3 (a) Female-Non ANC .
15.3 (a) Female with ANC

15.4 Malaria tests conducted PHC DH SDH

15.4.1 Blood smears examined CHC
Total number of blood smears tested for malaria during the
reporting month. Malaria blood smears examined, as per
laboratory tests according to IDSP guidelines indicates
prevalence in the group of patients being tested- also the
need for treatment and follow up.
Data Source –Laboratory Register

15.4.2 Plasmodium Vivax test positive PHC DH SDH

CHC
Out of blood smears tested (reported in 15.4.1), number
positive for Plasmodium Vivax during the reporting month.
DH SDH
15.4.3 Plasmodium Falciparum test positive PHC
CHC
Out of blood smears tested (reported in 15.4.1), number positive for
Plasmodium Falciparum during the reporting month.

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Part D: Monthly Inventory Status

(Data to be collected from the district warehouse /stores)

Ref no. Data Element Applicable to

Stock Position (During the month)

Balance from Previous month A

DHQ

Balance remaining in the store at the last day of the previous month

Stocks received B
DHQ

Stock received from 1st to last day of the reporting month

Unusable stock C DHQ

The stock, which becomes unusable due to any reason during the
reporting month. Unusable Stock can occur due to a variety of
reasons like breakage, expiry, Wastages etc. and this
quantum/number is to be recorded. Recording this is necessary to
arrive at the Total Stock in Hand.

Stock Distributed D DHQ

Stock distributed to the health facilities in the district during the

reporting month

Total stock (Stock in Hand) E= (A+B)-(C+D)

Stock balance in the store on the day of the reporting month.

The information is to be given for the following items:
16.1 Vaccines (in Doses) DHQ

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

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Ref no. Data Element Applicable to

16.1.8 Hepatitis B

16.2 Family Planning (in number) e.g. number of condoms, number DHQ
of oral pill cycles, number of IUDs etc
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

DHQ
16.3 Other Items (in No.s) for Syrup based medicines no. of bottles is
to be given
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 (Paediatric)
16.3.09 Paediatrics Antibiotics (Cotrimaxozole and Injectable Gentamicin)
16.3.10 Vitamin A solution
16.3.11 ORS (New WHO formulation)

16.4 Syringes
DHQ
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

Ref no. Data Element Cause code

M17 Details of deaths reported during the month with probable

cause
This section deals with compiling data on Deaths by major causes.
The probable cause of death is to be reported against ONE and
ONLY ONE major cause. In certain cases, death may have occurred
due to multiple reasons or reasons unknown. In such cases, the
information of the deceased is to be captured by the nearest
probable cause of death. Deaths occurring at private health
institutions or at home are to be reported in the Health Sub Centre,
form.

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At the District level this information will be compiled from .the

respective facility level forms (Line Listing of Deaths) and tabulated
according to the major cause of death and age category.

17.1 Infant deaths within 24 hrs of birth C01

Total number of newborn deaths within 24 hrs of birth in the facility
during the reporting month. For sub centres, deaths after home
delivery will also be included.

17.2 Infant Deaths up to 4 weeks by cause

Up to 1 week of Birth
Report deaths which occurred after 24 hours and up to 1 week of
birth of child due to any of the following reasons
Between 1 week & 4 weeks of birth
Report deaths which occurred from 1 week & 4 weeks of birth of
child due to any of the following reasons

17.2.1 Sepsis C02

Sepsis is a blood infection that occurs in an infant younger than 90
days. It is caused due to bacterial infection.
17.2.2 Asphyxia C03
Any fever or even without fever, refusal to take feeds with weak cry
in the first 28 days of life. Diarrhea, pneumonia, measles etc. are
not differentiated in this period and all are reported together as
sepsis. Usually infants present with respiratory distress, fever and
jaundice. Predisposing causes include -Prolonged/obstructed
labour, severe birth asphyxia, maternal pre-partum/peri partum
pyrexia and home/traditional birth attendant deliveries.
Asphyxia is a condition of severely deficient supply of oxygen to the
body that arises from being unable to breathe normally. Asphyxia
causes generalized hypoxia, which primarily affects the tissues and
organs most. In newborn it causes the most harm.

17.2.3 LBW C04

Low Birth weight i.e. Birth Weight less than 2500 gms
17.2.4 Others
Deaths occurring due to any reasons not covered above

17.3 Infant/ Child Deaths up to 5 years by cause

Deaths occurring in the age group of 1-11 months, and 1-5 years of
age

17.3.1 Pneumonia C05

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Pneumonia is a severe respiratory infection in children. Any death

in a child less than five years, but more than one month, related to
lower respiratory infection.

17.3.2 Diarrhoea C06

Any Diarrhoea is frequent runny or watery bowel movements (poop)
— is usually brought on by gastrointestinal (GI) infections caused
by viruses, bacteria, or parasites.

17.3.3 Fever related C07

(Illness characterised by fever and not covered by specific
diagnosis)

17.3.4 Measles C08

Measles, also called rubella, is a respiratory infection that is caused
by a virus. It causes a total-body skin rash and flu-like symptoms,
including a fever, cough, and running nose. The first symptoms of
the infection are usually a hacking cough, running nose, high fever,
and watery red eyes. Another marker of measles is Koplik's spots,
small red spots with blue-white centres that appear inside the
mouth.

17.3.5 Others C09

Death due to any other cause

17.4 Adolescent/Adult Deaths by cause

Deaths occurring in the age group of 6-14 years, 15-55 years and
above 55 years of age
17.4.01 Diarrhoeal diseases A01
Deaths associated with loose stools more than thrice per day

17.4.02 Tuberculosis A02

17.4.03 Respiratory diseases including infections (other than TB) A03

Death clinically to be primarily due to respiratory infection,
including pneumonia, asthma would be included.
17.4.04 Malaria A04

17.4.05 Other Fever Related A05

Any death other than the above three that was related to fever

17.4.06 HIV/AIDS A06

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17.4.07 Heart disease/Hypertension related A07

17.4.08 Neurological disease including strokes A08

Any death due to any neurological disease including cerebro-
vascular disease/strokes or fits or paralysis of any sort etc.

17.4.09 Maternal deaths

Death of a pregnant woman from any cause related to or
aggravated by pregnancy or its management, but not from
accidental or incidental causes, during antennal period, labour or
up to 6 weeks after delivery.
17.4.09(a) Abortion M01

17.4.09 (b) Obstructed/ prolonged labour M02

Any labour that went over 24 hours in a first pregnancy or over 12
hours in any subsequent pregnancy or over 6 hours without
progression by a partogram.

17.4.09 (c) Severe hypertension/fits M03

17.4.09 (d) Bleeding M04

Mothers with severe bleeding-more than 500 ml before , during or
after delivery

17.4.09 (e) High fever M05

Mother’s death with high fever as major cause-this could be
antenatal period or post-natal period

17.4.09 (f) Other Causes (including causes not known) M06

17.4.10 Trauma/Accidents/Burn cases A09
Any death arising out of trauma or burns-accidental or inflicted
other than those which are self-inflicted

17.4.11 Suicide A10

Death which is self-induced, whatever the cause

17.4.12 Animal bites and stings A11

17.4.13 Other Causes

17.4.13 (a) Known Acute Disease (Illness less than 6 weeks) A12
17.4.13 (b) Known Chronic Disease (Illness more than 6 weeks) A13
17.4.13 (c) Causes not known A14
Any death where the information known is too little to fit into any
of the above categories

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Line Listing of Deaths (For Facility Forms only) PHC DH SDH

SC
CHC
The facility level forms also capture the details of death by major causes. It may be appreciated that
in certain cases, death may have occurred due to multiple reasons or reasons unknown. In such
cases, the information of the deceased is to be captured by the nearest probable cause of death. It
may be noted that only deaths occurring at facilities is to be captured in the respective facility
forms. In the form for the Health Sub Centre, deaths occurring at a Private Health Institution or at
Home are to be reported. The ANM may classify the cause of death to the nearest probable cause of
death in the Cause Code column based on the codes given in the form.
Name and village of
S No. Sex Age Cause Code
deceased
1
2
3
4
5
6
7
8

The following table gives the Cause Codes for the probable cause of death to be entered in the
Cause Code column of the format.
Code Probable Causes of Death Description
Infant Deaths (up to 1 year of age)
C01 Within 24 hrs of birth Total number of newborn deaths within 24 hrs of
birth in the facility during the reporting month. For
Sub Centres, deaths after home delivery will also be
included
C02 Sepsis Sepsis is a blood infection that occurs in an infant
younger than 90 days old. It is caused due to
bacterial infection.
C03 Asphyxia Asphyxia is a condition of severely deficient supply of
oxygen to the body that arises from being unable to
breathe normally. Asphyxia causes generalized
hypoxia, which primarily affects the tissues and
organs most. In newborn it causes the most harm.
Usually infants present with respiratory distress,
fever and jaundice. Predisposing causes include -
Prolonged/obstructed labour, severe birth asphyxia,
maternal pre-partum/peripartum pyrexia and
home/traditional birth attendant deliveries.

C04 Low Birth Weight (LBW) for Low Birth weight i.e. birth weight less than 2500 gms
Children up to 4 weeks of age
only

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C05 Pneumonia Pneumonia is a severe respiratory infection in

children
C06 Diarrhoea
C07 Fever related
C08 Measles
C09 Others
Maternal Deaths by major cause
M01 Abortion Death of a pregnant woman from any cause related
M02 Obstructed/prolonged labour to or aggravated by pregnancy or its management,
M03 Severe hypertension/fits but not from accidental or incidental causes, during
M04 Bleeding antennal period, labour or up to 6 weeks after
M05 High fever pregnancy.
M06 Other Causes (including causes
not known)
Adolescents & Adults
A01 Diarrhoeal diseases
A02 Tuberculosis
A03 Respiratory diseases including
infections (other than TB)
A04 Malaria
A05 Other Fever Related
A06 HIV/AIDS
A07 Heart disease/Hypertension
related
A08 Neurological disease including
strokes
A09 Trauma/Accidents/Burn cases
A10 Suicide
A11 Animal bites and stings
Other Diseases
A12 Known Acute Disease
A13 Known Chronic Disease
A14 Causes not known

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Quarterly Format

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Guidelines for Quarterly Reporting Format

(Consolidated)

Part A: Status of Health Infrastructure

Ref no. Data Element Applicable to

Q1 Details of Primary Health Centres (PHCs)

DHQ

1.1 Number of PHCs functioning as 24 x7 (With 2 Staff Nurses)

Total number of PHCs functioning as 24x 7 and also have 2 staff nurses
in position.
A 24 hour PHC is one which provides basic essential obstetric care and
reproductive health services which includes (i) 24 hour delivery services
(assisted +normal), (ii) Essential new born care, (iii) referral for
emergency (iv) Routine ANC (v) PNC and (vi) Safe Abortion services
(vii) Family planning (viii) Prevention and management of RTIs/STIs.
(ix) Essential lab services

1.2 Number of PHCs that are IPHS compliant DHQ

Total number of PHCs which are functioning as per IPHS norms on the
last day of the reporting quarter for which report is being generated.

Q2 Anganwadi Centres DHQ

2.1 Number of Anganwadi centres in the district
Total number of Anganwadi centres functioning in the district as on last
day of the reporting quarter.

Part B: Trainings Conducted

Ref no. Data Element Applicable to

Q3 Number of Doctors trained in DHQ

Total number of New General Duty Medical officers trained during
the quarter on specific skills.

3.01 Life saving Anaesthesia skills for EmOC

3.02 Obstetric Care & Management including Caesarean Section
3.03 Skilled Birth Attendant
3.04 No-Scalpel Vasectomies (NSV)
3.05 Minilap
3.06 Laparoscopic Sterilization (for Specialists)
3.07 Intrauterine Device (IUD)

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Ref no. Data Element Applicable to

3.08 Blood Storage

Reproductive Tract Infections/Sexually transmitted infections
3.09
(RTI/STI)
Integrated Management of Newborn and Childhood Illnesses
3.10
(IMNCI)
3.11 Sick Newborn Care Unit (SNCU) training
3.12 Safe Abortion Services (MTP)
3.13 Adolescent Reproductive and Sexual Health (ARSH)
3.14 Infection Management and Environment Plan (IMEP)
3.15 Professional Development (CMO/ Dy. CMO/ SMO)
3.16 Others (Specify)
Any other training held in the district during the reporting quarter.

DHQ
Q4 Number of GNM/ ANM/ LHV trained in
Total number of GNM (General Nurse Midwife)/ ANM (Auxiliary
Nurse Midwife) / LHV trained in specific skills during the reporting
quarter

4.1 Skill Birth Attendants

4.2 Intrauterine Device (IUD)
4.3 Contraceptive update training
4.4 Integrated Management of Neonatal and Childhood Illness (IMNCI)
4.5 Facility Based Newborn Care (FBNC)
4.6 Home Based Newborn Care (HBNC)
Reproductive Tract Infections / Sexually transmitted infections
4.7
(RTI/STI)
4.8 Infection Management and Environment Plan (IMEP)
4.9 Adolescent Reproductive and Sexual Health (ARSH)
4.10 Immunisation
4.11 Others (Specify)
Any other training held in the district during the reporting quarter.

Number of Programme Management Units (PMU) personnel

Q5
trained SG
5.1 State Programme Management Units (SPMU)
Total number of State Programme Management Unit Personnel given
trainings during the reporting quarter
5.1.1 Programme Managers
5.1.2 Accounts/ Finance Manager
5.1.3 MIS/ Data Manager SG
5.2 District Programme Management Units (DPMU)
Total number of District Programme Management Unit (DPMU)
Personnel given trainings during the reporting quarter
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Ref no. Data Element Applicable to

5.2.1 Programme Managers

5.2.2 Accounts/ Finance Personnel
5.2.3 MIS/ Data Personnel

5.3 Block Programme Management Units (BPMU) DHQ

Total number of Block Programme Management Unit (BPMU)
personnel given trainings during the reporting quarter
5.3.1 Programme Managers
5.3.2 Accounts/ Finance Personnel (Including PHC)
5.3.3 MIS/ Data Personnel

SG
Number of Programme Managers (State Officers/ CMO/ Dy.
Q6
CMO) Trained
Total number of Programme Managers trained during the reporting
quarter
6.1.1 Chief Medical Officer (CMO)
6.1.2 Deputy Chief Medical Officer (Dy. CMO)
6.1.3 Block Medical Officer (BMO)
DHQ
Q7 Other Para medical staff, Statistical officers/ assistants and AWW
Total number of officers/staff trained during the reporting quarter
7.1.1 Statistical Officers
7.1.2 Assistants
7.1.3 CDPO
7.1.4 Anganwadi Worker (AWW)
DHQ
Q8 Other Trainings (specify)
Specify the designation of the trainee and type of training if not
captured above
8.1
8.2
8.3

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Part C: Additional NRHM components

Ref no. Data Element Applicable to

Q9 State Health Mission

SG
9.1 Number of meetings of State Health Mission
Number of formal meetings of the State Health Mission (SHM) held
during the reporting quarter. A formal meeting is defined as one for
which written minutes are prepared.
As per the constitution of SHM, one meeting of SHM must be held
every quarter.

Number of meetings of Quality Assurance (QA) Committee for SG

9.2 DHQ
Family Planning
Number of formal meetings of the State Quality Assurance
Committee for family planning during the reporting quarter. A
formal meeting is defined as for which written minutes are prepared.

Number of institutions identified to provide QA services for Family DHQ SG

9.3
Planning
Number of new institutions identified during the quarter, for
providing QA services for family planning.

9.4 Number of institutions adhering to the prescribed QA norms DHQ SG

Total number of institutions adhering to prescribed QA norms – (to
be identified based on specified criteria)

9.5 Number of Link workers other than ASHA selected

Total number of link workers (other than ASHA) selected during the DHQ
reporting quarter.

9.6 Number of Sub centre where Joint Account has been operationalised DHQ
Total number of sub-centres where joint account of ANM and
member of Panchayat has been opened.

9.7 Are Mobile Medical Units (MMUs) operational in the district? DHQ
To be reported by district whether any Medical Mobile Unit (MMU)
is operational in the District during the quarter.
Answer to be given as YES/NO.
SG
9.8 Number of Districts implementing IMNCI
To be reported by District whether IMNCI is being implemented or
not.

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SG
9.9 Number of District covered by Mother NGO (MNGO)
Total number of districts covered by Mother NGOs in the state.

Q10 District Health Societies

The District Health Society is being strengthened through the
integration of all health societies in the district and this society will
be responsible for project management in districts.

Number of Districts where health societies have merged with SG

10.1
District Health Society
Total number of districts where all vertical health societies have
merged with district into single society with one common account.

10.2 Number of meetings of District Health Societies during the quarter DHQ
Number of formal meetings of the District Health Society held
during the reporting quarter. A formal meeting is defined as for
which written minutes are available.
As per the constitution of DHM, at least one meeting of DHM
should be held every month.

ASHAs and Functioning of Village Health and Sanitation

Q11
Committee (VHSCs)
The village level committees and community based organization are
entrusted with the planning, monitoring & implementation of NRHM
activities in the villages. The VHSC is the key agency for developing
Village Health Plan and the entire planning of village Panchayat for
NRHM. This committee comprises of Panchayat representatives,
ANM, MPW, Anganwadi workers, Teachers, Community health
volunteers, ASHA etc.

11.1 Number of ASHAs recruited DHQ

The total number of ASHAs who have been recruited in the district
during the quarter should be recorded.

11.2 Number of ASHAs fully trained (5 modules - 23 days) DHQ

Total number of ASHAs fully trained in all the 5 modules.

11.3 Number of ASHAs having regular supply of drug kits DHQ

Total number of ASHAs having regular supply of drug kits during
the quarter should be recorded.

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11.4 Number of VHSCs received funds during the quarter DHQ

Total number of Village Health & Sanitation Committees (VHSCs)
which have received funds during the quarter.

11.5 Number of VHSCs submitted Statement of Expenditure (SOE) DHQ

Total number of VHSCs, which have submitted SOEs during the
quarter for which report is being generated. Each VHSC to be
counted only once even if SOE has been submitted more than once
during the quarter.

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Annual Format

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Guidelines for Annual Reporting Format

(Consolidated)

Part A: Demographic

Ref no. Data Element Applicable to

A1 Total Number of Districts SG

Total number of districts in the State as on 1st April of the reporting
year.

A2 Total Number of towns above 1 lakh population DHQ

Total number of towns in the State having population above 1 lakh as
on 1st April of the reporting year. This information should be based on
last census or latest survey for this purpose, which may have been
carried out in the state.

A3 Number of villages with less than 500 population DHQ

Total Number of villages having population less than 500 as on 1st
April of the reporting year. This information should be based on last
census or latest survey for this purpose, which may have been carried
out in the state.

Percent of state’s population Below Poverty Line (BPL) as per SG

A4
State Survey
Per cent of state’s population Below Poverty Line (BPL) is to be
recorded. This may be obtained from State Records. RCH indicators
are usually poor for this section of the population. It will help to
identify vulnerable/disadvantaged sections, which would aid in
planning to ensure equity and access to reproductive and child health
care.

4.1 Reference year of BPL survey

The year in which the BPL survey was carried out in the state on the
basis of which the information at A4 has been given.

SG
Estimated Mid Year Population of State during the year (000s) -
A5 (Information to be given only when population projection of RGI
are not being used)
Urban
1. Male
2. Female
Rural
1. Male
2. Female

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Estimated number of eligible women in 15-49 age group

A6 Urban DHQ
Rural
Estimated number of eligible women both for rural and urban in 15-49
years age groups has to be provided. Calculating proportion of married
eligible women should be on the basis of proportion of married eligible
women to total population. The proportion is usually known through
causes or surveys like NFHS/RHS. Use this proportion to projected
population to get the estimates (nationally it is around 15-17%). This is
important because it is the base for calculating most of the RCH
process indicators

Estimated number of pregnancies during the year

DHQ
A7 Urban
Rural
Estimate number of pregnancies during the year using the previous
year’s birth rate plus an addition of 10% to birth rate as foetal wastage
and record here. Separate estimations need to be done for rural and
urban areas

Part B: From the Eligible Couple register

Ref no. Data Element Applicable to

A8 Number of eligible women (15-49 years) having

DHQ

A8 (a) No Child
A8 (b) One child
A8 (c) Two children
A8 (d) Three or more children

Total break up of number of eligible women (15-49 years) by her number of children has to be
provided.

Part C: Selected Indicators

Ref no. Data Element Applicable to

Number of villages selected for ASHA intervention- for High DHQ

A9
Performing States (HPS)
Number of villages in the district where it is proposed to have ASHA

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during the reporting year in High Performing States

DHQ
A10 Number of ASHAs in-position as of April 01 of the year
Total number of ASHAs actually working as on April 1 of the reporting
year in the district

A11 Number of Institutions approved for providing MTP Services in:

This provides information on number of Institutions (Public Sector /
Private (under PPP) / Private (Others) approved for providing MTP
Services

11.1 Public Sector DHQ

Total number of institutions in public sector approved for providing
MTP services in the district as on 1st April of the reporting year

Private sector health institutions - under Public Private Partnership DHQ

11.2
(PPP)
Total number of institutions in private sector approved for providing
MTP services, under PPP, in the district as on 1st April of the reporting
year

11.3 Private sector health institutions - others DHQ

Total number of institutions in private sector approved for providing
MTP services, in the district as on 1st April of the reporting year

Part D: Urban Health Infrastructure

Ref no. Data Element Applicable to

DHQ SG
A12 Number of Urban Health Centres/ Maternity Centres
Total number of Urban Health Centres & Maternity Centres in the
district as on 1st April of the reporting year.
Urban Health Centres/ Maternity and child centre/urban family
welfare centres: centres, which have a Medical officer posted and are
covering about 50,000 populations. Each centre is to be counted only
once. Type D health posts is also to be reported here

A13 Number of Urban Health Posts DHQ SG

Total number of Urban Health posts and UFWC in the district as on
1st April of the reporting year ( Other than type D health posts and

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Type IV UFWC)

DHQ SG
A14 Number of Municipal/ Govt. Dispensaries
14.1 Allopathic
Total number of allopathic dispensaries in the district as on 1st April
of the reporting year.

14.2 AYUSH
Total number of AYUSH dispensaries in the district as on 1st April of
the reporting year

Part E: Status of Health Infrastructure

Ref no. Data Element Applicable to

SG
A15 Total number of Medical Colleges
Total number of medical colleges in the State as on 1st April of
the reporting year

15.1 Public
Total number of medical colleges in the govt. sector in the State
as on 1st April of the reporting year

15.2 Private
Total number of medical colleges in the private sector in the state
as on 1st April of the reporting year

15.3 AYUSH
Total number of AYUSH medical colleges (Both in Public &
Private Sector) in the State as on 1st April of the reporting year.
DHQ SG
A16 Number of District Hospitals
Total number of Hospitals, designated as District hospital is to
be recorded. This section refers to the total number of public
sector hospitals in the district. Include district hospitals and
medical college hospitals, ESI hospitals. In few places, there are
other public sector hospitals such as Railway hospitals, Defence
hospitals and others and these are not to be included here.
Similarly, all the colony hospitals, Civil Hospitals etc are not to
be taken here.

16.1 District Hospital (having less than 30 beds)

Total DH having less than 30 beds in the State as on 1st April of
the reporting year

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SG
16.2 District Hospital (having more than 30 beds)
Total hospitals having less than 30 or more beds, in the State as
on 1st April of the reporting year.

DHQ SG
A17 Number of Sub District Hospitals
Record total number of Sub-Divisional Hospitals. This refers to
the number of hospitals at sub district /sub divisional level and
rural hospitals as on 1st April of the reporting year.

17.1 Sub District Hospital (having less than 30 beds)

Total Sub-District hospital having less than 30 beds in the State.

17.2 Sub District Hospital (having more than 30 beds)

Total Sub - District hospital having more than 30 beds in the
State.

17.3 Number functioning in govt. building

Out of the sub-district hospitals reported in 17.1 & 17.2 those
functioning from govt building are to be reported here.
DHQ SG
A18 Number of CHCs
Total number of CHCs in the State as on 1st April of the
reporting year is to be recoded here.
Under NRHM action plan for infrastructure strengthening, all
the CHCs have to be upgraded to IPHS standards. Hence, there
is a need to understand the progress in this activity on a
quarterly basis. In addition, one of key strategies of NRHM is to
strengthen all CHCs for First Referral Care.

18.1 CHC (Having less than 30 beds)

Total number of Community Health Centres (CHCs) having less
than 30 beds

18.2 CHC (Having 30 or more beds)

Total number of community Health Centres having 30 or more
beds.

18.3 CHC Functioning in Govt. Buildings

Total number of community Health Centres in the State SG
functioning in govt building out of those reported in 18.1 and
18.2.

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SG
A19 Number of PHCs
Total number of Primary Health Centres (PHCs) in the State as
on 1st April of the reporting year is to be recoded here. This
includes PHCs functioning as 24-hour RCH centres and other
PHCs.

A 24 hour PHC is one which provides Basic Essential Obstetric

Care and reproductive health services which includes (i) 24 hour
delivery services (assisted +normal), (ii) Essential new born
care, (iii) referral for emergency (iv) Routine ANC (V) PNC and
(vi) Safe Abortion services (vii) Family planning (viii) Prevention
and management of RTIs/STIs. (ix) Essential lab services.

19.1 PHC having less than 30 beds

Total number of PHCs having less than 30 beds.

19.2 PHC having 30 or more beds

Total number of PHCs having 30 or more beds.

19.3 PHC Functioning in Govt. Buildings

Total number of PHCs in the State functioning in govt building
(out of those reported in 19.1 and 19.2) .

Number of PHCs equipped to provide Basic Obstetric and

19.4
Institutional Sick childcare
Total number of Primary Health Centres (PHCs) in the state
equipped to provide basic Obstetric and Institutional Sick
childcare (out of those reported in 19.1 and 19.2)

A20 Number of SCs DHQ SG

Total number of Sub-Centres on 1st April of the reporting year.
By functional it is meant that ANM is posted, available and is
providing services and residing.
As per NRHM norms, each sub centre should be having 2 ANMs.
The projected requirement of Sub Centres to be
established/strengthened as per IPHS norm are 1, 75,000 in the
country. Targets for number of such sub centres may vary from
state to state.

20.1 Total number of SCs

20.2 Number functioning in Govt. Buildings
Total number of functional Sub-Centres (ANM is available and
20.3
residing)

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SG
Number of Sub-Centres submitting Statement of Expenditure
20.4
(SOE)
Total number of SCs, which have reported SOE, (related to
financial expenditure in the previous reporting year) Each sub
centre is to be reported once only even if more than 1 SOE is
submitted.

As part of the National Rural Health Mission, it is proposed to

provide each sub centre with Rs.10, 000 as an untied fund to
facilitate meeting urgent yet discrete activities that need
relatively small sums of money. The fund shall be kept in a joint
bank account of the ANM and the Sarpanch. Decisions on
activities for which the funds are to be spent will be approved by
the Village Health Committee (VHC) and be administered by the
ANM. In areas where the sub centre is not co-terminus with the
Gram Panchayat (GP) and the sub centre covers more than one
GP, the VHC of the Gram Panchayat where the SC is located will
approve the Action Plan. The funds can be used for any of the
villages, which are covered by the sub centre. Untied Funds will
be used only for the common good and not for individual needs,
except in the case of referral and transport in emergency
situations.

Number of Other Public Hospital/Health Facilities

A21 DHQ SG
(Central/State/Municipal/PPP etc.)
Total number of Other Govt Hospitals, health facilities including
the institutes run by Central Government, State Government,
Municipal Committees and also health institutes run under the
public private arrangement as on 1st April of the reporting year (
This will also include Maternity Homes)

21.1 Having less than 30 beds

21.2 Having 30 or more beds
21.3 Number of AYUSH Hospitals
Total number of AYUSH hospitals in the State.
SG
A22 Number of Private Hospital/Health Facilities
Total number of Private Hospitals/ Health facilities in the state
as on 1st April of the reporting year

22.1 Having less than 30 beds

22.2 Having 30 or more beds
22.3 Of which accredited for family planning services

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SG
Total number of Private Facilities accredited for Family Planning
Services.
Accreditation is a Public Private Partnership between the
Private institute and Govt where the payments are made for
specified services based on a Memorandum of Understanding.

SG
A23 Blood Banks
Total number of blood banks (Public/Private) in the state as on
1st April of the reporting year
23.1 Public
23.2 Private
SG
A24 Blood Storage Centres
Total number of blood storage units in the state as on 1st April of
the reporting year
24.1 Public
24.2 Private

Part F: Status of Human Resource Availability- Staffing status of selected positions

Ref no. Data Element Applicable to

A25 Programme Management Units

Programme Management Units Status to be reported as on 1st April of
the reporting year
Number of Posts sanctioned
Number of People in position
SG
25.1 State Programme Management Unit (SPMU)
The main objective of establishing this unit is to strengthen the existing
management structures/functions at the state and district levels
respectively as NRHM is characterized by allocation of flexible funds to
states, preparation of program implementation plans by States and
districts and performance linked disbursement based on MOU.
Consultants recruited under SPMU are expected to improve the
performance levels of the public health infrastructure and functionaries
and to make the system more responsive and transparent. The SPMU is
responsible for the overall state level planning and monitoring for
NRHM, management of flexi pool funds, initiation of health sector
reforms, continuous process improvement and for secretarial functions
to the State Health Mission and State Health Society.
The SPMU consists of following positions. The availability of following

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persons in SPMU needs to be recorded.

25.1.1 Programme Manager

25.1.2 Finance Manager
25.1.3 Accounts Manager
25.1.4 Data Manager
25.1.5 Other Consultants
SG
25.2 District Programme Management Unit (DPMU)
In districts, the cornerstone for smooth and successful implementation of
NRHM programme is dependent on the management capacity of District
Programme Managers; smooth functioning of District Health Society
and empowerment of the programme implementation structure. The
District Health Society is being strengthened through the integration of
all health societies in the district and this society will be responsible for
project management in districts. The district PMU is composed of three
skilled personnel i.e. Programme Manager, Accounts Manager and Data
Assistant have been provided in each district. These personnel are there
to provide the basic support for programme implementation and
monitoring at district level.
The DPMU consists of following positions. The availability of following
persons in DPMU needs to be recorded.

25.2.1 Programme Manager

25.2.2 Accounts Manager
25.2.3 Data Manager/Officer
25.2.4 Others Consultants

25.3 Block Programme Management Unit (BPMU) SG

25.3.1 Programme Manager

25.3.2 Accountant
25.3.3 Data Assistant
25.3.4 Other Consultants
25.4 PHC Accountant
DHQ
A26 Medical Officers in District Head Quarters

26.1 CMOs/Civil Surgeon or equivalent

26.2 District Program Officers(Including doctors in CMO office)
26.3 DHEIO(District Health Education and Information Officer)
26.4 Nursing Administrators, if any

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DHQ
A27 Staff in CHC (as per IPHS)
27.01 Surgeon
27.02 Anaesthetists
27.03 Gynaecologists
27.04 Paediatricians
27.05 General Physician
27.06 Eye Surgeon
27.07 Dental Surgeon
27.08 GDMO (General Duty Medical Officer)
27.09 Public Health Manager
27.10 Pharmacist
27.11 Radiographer
27.12 Staff Nurse
27.13 Staff Nurse-SBA Trained Skilled Birth attendant
27.14 Public Health Nurse (PHN)
27.15 Lab Technician
27.16 Lab Assistant
Statistical Assistant
27.17
27.18 No. of Doctors trained in
27.18 (a) Anaesthesia
27.18 (b) CEmOC Skills
27.18 (c) SNCU (Sick Neo-Natal and Child Care Unit)/ FBNC

27.19 AYUSH doctors

27.20 AYUSH Pharmacist

A28 Staff in PHC

DHQ
28.1 Medical Officer
28.1.1 Allopathic
28.1.2 AYUSH
28.2 Staff Nurses
28.2.1 Total Number of Staff Nurses
28.2.2 Of which number which are SBA trained
28.2.3 Of which number which are IMNCI trained

28.3 Nurse Mid-wife

28.4 Lab Technicians/ Assistant
28.5 Health Assistant Male
28.6 Health Assistant Female (LHV)
28.7 Pharmacist
28.8 BHEIO

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28.9 Statistical Assistant

DHQ
A29 Staff in Sub Centres
29.1 MPW
29.1.1 Male
29.1.2 Female /ANM – Regular
29.1.3 Female / ANM- Contractual

Number of sub-centres in which at least one ANM has received SBA,

29.2
IMNCI and FP related skills
Number of sub-centres with at least one ANM who reported to have
received ALL the three trainings - SBA, IMNCI and FP related skills

29.3 Number of sub-centres which has at least two ANM

Number of Sub Centres to be reported which have two ANMs Posted

DHQ
A30 District Health Mission
All vertical Health and Family Welfare Programmes at District merge
into one common “District Health Mission” at the District level. The
District Health Mission would guide activities of sanitation at district
level, and promote joint IEC for public health, sanitation and hygiene,
through Village Health & Sanitation Committee, and promote household
toilets and School Sanitation Programme. ASHA would be paid
incentives for promoting household toilets by the Mission. District
Health Mission, under the leadership of Zila Parishad with District
Health Head as Convener and all relevant departments, NGOs, private
professionals etc represented on it.

Is the Integrated District Health Action Plan complete (Prepared and

30.1
approved) for the coming year?
Integrated District Health Action Plan is considered complete only when
it has been approved by District Heath Society.
In order to make NRHM accountable, the Integrated District Health
Action Plan will be the principle instrument for planning,
implementation and monitoring. Under NRHM, each district is required
to prepare a comprehensive health plan and the intention is to assess the
needs of the district through household and facility survey that track the
base line situation of institutions and households. A detailed process
manual for preparing the DAPs has already been sent to the State
governments.
SG
A31 Health Programmes

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31.1 Number of eye banks functioning

Total Number of eye banks functioning in the State.

Part G: Infrastructure & Training

Ref no. Data Element Applicable to

A32 Status of IPHS for Health Facilities

Indian Public Health Standards (IPHS) are a set of standards envisaged
to improve the quality of health care delivery in the country under the
National Rural Health Mission. It describes benchmarks for quality
expected from various components of health care organizations. It is a
set of standards for quality of services, facilities, infrastructure,
manpower, machines & equipment, drugs etc. It is the main driver for
continuous improvements in quality and standards for assessing
performance of health care delivery system These standards would help
monitor and improve the functioning of the facility.
SG
32.1 Number of Health Facilities functioning as per IPHS
Total number of facilities (DH/ SDH/ CHC/ PHC/ SC) functioning as
per IPHS as on 1st April of the reporting year is to be given.

32.1.1 District Hospital

IPHS is to provide health care that is quality oriented and sensitive to
the needs of the people of the district. The specific objectives of IPHS for
DHs are to provide comprehensive secondary health care (specialist and
referral services) to the community through the district hospital, to
achieve and maintain an acceptable standard of quality of care, to make
the services more responsive and sensitive to the needs of the people of
the district and the hospitals/ centers from which the cases are referred
to the district hospitals.
32.1.2 Sub District Hospital
A subdivision hospital caters to about 5-6 lakh people. In bigger districts
the sub-district hospitals fills the gap between the block level hospitals
and the district hospitals.
The specific objectives of IPHS for Sub District Hospitals are to provide
comprehensive secondary health care (specialist and referral services)
to the community through the Sub District Hospital, to achieve and
maintain an acceptable standard of quality of care, To make the services
more responsive and sensitive to the needs of the people of the district
and act as the First Referral Unit (FRU) for the hospitals/centers from

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which the cases are referred to the Sub District hospitals

32.1.3 CHC
IPHS for CHC are being prescribed to provide optimal expert care to
the community and achieve and maintain an acceptable standard of
quality of care. The specific objective of IPHS for CHC is that All
“Assured Services” as envisaged in the CHC should be available, which
includes routine and emergency care in Surgery, Medicine, Obstetrics
and Gynecology and Pediatrics in addition to all the National Health
programs. Appropriate Guidelines for each National Program for
management of routine and emergency cases are being provided to the
CHC. All the support services to fulfill the above objectives will be
strengthened at the CHC level. Minimum requirement for delivery of the
above-mentioned services: The following requirements are being
projected based on average bed occupancy of 60%. It would be a
dynamic process in the sense that if the utilization goes up, the standards
would be further upgraded. As regards manpower, 2 specialists namely
Anesthetist and Public Health program Manager will be provided on
contractual basis in addition to the available specialists namely Surgery
Medicine, Obstetrics and Gynecology and Pediatrics. The support
manpower will include a Public health Nurse and ANM in addition to
the existing staff. An Ophthalmic Assistant will also be needed to be
provided in centre where currently there is none.

32.1.4 PHC
The IPHS prescribed are for a PHC covering 20,000 to 30,000
populations with 6 beds. The Service Delivery of PHC includes:
All “Assured Services” as envisaged in the PHC should be available,
which includes routine, preventive, promotive, curative and emergency
care in addition to all the national health programmes. Appropriate
guidelines for each National Programme for management of routine and
emergency cases are being provided to the PHC. All the support services
to fulfil the above objectives will be strengthened at the PHC level.

32.1.5 SC
IPHS for Sub-centres has been prepared keeping in view the resources
available with respect to functional requirement for Sub-centres with
minimum standards, such as building, human resources, instruments and
equipments, drugs and other facilities etc. As far as human resources is
concerned, one more ANM is being provided in addition to the existing
one ANM and one Male Health Worker.

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Number of Health Facilities having Professional Quality SG

32.2
Accreditation (ISO, QCI, etc.)
Total number of facilities having Professional Quality Accreditation like
ISO, QCI etc. as on 1st April of the reporting year.

32.2.1 District Hospital

32.2.2 Sub District Hospital
32.2.3 CHC
32.2.4 PHC
32.2.5 SC

ANM Training Capacity Assessment SG

A33
33.1 Govt. Aided ANM training centres
Total Number of Govt. Aided ANM Training centres as on 1st April of
the reporting year.

33.1.1 Numbers recognized by Indian Nursing Council

33.1.2 Numbers recognized by State Nursing Council
33.1.3 Numbers closed during the previous FY
33.1.4 Number of students admitted during previous Financial Year
33.1.5 Number of students passed out during previous Financial Year

33.2 Faculty Position

Posts for faculty in the Government and Govt Aided ANM training
centres
33.2.1 Number of sanctioned post
33.2.2 In Position

33.3 Position of Support Staff

Support staff posts in the Government and Govt. Aided ANM training
centres
33.3.1 Number of sanctioned post
33.3.2 In Position

33.4 Private ANM training centres

Total number of private ANM training centres as on 1st April of the
reporting year.
33.4.1 Number Recognized by Indian Nursing Council
33.4.2 Number Recognized by State Nursing Council
33.4.3 Number closed

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Total number of ANM training centres closed during the previous

financial year.
33.4.4 Number of students admitted during previous Financial Year
33.4.5 Number of students passed out during the previous financial year.
SG
A34 LHV Training Capacity Assessment
LHV Training centres as on 1st April of the reporting year, existing and
functional
34.1.1 Existing
34.1.2 Functional
34.1.3 Number of students admitted during previous Financial Year
34.1.4 Number of students passed out during previous Financial Year

34.2 Faculty position

Faculty in the LHV training centres
34.2.1 Number of sanctioned post
34.2.2 In Position

34.3 Position of Support Staff

Support Staff posted in the LHV training centres
34.3.1 Number of sanctioned post
34.3.2 In Position
SG
A35 MPW (Male)- Physical Achievement
MPW (Male) Training centres as on 1st April of the reporting year
35.1.1 Existing
35.1.2 Functional
35.1.3 Number of students admitted during previous Financial Year
35.1.4 Number of students passed out during previous Financial Year

35.2 Faculty position

Faculty in the MPW training centres
35.2.1 Number of sanctioned post
35.2.2 In Position

35.3 Position of Support Staff

Support staff posted in the MPW training centres
35.3.1 Number of sanctioned post
35.3.2 In Position

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 As on 8th July, 2010

Ref no. Data Element Applicable to

SG
A36 HFWTC: Physical Achievement
Health & Family Welfare Training centres as on 1st April of the
reporting year.
36.1.1 Existing
36.1.2 Functional
36.1.3 Number of Health Personnel Trained during previous Financial Year
36.1.4 Number of trainings during previous Financial Year

36.2 Faculty position

Posts for faculty in the HFWTC
36.2.1 Number of sanctioned post
36.2.2 In Position

36.3 Position of Support Staff

36.3.1 Number of sanctioned post
36.3.2 In Position

A37 SIHFW: State Institute of Health & Family Welfare SG

State Institute of Health & Family Welfare centres during the previous
financial year.
37.1 Number of Health Personnel Trained during previous financial year
Total Number of health personnel trained in the SIHFW
37.2 Number of trainings during previous financial year

37.3 Faculty position

Posts for faculty in the SIHFW
37.3.1 Number of sanctioned post
37.3.2 In Position

Position of Support Staff

37.4
37.4.1 Number of sanctioned post
37.4.2 In Position

Guidelines for HMIS Reporting Format Page 75

 As on 8th July, 2010

FINANCIAL MANAGEMENT REPORT

(FMR)

Guidelines for HMIS Reporting Format Page 76

 As on 8th July, 2010

Reporting Qtr. Cummulative Illustrative Guidelines for

classification of activities
Actual Varia Varia
Code STRATEGY/ACTIVITIES PIP
Expendi nce
PIP Actual
nce
under RCH
Budget ture Budget Expenditure
% %
(5) (6) (7) (12) (13) (14)
A RCH - TECHNICAL Details of Infrastructure,
STRATEGIES &
ACTIVITIES (RCH Human resources, Training,
Flexible Pool) IEC/BCC, Equipment and
A.1 MATERNAL HEALTH Drugs etc in A.9, A.11, A.12,
A.13
A.1.1 Operationalise facilities
(only dissemination,
monitoring, and
quality)
A.1.1.1 Operationalise FRUs 1.Organise dissemination
A.1.1.2 Operationalise 24x7
PHCs workshops for
FRU/24x7 guidelines,
2. Prepare plan for
operationalisation across
districts (including staffing,
infrastructure, training,
equipment, drugs and
supplies etc.
3. Monitor progress against
the plan
4. Monitor quality of
service delivery and
utilization including field
visits
A.1.1.3 MTP services at health 1. Prepare plan for
facilities
A.1.1.4 RTI/STI services at operationalisation across
health facilities districts (including staffing,
A.1.1.5 Operationalise Sub-
centres infrastructure, training,
equipment, drugs and
supplies etc.
2. Monitor progress against
the plan
3. Monitor quality of
service delivery and
utilization including
field visits
A.1.2 Referral Transport 1. Prepare and disseminate
guidelines for
referral transport for
pregnant women and
sick newborns/children’s
2. Implementation by the
districts

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 As on 8th July, 2010

Reporting Qtr. Cummulative Illustrative Guidelines for

classification of activities
Actual Varia Varia
Code STRATEGY/ACTIVITIES PIP
Expendi nce
PIP Actual
nce
under RCH
Budget ture
Budget Expenditure
% %
(5) (6) (7) (12) (13) (14)
A.1.3 Integrated outreach
RCH services
A.1.3.1 RCH Outreach Camps 1. Implementation by
districts of RCH outreach
Camps
2. Monitor quality of
service and utilization
A.1.3.2 Monthly Village Health 1. Implementation by
and Nutrition Days
districts of Monthly
Village Health and
Nutrition days
2. Monitor quality of
service and utilization
A.1.4 Janani Suraksha
Yojana / JSY
A.1.4.1 Home Deliveries
A.1.4.2 Institutional Deliveries
A.1.5 24 Hours Deliveries
A.2 CHILD HEALTH Details of Training,
Drugs and Supplies
under A.11 and A.13
A.2.1 IMNCI 1. Prepare detailed
operational plan for IMNCI
across districts.
2. Implementation of
IMNCI activities in
districts,
3. Monitor progress against
the plan.
4. Pre-service IMNCI
activities in medical
colleges, nursing colleges
and ANM TCs
A.2.2 Facility Based Newborn 1. Prepare and disseminate
Care/FBNC
guidelines for FBNC
2. Prepare detailed
operational plan for FBNC
across districts
3. Implementation of
FBNC activities in districts
4. Monitor progress against
the plan
A.2.3 Home Based Newborn 1. Prepare and disseminate
Care/HBNC
guidelines for HBNC

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 As on 8th July, 2010

Reporting Qtr. Cummulative Illustrative Guidelines for

classification of activities
Actual Varia Varia
Code STRATEGY/ACTIVITIES PIP
Expendi nce
PIP Actual
nce
under RCH
Budget ture
Budget Expenditure
% %
(5) (6) (7) (12) (13) (14)

2. Prepare detailed
operational plan for HBNC
across districts
3. Implementation of
HBNC activities in districts
4. Monitor progress against
the plan
A.2.4 School Health 1. Prepare and disseminate
Programme
guidelines for School
Health Programme
2. Prepare detailed
operational plan for School
Health Program across
districts
3. Implementation of
School Health Programme
in districts
4. Monitor progress against
the plan
A.2.5 Infant and Young Child 1. Prepare and disseminate
Feeding/IYCF
guidelines for IYCF
2. Prepare detailed
operational plan for ITCF
across districts
3. Implementation of IYCF
activities in districts
4. Monitor progress against
the plan
A.2.6 Care of Sick Children and 1. Prepare and disseminate
Severe Malnutrition
guidelines
2. Prepare detailed
operational plan across
districts
3. Implementation of
activities in districts
4. Monitor progress against
the plan
A.2.7 Management of
Diarrohea, ARI and
Micronutrient Malnutrition
A.2.8 Other strategies/activities To be specified. -
PPP/Innovations/NGO to
be mentioned under A 2.8

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 As on 8th July, 2010

Reporting Qtr. Cummulative Illustrative Guidelines for

classification of activities
Actual Varia Varia
Code STRATEGY/ACTIVITIES PIP
Expendi nce
PIP Actual
nce
under RCH
Budget ture
Budget Expenditure
% %
(5) (6) (7) (12) (13) (14)
A.3 FAMILY PLANNING Details of Training,
IEC/BCC, Equipment,
Drugs and Supplies under
A.11, A.12 and A.13
A.3.1 Terminal/Limiting
Methods
A.3.1.1 Dissemination of
manuals on sterilisation
standards & quality
assurance of sterilisation
services
A.3.1.2 Female Sterilisation includes female
camps
sterilization services on
fixed days at health
facilities in districts
A.3.1.3 NSV camps includes NSV services on
fixed days at health
facilities in districts
A.3.1.4 Compensation for female
sterilisation
A.3.1.5 Compensation for male
sterilisation
A.3.1.6 Accreditation of private all expenses relating to
providers for sterilisation
services accreditation for
terminal/limiting methods
A.3.2 Spacing Methods
A.3.2.1 IUD camps
A.3.2.2 IUD services at health
facilities
A.3.2.3 Accreditation of private all expenses relating to
providers for IUD
insertion services accreditation for IUD
insertion into services
A.3.2.4 Social Marketing of
contraceptives
A.3.2.5 Contraceptive Update
seminars
A.3.3 POL for Family
Planning/ Others
A.3.4 Repairs of
Laparoscopes
A.4 ADOLESCENT Details of Training,
REPRODUCTIVE AND
SEXUAL HEALTH / IEC/BCC, under A.11 and
ARSH A.12
A.4.1 Adolescent services at 1. Disseminate ARSH
health facilities.
guidelines, 2. Prepare
operational plan for ARSH
services across districts 3.
Implement ARSH services
in districts, 4. Setting up of
Adolescent clinics at health

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 As on 8th July, 2010

Reporting Qtr. Cummulative Illustrative Guidelines for

classification of activities
Actual Varia Varia
Code STRATEGY/ACTIVITIES PIP
Expendi nce
PIP Actual
nce
under RCH
Budget ture
Budget Expenditure
% %
(5) (6) (7) (12) (13) (14)

facilities, 5. Monitor
progress, quality and
utilization of services
A.4.2 Other strategies/activities To be specified. -
PPP/Innovations/NGO to
be mentioned under A.8
A.5 URBAN RCH 1. Identification of urban
areas/mapping of urban
slums
2. Prepare operational plan
for URBAN RCH
3. Implementation of
Urban RCH such as
Recruitment and Training
of link workers for urban
slums, Strengthening of
Urban health posts, provide
maternal, child, ARSH etc
services and
4. Monitor progress,
quality and utilization of
services.
A.6 TRIBAL RCH 1. Identification of Tribal
areas/mapping of tribal
areas,
2. Prepare operational plan
for Tribal RCH
3. Implementation of
Tribal RCH such as
Recruitment and Training
of link workers for Tribal
areas, provide maternal,
child, ARSH etc services
and
4. Monitor progress,
quality and utilization of
services.
A.7 VULNERABLE Specific health activities
GROUPS
targeting vulnerable
communities such as SCs,
STs, and BPL populations
living in urban and rural
areas (NOT COVERED
BY Urban and Tribal RCH.
This may also include

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 As on 8th July, 2010

Reporting Qtr. Cummulative Illustrative Guidelines for

classification of activities
Actual Varia Varia
Code STRATEGY/ACTIVITIES PIP
Expendi nce
PIP Actual
nce
under RCH
Budget ture
Budget Expenditure
% %
(5) (6) (7) (12) (13) (14)

Mapping of vulnerable
groups, preparation of
operational plan,
Implementation and
Monitoring of progress
A.8 INNOVATIONS/ PPP/
NGO
A.8.1 PNDT and Sex Ratio 1. Operationalise PNDT
Cell,
2. Orientation of
programme managers and
service providers
on PNDT Act,
3. Monitoring of Sex Ratio
at Birth or any other
activity
A.8.2 Public Private
Partnerships
A.8.3 NGO Programme
A.8.4 Other innovations( if any)
A.9 INFRASTRUCTURE &
HUMAN RESOURCES
A.9.1 Contractual Staff &
Services
A.9.1.1 ANMs
A.9.1.2 Laboratory Technicians
A.9.1.3 Staff Nurses
A.9.1.4 Specialists (Anesthetists,
Pediatricians, Ob/Gyn,
Surgeons, Physicians)
A.9.1.5 Others - Computer
Assistants/ BCC Co-
ordinator/ ASHA Link
Worker etc
A.9.1.6 Incentive/ Awards etc. to
ASHA Link worker/ SN/
Mos etc.
A.9.2 Major civil works (New
constructions/
extensions/additions)
A.9.2.1 Major civil works for
operationalisation of
FRUS
A.9.2.2 Major civil works for
operationalisation of 24
hour services at PHCs
A.9.3 Minor civil works
A.9.3.1 Minor civil works for
operationalisation of
FRUs

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 As on 8th July, 2010

Reporting Qtr. Cummulative Illustrative Guidelines for

classification of activities
Actual Varia Varia
Code STRATEGY/ACTIVITIES PIP
Expendi nce
PIP Actual
nce
under RCH
Budget ture
Budget Expenditure
% %
(5) (6) (7) (12) (13) (14)
A.9.3.2 Minor civil works for
operationalisation of 24
hour services at PHCs
A.9.4 Operationalise Infection 1. Organise dissemination
Management &
Environment Plan at workshops on IMEP
health facilities guidelines
2. Prepare plan for
operatoinalisation across
districts,
3. Monitor progress against
the plan
A.9.5 Other Activities (RCH-I
Civil Works)
A.10 INSTITUTIONAL
STRENGTHENING
A.10.1 Human Resources 1. HR Consultant 2.
Development
Mapping of Human
resources, 3. Development
of transfer and cadre
restructuring policy, 4.
Performance appraisal and
reward system
development 5.
Management Development
programmes for Mos etc
A.10.2 Logistics management/ 1. Implementation or
improvement
improvement of Logistic
management system, 2.
Training of Staff in
logistics management, 3.
Strengthening of
warehousing facilities’
such computers, software
etc 4. Other logistics
initiatives
A.10.3 Monitoring & Evaluation / 1. Strengthening of M&E
HMIS
Cell,
2. Operationalization of
new MIES format (such as
review of existing
registers, Printing of new
forms, training of staff etc)
A.10.4 Sub Centre Rent and
Contingencies
A.11 TRAINING
A.11.1 Strengthening of 1. Carry out
Training Institutions
repairs/renovation of

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 As on 8th July, 2010

Reporting Qtr. Cummulative Illustrative Guidelines for

classification of activities
Actual Varia Varia
Code STRATEGY/ACTIVITIES PIP
Expendi nce
PIP Actual
nce
under RCH
Budget ture
Budget Expenditure
% %
(5) (6) (7) (12) (13) (14)

training institutions 2.
Provide equipment and
training aids to training
institutions 3. Contractual
staff recruited etc
A.11.2 Development of includes development,
training packages
translation, printing etc
A.11.3 Maternal Health
Training
A.11.3. Skilled Birth Attendance 1. Setting up of SBA
1 / SBA
training centres, 2. TOT
for SBA 3. Training of
Medical Officers in SBA,
4. Training of Staff Nurses
in SBA, 5. Training of
ANMs/LHVs in SBA
A.11.3. EmOC Training 1. Setting up of EmOC
2
training centres, 2. TOT
for EmOC 3. Training of
Medical Officers in
EmOC,
A.11.3. Life saving Anesthesia 1. Setting up of Life
3 skills training
Saving Anaesthesia skills
Training Centres, 2.
TOT for Anaesthesia skills
training
3. Training of MOs in Life
saving Anaesthesia skills
A.11.3. MTP training 1. TOT on MTP using
4
IMVA, 2. Training of
MOs in MTP using MVA,
3. Training of Mos in MTP
using other methods
A.11.3. RTI / STI Training 1. TOT on RTI/STI
5
training, 2. Training of
MOs in RTI/STI,
3. Training of Lab
Technicians in RTI/STI,
4. Training of Staff Nurses
in RTI/STI, 5.Training of
ANMs/LHVs in RTI/STI,
A.11.3. Dai Training
6
A.11.3. Other MH Training (ISD
7 Refresher )

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 As on 8th July, 2010

Reporting Qtr. Cummulative Illustrative Guidelines for

classification of activities
Actual Varia Varia
Code STRATEGY/ACTIVITIES PIP
Expendi nce
PIP Actual
nce
under RCH
Budget ture
Budget Expenditure
% %
(5) (6) (7) (12) (13) (14)
A.11.4 IMEP Training 1. TOT on IMEP,
2. IMEP training for State
and district programme
mangers
3. IMEP training for MOs
A.11.5 Child Health Training
A.11.5. IMNCI 1. TOT on IMNCI (pre-
1
service and in-service),
2. IMNCI training for MOs
3. IMNCI training of Staff
nurses, ANMs/LHVs and
also Anganwadi Workers
A.11.5. Facility Based Newborn 1. TOT on FBNC, 2.
2 Care
Training on FBNC for
MO/Staff nurses
A.11.5. Home Based Newborn 1. TOT on HBNC, 2.
3 Care
Training on HBNC for
ASHA
A.11.5. Care of Sick Children and 1. TOT on Care of sick and
4 severe malnutrition
severe malnutrition
children
2. Training for MO etc
A.11.5. Other CH Training (pl.
5 specify)
A.11.6 Family Planning
Training
A.11.6. Laparoscopic Sterilisation 1. TOT on Laparoscopic
1 Training
Sterilization
2. Laparoscopic
sterilization training for
MO
A.11.6. Minilap Training 1. TOT on Minilap
2
Training
2. Training for MO on
Minilap
A.11.6. NSV Training TOT on NSV and Training
3
of MOs
A.11.6. IUD Insertion Training TOT & training of MO
4
/Staffnurses/ANMs/LHVs
A.11.6. Contraceptive
5 Update/ISD Training
A.11.6. Other FP Training (pl.
6 specify)
A.11.7 ARSH Training TOT and Training of MO/
Staff nurses /ANMs /LHVs

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 As on 8th July, 2010

Reporting Qtr. Cummulative Illustrative Guidelines for

classification of activities
Actual Varia Varia
Code STRATEGY/ACTIVITIES PIP
Expendi nce
PIP Actual
nce
under RCH
Budget ture
Budget Expenditure
% %
(5) (6) (7) (12) (13) (14)
A.11.8 Programme
Management Training
A.11.8. SPMU Training
1
A.11.8. DPMU Training
2
A.11.9 Other training (pl.
specify)
A.12 BCC / IEC
A.12.1 Strengthening of
BCC/IEC Bureaus
(state and district
levels)
A.12.2 Development of State
BCC/IEC strategy
A.12.3 Implementation of
BCC/IEC strategy
A.12.3. BCC/IEC activities for
1 MH
A.12.3. BCC/IEC activities for CH
2
A.12.3. BCC/IEC activities for FP
3
A.12.3. BCC/IEC activities for
4 ARSH
A.12.4 Other activities (please
specify)
A.13 PROCUREMENT
A.13.1 Procurement of
Equipment
A.13.1. Procurement of 1. Procurement of
1 equipment: MH
equipment for skill based
services (anaesthesia,
EmOC, SBA),
2. Procurement of
equipment for blood
storage facility,
3. Procurement of
MVA/EVA equipment for
health facilities,
4. Procurement of RTI/STI
equipment for health
facilities
A.13.1. Procurement of 1. Procurement of
2 equipment: CH
equipment for IMNCI
2. Procurement of
equipment for FBNC,
3. Procurement of
equipment for care of sick
and server malnutrition
children

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 As on 8th July, 2010

Reporting Qtr. Cummulative Illustrative Guidelines for

classification of activities
Actual Varia Varia
Code STRATEGY/ACTIVITIES PIP
Expendi nce
PIP Actual
nce
under RCH
Budget ture
Budget Expenditure
% %
(5) (6) (7) (12) (13) (14)
A.13.1. Procurement of 1. Procurement/Repair of
3 equipment: FP
Laparoscopes/Laprocators
2. Procurement of NSV
Kits,
3. Procurement of IUDs,
4. Procurement of
operating
microscopes/accessories
for reconciliation
services
A.13.1. Procurement of
4 equipment: IMEP
A.13.2 Procurement of Drugs
and supplies
A.13.2. Drugs & supplies for MH Where overlapping, please
1
indicate the head having
major portion or on
proportionate basis
A.13.2. Drugs & supplies for CH
2
A.13.2. Drugs & supplies for FP
3
A.13.2. Supplies for IMEP
4
A.13.2. General drugs & supplies
5 for health facilities
A.14 PROGRAMME
MANAGEMENT
A.14.1 Strengthening of State 1. Contractual staff for
society/State
Programme SPMSU
Management Support 2. Mobility support for
Unit SPMSU
3. Provision of equipment
and furniture’s
A.14.2 Strengthening of 1. Contractual staff for
District society/District
Programme DPMSU
Management Support 2. Mobility support for
Unit DPMSU
3.. Provision of equipment
and furniture’s
A.14.3 Strengthening of 1. Training in finance and
Financial Management
systems accounts,
2. Audits (Annual Audit,
Concurrent Audit)
3. Operationalization of e-
banking etc

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 As on 8th July, 2010

Reporting Qtr. Cummulative Illustrative Guidelines for

classification of activities
Actual Varia Varia
Code STRATEGY/ACTIVITIES PIP
Expendi nce
PIP Actual
nce
under RCH
Budget ture
Budget Expenditure
% %
(5) (6) (7) (12) (13) (14)
A.14.4 Other activities (Prog.
Management Expenses,
Mobilty support to state,
district, block for all staff).
B TIME LINE ACTIVITIES -
Additinalities under
NRHM (Mission Flexible
Pool)
B1 ASHA
Selection & Training of
B1.1 ASHA
Procurement of ASHA
B1.2 Drug Kit
Performance related
B1.3 incentives to ASHAs
B2 Untied Funds
B2.1 Untied Fund for CHCs
B2.2 Untied Fund for PHCs
Untied Fund for Sub
B2.3 Centers
B2.4 Untied fund for VHSC
B3 Hospital Strengthening
Upgradation of CHCs,
B3.1 PHCs, Dist. Hospitals to
IPHS)
B3.1.1 District Hospitals
B3.1.2 CHCs
B3.1.3 PHCs
B3.1.4 Sub Centers
B3.1.5 Others
Strengthening of
District and Su-
B3.2 divisional Hospitals
Annual Maintenance
B4 Grants
B4.1 CHCs
B4.2 PHCs
B4.3 Sub Centers
New Constructions/
Renovation and
B5 Settingup
B5.1 CHCs
B5.2 PHCs
B5.3 SHCs/Sub Centers
Setting up Infrastructure
B5.4 wing for Civil works
Govt. Dispensaries/
B5.5 others renovations
Construction of BHO,
Facility improvement, civil
work, BemOC and
B5.6 CemOC centers
Corpus Grants to
B6 HMS/RKS
B6.1 District Hospitals

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 As on 8th July, 2010

Reporting Qtr. Cummulative Illustrative Guidelines for

classification of activities
Actual Varia Varia
Code STRATEGY/ACTIVITIES PIP
Expendi nce
PIP Actual
nce
under RCH
Budget ture
Budget Expenditure
% %
(5) (6) (7) (12) (13) (14)
B6.2 CHCs
B6.3 PHCs
Other or if not bifurcated
B6.4 as above
District Action Plans
(Including Block,
B7 Village)
B8 Panchayti Raj Initiative
Constitution and
Orientation of Community
leader & of
VHSC,SHC,PHC,CHC
B8.1 etc
Orientation Workshops,
Trainings and capacity
building of PRI at
State/Dist. Health
B8.2 Societies, CHC,PHC
B8.3 Others
Mainstreaming of
B9 AYUSH
B10 IEC-BCC NRHM
B10.1 Health Mela
Creating awareness on
B10.2 declining sex ratio issue
B10.3 Other activities
Mobile Medical Units
(Including recurring
B11 expenditures)
Referral Transport
B12 (Including EMRI)
B12.1 Ambulance
B12.2 Operating Cost (POL)
School Health
B13 Programme
Additional Contractual
Staff (Selection,
Training,
B14 Remuneration)
Additional Staff/
Supervisory Nurses
PHC,CHC (Including
B14.1 Ayush Stream)
Additional ANM, ,LHV,
B14.2 MPW
B14.3 PHNs at PHC level
Medical Officers at PHCs
(Including AYUSH
B14.4 stream)
Additional Allowances to
B14.5 MOs PHC, CHC
Lab technicians,
Gynecologists,
Anesthetists,
Pedisterian, Specialist
CHC, Radiologist,
B14.6 Sonologist, Pathologist,

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 As on 8th July, 2010

Reporting Qtr. Cummulative Illustrative Guidelines for

classification of activities
Actual Varia Varia
Code STRATEGY/ACTIVITIES PIP
Expendi nce
PIP Actual
nce
under RCH
Budget ture
Budget Expenditure
% %
(5) (6) (7) (12) (13) (14)
Dental Surgeons.

B15 PPP/ NGOs

Non governmental
providers of health care
B15.1 RMPs/TBAs
B15.2 Grant in Aid to NGOs
B16 Training
Strengthening of Existing
Training
Institutions/Nursing
B16.1 School
New Training
B16.2 Institutions/School
Training and Capacity
B16.3 Building Under NRHM
Promotional Trg of health
workers females to lady
B16.3.1 health visitor etc.
Training of AMNs,Staff
B16.3.2 nurses,AWW,Anganbadi
Other training and
capacity building
B16.3.3 programmes
B17 Incentives Schemes
Incentives to Specialists
B17.1 (CHCs)
Incentives to Medical
B17.2 Officers (PHCs)
Other Incentives
B17.3 Schemes
Planning,
Implementation and
B18 Monitoring
Community Monitoring
(Visioning workshops
at state, Dist, Block
B18.1 level)
B18.1.1 State level
B18.1.2 District level
B18.1.3 Block level
B18.1.4 Other
B18.2 Quality Assurance
B18.3 Monitoring and
Evaluation
B18.3.1 Computerization HMIS
and e-governance, e-
health
B18.3.2 Other M & E
B19 Procurements
B19.1 Drugs
B19.2 Equipments
B19.3 Others
B20 PNDT Activities

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Reporting Qtr. Cummulative Illustrative Guidelines for

classification of activities
Actual Varia Varia
Code STRATEGY/ACTIVITIES PIP
Expendi nce
PIP Actual
nce
under RCH
Budget ture
Budget Expenditure
% %
(5) (6) (7) (12) (13) (14)
B21 Regional drugs
warehouses
B22 New Initiatives/
Strategic Interventions
(As per State health
policy)/ Innovation/
Projects (Telemedicine,
Hepatitis, Mental Health,
Nutition Programme for
Pregnant Women,
Neonatal NRHM Helpline
etc.) as per need or
Block/ District Action
Plans)
B23 Health Insurance
Scheme
B24 Research, Studies,
Analysis
B25 State level health
resources
center(SHSRC)
B26 Support Services
B26.1 Support Strengthening
NPCB
B26.2 Support Strengthening
Midwifery Services under
medical services
B26.3 Support Strengthening
RNTCP
B26.4 Contingency support to
Govt. dispensaries
B26.5 Other Support
Programmes
B27 NRHM Management
Costs/ Contingencies
B27.1 Block Level PMU
B27.2 District level
B27.3 State level
B27.4 Audit Fees
B27.5 Concurrent Audit system
B27.6 Other Management
expenses
B27.7 Telephone and Mobile
phone, Contingencies
expenses
B27.8 Mobility Support to
BMO/MO/Others
B.28 Other Expenditures
(Power Backup,
Convergence etc)
C IMMUNISATION
C.1 RI strengthening project
(Review meeting, Mobility
support, Outreach
services etc)
C.2 Cold chain maintenance
C.3 Pulse Polio operating

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Reporting Qtr. Cummulative Illustrative Guidelines for

classification of activities
Actual Varia Varia
Code STRATEGY/ACTIVITIES PIP
Expendi nce
PIP Actual
nce
under RCH
Budget ture
Budget Expenditure
% %
(5) (6) (7) (12) (13) (14)
costs
D IDD
E IDSP
E.1 Civil Works (Renovation
& Repair)
E.2 Furniture & Fixtures
E.3 Lab Equipments
E.4 Lab Material & Supplies
E.5 Office Equipments
E.6 Consultants/Contract
Staff
E.7 IEC
E.8 Training
E.9 Operational Cost
F NVBDCP
G NLEP
H NBCP
H.1 Cataract Performance
H.1.1 Facility
H.1.2 Medical College
H.1.3 District College
H.1.4 CHC/Sub District
Hospital
H.1.5 NGOs
H.1.6 Pvt. Sector
H.1.7 Others
H.2 School Eye Screening
H.2.1 No. of teachers trained in
screening for Refractive
errors
H.2.2 No. of school going
children screened
H.2.3 No. of school going
children detected with
Refractive errors
H.2.4 No. of school going
children provided free
glasses
H.3 Eye Donation
H.3.1 No. of Eyes collected
H.3.2 No. of Eyes utilized
I RNTCP
I.1 Civil Works
I.2 Laboratory Materials
I.3 Honorarium
I.4 IEC
I.5 Equipment maintenance
I.6 Training
I.7 Vehicle Maintenance
I.8 Vehicle Hiring
I.9 NGO/PP Support
I.10 Medical College

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Reporting Qtr. Cummulative Illustrative Guidelines for

classification of activities
Actual Varia Varia
Code STRATEGY/ACTIVITIES PIP
Expendi nce
PIP Actual
nce
under RCH
Budget ture
Budget Expenditure
% %
(5) (6) (7) (12) (13) (14)
I.11 Miscellaneous
I.12 Contractual Services
I.13 Printing
I.14 Research & Studies
I.15 Salary of regular staff
I.16 Procurement of drugs
I.17 Procurement of vehicles
I.18 Procurement of
Equipment
GT Grand Total
(A+B+C+D+E+F+G+H+I)

Certified that the above amount of expenditure is duly reconciled with the amount recorded in the
relevant ledger heads.

(Finance Manager/Finance Controller/ Finance

Officer)

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Glossary of Terms and Terminology

S. No Abbreviation Full Form

1. AD Syringe Auto Destruct Syringe
2. AEFI Adverse Events Following Immunisation
3. AFB Acid fast Bacillus. Usually refers to Tuberculosis bacilli,
although organism for Leprosy is also Acid fast.
4. AMC Annual Maintenance Contract
5. ANC Ante Natal Care
6. ANC completed IFA Number of antenatal cases who have taken Iron & Folic
prophylaxis Acid tablets for 100 days during pregnancy.
7. ANC given 3 checkups Antenatal cases who have been given three checkups as
per Schedule Ist Check-up at 20-24 weeks, 2nd at 28-32
weeks and 3rd at 36 weeks of pregnancy
8. ANM Auxiliary Nurse Midwife
9. APH Ante Partum Haemorrhage: Bleeding during pregnancy
from 28 weeks onwards till delivery.
10. APL Above Poverty Line
11. Aseptic delivery Delivery not contaminated by sepsis/infection. Normal
deliveries are usually aseptic.
12. ASHA Accredited Social Health Activist
13. ASHA Kit Drug and item kit provided to ASHA for daily use
14. Asphysixia ARI (hypoxia) to a newborn infant long enough to cause
harm
15. Assisted delivery An assisted delivery is a situation where birth of a child
may have to be assisted using forceps or vacuum
extraction. It may happen in normal delivery or during
abnormal presentations like Breech delivery etc. It may
also be required in medical conditions like preeclampsia
etc.
16. Audiometrician A technician trained to carry out tests for hearing using
special equipment.
17. Auto analyser Equipment for carrying out automatic tests in labs.
18. Autoclave Equipment used to sterilise equipments/ dressing material.
19. AV Aids Audio Visual Aids
20. Average daily OPD Calculated by dividing total OPD of the month by
available OPD days (Total No. Of days on which OPD
services are available)
21. AYUSH Stands for department of Ayurveda, Yoga & Naturopathy,
Unani, Siddha and Homeopathy
22. BCC Behaviour Change Communication
23. Bed Days Available The maximum number of inpatient days of care that would
have been provided if all beds were filled during the year.
If 50 beds were available for use each day during the year,
bed days available would be 50 x 365 = 18,250. If the
number of beds fluctuated throughout the year, bed days
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S. No Abbreviation Full Form

available should reflect this and the calculation would be
more complicated. Other terms used for bed days available
include "potential days," "maximum patient days," or
"total inpatient bed count days."
24. Bed occupancy rate To calculate the average occupancy rate for a typical one-
year reporting period, two data item are needed.
(Inpatient Days of Care / Bed Days Available) x 100
These include "Inpatient Days of Care" and "Bed Days
25. BeMOC Basic Emergency Obstetric Care. Services refer to
facilities with following essential services –
1 Parenteral administration of Antibiotic
2. Parenteral administration of Anticonvulsants
3. Parenteral administration of Oxytocics
4. Assisted vaginal delivery
5. Manual removal of Placenta.
6. Removal of retained products of conception
26. Bio medical waste Any waste, which is generated during the diagnosis,
treatment or immunisation of human beings
27. Bitot’s Spots Bitot's spots are superficial, foamy gray, triangular spots
on the white of the eyeball due to Vitamin A deficiency
28. Blood Smear Examination of blood for different types of cell counts
29. Blood Storage Unit Smaller blood storage facilities primarily designed for
FRUs abut may also be located at any CHC, PHC or any
other govt hospital. These units have blood storage
capability of 50 units at one time.
30. Bone marrow biopsy Biopsy of bone marrow cells
31. Boyles Apparatus Equipment for providing anaesthesia and respiratory
assistance
32. BPL Below Poverty Line
33. Breech presentation Delivery of foetus with feet presentation.
34. Bronchoscopy Examination of bronchi (Lungs) using an instrument –
Bronchoscope
35. CeMOC Critical Emergency Obstetric Care. Services refer to
facilities with all services listed under BeMOC and also
include the following-
1. Availability of blood and blood transfusion
facility.
2. Facility for Caesarean section for delivery of
foetus in emergency cases
36. Cervical tear Tear of cervix during delivery
37. Citizen’s charter It is a document which focuses on rights of citizens with
respect to services to be provided at different levels and in
different type of facilities. It describes level and quality of
services which a citizen can expect and also the people
responsible for these services.
38. Cold Chain This is a temperature controlled supply chain, usually for
temperature sensitive items like vaccines and sera.

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S. No Abbreviation Full Form

Different types of equipment is usually available at various
facilities like – Deep freezer, ILR(Ice Lined Refrigerator),
Cold boxes etc.
39. Colony Hospital Health facilities in urban areas having indoor facilities
with more than 30 beds
40. Cradle A cradle (also called a crib) is a small bed, for holding
babies in maternal wards.
41. CSF Cerebral Spinal Fluid
42. CSF Analysis Study (Lab test) of Cerebro spinal fluid
43. DDK Disposable Delivery Kit
44. Disease classification The system is based on WHO classification manual – ICD
hospital records. -10. It is a system used to classify diseases and other health
problems which are recorded on many types of health and
vital records including death certificates
45. DMC Designated Microscopic Centre
46. DOTS Directly Observed Treatment Strategy
47. DPMU District Program Management Unit
48. DPT 3 3rd dose of DPT vaccine
49. Eclampsia It is a serious complication of pregnancy characterised by
convulsions. It usually follows pre-eclampsia.
50. Ectopic pregnancy Pregnancy where product of conception is outside the
uterus
51. EDD Expected Date of Delivery
52. ESI Employees State Insurance
53. Fiberoptic endoscopy Examination of internal cavities of body using an
instrument – endoscope- which has a Fiberoptic light
source at the end and is flexible.
54. FMR Financial Monitoring Report
55. Forceps delivery Delivery of child using the forceps in second stage
56. GIS Geographical Information System
57. GOI Government of India
58. Haematology Refers to study of blood and blood products. Usually
refers to examination of blood cells and their functions
through laboratory testing.
59. Health Post Outreach service post (Type a, b and c) in urban areas
having less than 10,000 population. It is manned by ANM.
Type D health post is manned by Medical officer and
caters to a population of 30,000 – 50,000.
60. HFWTC Health& Family welfare Training Centres
61. High dependency Units Special Wards for patients needing more intensive care
(HDU)- (more than general ward, but less than intensive care).
62. Histopathology Branch of pathology that deals with examination of
different types of tissues

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S. No Abbreviation Full Form

63. HIV Human Immunodeficiency Virus
64. HRD Human Resource Development
65. Hysterectomy Surgical removal of uterus
66. ICDS Integrated Child Development Services
67. IDSP Integrated Disease Surveillance Program
68. IEC Information Education &Communication
69. IFA Iron & Folic Acid
70. IMEP Infection Management and Environmental Protection
71. IMNCI Integrated Management of Neonatal & Child Infections
72. Incubator Equipment used to keep the new born babies warm
especially after premature birth. Can also be used to
transport the baby to other hospitals.
73. Infant Newborn up to Ist year of life.
74. Infertility treatment Treatment for failure to conceive
Inpatient days of Care Sum of each daily inpatient census for the year. To arrive
at this total, you would simply add together each daily
census for the 365 days in the year. Other synonymous
terms include "total inpatient service days," "occupied bed
days," or "census patient days of care."
75. IPD In patient Department
76. IPHS Indian Public Health Standards
77. Isolation room The isolation rooms are used for patients who need
respiratory isolation. This is a negative pressure room that
uses reverse circulation of the air to maintain isolation.
78. Ist trimester registration Registration within 12 weeks of pregnancy
of Pregnancy
79. IUD Intra Uterine Device
80. IUD 380 Copper T which can provide protection for 10 years.
81. JSY Janani Suraksha Yojna
82. Laprotomy A Laprotomy is a surgical procedure involving an incision
through the abdominal wall to gain access into the
abdominal cavity
83. Laryngoscope A laryngoscope is a medical instrument that is used to
obtain a view of the vocal cords and the glottis, which is
the space between the cords.
84. LHV Lady Health Visitor
85. LMP Last Menstrual Period ( usually refers to first day of last
cycle)
86. Lumber puncture Puncture of lower spinal cord (in lumber region), usually
done as a diagnostic procedure to remove Cerebro spinal
fluid-CSF)

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S. No Abbreviation Full Form

87. Major surgery Usually refers to surgery which requires general or spinal
anaesthesia.
88. Malnutrition Malnutrition is a general term for a medical condition
caused by an improper or insufficient diet. It most often
refers to under nutrition resulting from inadequate
consumption, poor absorption, or excessive loss of
nutrients.
89. Maternal Death Death of any women during pregnancy due to any cause or
post partum period (up to 42 days after delivery).
90. Maternity Home Health facilities in Urban areas which provide indoor
services for institutional deliveries. They have less than 30
Beds.
91. MCH Maternal and Child Health
92. MD Mission Director
93. MDT Multi Drug Treatment
94. Meeting register Register for recording minutes of meeting and other
details.
95. Micro birth plan This is a tool basically to structure the events/actions
related with pregnancy and delivery (To be drawn up by
ANM/ASHA). Essentially it consists of –
a. Registration and filling up of JSY card
b. Calculation of EDD(Expected date of delivery)
c. Informing dates of three essential check ups
d. Identification of health facility where delivery will
take place
e. Identification of means of transport
96. Mid trimester abortion Abortion between 14 and 24 weeks of pregnancy.
97. Minor surgery Usually refers to surgery which requires local/ no
anaesthesia
98. MIS Management Information System
99. Miscarriage Spontaneous abortion on or before 20 weeks of pregnancy
100. MOU Memorandum of Understanding
101. MPHW (M) Multi Purpose Health Worker (Male)
102. MTP Medical Termination of Pregnancy
103. MVA Syringe Manual Vacuum Aspiration Syringe
104. Neo natal sepsis Neonatal sepsis is a blood infection that occurs in an infant
younger than 90 days old. It is caused due to bacterial
infection
105. Neonate Newborn up to 28 days after birth
106. New born care corner Refers to set up for care of sick new born. It has minimum
resuscitation equipment, arrangement for baby warmth and
weighing etc.
107. NIDDCP National Iodine Deficiency Disorders Control Program

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S. No Abbreviation Full Form

108. NLEP National Leprosy Eradication Program
109. NPCB National Program for Blindness Control
110. NRHM National Rural Health Mission
111. NSP Non Sputum Positive Case
112. NSV No Scalpel Vasectomy
113. NVBDCP National Vector Borne Disease Control Program
114. OCP Oral Contraceptive Pills
115. OPD Out Patient Department
116. OPV Oral Polio Vaccine
117. OPV3 3rd dose of oral polio vaccine
118. ORS Oral Rehydration Solution
119. OT Operation Theatre
120. PAP smear (Papanicolaou A Pap smear is an examination under the microscope of
test) cells scraped from the Cervix.
121. Partograph Tool used to assess the progress of labour and to identify
when intervention is necessary.
122. Pericardial tapping Removal of fluid which may collect in between the
membranes covering the heart
123. PHN Public Health Nurse
124. Phototherapy unit Equipment used to provide phototherapy for babies with
neo natal jaundice.
125. Pleural biopsy Biopsy of membrane (pleura) covering the lungs.
126. PNC Post Natal Care
127. POL Petrol, Oil & Lubricants
128. PP Units Post Partum Units
129. PPH Post Partum Haemorrhage- Excessive bleeding occurring
after child birth (up to six weeks after delivery).
130. PPI Pulse Polio Immunisation
131. PPP Public Private Partnership
132. Pre-Eclampsia It is medical condition arising in pregnancy which is
characterised by hypertension and loss of proteins in urine.
133. PRI Panchayati Raj Institution
134. Pulmonary function test Pulmonary function tests are a group of tests that measure
how well the lungs take in and release air and how well
they move oxygen into the blood
135. Radiant heat warmer These are equipments designed to provide intense source
of radiant energy to keep the babies warm
136. RCH Reproductive & Child Health
137. Refractionist A technician trained to measure the refraction of the eye

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S. No Abbreviation Full Form

and to determine the proper corrective lenses
138. Resuscitation equipment Equipment used for resuscitation like – end tracheal tubes,
laryngoscope, ambu bag etc.
139. Retained placenta Condition where all or part of placenta is retained in the
uterus
140. RIMS Routine Immunisation Monitoring System
141. RKS Rogi Kalyan Samiti
142. RMP Registered Medical Practitioner
143. RNTCP Revised National Tuberculosis Control Program
144. RPR Test Rapid Plasma Reagin
145. RTI/STI Reproductive Tract Infection/Sexually Transmitted
Infection
146. SBA Skilled Birth Attendant (Special training course is
available for SBA)
147. Septic delivery Delivery contaminated by infection
148. SHG Self Help Group
149. SPMU State Program Management Unit
150. STLS Senior Tuberculosis Laboratory Supervisor
151. STS Senior Treatment Supervisor
152. TNSMC Tamil Nadu State Medical Corporation
153. Total ANC Registration Total of all new Antenatal cases registered during the
given period
154. Ultrasound guided biopsy A biopsy carried out using ultrasound for guidance
155. VCTC Voluntary Counselling and Testing Centre
156. Vertical health These are stand alone health programs which have not
programs/societies been integrated so far such as – AIDS control program,
pulse polio program etc. These programs have separate
funding and organisation structure
157. VHND Village Health and Nutrition Day
158. VHSC Village Health & Sanitation Committee
159. Wet mount The vaginitis wet mount test is a test to detect an infection
of the vagina.

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Contact Details

1. E-mail ID for communication: [email protected]

2. MOHFW Officers

S. Designation Tele-fax e-mail

No.
1. Additional Director General 011-2306 1334 [email protected]
(Statistics)
2. Chief Director (Statistics) 011-2306 2699 [email protected]
3. Deputy Director General 011-2306 1238 [email protected]
(Statistics) [email protected]
4. Deputy Secretary (NRHM- 011-2306 1831 [email protected],
Finance)

End of Document

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