1. SITUATION ANALYSIS NLR supported States in India

2. DN staff availability status State DLOs’MOs’NMSs’/ NMAs’ (minimum 1 in each distt) PTs’ Regular No. (%) In-charge No. (%) Vacant No. (%) Available No. (%) Available No. (%) Available No. (%) Bihar (5 Districts) 3 (60%)2 (40%)-4 (80%)5 (100%)3 (60%) Delhi (5 Districts) 5 (100%) 0 (0.0%) 0 (0.0%) 1 (20.0%) 5 (100%) 0 (0.0%) W.B. (3 Districts) 2 (66.6%) 1 (33.3%) 0 (0.0%) 2 (66.6%) 3 (100%) 0 (0.0%) Jharkhand (22 Districts) 16 (72.7%) 06 (27.3%) 0 (0.0%) 14 (63.6%) 22 (100%) 06 (27.3%) Uttara-khand (13 Districts) 0 (0.0%) 13 (100%) 0 (0.0%) 4 (31.0%) 13 (100.0%) 2 (22.0%) U.P. (70 Districts) 50 (71.4%) 10 (14.3%) 10 (14.3%) 39 (55.7%) 70 (100.0%) 33 (47.1%)

3. DN staff training status State DLOs’MOs’NMSs’PTs’ Bihar (5 Districts) 5 (100%)4 (100%)11 (100%)3 (100%) Delhi (5 Districts) 3 (60%)0 (0.0%)5 (100%)N Applicable W.B. (3 Districts) 2/3 (66.6%)½ (50.0%)6/6 (100%)Not Applicable Jharkhand (22 Districts) 22 (100%) 14 (100%) 22 (100%) 6 (100%) Uttara-khand (13 Districts) 5/13 (42.0%) 4/4 (100.0%) 6/13 (46.0%) 2/2 (100.0%) U.P. (70 Districts) 44 (62.8%) 27 (69.2%) 140/160 (87.5%) 31 (93.9%)

4. Status of supervision status & CMO meetings in the last quarter of 2007 State Supervisory visits made in the last quarter No. (%) No. of Distts. where supervisory reports are available No. (%) Participation of DLO in the monthly meeting of the Civil Surgeon No. (%) Nil1-1516-45 ≥ 46Nil1≥ 2 Bihar (5 Districts) 0 (0.0%) 1 (20.0%) 4 (80.0%) 0 (0.0%) 0 (0.0%)0 (0.0%) 0 (0.0%) 5 (100%) Delhi (5 Districts) 0 (0.0%) 1 (20.0%) 4 (80.0%) 0 (0.0%) 0 (0.0%)0 (0.0%) 0 (0.0%) 5 (100%) W.B. (3 Districts) 0 (0.0%) 2 (66.6%) 1 (33.3%) 0 (0.0%) 0 (0.0%)0 (0.0%) 0 (0.0%) 3 (100%) Jharkhand (22 Districts) 0 (0.0%) 3 (13.6%) 19 (86.4%) 0 (0.0%) 0 (0.0%)0 (0.0%) 22 (100%) 0 (0.0%) Uttara-khand (13 Districts) 4 (30.8%) 7 (53.8%) 2 (15.4%) 0 (0.0%) 13 (100.0%)-13 (100%) - U.P. (70 Districts) 2 (2.8%) 10 (14.3%) 54 (77.1%) 4 (5.7%) 19 (27.1%) Not Avail Not Avail Not Avail

5. DN staff vehicles status StateTotal No. of Districts No. (%) Availability of vehicles No. (%) Distts. where vehicles are used for NLEP No. (%) Distts. where vehicles are hired No. (%) Nil1-2≥ 2 Bihar (5 Districts) 5 (100%) 0 (0.0%) 3 (60%) 2 (40%) 2 (40.0%) 2 (40.0%) Delhi (5 Districts) 5 (100%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 5 (100.0%) 5 (100.0%) W.B. (3 Districts) 3 (100%) 1 (33.3%) 2 (66.6%) 0 (0.0%) 2/2 (100.0%) 1 (33.3%) Jharkhand (22 Districts) 22 (100%) 0 (0.0%) 16 (72.7%) 6 (27.3%) 22 (100%) 1 (4.5%) Uttara-khand (13 Districts) (13) 06 vehicles (46.0%) Shared vehicle 07 Dist (54.0%) 06 (46.0%) 0 (0.0%)13 (100.0%) 0 (0.0%) U.P. (70 Districts) 69/70 (98.6%) 1/70 (1.4%)52/69 (75.4%) 17/69 (24.6%) 68/69 (98.6%) 5/70 (7.1%)

6. DN staff training status * StateRemarks BiharAll DN staff has received DN training. DelhiThe remaining 2 DLOs’ and 1 MO were to receive training from 9 th June to 12 th June 2008 at TLM hospital Nand Nagri. West Bengal 1 DLO is not trained out of 3DLOs’. 1 MO also is not trained out of 2MO. ALL NMSs’ are trained. JharkhandAll DN staff has received DN training. Uttara-khand8 of 13 DLOs’ and 7 of 13 NMSs’ have not received DN training, yet. U.P.26 of 70 DLOs’, 12 of 39 MOs’, 7 of 160 NMSs’ and 2 of 33 PTs’ have not received DN training, yet.

7. Facts came out after Analysis of D. N. functioning & Action suggested S No ObservationSuggestion Jharkhand 1 6 of 22 DLOs’ are part time. Govt. has been requested to place permanent DLOs’. 28 of 22 DNs’ does not have Medical Officer. SLO to Nominate these eight posts of MOs’. 3 Only 6 out of 22 DNs’ has P.T.NMS/NMA may be trained in other distts. 4D. N. Team need strengthening of their managerial skills. Management training has been imparted to 10 districts in June 2008. Second batch is due to receive training in July 2008. 5 Society meetings are not being done in organized way Advocacy meeting with CMO is planned for 2 nd July 2008. 6Supervision visits are done without ATP, Checklist and Activities report Need training which will systematized supervisory visit. Mobility to be provided. 7Communication between SLO/D.N. is not established. No Telephone, No Fax May be requested from SLO.

8. Facts came out after Analysis of D. N. functioning & Action suggested S No ObservationSuggestion Bihar 1 2 of 5 DLOs’ are part time. S.L.O. to make nomination for this. 21 of 5 DNs’ does not have Medical Officer. C.M.O. to make nomination for this. 3 2 of 5 DNs’ do not have P.T.NMS/NMA may be trained in these distts./ D.L.O. to make nomination for this. 4D. N. Team need strengthening of their managerial skills. Training in management is being provided by LPAs’ during field visits. 5Only 3 out of 5 DNs’ do not both telephone and Computer facility available with them. However, 2 of 5 DNs’ have telephone available in their office. State govt. may be requested to make at least telephone available in DLOs’ office. 6In 2 out of 5 districts, available vehicles are not used for NLEP activities.

9. Facts came out after Analysis of D. N. functioning & Action suggested S. No. ObservationSuggestion Uttarakhand 18 of 13 DLOs’ and 7 of 13 NMSs’ have not received DN trg. This should be discussed with S.L.O. and the ILEP state coordinator. 29 of 13 D. N. are working without Medical Officer. CMO to make nomination for this. This should be discussed with S.L.O. and the ILEP state coordinator. 311 of 13 DNs’ are working without P.T. DLOs’ to make nomination for this. This should be discussed with S.L.O. and the ILEP state coordinator. 4D. N. Teams require strengthening of their managerial skills. Training in management for Uttarakhand is planned to take place in the month of August 2008. 5 Only 4 DNs’ have both telephone and Computer facility available with them. However, all DNs’ have telephone available in their office. State govt. may be requested to provide computer to each DN.

10. Facts came out after Analysis of D. N. functioning & Action suggested S. No. ObservationSuggestion Uttar Pradesh 126 of 70 DLOs’, 12 of 39 MOs’, 20 of 160 NMSs’ and 2 of 33 PTs’ have not received DN trg. 2 of 70 DNs’ are working with untrained NMSs’. This should be discussed with S.L.O. and the ILEP state coordinator. 2In 10 out of 70 districts D.L.O.s’ are part-time and in the other 10 districts DLO position are lying vacant. SLO to make nomination for this. 331 of 70 D. N.s’ are working without M.O. SLO/CMO to make nomination for this. This should be discussed with S.L.O. and the ILEP state coordinator. 4 37 of 70 D. N.s’ are working without P.T. CMO to make nomination for this. This should be discussed with S.L.O. and the ILEP state coordinator. 5 D. N. Teams require strengthening of their managerial skills. Training in management for Uttar Pradesh is in offing. 6 Communication between SLO/D.N. is not established as 56 of 70 DNs’ do not have both telephone and computer facility. None of the DNs’ have computer available with them State govt. may be requested to provide at least telephone to improve the communication between DLOs’ and SLO.

11. Facts came out after Analysis of D. N. functioning & Action suggested S. No. ObservationSuggestion West Bengal 11 of 3 DLOs and 1 of 2MO have not received DN trg. This should be discussed with S.L.O. and the ILEP state coordinator. 2In 1 D. N., D.L.O. is part-time. 1 out of 3 DNs’ do not have Medical Officer. SLO to make nomination for this. This should be discussed with S.L.O. and the ILEP state coordinator. 3All 3 D. N. are working without P.T. CMO to make nomination for this. This should be discussed with S.L.O. and the ILEP state coordinator. 4D. N. Teams require strengthening of their managerial skills. Training in management is being provided by LPAs’ during field visits. 5 In 2 out of 3 districts there is no communication between SLO/D.N as these 2 districts do not have telephone available in their office. However, computer is available in D.L.O.s’ office of all three districts. State govt. may be requested to provide telephone to these 2 DLOs’ to improve the communication between DLOs’ and SLO.

12. Facts came out after Analysis of D. N. functioning & Action suggested S. No. ObservationSuggestion Delhi 12 of 5 DLOs’ and 1 of 1MO have not received DN trg. Training was scheduled for 9-12 June 2008. But this did not take place. This will be discussed with ILEP state coordinator in the forthcoming meeting. 24 of 5 D. N. teams do not have Medical Officer. DLOs’ to make nomination for this. This will be discussed with SLO in the forthcoming meeting. 3All 5 D. N. are working without P.T.DLOs’ to make nomination for this. This will be discussed with SLO in the forthcoming meeting. 4D. N. Teams require strengthening of their managerial skills. Managerial training was organised by NLR in the month of Feb’08. On job training is provided by LPAs’. 5Meetings with community leaders/ community groups/ ANM/ ASHAs’ are not a regular feature. These meetings have been included and streamlined in plan of action for the year 2008-09. 6Supervision visits are done without ATP, Checklist and Activities report Need training which will systematized supervisory visit. Mobility to be provided. 71 of 1 DN (North Delhi) has a part- time PMW. SLO will be suggested to provide full time PMW/NMS to North Delhi district. 8Not all health units under other health agencies are involved in NLEP activities. Decision on Dates, time and venue for the advocacy meeting of high level functionaries of various health agencies is awaited.