Guidelines of the School Health Programme

Brief on the Programme:

Introduction:

School Health program is a program for school health service under National
Rural Health Mission, which has been necessitated and launched in fulfilling the
vision of NRHM to provide effective health care to population throughout the country
It also focuses on effective integration of health concerns through decentralized
management at district with determinant of health like sanitation, hygiene, nutrition,
safe drinking water, gender and social concern.

2. The School Health Programme intends to cover 12,88,750 Government and

private aided schools covering around 22 Crore students all over India.

Rationale for School Health Programme

3. The School health programme is the only public sector programme

specifically focused on school age children. Its main focus is to address the health
needs of children, both physical and mental, and in addition, it provides for nutrition
interventions, yoga facilities and counseling. It responds to an increased need,
increases the efficacy of other investments in child development,
ensures good current and future health, better educational outcomes
and improves social equity and all the services are provided for in a cost
effective manner.

4. The programme at the national level has been developed to provide

uniformity/guidance to States who are already implementing or plan to implement
their own versions of programme and to give guidance in proposing a coherent
strategy for school health programme in next years NRHM PIP to those States who
have not yet started their programme.

Process adopted for developing the Programme

5. The decentralized framework of implementation under NRHM has enabled

various states to devise and implement their own version of School Health
Programme. A detailed study was undertaken through which the programmes being
implemented in various States was documented . Through the analysis of the
strengths and weaknesses of these programmes being implemented in various

1
States a broad strategy for the school health programme was developed. This
strategy was shared in meeting chaired by HFM and attended by Secretary (HFW)
apart from various other senior officers. The contours of the programme was shaped
after this consultation.

6. Components of School Health Program:

Health service provision:
Screening, health care and referral:
o Screening of general health, assessment of Anaemia/Nutritional status,
visual acuity, hearng problems, dental check up, common skin conditions,
Heart defects, physical disabilities, learning disorders, behavior problems,
etc.
o Basic medicine kit will be provided to take care of common ailments
prevalent among young school going children.
o Referral Cards for priority services at District / Sub-District hospitals.
Immunisation:
o As per national schedule
o Fixed day activity
o Coupled with education about the issue
Micronutrient (Vitamin A & IFA) management:
o Weekly supervised distribution of Iron-Folate tablets coupled with
education about the issue

o Administration of Vitamin-A in needy cases.

De-worming
o As per national guidelines
o Biannually supervised schedule
o Prior IEC
o Siblings of students also to be covered
Health Promoting Schools
o Counseling services
o Regular practice of Yoga, Physical education, health education
o Peer leaders as health educators.

2
 o Adolescent health education-existing in few places
o Linkages with the out of school children
o Health clubs, Health cabinets
o First Aid room/corners or clinics.
Capacity building
Monitoring & Evaluation
Mid Day Meal

The strategy suggested for the programme:

7. Various options of implementation have been suggested under the

programme based on the assessment of various on-going school health
programmes in various States. Out of these options, one main strategy (Option-1)
has been recommended which tries to bring uniformity/give guidance to the school
health programmes being implemented in various States and provide a framework
for initiating the programme in those states who have not yet started the programme.
Within these guidelines, it is proposed that ANM may be apared once a week for
school health only if she has either MPW(male) or second ANM to support her at the
health subcentre. The Multi Purpose Worker(male) will be more appropriate for
exclusive boys senior basic schools.The guidelines along with indicative costing will
help the States where the programme has not been started to propose the
programme in next years PIP in a more structured and realistic manner.

8. Based on a cascading training strategy involving Health and Education

Departments ToTs will take place at State and District levels and teachers will be
oriented on the programme so that they internalize the core values and strategies of
the programme. Apart from the teachers screening the children, area ANMs/MPWs
will visit one school every week on an average for detailed screening and treatment
of minor ailment and required referral. In addition, a Medical Officer will also visit one
school per week for additional screening, treatment and referral.

9. Inferring from the indicative costing, it has been proposed that the programme
may be taken up in a phased manner covering 20% schools in the first year and
40% schools each in second and third year. The proposed cost of implementation so
phased can then be met out of RCH-II Flexible Pool/Mission Flexible Pool.

3
10. Management Structure for effective management:

Management structure has been provided for in the guidelines at national,

State and District levels.

The NRHM convergence mechanism will apply to this programme as well.

The involvement of MSG, State Health Mission and District Health Mission
has been ensured by placing the school health programme management
committees under the overall supervision/guidance of these overarching
structures.

In addition, emphasis has been placed at making these management

committees multi-departmental involving the functionaries of various related
departments/organisations such as Education, Rural Development, WCD,
NACO, etc.

Various School Health Promotion Committees recommended at State,

District, Block and School levels is detailed in the enclosed write-up of the
programme.

School Health Coordinator on contract basis at the State and District levels
has been provided to support the programme in the areas of coordination
and monitoring and evaluation.

11. These management committees have been proposed in a manner that they
bring in convergence between related departments/organizations. The main
convergence required in the programme is between the Ministry of Health & Family
Welfare, Ministry of Human Resources Development (MHRD) and Ministry of Rural
Development (MRD). MHRD will be partner in capacity building, IEC, Monitoring &
Evaluation. MRD needs to take care of water, safety education, Sanitation Education
and Garbage disposal waste management. The MoHFW will take care of screening,
health care services, immunization, referral, micronutrient management, health
education, capacity building, monitoring and evaluation, etc.

12. Cost of implementing the strategy:

12.1 The cost of implementing the strategy will include:

i. Cost of training and orientation at all levels, mobility support to

functionaries and incentives to them for carrying out this additional
work;

ii. Fixed costs, such as hardware & medical supply, IEC, printing of

4
 training manual, additional manpower provisioning at State and District
Health Society levels for monitoring and evaluation.

iii. Provisioning of School Health Coordinator, 1 each at the State and

District Health Society level for programme coordination, monitoring
and evaluation.

12.3 The indicative cost for the programme at the all India level, including the three
components mentioned above, is estimated at approximately Rs.84.39 Crores in the
1st year, Rs.283.12 Crores in the 2nd year, Rs.345.31 Crores in the 3rd year and
Rs.326.39 Crores from 4th year onwards.

13.2 The guidelines and indicative costing will not be mandatory to be followed by
States who have already initiated their own school health programmes, although
they can borrow from these guidelines if it helps them to better structure their
programme. The costing is also indicative and for the purpose of helping the States
cost their interventions under the programme in a better way while proposing the
programme in their NRHM PIP for the next year.

5
 Indicative costing for major activities under School Health Programme
1. Common Costs for all options:
A. Additional manpower requirement at the State Health Society:

Total Annual
Cost
Monthly Annual per (All
per State State States/UTs)
1 Renumeration to School Health
Programme Coordinator
(1 post): Rs.
Rs. 25,000 Rs. 1,05,00,000
(MBA/ Master of Sociel Work (with 3,00,000
experience in training and outreach
social work)
2 Mobility support to the School
Rs. 5,000 Rs. 60,000 Rs. 21,00,000
Health Coord.
Rs.
Rs. 30,000 Rs. 1,26,00,000
TOTAL STATE LEVEL: 3,60,000

B. Additional manpower requirement at the District Health Society:

Total Annual Cost

Monthly Annual per (All States/UTs)
per District District (600 Districts)
1 Remuneration to School Health
Programme Coordinator (1 Post):
(Master of Social work with commerce
background at +2 level and experience in
training and outreach social work).
The Coordinator will coordinate School
Health Programme and also the fund flow for Rs. 15,000 Rs. 1,80,000 Rs. 10,80,00,000
the programme. S/he will also assist the
District Accounts Manager in releasing funds
and maintaining the accounts for the SHP.
District Accounts Manager will look after the
overall accounting of School Health
programme in the District.
Mobility support to the School
Rs. 5,000 Rs. 60,000 Rs. 3,60,00,000
2 Health Coord.

Rs. 20,000 Rs. 2,40,000 Rs. 14,40,00,000

TOTAL AT DISTRICT LEVEL:

6
Cost of hiring School Health Coordinator at the District Health Society level as per phasing
of coverage of Districts
(These costs are estimates for entire country and would vary from State to State based on number of Districts covered
in each year)
20% Districts 40% Districts 40% Districts 100% districts
(1st Year) (2nd Year) (3rd Year) (4th Year Onwards)
Rs. 2,88,00,000 Rs. 5,76,00,000 Rs. 5,76,00,000 Rs. 14,40,00,000

C. Hardware and Medical Supply (for a Unit of 250 students) / annum

2nd Year
st
1 year onwards
One time capital cost:
Weighing scale (Rs.500) and height
1. measurement equipment (wall mounted) Rs. 680 NIL
(Rs.100) and Snellens Chart for bigger
schools (Rs.80) -
Student health cards, referral cards, 2
2. Rs. 535 Rs. 535
registers per year
3. Medical Kit Rs. 140
4. IFA Tablet Rs. 547 Rs. 547
5. Albendazole Rs. 250 Rs. 250
Spectacles (@ Rs.125/being revised to
Rs.200 per 250 students)- The cost may be
6. Rs. 0 Rs. 125
borne by National Programme for
Control of Blindness
Hearing aid - (@ Rs.2 per 250 students)-
7. The cost may be borne by National Rs. 0 Rs. 0
Programme for Control of Deafness
Travel cost for referral (1% of all
8. Rs. 250 Rs. 250
screaned) @Rs.100 per referral
Total cost for a Unit of 250 students Rs. 2,402 Rs. 1,707
Total cost for all students in schools
(Govt. & aided) in India = 22,00,00,000 Rs. Rs.
(NCERT data), which would constitute 2,11,37,60,000 1,50,21,60,000
8,80,000 units of 250 students each

7
 Phasing of cost incurred on Hardware and Medical supply
(These costs are estimates for entire country and would vary from State to State based
on number of Districts & schools covered in each year)
4th Year
1st Year 2nd Year 3rd Year onwards/per
(20%) (40%) (40%) year
No. of units of 250 176000 352000 352000 880000
students each
Expenditure in 3 Rs. Rs. Rs.
years for new 42,27,52,000 84,55,04,000 84,55,04,000
units taken up for (with capital (with capital (with capital
the first time expenditure) expenditure) expenditure)
Expenditure in 3 Rs. Rs.
years for old units 1,14,59,36,000 1,74,68,00,000
Expenditure from Rs. 1,50,21,60,000
4th Year onwards
Total
Rs. 42,27,52,000 Rs. 1,99,14,40,000 Rs. 2,59,23,04,000 Rs. 1,50,21,60,000
Expenditure:

D. Printing of Training Manual (for 13 lakh schools @ Unit cost Rs.100 per copy):

Phasing of printing and supply of training manual

(These costs are estimates for entire country and would vary from State to State based on
number of Districts & schools covered in each year)
3rd Year
1st Year 2nd Year (40%: 5,20,000
(20%: 2,60,000 schools) (40%: 5,20,000 schools) schools)
Rs. 2,60,00,000 Rs. 5,20,00,000 Rs. 5,20,00,000

E. IEC: Cost with phasing for entire country (state-wise costs would depend on no. of
schools taken up every year):

Cost for 1st Cost for 2nd Cost for 3rd Cost from 4th
Year Year Year Year Onwards
No. of Schools No. of Schools No. of Schools No. of Schools
(20%): (40%): (40%): (100%):
260000 520000 520000 1300000
Posters:
(4 each school Rs. 1,04,00,000 Rs. 2,08,00,000 Rs. 2,08,00,000
@ Rs.10 each)
Leaflet:
(170 per school Rs. 2,21,00,000 Rs. 4,42,00,000 Rs. 4,42,00,000
@ Rs.0.50 each)
Repeat
requirement Rs. 1,04,00,000 Rs. 3,12,00,000
of Posters
Repeat
requirement Rs. 2,21,00,000 Rs. 6,63,00,000 Rs. 11,05,00,000
of Leaflets
Rs.
Rs. 3,25,00,000 Rs. 9,75,00,000 Rs. 11,05,00,000
16,25,00,000

8
 2. Cost of various options:
A. OPTION-1 : Teachers screen students on a continuous basis and ANMs and a

3. Doctor visit the schools for treatment of minor ailments and referral

A.1 State level: Training of Master Trainers from Districts at SIHFW: (1 batch

i. Cost of engaging State level Resource persons (3) for 5 days for imparting training:
Per day Total per Total all 5 Total 35
cost/ day (3 days States
person persons) State level training will
Honorarium Rs. 700 Rs. 2,100 Rs. 10,500 Rs. take place in all States,
3,67,500 thus, no phasing is
Refreshment Rs. 50 Rs. 150 Rs. 750 Rs. 26,250 possible.
Rs. 750 Rs. 2,250 Rs. 11,250 Rs. 3,93,750

ii. Cost of training of participants from Districts

For the sake of costing if we take 35 Districts, 70 participants would be trained at the State level - 1 from DIET
(Education Dept.) and 1 MO from Health Department
Phasing
Per day Total per Total for
cost/ day 70 70 persons Total for 35 20% 40% 40%
person persons for 5 days States/UT (1st Year) (2nd Year) (3rd Year)

Honorarium Rs. 500 Rs. 35,000 Rs. 1,75,000

Rs.
61,25,000
Rs.
Refreshment Rs. 50 Rs. 3,500 Rs. 17,500
6,12,500
Rs.
Stationery Rs. 20 Rs. 1,400 Rs. 7,000
2,45,000
Rs. Rs. Rs. Rs.
TOTAL: Rs. 570 Rs. 39,900 Rs. 1,99,500
69,82,500 13,96,500 27,93,000 27,93,000
consisting of 2 personnel from each District trained for 5 days):

9
 A.2 District level: Training of Block trainers at DIET (District Institute of
Education & Training) for 3 days: 1 batch of 20 trainees from 10 blocks in the
District (no. of blocks here has been taken only for costing purpose):
i. Cost of engaging 2 Master Trainers (who have been trained at State level) for imparting training to
Block level trainers:
Phasing
Total per Total 20% 40%
Per day day (all all Total 600 (1st (2nd 40%
cost/person persons) days District Year) Year) (3rd Year)
Rs. Rs.
Honorarium Rs. 300 Rs. 600 1,800 10,80,000
Rs.
Refreshment Rs. 50 Rs. 100 Rs. 300 1,80,000
Rs. Rs. Rs. Rs. Rs.
Rs. 350 Rs. 700 2,100 12,60,000 2,52,000 5,04,000 5,04,000

ii. Cost of training trainees from Blocks within the District (10 blocks have been taken for calculation
purposes) for 2 days: 2 persons from each block need to be trained - 1 from BRC (Block Resource Centre
of Education Department) and 1 Doctor from CHC/PHC.
Phasing
20% 40%
(1st (2nd 40%
rd
Year) Year) (3 Year)

Rs. Rs.
TA/DA Rs. 200 Rs. 4,000 8,000 5,20,00,000
Rs. Rs.
Refreshment Rs. 50 Rs. 1,000 2,000 1,30,00,000
Rs.
Stationery Rs. 20 Rs. 400 Rs. 800 52,00,000
Rs. Rs. Rs. Rs. Rs.
Rs. 270 Rs. 5,400 10,800 7,02,00,000 1,40,40,000 2,80,80,000 2,80,80,000

10
 i. Cost of engaging 2 Master Trainers who have been trained at District level (1 from BRC and 1
Doctor from CHC/PHC) for 2 days

Phasing
Total all
Per Total days
day per day (2 days X 8
cost/ (2 batches = Total 6500 20% 40% 40%
person persons) 16 days) Blocks (1st Year) (2nd Year) (3rd Year)

Rs.
Honorarium Rs. 200 Rs. 400 Rs. 6,400 4,16,00,000
Rs.
Refreshment Rs. 50 Rs. 100 Rs. 1,600 1,04,00,000
Rs.
Stationery Rs. 20 Rs. 40 Rs. 640 41,60,000
Rs. Rs. Rs. Rs.
Rs. 270 Rs. 540 Rs. 8,640 5,61,60,000 1,12,32,000 2,24,64,000 2,24,64,000

ii. Cost of training Teachers from schools in the Block (2 teachers from each school)
As there are approximately 1500 schools in a District, there would be 150 schools in a block. Thus, 300
teachers @ 2 teachers per school need to be trained.
If the BRC can take a batch of 40 teachers, 8 batches would be needed to cover 300 teachers.
Phasing
Total all
Per Total days
day per day (2 days X 8
cost/ (40 batches = Total 6500 20% 40% 40%
person persons) 16 days) Blocks (1st Year) (2nd Year) (3rd Year)
Rs.
TA/DA Rs. 100 Rs. 4,000 Rs. 64,000 41,60,00,000
Rs.
Refreshment Rs. 50 Rs. 2,000 Rs. 32,000 20,80,00,000
Rs.
Stationery Rs. 20 Rs. 800 Rs. 12,800 8,32,00,000
Rs. Rs. Rs. Rs. Rs.
Rs. 170 Rs. 6,800 1,08,800 70,72,00,000 14,14,40,000 28,28,80,000 28,28,80,000

A.3 Block level: Training of School Teachers at BRC (Block Resource

Centre of Education Department) for 2 days (2 Master Trainers who have been

11
 trained at DIET (I from BRC and 1 from Health Deptt.) would provide training to School
Teachers for the Schools in the Block)

A.4 In addition to continuous screening by teachers, the existing ANMs/MPWs (in

a team of 2 each) visit on a fixed day for treatment of minor ailments and
referral. These teams will take care of the students already screened by
teachers. In addition, a Doctor from CHC/PHC will also visit one school per
week based on the screening reports submitted by the teams of ANMs.

Presumptions for calculation:

Taking total number of students in India (in Government and Aided private
schools) to be 22 Crores, on an average there would be approximately 35770
students in approx. 211 schools in a block. Thus, there would be approx. 169
students in each School.
As there are on an average 30 ANMs in a Block, 15 Teams of 2 ANMs each
can be formed for School Health Programme.
If a Team of 2 ANMs can cover 1 school in a day, it will take211 days to cover
211 schools in a Block.
Thus, time taken to cover 211 schools by 15 teams of ANMs will be 14 days.
One Doctor from CHC/PHC will also visit one school per week. As there are 32
weeks in a school session 32 such visits will be possible.

i. Orientation of ANMs for SHP in Block CHC for 2 days:

Block District
level Level All India Phasing
Each Each For 30 for 300
ANM ANM ANMs in ANMs in
each for 2 a Block a District 600 20% 40% 40%
day days for 2 days (2 days) Districts (1st Year) (2nd Year) (3rd Year)

Rs.
TA/DA Rs. 100 Rs. 200 Rs. 6,000 Rs. 60,000 3,60,00,000
Rs.
Refreshment Rs. 50 Rs. 100 Rs. 3,000 Rs. 30,000 1,80,00,000
Rs.
Stationery Rs. 20 Rs. 40 Rs. 1,200 Rs. 12,000 72,00,000
Rs. Rs. Rs. Rs. Rs.
Rs. 10,200 1,02,000 6,12,00,000 1,22,40,000 2,44,80,000 2,44,80,000

12
 ii. Mobility support to ANMs to visit schools:
Phasing

For 14 20% 40% 40%

Per day working days (1st Year) (2nd Year) (3rd Year)
For 1 ANM each day Rs. 100 Rs. 1,400
For 1 team (of 2 ANMs) Rs. 200 Rs. 2,800
For 15 teams in a Block Rs. 3,000 Rs. 42,000
For 150 teams in a
District Rs. 30,000 Rs. 4,20,000
For (150*600)= 90000 Rs. Rs. Rs. Rs. Rs.
Teams in 600 Districts 1,80,00,000 18,00,00,000 3,60,00,000 7,20,00,000 7,20,00,000

iii. Incentive to ANMs for covering each school Phasing

20% 40% 40%
(1st Year) (2nd Year) (3rd Year)
Incentive to 1 ANM for covering 1
school Rs. 100
Incentive to 1 ANM for 14 schools
in a year Rs. 1,400
Incentive to 1 Team (2 ANMs) for
14 schools in a year Rs. 2,800
Incentive to 15 teams of ANMs in
a Block for covering 14 schools in a
year Rs. 42,000
Incentive to 150 teams in a District
in a year for covering 14 schools in
each Block Rs. 4,20,000
For (150*600)= 90000 Teams in Rs. Rs. Rs. Rs.
600 Districts 25,20,00,000 5,04,00,000 10,08,00,000 10,08,00,000

iv. Incentive to Doctor:

A Doctor from Block CHC/any PHC will visit one school per week to cover 32 schools
per annum. The selection of school will be based on the screening reports submitted
by ANMs.

Phasing

13
 For
Per For 6500 20% 40% 40%
32
visit Blocks (1st Year) (2nd Year) (3rd Year)
visits
Incentive to
1 Doctor to
visit 1 school
per week (32
weeks are
available
during
school Rs. Rs. Rs. Rs. Rs.
session) Rs. 300 9,600 6,24,00,000 1,24,80,000 2,49,60,000 2,49,60,000

Mobility
support to Rs.
Rs. Rs. Rs. Rs.
Doctors to 10,40,00,000
Rs. 500 16,000 2,08,00,000 4,16,00,000 4,16,00,000
visit schools

YEAR-4
YEAR-1 YEAR-2 YEAR-3
ONWARDS
TOTAL
OPTION- Rs. Rs. Rs. Rs.
1: 30,06,74,250 60,09,54,750 60,09,54,750 3,16,05,56,250

OPTION-2: Existing ANM/MPW visits on a fixed day for screening, treatment

of minor ailments and referral and a Doctor visits 1 school per week

Presumptions for calculation:

Taking total number of students in India (in Government and Aided private
schools) to be 22 Crores, on an average there would be approximately 35770
students in approx. 211 schools in a block. Thus, there would be approx. 169
students in each School.
As there are on an average 30 ANMs in a Block, 15 Teams of 2 ANMs each can be
formed for School Health Programme.
If a team of 2 ANMs can cover 40 students in a day, it will take 4 working days to
cover a school having 169 children.

14
 Thus, the time taken to cover 211 schools by 15 teams of ANMs will be 56 working
days.

i. Orientation of ANMs for SHP in Block CHC for 2 days:

Block District
level Level All India Phasing
Each Each For 30 for 300
ANM ANM ANMs in ANMs in
each for 2 a Block a District 600 20% 40% 40%
day days for 2 days (2 days) Districts (1st Year) (2nd Year) (3rd Year)

Rs.
TA/DA Rs. 100 Rs. 200 Rs. 6,000 Rs. 60,000 3,60,00,000
Rs.
Refreshment Rs. 50 Rs. 100 Rs. 3,000 Rs. 30,000 1,80,00,000
Rs.
Stationery Rs. 20 Rs. 40 Rs. 1,200 Rs. 12,000 72,00,000
Rs. Rs. Rs. Rs. Rs.
Rs. 10,200 1,02,000 6,12,00,000 1,22,40,000 2,44,80,000 2,44,80,000

ii. Mobility support to ANMs to visit schools:

Phasing
For 56 20% 40% 40%
Per day
working days (1st Year) (2nd Year) (3rd Year)
For 1 ANM each day Rs. 100 Rs. 5,600
For 1 team (of 2
ANMs) Rs. 200 Rs. 11,200
For 15 teams in a
Block Rs. 3,000 Rs. 1,68,000
For 150 teams in a
District Rs. 30,000 Rs. 16,80,000
For (150*600)=
Rs. Rs. Rs. Rs. Rs.
90000 Teams in 600
1,80,00,000 1,00,80,00,000 20,16,00,000 40,32,00,000 40,32,00,000
Districts

iii. Incentive to ANMs for covering each school Phasing

20% 40% 40%
(1st Year) (2nd Year) (3rd Year)
Incentive to 1 ANM for covering 1
school Rs. 100

15
Incentive to 1 ANM for 14 schools
in a year Rs. 1,400
Incentive to 1 Team (2 ANMs) for
14 schools in a year Rs. 2,800
Incentive to 15 teams of ANMs in
a Block for covering 14 schools in a
year Rs. 42,000
Incentive to 150 teams in a District
in a year for covering 14 schools in
each Block Rs. 4,20,000
For (150*600)= 90000 Teams in Rs. Rs. Rs. Rs.
600 Districts 25,20,00,000 5,04,00,000 10,08,00,000 10,08,00,000

iv. Incentive to Doctor:

A Doctor from Block CHC/any PHC will visit one school per week to cover 32 schools
per annum. The selection of school will be based on the screening reports submitted
by ANMs.

Phasing
For
Per For 6500 20% 40% 40%
32
visit Blocks (1st Year) (2nd Year) (3rd Year)
visits
Incentive to
1 Doctor to
visit 1 school
per week (32
weeks are
available
during
school Rs. Rs. Rs. Rs. Rs.
session) Rs. 300 9,600 6,24,00,000 1,24,80,000 2,49,60,000 2,49,60,000

Mobility
support to Rs.
Rs. Rs. Rs. Rs.
Doctors to
Rs. 500 16,000 10,40,00,000 2,08,00,000 4,16,00,000 4,16,00,000
visit schools

YEAR-4
YEAR-1 YEAR-2 YEAR-3 ONWARDS
TOTAL Rs. Rs. Rs. Rs.
OPTION-2 29,75,20,000 59,50,40,000 59,50,40,000 1,48,76,00,000

16
OPTION-3: Two ANMs/MPWs/GNMs/PHNs/JPHNs are engaged per Block on
contractual basis (@Rs.5000/month)
i. Remuneration for 2 ANMs/MPWs/GNMs/PHNs/JPHNs

Phasing
Per Month Per Annum 20% 40% 40%
(2 ANMs) (2 ANMs) All 6500 Blocks (1st Year) (2nd Year) (3rd Year)
Rs. Rs. Rs. Rs. Rs.
Rs. 10,000 1,20,000 78,00,00,000 15,60,00,000 31,20,00,000 31,20,00,000

ii. Orientation of ANMs for SHP in Block CHC for 2 days

Phasing
For 2
Each Each ANMs in for 20
ANM ANM a Block ANMs in a
each for 2 for 2 District (2 20% 40% 40%
day days days days) 600 Districts (1st Year) (2nd Year) (3rd Year)
Rs. Rs. Rs. Rs.
TA/DA 100 200 400 Rs. 4,000 24,00,000
Rs. Rs. Rs. Rs.
Refreshment 50 100 200 Rs. 2,000 12,00,000
Rs. Rs. Rs.
Stationery 20 40 Rs. 80 Rs. 800 4,80,000
Rs. Rs. Rs. Rs. Rs. Rs.
TOTAL 680 6,800 40,80,000 8,16,000 16,32,000 16,32,000

iii. Mobility support for all 240 days

Phasing
20% 40% 40%
(1st Year) (2nd Year) (3rd Year)
For a
District
For 2 (20
ANMs ANMs) ALL INDIA
For 1 for 240 for 240 For 600
ANMs/day days days Districts
Rs. 100 Rs. Rs. Rs. Rs. Rs. Rs.

17
 48,000 4,80,000 28,80,00,000 5,76,00,000 11,52,00,000 11,52,00,000

YEAR-4
YEAR-1 YEAR-2 YEAR-3 ONWARDS
TOTAL
OPTION- Rs. Rs. Rs. Rs.
3 21,44,16,000 42,88,32,000 42,88,32,000 1,07,20,80,000
GRAND TOTAL ALL OPTIONS (entire country):
(Including PROG. MANAGEMENT MANPOWER + HARDWARE/MEDICINE +
PRINTING OF MANUAL + IEC)

Rs. In Crores
YEAR-4
onwards
YEAR-1 YEAR-2 YEAR-3 (100%
(20% Schools) (40% Schools) (40% Schools) Schools)

OPTION-1:
Teachers screen on
continuous basis + Rs.
ANMs/Doctors visit
periodically Rs. 82.33 Rs. 281.21 Rs. 347.80 492.98
OPTION-2:
Existing ANMs Rs.
screen children +
Doctor visit Rs. 82.02 Rs. 280.62 Rs. 347.20 325.69
OPTION-3:
Two ANMs are Rs.
engaged on contract
in each Block Rs. 73.71 Rs. 264.00 Rs. 330.58 284.13

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