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Project Report Towards Organisational effectiveness of OPD service in Ayurvedic Dispensaries in District Gautam Budh Nagar, Uttar Pradesh Submitted by Dr. Surendra Chaudhary (PGC/ 3756/2010) For Certificate Course in Health and Family Welfare Management 2010-2011 National Institute of Health and Family Welfare-New Delhi

Towards Organisational effectiveness of OPD service in Ayurvedic Dispensaries in District Gautam Budha Nagar,U.P

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Project report on Outpatient services provided by the department of Ayurveda in Gautam Budha Nagar district of Uttar Pradesh. Covers total number of dispensaries, facilities available, total patient treated, budget allocation etc. includes the Essential Drug List for Ayurveda Dispensaries prepared by department of AYUSH, GOI

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Page 1: Towards Organisational effectiveness of OPD service in Ayurvedic Dispensaries in District Gautam Budha Nagar,U.P

Project Report

Towards Organisational effectiveness of

OPD service in Ayurvedic Dispensaries in

District Gautam Budh Nagar, Uttar Pradesh

Submitted by

Dr. Surendra Chaudhary

(PGC/ 3756/2010)

For

Certificate Course in Health and Family Welfare Management

2010-2011

National Institute of Health and Family Welfare-New Delhi

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Acknowledgement

I am gracefully acknowledge, the immense support of my family members for

their constant motivation. I am personally thankful to my wife for her motivation and

allow me for sparing time for this project. My daughter, make this project error free

by her editing and my son’s overseas calls always boost me for timely completion of the

project.

I am also graceful to all the faculty of distance learning cell, NIHFW New Delhi for

their guidance. All my fellow medical officers and paramedical staff of district

Ayurveda dispensaries support me warmly by providing the relevant data, answering

my survey questions and other information.

I personally thank Divisional Ayurvedic Officer Gautam Budh Nagar, Dr. Dhruv

Singh for proving the budget and other data required for this project.

Last but not the least; I thank all my friends for their pschycological support, and my

patients who missed me during my leaves for the contact programs.

I am very much thankful to Dr. Deoki Nandan , Director, NIHFW New Delhi for

inspiring me of joining this course during my earlier visits to the institute as U.P.

Government representative for trainings under NRHM.

-Surendra Chaudhary

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Contents

S.N. Contents Page number

1. Introduction 5-6

About Ayurveda 6

2. Section I: Description of the selected Organization 7-15

Divisional Ayurvedic Office G.B.Nagar 7

Map Uttar Pradesh 8

Map Gautam Budha Nagar 9

District profile 10

Location of Ayurveda dispensaries on map 12

Organizational chart 13

Staffing pattern 14

Budget of the organization 15

3. Section-II: Situational analysis 17-23

Health status 17

Health facilities 17

Service program 18

Management analysis 19

Community participation, inter- sectoral coordination 22

SWOT analysis 22

Management problems and causes 23

Future development plan 23

4. Section-III: Selected health care programme 24-35

Objectives 24

Infrastructure 24

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Staff position at field level 25

Basic qualification, experience and training- 26

Status of Medical Officers (experience) 27

Facilities at dispensaries 27

Performance, coverage and quality of the services 28

Patient’s growth 29

Other services 30

Target achieved 31

Observation 32

5. Section-IV: Managerial problems 36-37

Problems 36

Priorities of the problems 37

6. Section-V: suggested Interventions 39-41

7. Section VI: Action Plan 42-46

Appendix

Photos during field survey 47-49

List of medicine purchased by District officer 50

Questionnaire for medical officers- General Knowledge based 51

Questionnaire for medical officers- Hospital specific- 52

Essential drug list 54-75

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Introduction

Ayurveda services are mainly availed by the poor population groups who are not served by

the popular medical care. For last few decades modern health care system develops very fast

resulting drastic decline in the services of Ayurvedic dispensaries. Most of the Ayurvedic

dispensary limited to serve the chronic or the common ailments only.

Ayurveda, even having an old medical delivery institute and such a tremendous community

involvement, OPD attendance is very thin in this district. The main propose of this project is

to find out the factors which affect the working of the system and how we can improve after

studying the public health management tools.

About Ayurveda

Ayurveda can be defined in terms of basics which include the Tridosha and

Panchmahbhoot theories. A brief introduction is given below-

Basics of Ayurveda Life in Ayurveda is conceived as the union of body, senses, mind and soul. The

living man is a conglomeration of three humours (Vata, Pitta &Kapha), seven basic tissues

(Rasa, Rakta, Mansa, Meda, Asthi, Majja & Shukra) and the waste products of the body

such as faeces, urine and sweat. Thus the total body matrix comprises of the humours, the

tissues and the waste products of the body. The growth and decay of this body matrix and its

constituents revolve around food which gets processed into humours, tissues and wastes.

Theory of Panchamahabhutas

According to Ayurveda all objects in the universe including human body are

composed of five basic elements (Panchamahabhutas) namely, earth (Prithvi), water (Jal),

fire (Agni), air (Vayu) and vacuum (Akaash, ether). There is a balanced condensation of

these elements in different proportions to suit the needs and requirements of different

structures and functions of the body matrix and its parts. The tissues of the body are the

structural whereas humours are physiological entities, derived from different combinations

and permutations of panchmahbhoot

Health and Sickness Health or sickness depends on the presence or absence of a balanced state of the total body

matrix including the balance between its different constituents. Both the intrinsic and

extrinsic factors can cause disturbance in the natural equilibrium giving rise to disease. This

loss of equilibrium can happen by dietary indiscrimination, undesirable habits and non-

observance of rules of healthy living. Seasonal abnormalities, improper exercise or erratic

application of sense organs and incompatible actions of the body and mind can also result in

creating disturbance of the existing normal balance. The treatment consists of restoring the

balance of disturbed body-mind matrix through regulating diet, correcting life-routine and

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behaviour, administration of drugs and resorting to preventive Panchkarma and Rasayana

therapy

Preventive Treatment and the concepts of Aetio-Pathogenesis

Ayurveda has developed a very vivid analytical description of the stages and events

that take place since the causative factors commence to operate till the final manifestation of

disease. This gives this system an additional advantage of knowing that possible onset of

disease much before the latent symptoms become apparent. This very much enhances the

preventive role of this system of medicine by making it possible to take proper and effective

steps in advance, to arrest further progress in pathogenesis or to take suitable therapeutic

measures to curb the disease in its earliest stage.

Treatment The basic therapeutic approach is, that alone is the right treatment which makes for

health and he alone is the best doctor who frees one from disease. This sums up the principal

objectives of Ayurveda, i.e. maintenance and promotion of health, prevention of disease and

cure of sickness.

Treatment of the disease consists in avoiding causative factors responsible for

disequilibrium of the body matrix or of any of its constituent parts through the use of

Panchkarma procedures, medicines, suitable diet, activity and regimen for restoring the

balance and strengthening the body mechanisms to prevent or minimize future occurrence of

the disease.

Diet and Ayurvedic Treatment In Ayurveda, regulation of diet as therapy has great importance. This is because it considers

human body as the product of food. An individual’s mental and spiritual development as

well as his temperament is influenced by the quality of food consumed by him. Food in

human body is transformed first into chyle or Rasa and then successive processes involve its

conversion into blood, muscle, fat, bone, bone-marrow, reproductive elements and ojas.

Thus, food is basic to all the metabolic transformations and life activities. Lack of nutrients

in food or improper transformation of food lead to a variety of disease conditions

----------------------------------------------------------------------

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Section I: Description of the selected Organization

District Ayurvedic office Guatam Budha Nagar

Sponsoring agency - Government of Uttar Pradesh

The entire district Ayurveda service is governed by the Director Ayurveda services Uttar

Pradesh and comes under the ministry of Medical education headed by a cabinet minister

and supported by the minister of state (Ayurveda).

The department is headed by the director at state level and Regional Ayurvedic and Unani

Officer at district level.

We have 71 districts and 59 Divisional Ayurvedic officers.

Ayurveda department of this district is a new one and was created only on 15th

Nov 2008.

Gautam Budha Nagar district was created in year 1997 from district Ghaziabad and Buland

shar. Department of Ayurveda was controlled by Divisional Ayurvedic Officer Ghaziabad

for 7 dispensaries and 5 dispensaries were governed by the Divisional Ayurvedic Officer

Bulandshahar.

Now all the administrative control is under Divisional Ayurvedic Office Gautam Budha

Nagar, located at Government Ayurvedic dispensary Dadri.

District Gautam Budha Nagar is one of the small districts of U.P. so is our department.

DEPARTMENT OF AYURVEDA is one of the oldest departments in U.P. providing health

care services through its dispensaries and hospitals throughout the state particularly in rural

areas.

We are not the partner of any National Health Programmes run by the Government of India

(GOI). We had an annual budget of Rs. 8000 (eight thousand only) per dispensary for

medicine supplied by the Government Ayurvedic Pharmacies situated at Lucknow and

Pilibhit. Budget allocation for district office includes contingencies, rent and very nominal

amount for maintenance of the building.

For last two years medicines worth Rs. 25 thousand for every dispensary are being supplied

by the department of AYUSH, GOI under the scheme strengthening of the existing AYUSH

dispensaries.

Most of the dispensaries of this district lack in proper maintenance of building, furniture,

equipments and all the other basic facilities.

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District Gautam Budha Nagar

Uttar Pradesh showing district and state boundaries

(Source- http://censusindia.gov.in/2011-prov-results/prov_data_products_up.html - Provisional Population Totals Paper 1 of 2011 Series

10 - Uttar Pradesh)

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Map G.B. Nagar (http://gbnagar.nic.in/)

District profile –Gautam Budh Nagar

The District Gautam Buddh Nagar was formed on 6/9/97 with effect from Govt. order no

1249/97/82/97.District Gautam Buddh Nagar includes Dadri,Noida and Greater Noida from

gaziabad and Tehsil Sikandrabad and part of Khurja from Bulandshahar.The district has 4

development blocks,3 administrative tehsils and 16 police station.

District Gautam Budha Nagar is surrounded by Delhi NCR,Haryana, Bulandshar, Ghaziabad

and Aligarh district of U.P

(Map courtesy-http://gbnagar.nic.in/Map/map.jpg)

Population India Uttar Pradesh GB Nagar

Total 1,21,01,93,42 199,581,47 1,674,714

Male 62,37,24,24 104,596,41 904,505

Female 58,64,69,17 94,985,06 770,209

Population Density/sq.Km 382 828 1306

Sex ratio(per 1000 males) 940 908 852

Child 0-6 yrs Total 158,789,28 29,728,23 245,232

Child 0-6 yrs (Male ) 82,952,13 15,653,17 132925

112307 Child 0-6 yrs (Female ) 75,837,15 14,075,06

Literacy Rate 74.0 69.72 82.20

Literacy Rate-Male 82.1 79.24 90.23

Literacy Rate-Female 65.4 59.26 72.78

(Source- http://censusindia.gov.in/2011-prov-results/prov_data_products_up.html - Provisional Population Totals Paper 1 of 2011 Series

10 - Uttar Pradesh)

Description Figure Reference

Area 1442 Sqr KM

http://gbnagar.nic.in/

No. Of Tehsil 3

No. Of blocks 4

No. Of Lokshabha seats 1

No. Of Vidhan Sabha 3

Total village 373

Climate-Rainfall 303

Maximum temperature 44.4 http://www.uponline.in/Profile/districts/

Gautam.asp Minimum temperature 2.2

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Government Hospitals at Gautam Budh Nagar as on 2009-10

(As per development atlas of G.B. Nagar, dept of statics,Vikas Bhawan, SurajPur-G.B.nagar)

S.N. Nature of hospitals Numbers

1. Allopathic 4

2. Ayurvedic 12

3. Homeopathic 19

4. Unani 0

5. Community Health Centre 3

6. Primary Health Centre 18

7. Family and Mother-Infant Centre 43

8. Family and Mother-Infant Sub-Centre 327

9. Tuberculosis 1

10. Leprosy 1

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Location of Ayurvedic dispensaries in District Gautam Budh Nagar- Block wise

distribution (http://gis.up.nic.in:8080/srishti/)

Geographical data of Ayurvedic dispensaries (http://gis.up.nic.in:8080/srishti/)

S.No. Village Tehsil Block Population*

As per 2001

census

Distance

from health

centre(KM)

1. Beel Dadri Dadri 1976 6-10

2. Bhaipur Jewar Jewar 2624 6-10

3. Parsaul Gb nagar Dankaur 4098 6-10

4. MandiShyamnagar GB Nagar Dankaur 4882 0

5. Dadri Dadri Dadri 57416 0

6. Surajpur GB Nagar Bisrakh 5569 6-10

7. Dujana Dadri Bisrakh 7901 0

8. Noida* Dadri Bisrakh 305058 0

9. Jahangirpur Jewar Jewar 7901 0

10. Sarfabad* Dadri Bisrakh 4291 6-10

11. Sidipur Dadri Dadri 1197 6-10

12. Bhunna Taga Jewar Jewar 1391 6-10

*Noida and Sharfabad dispensary are working at another place. Sharfabad is situated at

Chhijarsi and Noida, even being Urban dispensary is situated in villege Bajid Pur , Sec-63

Noida

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Organization Chart #

*There are 71 districts in Uttar Pradesh and Divisional Ayurvedic Officers are working in

only 59 districts.

Minister

Medical Education

Director Ayurveda

Additional Director

Administeration

Deputy Director(3)

Administeration, Planning ,Education

Divisinal Ayurvedic Officer(59)*

Adittional Drug Controller

Finance Controller

Director Education

(Pathyakarm Mulyankan)

Principal Secretory

Medical Education

Special Secretory

Ayush-2

(Ayurveda)

Joint Secretory

Ayush-2

State Minister

(Ayurveda)

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# Restructure of department of Ayush is in progress and post of Director General Ayush has

been created, but no further development has done at the time of preparing this project.

Resources-

a. Human-Staffing pattern-

S.

N.

Designation Sanctioned Positioned Vacant Remarks

A. At Divisional Ayurveda and Unani Office

1. Divisional Ayurvedic Officer 1 1 1* Officiating

2. L.D.C. 1 1

3. Chowkidar 1 1

4. Peon 1 1

B. At field level (Dispensary)

1. Medical Officer 13 11 2

2. Pharmacist 13 6 7

3. Staff Nurses 3 3

4. Bhritya 12 10 2

5. Chowkidar 1 1

6. Sweeper 2 3* 0ne surplus

7. Sweeper cum Chowkidar 7 6 1

8. Part time sweeper* 3 3 *Rs.25/month

*Dispensary having OPD facilities only, doesn’t have sweeper,

Only three (25%) dispensaries have full staff against the sanctioned post, while 75% of

dispensaries are short of staff in the form of Pharmacist, M.Os and class IV employees.

There is one dispensary where post of Medical Officer and Pharmacist are lying vacant

and Medical Officer of another dispensary is on attachment there.

Availability of the field staff-

Description of dispensary Number

Dispensary having Medical officer along with pharmacist 5

Dispensary having Medical officer but without pharmacist 5

Dispensary Without Medical officer and Pharmacist 1

Dispensary having Pharmacist only 1

Dispensary having full staff as sanctioned 3

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b. Financial-Budget allocation for the year 2009-10

Bu

dge

t H

ead

Bu

dge

t Budget Items (Rs. Laks)

Salary TA/DA Raw Drugs

Aushadi

and

Rasayan*

Anurakshan

(Maintenan

ce)

Others

Ru

ral

45.9 R E R E R E R E R E R E

30 30 6.0 6.0 1.50 1.50 3.50 3.50 1.50 1.50 2.40 2.40

Urb

a

n 26.65

20 20 4.0 4.0 0.20 0.20 0.70 0.70 0.15 0,00 1.60 1.60

Tota

l

72.55 50 50 10.0 10.0 1.70 1.70 4.20 4.20 1.65 1.50 4 4

Year end surrender amount – Rs 15,000

Budget allocation for the year 2010-11

Bu

dge

t H

ead

Bu

dge

t

Budget Items(Rs. Laks)

Salary TA/DA Raw Drugs

Aushadi and

Rasayan

(Prepared

and dressing

materials)

Anuraksha

n

(Maintena

nce)

Others

Ru

ral

85.70

R E R E R E R E R E R E

62 56 21 16.75 0.10 0.10 2.50 2.50 Nil Nil Nil N

il

Urb

an

37.13

24 24 8.5 5.30 0.10 0.10 0.30 0.30 Nil Nil 4* 4

Total 122.83 86 80 29.

5

22.05 0.20 0.20 2.80 2.80 Nil Nil 4 N

il

Year end surrender amount – Rs 6, 33,000

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Section-II: Situational analysis

1. Health status situation-

S.N. Rates and Ratio Value reference

1. Crude death rate 8.4 SRS 2008

2. Crude birth rate 29.1 SRS 2008

3. Infant mortality rate (IMR) 67 SERS 2008

4. Maternal mortality rate (MMR) 440 SRS 2008

5. Total fertility 3.8 SRS 2008

6. Sex Ratio/1000 male 852 Provisional

population report

census2011 7. Total literacy rate 90.23

8. Literacy rate female 72.78

9. Growth rate % 51.52

2. Health facilities- Health facilities in Gautam Budh Nagar are provided by the

government, private and corporate hospital. Government facilities are more rural

population centric while private and corporate health sector is available in urban

areas only.

Private health facilities-

Corporate multispecialty hospitals- 2

Private multispecialty hospital - 2

Private hospitals >100 beds 10

Private hospitals <100 beds >50

There is one medical college at Greater Noida having a 500 bed hospital

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Government Hospitals at Gautam Budh Nagar as on 2009-10

(As per development atlas of G.B. Nagar, dept of statics,Vikas Bhawan, SurajPur-G.B.nagar)

S.N. Nature of hospitals Numbers

1. Allopathic 4

2. Ayurvedic 12

3. Homeopathic 19

4. Unani 0

5. Community Health Centre 3

6. Primary Health Centre 18

7. Family and Mother-Infant Centre 43

8. Family and Mother-Infant Sub-Centre 327

9. Tuberculosis 1

10. Leprosy 1

Two multispecialty hospitals are under construction, one each at Noida and Greater

Noida urban area.

Total number of dispensary-12

Dispensary running in

Rented 6

Government owned 2

Rent free/ Panchayat, Mandir, School , other 4

Having own land 2

Having only one room 4

Insufficient space 4

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3. Service Program- All the National health programmes are run by the district health

and family welfare department. Department of Ayurveda is providing OPD services

as primary service with very limited IPD service, which is being utilized as day care

facility.

4. Management analysis of-

1) Policy, objectives, strategies and inputs-

There are no clear objectives and targets other than attending at least 20 new patients per

day. Strategies are framed at state level and forwarded to district level.

Inputs-

Human resources- Medical Officers are available in most of the dispensary but

pharmacist are short and affecting the function of the organization. There are some

dispensaries without medical officer and pharmacist. Pharmacist or medical officer

of another dispensary is attached, thus affecting both the dispensary.

Infrastructure – Infrastructure is very poor in the entire district. Rent free buildings

are in bad shape and need a lot of money for repairing or maintenance.

Furniture and equipments- Most of the dispensaries do not have enough or good

quality furniture.

Equipments and instruments are neither adequate nor appropriate in nature.

Budget- Budget provision other than committed like salary, arrears etc is not

sufficient. Budget for maintenance or repairing is not provided every year. Medicinal

budget is sufficient as medicines are supplied as central assistance.

2) Organizational structure-

District organization is headed by Divisional Ayurvedic Officer supported by a junior clerk

and two class IV employees. There is no vehicle so management can’t be up to the mark. At

dispensary level management is done by the medical officer and pharmacist (in case of un

availability of the M.O.)

3) Status of human resources management-

a) Staffing norms-

S.

N.

Designation Sanctioned Positioned Vacant

1. Divisional Ayurvedic Officer 1 1 1*

2. L.D.C. 1 1

3. Chowkidar 1 1

4. Peon 1 1

1. Medical Officer 13 11 2

2. Pharmacist 13 6 7

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3. Staff Nurses 3 3

4. Bhritya 12 10 2

5. Chowkidar 1 1

6. Sweeper 2 3

7. Sweeper cum Chowkidar 7 6 1

8. Part time sweeper 3 3

* Presently, post is holding on officiating base.

b) Status of the vacant posts-

Name of the post Sanctioned Posting Vacant Vacant

%

1. Medical Officer 13 11 2 15

2. Pharmacist 13 6 7 54

3. Bhritya 12 10 2 17

4. Sweeper cum Chowkidar 7 6 1 14

c) Availability of the staff-Most vacant posts belong to pharmacists which are more

than 50% followed by class IV employees, while medical officers are posted in all

the dispensaries other than two.

Observations on availability of the staff-

In the absence of pharmacists medicines are distributed by the class IV employees, who are

not competent and technical. This increases the waiting time and medical officers always

fear about any lapse in distribution of the medicine.

90% of the field staff not staying at the headquarters. Reasons are-

No residential quarters- There is no provision for residence at the field units, so

staff is not staying there. Class IV employees are generally posted near their villages,

so they don’t reside there. Medical officers reside in nearby towns.

Location of the field unit- These are situated in villages far from the city or town

having no facilities like education, entertainment and electricity etc, so medical

officers and pharmacist reside 10-20 km away from the headquarters.

d) Staff motivation- Staff motivation is at the lowest level. Entire staff is doing its

duties just till the withdrawal of their salary only. Salary, T.A, and other dues of the

staff are not paid in time because of lack of commitment of the district office.

Lack of motivation concerts the low turn up of the patients and cleanliness of the premises.

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e) Training- Training was never planned. There is no provision of in-service training

for technical personnel.

There is no organizational policy for training.

Few of the medical officers take training for the financial management.

If there is any training program sponsored by the central government, employees are

not informed and never relieved for the training.

Technical skills of the medical and Para-medical staff are never evaluated and they

never feel the need of any training.

f) Leadership and supervisory practices- At district level no supervision or

monitoring is performed because of unavailability of the vehicle to inspect the

dispensaries. Medical officers are not trained in modern tools of management

including monitoring and supervision.

There is no supervisory plan for regular supervision.

There is no supervisory check-list.

No feedback is provided to the superiors.

Supervisors do not have adequate skill to supervise.

g) Team work-

There are some units where entire staff works as a team and achieves the desired targets.

Most of the units have some inter-personal conflicts, which require timely intervention of

solution.

h) Support system:

1. Financial support- Financial support is in the form of budgetary allocation from the

state government for the wages, medicine and equipments.

2. Materials support-

Medicines are supplied from the following sources-

1. State government- A total of Rs. 8,000 is earmarked for the medicine supplied

by the two state Ayurvedic pharmacies.

2. Local supply- Budget is provided for the local procurement of medicine and

other equipments. For local purchase three categories are defined,

I. Raw drugs- As per Ayurveda principle, certain medicines are available in

certain geographical areas which are very beneficial for the ailments which exist

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in those areas, so government allocates certain budget to purchase these raw

drugs for individual dispensaries.

II. Aushad and Rasayan- This category has readymade medicines including

classical medicines. Dressing material is also procured under this category.

III. Third category consists of drugs from various sources including patent

Ayurvedic medicines.

Budget allocation for medicine (Last two years)

Year Raw drug Aushadi and Rasayan

2010-11 20,000 2,80,000

2009-10 1,70,000 4,20,000

3. Central government assistance-

Under the Ayush, GOI scheme for medicine @Rs. 25 thousand per dispensary is being

supplied for last two years. From year 2010-11 this amount has been increased to Rs.50,

000 per dispensary.

Procurement process-

For central assistance and state supply, directorate of Ayurveda services purchases

medicines on the recommendation of the purchase committee, while at district level

procurement is done on the bases of demand letter from the dispensaries. But this practice is

not followed and purchase is made at divisional Ayurvedic officer’s discretion only.

4) Community participation, inter- sectoral coordination and IEC-

Total aversion from community, there is no involvement. Medical officers are not

aware about the community need although Ayurveda has very good community

involvement in terms of knowledge.

No interaction between field unit staff and the community.

Most of the time community is not aware about the services we are providing,

resulting in loss of faith as well as patients.

NGOs never involve Ayurvedic dispensaries in their working environment.

There is no inter-sectoral coordination; involvement of main stream health service

department is limited to engage Ayurveda medical officer in immunization program

or using their facilities for setting up of the immunization booths during Pulse Polio

drive.

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No IEC material ever supplied to the hospitals, neither staff is aware about any IEC

services.

Ayurvedic medical officers are not aware about the Village health societies and/or

Togi Kalian Samitis.

No Medical Officer is member of any Village health society or RKS.

Swot analysis

Strengths:

1. Strong community involvement in terms of Ayurveda knowledge.

2. Good acceptance among the people.

3. Experienced, committed medical and paramedical staff.

Weaknesses:

1. Poor infrastructure.

2. Poor record keeping.

3. No clear policies.

Opportunities:

1. Conducting of specialized clinic- kshar sutra, geriatric and rasayan therapy.

2. Propagation of lifestyle modification for prevention of disease.

3. Potent integration with the National Health Programs.

Threats:

1. Political patronage does not provide support to this system and political interference

is the biggest threat.

2. If involved in national health programs, department of health will misuse the

workforce and medical officers will be used for any work other than the treatment.

5) Decentralization-

No decentralization is done. There are two types of planning which are supposed to be done

at dispensary level-

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Purchase of crude drugs- budget is allocated for purchasing local need based crude herbs to

provide the effective treatment, but this is not being followed. Divisional Ayurvedic officer

purchases raw drug on his own and supplies to the dispensaries.

User charges- 50% of user charges are supposed to be used exclusively for the betterment of

that particular unit in the form of purchase of most essential equipment, instrument or

furniture, but it is not performed at dispensary level.

6) Management problem and causes-

Most important management problems are supervision and monitoring. There is no

evaluation of the service at all. Vehicle is the main cause of the problem, without which

field movement is not possible. Dispensaries are situated far from the district headquarter

and public transport is not available every time.

Disbursement of wages and other arrears- most of the staff is facing this problem. Salary is

not disbursed in time and the cause is inter-personal conflict between LDC and the

Divisional Ayurvedic officer.

7) Future development plan of the organization- At district level every year provision of

certain new dispensaries is made in the district plan, but never succeeds in releasing the

state budget. This year also six new dispensaries are proposed in district plan.

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Section-III: Selected health care programme

OPD services in Ayurveda dispensaries of Gautam Budh Nagar

III. i. Objective-

Main objective of Ayurveda services is to provide quality health care on two grounds-

Preventive- As Ayurveda theory explains that most of the diseases occur because of

unhealthy life style, we can prevent many diseases by adopting a healthy life style as per our

Prakriti as stated by Ayurveda.

This can be done by advising people to eat properly and act in accordance of nature.

Curative- If we are not following the regimen explained by the Ayurveda we can take

medicine to cure the diseases.

Main goal and objective is to attend at least 20 new patients per day i.e. a total of at least

7300 patients annually.

III. ii. Infrastructure, facilities and resources-

There are 12 dispensaries in the district covering mainly the rural population.

S.No. Dispensary at Tehsil Block Nature of

Dispensary

Bed

capacity

13. Beel Dadri Dadri Indoor 4

14. Bhaipur Jewar Jewar Indoor 4

15. Parsaul Gb nagar Dankaur Indoor 4

16. MandiShyamnagar GB Nagar Dankaur Out door 0

17. Dadri Dadri Dadri Indoor 15

18. Surajpur GB Nagar Bisrakh Out door 0

19. Dujana Dadri Bisrakh Out door 0

20. Noida* Dadri Bisrakh Indoor 4

21. Jahangirpur Jewar Jewar Out door 0

22. Sarfabad* Dadri Bisrakh Indoor 4

23. Sidipur Dadri Dadri Indoor 4

24. Bhunna Taga Jewar Jewar Indoor 4

Total bed capacity 43

*Noida and Sharfabad dispensary are working at another place. Sharfabad is situated at

Chhijarsi and Noida, even being Urban dispensary is situated in villege Bajid Pur , Sec-63

Noida

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Rural -Urban classification-

Total dispensaries Urban Rural

12 2* 10

*Although classification of the dispensaries are as per budgetary provision in terms of Rural

or Urban, but due to fast urbanization of Noida and Greater Noida more and more Rural

dispensaries are serving urban population as well.

Building status of the dispensaries

Type No. %

Rented 6 50

Own 2 17

Rent free 4 33

Staff position at field level-

Name of the post Sanctioned Posting Vacant Posting %

1. Medical Officer 13 11 2 85

2. Pharmacist 13 6 7 46

3. Staff Nurses 3 3 X 100

4. Bhritya 12 10 2 83

5. Chowkidar 1 1 X 100

6. Sweeper 2 3* X 150

7. Sweeper cum Chowkidar 7 6 1 86

8. Part time sweeper* 3 3 X *Rs.25/month

Availability of the staff-

Description of dispensary Number %

Dispensary having Medical officer along with pharmacist 5 42

Dispensary having Medical officer but without pharmacist 5 42

Dispensary Without Medical officer and Pharmacist 1 8

Dispensary having Pharmacist only 1 8

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Basic qualification, experience and training status of Medical Officers-

S.

N.

Name

Qu

ali

fica

ti

on

D

ura

tion

in

ser

vic

e

(In

Yea

rs)

Du

rati

on

of

pre

sen

t

post

ing

(In

Yea

rs)

Extr

a

qu

ali

fica

ti

on

(if

an

y)

A

ny i

n -

serv

ice

train

ing

1. DR. Surendra Chaudhary B.A.M.

S.

28 5 Nil TOT in

NRHM from

NIHFW

2. Dr.Ashok Sharma -do- 22 13 Nil X

3. Dr. Anjali Sharma -do- 22 3 Nil DDO

Training

4. Dr. Sneh Lata -do- 23 6 Nil Ultra sound

training

5. Dr. Kavita Singh -do- <1 < 1 Nil X

6. Dr. Digvijay Pal Singh -do- 18 5 Nil X

7. Dr. Sukh Pal Singh -do- 24 3 Nil X

8. Dr. Dhruv Singh Rajawat -do- 31 3 Nil DDO

training

9. Dr.Dinesh Chandra

Salwani

-do- 2 2 Nil X

10. Dr. Umesh Agarwal -do- 24 3 Nil X

11. Dr. Archna Singh -do- 10 days 10 days nil X

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27

Experiences of Medical officer-

A. Length of service B. Posting at one place

Facilities at dispensaries

Total number of dispensary-12

Facilities Availability Non-availability

1. Appropriate location of dispensary Y=58% No=42%

2. Space as per facility 50% 50%

3. Signage and board 85% 15%

4. Drinking water- Hand pump 90% 10%

5. Toilet 50% 50%

6. Electricity* 67% 33%

7. Fan for patients* 50% 50%

8. Sufficient Sitting space for patients 100% 0

9. Separate sitting space for patients 70% 30%

10. Sitting furniture 100% 0

11. Public telephone 0 100%

12. Separate registration counter No No

13. Separate dressing room 0 100%

14. Sufficient Dressing material 80% 20%

15. Cleanness of the premises Yes 0

*There is no electricity in rural dispensaries during day time, even though dispensaries have

electricity connections.

3 or <3 yrs, 3

18 yrs, 1

20-30 yrs, 6

>30 yrs, 1

0 to 3 years, 6

3 to 5 years, 3

> 5 years ,

1

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III. iii. Performance, coverage and quality of the services-

Outpatient services across the district are low as compared to the objective and target of the

department. Quality is not being provided because of poor infrastructure and low morale of

the staff. Medicines are adequate in terms of supply but are not as per the diseases

prevalence, resulting low turnout of the patients.

There are many drugs which are supplied in excess, while some drugs are not supplied in

sufficient quantity. There are some diseases for which no medicine is being supplied for the

last many years.

Total number of patients-

Dispensary wise distribution of the total patients for last three years

143368 138408

100598

0

20000

40000

60000

80000

100000

120000

140000

160000

2010-11 2009-10 2008-09

Total Patients

Total Patients

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Patient growth- there is a remarkable growth in last two years as compared with the year 2008-09.

It was 38% in year 2009-10 and 43% in 2010-11. The main reason is supply of medicine from the

central government assistance and budgetary allocation for medicine at district level.

Patient’s growth in last two years-(Base 2008-09)

02000400060008000

100001200014000160001800020000

2010-11

2009-10

2008-09

43%

38%

2010-11

2009-10

35 36 37 38 39 40 41 42 43

Increment against 2008-09

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30

Comparison with other Ayush Facility

Homeopathy is another component of Ayush providing health care services in the district with the

same number of dispensaries (12). The comparative yearly total for the 2010-11 is given below-

Other services – Indoor patients (IPD)

Department has a bed capacity of 43 beds in 8 dispensaries including a 15 bed hospital.

Indoor facility is not being used by the department; only three dispensaries used indoor

facility and only 139 patients (old and new) were admitted as day care facility. Main reason

is unavailability of the facilities like diet, electricity, 24 hour staff and medical officer.

III. iv. Operational strategies-

Waiting time was more during peak hours of the OPD which was monitored and cut short by

adopting quick disbursement of the medicine. Cleanliness was taken care of on daily basis.

Facilities like drinking water, toilets and sitting space was being observed as a routine by the

medical officer.

III. v. Assessment of Performance -

Daily total of 20 new patients target was not achieved by most of the dispensaries. If we

compare target with base year of 2008-09 performance increases considerably, but was

below the target other than one dispensary. In year 2008-09 only one dispensary achieved

the target of attending a total of 7300 or more new patents in a year, only one dispensary

achieved 75-90% target, while 10 out of 12 dispensaries achieve less than 75% 0f the target.

143368

110073

0

20000

40000

60000

80000

100000

120000

140000

160000

Ayurveda Homeopathy

2010-11

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31

It is clear from the table below that only one dispensary achieved the target in all the three

years. This is 15 beds hospital with a provision of two medical officers.

Annual patient target (%) achieved against a total of 7300 new patients.

Name 2010-11 2009-10 2008-09

Beel Akbar Pur 92 97 38

Bhunna Taga 90 67 21

Sheedi Pur 84 75 30

Mandi Shyam Nagar 97 89 28

Jahangir Pur 99 89 40

Noida 89 87 41

Dadri 114 122 102

Sharfabad 89 73 33

Parsaul 79 62 28

Bhai Pur 79 70 29

Dujana 80 59 22

Suraj Pur 87 90 77

Comparison between new and old patients-

As total numbers of the patients increases in good numbers, but a reverse trend was noticed

between new and old patients after 2008-09. In this year most of the dispensaries show more

old patients in comparison to new one, while in successive years it starts in other way of

more new patients.

There were 92%(11) having more older patients than new followed by 50%(6) in 209-10

and only 25%(3) dispensary attend more older patients in year 2010-11.

100% 90-99% 75-90% <75%

2010-11 1 4 7 0

2009-10 1 2 4 5

2008-09 1 0 1 10

0

2

4

6

8

10

12

Nu

mb

er

of

Dis

pe

nsr

ies

Target Achieved

Page 32: Towards Organisational effectiveness of OPD service in Ayurvedic Dispensaries in District Gautam Budha Nagar,U.P

32

New and old patient’s daily average

2010-

11

2009-

10

2008-

09

Dispensary New Old New Old New Old

Beel Akbar Pur 18 6 19 8 8 13

Bhunna Taga 18 15 13 9 4 9

Sheedi Pur 17 11 15 12 6 11

Mandi Shyam Nagar 19 18 18 16 6 9

Jahangir Pur 20 20 18 22 8 16

Noida 18 22 17 27 8 17

Dadri 23 24 24 18 20 22

Sharfabad 18 34 15 30 7 29

Parsaul 18 14 12 14 6 16

Bhai Pur 16 14 14 9 6 10

Dujana 16 9 12 11 4 11

Suraj Pur 17 8 18 8 15 12

In this table bold and red are older patients more than the new.

Observation-

After interaction with medical officers and pharmacists of the respective dispensaries, it was

revealed that in the year 2008-09 there was no fix target for new patients, afterwards more

and more new patients were enrolled to achieve the target.

There are two dispensaries showing the static position in all the years in attending patients

having less number of old patients. These dispensaries witness patients for problems like

fever, vomiting, minor injuries, and diarrhoea having short duration of incubation.

To achieve the targeted goal medicines play an important role; medicines were not available

as per the disease demand resulting in inability of reaching the target.

If we look at the chart below (Total daily average), we will find that most of the dispensaries

failed to achieve the target even on total patients count which is less than the targeted figure

of 20 new patients. As I stated earlier, in year 2008-09 no target for new patient was laid by

the department, so most of the dispensaries daily average was in between 15-21 patients per

day.

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33

Total daily average of patients-

24

33

28

3740 40

38

52

25 25 25 2527

22

27

33

40

4542

44

2723 23

26

21

16 1715

24 25

42

36

21

16 15

27

0

10

20

30

40

50

60

2010-11 2009-10 2008-09

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34

Daily average of new and old patients for last three years:

0

5

10

15

20

25

30

35

40

2010-11 New

2010-11 Old

2009-10 New

2009-10 Old

2008-09 New

2008-09 Old

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35

Months of attending minimum monthly patients maximum monthly patients Y

ear

Dis

pen

sari

es

Month

s

Dis

pen

sari

es

Month

s

2010-11

25% Jun 17% February &

June

17% Oct 17% August

17% Dec 42% September

41% Other months 8% Other months

2009-10

50% April 17%each March &Oct

33% May 33% each July & Aug

17% Other months

2008-09

17% April 17% February

17% July 42% march

25% November 17% June

41% Other months 24% Other months

There is no definite pattern of attending minimum and/or maximum daily patients across the

district.

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36

Section-IV: Managerial problems

i. Problems

There are many problems which affect the functioning of the OPD services. These are

categorized as follows-

A. Infrastructure-

1. Non-availability of toilets.

2. Signage and board are not clear.

3. Inadequate infrastructure.

B. Human resources-

1. Punctuality of the staff.

2. Indoor patients’ facility is zero percent.

3. Malpractice such as absenteeism, pilfering of drugs.

4. Lack of interest.

C. Managerial problems

1. Display of Citizen charter- what we are providing and responsibilities of patients.

2. Working hours.

3. No in-service training.

4. No inter-sectoral coordination.

5. Motivation of the employees.

6. Decentralization of raw drug purchase.

7. User charges are not being utilized by the M.O.

8. Dispensing table not organized.

9. Very poor record keeping.

10. No SOPs.

11. No specialized clinic.

12. Timely disbursement of the salary and other dues.

13. Monitoring and evaluation.

14. Divorced from community.

15. No assessment of community’s health need.

16. No clear policies.

17. No evaluation of the services.

18. No regular in service training.

19. No defined targets.

20. Isolation from district officials and other workers.

D. Medicine-

1. Decentralization of raw drug purchase.

2. Timely supply of the medicine.

3. Appropriate supply of the drug.

4. Shortage of essential drugs and equipments.

5. Unused and broken down equipments.

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ii. Priorities of the problems:

Pro

ble

ms

A B C D

Low impact on

performance

Medium to

high impact

with low

severity

Require

attention, easy

to resolve

Remaining

problem need

more attention

1.Infrastructure

2.Inter-sectoral

Coordination

3.Poor record

Keeping

4.Toilet

5.Location

6.No specialized

clinic

1. Motivation

2.Timely supply

of the drugs

3.Adequate

drugs

1.Punctuality of

the staff

2.Opd strictly

follow 8 AM to

2 PM schedule

3.Cleanliness

4.Organised

dispensing

room

5.Waiting time

6.Availability of

the drug

7. supply of the

rational drugs

8..Timely

Disbursement

of the salary

and other dues

1.Infrastructure-

repairing,

construction of

new building

2.Monitoring

3.Decentralizatio

n of raw drugs

4.Training

5.Rational supply

of the drugs and

equipments

6.Specialized

clinic

7.Inter-sectoral

coordination

8.SOPs

May be ignored Low priority Right now take

action

Prepare an action

plan

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Section-V: suggested Interventions

After finding the problem I would suggest the following intervention to resolve and solve

the problem-

Problem Gap Solution

Motivation Not getting salary and

other dues in time

Timely disbursement of

all the dues and wages

Punctuality 8AM to 2PM timing are

not being followed

Motivation of the staff

about the fact of being in

time, regular supervision

and inspection

Waiting time at OPD Longer during peak hours Early distribution of the

medicine

Fan and light at waiting

area

No fan available Solar fans and lights can

be obtained through non

conventional energy

department at a very

nominal price.

Toilets Not available With coordination of PRI

toilets can be prepared

without problem.

Toilets Not clean Sufficient water storage in

the toilets can resolve the

problem.

Dispensing In very bad shape Medicine racks be well

organized having label at

all the containers.

Dispensing time Maximum time As Ayurveda prescription

have multi ingredient

formulation, some

common formulation can

be prepared by mixing the

ingredients in advance.

Dressing room No separate room If separate room is not

available, a corner of the

room can be used as

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39

dressing table which can

be separated by curtains.

Quantity of medicine In Sufficient As most of the essential

medicines are in short

supply, donation is the

best way of maintaining

required amount of

medicine.

Irrational supply Some medicines are in

large quantity while some

few.

Medicine purchase must

strictly be demand based.

Boards and signage Boards are not placed Boards should be host in a

manner that it is visible

from distance

Records keeping Very poor OPD registered has name,

age, sex, provisional

diagnosis and name of the

medicine. There must be

provision for records like

main complaints, finding

and symptoms with local

address and phone number

(if any). Prescription is not

clear and quantity of

medicine should be

mention clearly.

Progressive chart Not up to date Progressive report chart

about monthly patients

must have the number of

male, female, child, and

disease wise classification.

SOPs Not available SOPs be prepared for

OPDs as well as dressing

and certain diseases.

Community involvement Divorced from the

community

Community involvement

can be done by hosting

health melas or clinic in

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40

temple or community

centres. Dhanwantari

jyanti or Ayurveda day

can be celebrated with the

community.

Damaged and unusable

equipments and furniture

No C&D Condemnation and destroy

can be done periodically

Monitoring and evaluation Not performed Be done regularly at field

unit level.

Decentralization Not done Decentralization of drug

procurement be done at

dispensary level. Raw

drugs should be purchased

by the medical officer as

per his requirement. Other

medicine should be

procure as per the demand

from the medical officer

Inter-sectoral coordination No coordination at all Irrigation, ICDS, women

welfare, health and family

welfare, education, PRI

and forest departments are

the integral part of health

delivery system. Ayurveda

awareness can be spread

very fast through

coordination with these

departments.

IEC Not available IEC material can be

obtained from department

of ayush ,GOI regarding

prevention of certain

disease through diet,

general information about

plants and herbs which

may grown in kitchen

gardens.

Specialized clinic Not conducted Specialized clinic in the

field of geriatric care and

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41

use of Rasayan as

rejuvenate therapy can be

started with a little

training.

Training Not provided Several training schedule

are being offered by the

central government in the

form of campaign for

Amla, Kshar Sutra and

MCH.

National campaign Not aware Our medical can start

different national

campaign on Ayurveda,

which increase the

credibility and popularity.

National health programs Not involved Most of the national health

programs can easily be

performed by the medical

officer who again creates

awareness among the

people.

Citizen’s charter Not available There must a display of

services provided by us,

facilities available and

duties and responsibilities

of the patients be

displayed at an

appropriate place.

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42

Section VI: Action Plan

For the proper functioning of OPD services main problem is very poor infrastructure in the

form of building. There are 4 out of 12 dispensaries which are located in a single room and 4

others do not have sufficient space as per services provided by those dispensaries.

For the proper functioning of OPD services main problem is very poor infrastructure in the

form of building. There are 4 out of 12 dispensaries which are located in a single room and 4

other do not have sufficient space as per services provided by those dispensaries.

Analysis of the steps

S.N.

Activities to be performed

Where Time (Months)

Resources input required

Who does Monitoring to done by

1. Adverisement Local news papers

1-3 Budget Director D.A.O.

2. Constitution of the Bhawan Samiti

District 1 Medical officer

D.A.O. D.A.O

3. Scrutinizing of the request applications

District 2 days Human resource

committee D.A.O

4. Selection of the owner

District 2 days committee D.A.O.

5. Inspection of the building

District 1 day Human resource

committee D.A.O.

6. Recommendation of the rent

District 1 day Human resource

committee D.A.O.

7. D.M’s Approval District 1 District magistrate

M.O/ D.A.O.

8. Forwarding the recommendations

District 1 day Information

D.A.O. D.A.O.

9. Follow up Directorate 2

D.A.O D.A.O.

10. Sanctioning of rent

Directorate 6 Director D.A.O.

11. Provision of the budget

directorate 3 Information

Finance controller/Director

D.A.O.

12. Payment of the rent

District Any time

budget D.A.O. D.A.O.

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43

My action plan as follows-

Time – it will take at least one year in case of rented buildings and 1 to 5 years for the

organization’s owned or rent free premises.

A) For rented buildings-

Rented and rent free/ department owned has the equal ratio, 50:50.

Main sufferings

No maintenance of the building,

No electricity supply

No provision of toilet

Not allowing using drinking water facility

Not allowing sign board on their wall other than the rented portion

Not ready to provide any help to the employee

Sometimes spread negative remarks to get their promises vacated

Reason for these-

Rent not paid in time

Rent was not revised even after the contract period

Fear of not vacating their property- being government organization

With inflammation rent, increased many fold and land lord will get more rent

once vacated by the department.

Lack of fund in case of rent free/ department owned

Consequences-

Tense working environment

Low turnout of the patients

Facilities for the patients in waiting area are not adequate

Who are involved?

Landlord

Medical officer and other staff

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44

It comes from

Internal weakness and lethargic attitude of the organization

Inability to feel the need of landlord

Lack of knowledge about procedure and steps of rent related problems

External factors like inflation in rental value of the property.

To be solved by

Land lord

Medical officer

Divisional Ayurvedic Officer

Director, Ayurvedic services

Strategic choices-

There may two strategic choices

Increase the rent- the process takes less time for disposal and the land lord

feels that department is taking interest in solving his genuine problem. The

day process starts his attitude and behaviour changes a lot. It involves all the

parties from landlord to director.

There is a procedure for this which requires an application from the landlord

for requesting increase in the rent. A three members committee constituted at

district headquarter having the concerned medical officer as one of its

member. Committee recommends the need of increment in rent and new rate

also defined. These recommendations are sent to district magistrate for

approval and he has sent back the signed certificate after getting required

information about the rates and need of increasing rent. Now divisional

officer will send these recommendations along with his own remarks to the

director for final sanctions.

Shifting the hospital in new building- takes a longer time and procedure. It

should be published in local news papers and acceptance letters are invited

with rent quotations. The committee constituted for this purpose evaluate the

proposals and after physical inspection of the building gives its

recommendations and approval. Further process is the same as for increasing

the rent.

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45

Try for rent free space- It is the best option with many hurdles. Gram sabha

can provide the required space in panchayat ghar, primary school,

dharamshala, if there is any space available.

My strategy- new building on rent

Change in the system- as old building does not have enough space as per the

services available, and landlord never provides the extra space, I will choose

the new building at more appropriate location with all the requirements, like

electricity, toilet and drinking water available.

Inputs- required input is the money for advertisement which in this case is

done by the publicity department of the state. Man power in terms of

monitoring the whole process and finally the budget approval above and over

the sanctioned money.

Role and Responsibility – Medical officer’s role is very important. As being

the local officer he can search better space with the help of local community

involvement. District officer’s responsibility will make the whole process

easy and sanctioning of the rent can be speedy.

Obstacles- there are certain obstacles in this process. Foremost is negative

remarks by the present landlord and another is political pressure, where gram

pradhan or members of the gram panchayat pressurize about the location of

the building should be in their area.

Process-

Publication in the news papers, analysis of the request applications by the “Bhavan

Samiti” and choosing the best one on the bases of location, space specification and

facilities provided. Choosing the best one will initiate the further process like

submission of the application by the owner in the prescribed form supported by the

blue print of the premises and signing of the government agreement.

Committee recommends the quoted rent and its recommendations are send to district

magistrate for approval and he send back the signed certificate after getting required

information about the rates and justification. Now divisional officer will send these

recommendations along with his own remarks to the director for final sanctions.

2) For rent free or government owned-

As these are the rent free or government owned spaces, the only way is to improve

the facilities by constructing new building where land is available (in this case two

dispensaries have land and one has building).

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Process-

Only input is finance which can be try from

MLA fund

MP fund

Donations

Departmental budget allocation for the same

Evaluation and follow up of implementation of action plan-

Follow of the plan is very important for its implementations. In this plan I will

review and evaluate following-

What to review-

Request applications in response to advertisement

Following the status of district magistrate’s recommendation letter and

review it if some problem arises.

At directors office for any legal lacunae

How to review-

If the request application are as per the government guidelines

Committee’s recommendations are as per Performa

Personal contact with the concerned officer in other departments to get the

D.M’s letter

At director’s office requesting her for speedy approval

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No proper signage-

Properly place sign board-

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Indoor- un organised-

Indoor- organised

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Organised dispensing desk-

Un-organised dispensing desk-

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List of medicine purchased by the divisional Ayurvedic Officer year 2010-11

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Questions regarding medical officer’s awareness assessment-

1. raYT/Iya svaasqya kaya-k`ma @yaa hO iknhI dao kaya-k`maaoM ka naama.

2. iSaSau maR%yau dr (Infant Mortality Rate-IMR) ka Aqa- samaJato hOM yaid haM tao

yah dr @yaa hO?

3. Maternal Mortality Ratio ka Aqa- samaJato hOM yaid haM tao yah dr @yaa hO?

4. NRHM @yaa hO ?

5. JSS jananaI saurxaa yaaojanaa @yaa hO ?

6. ASHA @yaa hO ?

7. Mainstreaming of Ayurveda-@yaa Aapnao [sao saunaa hO? yaid haM tao yah @yaa

hO

8. National campaign of Ayurveda iksa iksa ivaYaya pr cala rha hO ?

9. @yaa kBaI iksaI BaI trh kI T/oinaMga maoM Aapnao Baaga ilayaa hO.yaid haM tao

kba AaOr iksa trh kI?

10. Apnao icaik%saalaya kao AaOr AiQak saxama banaanao ko ilayao ikna dao

ABaavaaoM Aqavaa AsauivaQaaAaoM ka saamanaa krnaa pD, rha hO.[sa idSaa maoM

Aapko rcanaa%mak sauJaava.

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Questionnaire about hospital premises and OPD facilities.

naama icaik%saalaya

1. kma-caarI sambainQat -

k`0saM0 naama / pd iSaxaa ivaBaaga maoM

kba sao

vat-maana sqaana

pr kba sao

Anya

1 icaik%saaiQakarI

2 famaa-isasT

2. icaik%saalaya sambainQat

1. icaik%saalaya ka p`kar baihrMga SaOyyaa yau@t

2. Bavana rajakIya ikrayao ka inaSaulk. ibajalaI knkOsana hO nahI.

3. icaik%saalaya ka baaoD- lagaa hO yaa nahI

4. isiqait @yaa icaik%saalaya ]icat sqaana pr Avaisqat hO Aqavaa nahI. yaid

nahI tao khaM pr haonaa caaihyao.

5. @yaa icaik%saalaya Bavana ]plabQa sauivaQaaAaoM ko Anau$p p`yaaPt hO yaid nahI

tao iksa sqaana kI sabasao jyaada AavaSyakta hO

6. icaik%saalaya ko Aasapasa Anya icaik%saa sauivaQaaAaoM ka ivavarNa yaqaa

eolaaopOiqak haomyaaopOiqak Qamaa-qa @laIinak yaid haM tao pkar @yaa [na

sauivaQaaAaoM sao Aapko icaik%saalaya kI raogaI saM#yaa pr p`Baava pD rha hO

7. icaik%saalaya ko pasa KalaI pirsar ]plabQa hO yaid ha^M tao ]saka @yaa

]pyaaoga ikyaa jaa rha hO.

3. baihrMga raogaI p`SnaabalaI

1. baihrMga raogaI kxa maoM raoigayaaoM ko baOznao ka samauicat sqaana evaM fnaI-car hO

Aqavaa nahI

2. raoigayaaoM ko ilayao pInao ko panaI kI vyavasqaa hO nahI.yaid haM nala Top ka

panaI sTaoroja TMkI ka panaI Anya ]plabQa pr iTk kroM

3. saava-jainak Aqavaa ivaBaagaIya Toilafaona hO nahI

4. raogaI pMijakrNa p`ik`yaa kOsaI hO

5. pirsar kI safa[- kOsaI hO

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53

6. @yaa SaaOcaalaya hO yaid haM tao ]sakI svacCta kOsaI hO

4. AaOYaQa sambainQat

1. AaOYaiQayaa^M p`yaaPt maa~a maoM ]plabQa hOM nahIM

2. AaOYaiQayaa^M AavaSyakta ko Anau$p hOM nahIM

3. Aapko Anausaar kao[- AaOYaQa A%yaiQak maa~a maoM AapUit- kI ga[- ]saka naama

4. @yaa kao[- A%yaMt AavaSyak AaOYaQa kma maa~a maoM AapUit- kI ga[- ]saka naama

5. ivagat tIna vaYaao-M maoM iksa raoga kI AaOYaQa A%yaMt kma maa~a maoM Aa[- Aqavaa

ibalkula nahI Aa[-. AavaSyak raoga va vaaMiCt AaOYaQa ka naama

5. DoisaMga

1. @yaa DoisaMga $ma Alaga sao banaa hO

2. @yaa DoisaMga ko ilayao AavaSyak saamaga`I yaqaa kOMcaI icamaTI inaiDla Qaagaa

kaTna pTTI Aaid p`yaaPt maa~a maoM hOM nahIM yaid nahI tao ivavarNa doM.

6. Anya

1. Aapko icaik%saalaya maoM sava-aiQak raogaI ikna vyaaiQayaaoM ko AatoM hOM.

1. 2. 3.

2. @yaa Aap raogaI ko inadana hotu laObaaoroTrI TOsT krato hOM

3. @yaa Aap raogaI kao kBaI eolaaopOiqak icaik%saalaya maoM rOfr krto hOM yaid ha^M

tao p`aya: iksa trh ko raoigayaaoM kao AaOr iksa Avasqaa maoM

4. @yaa raoigayaaoM kao GarolaU nausKoM batato hOM

5. Aapko icaik%saalaya ko Aasa pasa kao[- prmpra Aqavaa KanadanaI vaOd hO

yaqaa kN- vaoQana jalaaoka p`yaaoga hDDI baOzanao vaalao saaMp ibacCu Aqavaa Anya

jahr kI icaik%saa krnao vaalao

6. @yaa Aap raogaI kao iksaI BaI raYTIya svaasqya kaya-k`ma kI jaanakarI Aqavaa

pramaSa- doto hOM yaid ha^M tao ikna kaya-k`ma kI

7. @yaa Aapko gaaMva maoM raogaI klyaaNa samaIit ka gazna hO yaid haM tao @yaa

Aap ]sa ko sadsya hOM

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Essential Ayurvedic Drugs For Dispensaries & Hospitals

(This list is a compilation work based on “main streaming of Ayush undewr NRHM,

published by dept. Of Ayush ministry of health and family welfare, Government of

India)

Ayurvedic system of medicine holds numerous single and multi-ingredient formulations

made up of herbal, mineral and herbo-mineral combinations. Their use by the Ayurvedic

practitioners varies to a large extent. While some formulations being so frequently

prescribed in one part of the country may not find place in the prescription of the other

part. Region-wise traditions of Ayurvedic practice is also one of the important causes of

popularity of certain medicines in one particular region. Interestingly, the uses of Ayurvedic

formulations are also so diverse that sometimes not only the patients but doctors too, get

confused in situations where a medicine not indicated in a specific disease condition is

prescribed by the Ayurveda physician solely because of his own experience of treating that

particular disease condition with that very medicine. Though, it is rightly claimed that the

medicines have certain limit of actions yet the physician with his judicious approach can

use one particular medicine for various clinically diverse diseases or symptoms provided he

is well versed with underlying pathogenesis of the ailment and simultaneously has the

understanding of complete range of action and scope of the drug. Such guidelines for

varied uses of medicines are already described in the classical texts of Ayurveda.

List of ASU medicines procured in various States differ so much and some of the

departments and institutions have restricted its number to too little to cover the variety of

disease-condition.

In view of this and the administrative problems being faced for selection the Adyurvedic

drugs for a dispensary or a hospital, the need was felt to create a standard list of optimally

required medicines likely to be acceptable to the practitioners all over the country, who

would be able to prescribe the enlisted medicines in a judicious way.

The Department of Indian Systems of Medicine & Homoeopathy, took initiative in this

direction and the concerted efforts of various experts of Ayurveda and departmental

technical staff members have resulted in bringing out this document – "Essential Ayurveda

Drugs for Dispensaries and Hospitals". It is worthwhile to mention that Essential Ayurvedic

Drugs List is notably different from Essential Drugs List of Allopathic System of Medicine.

The former includes only those medicines which are essentially required in any Ayurvedic

dispensary or hospital whereas the latter one is the list of essential drugs for the treatment

of various clinical states of the patients.

The bid to formulate Essential Ayurveda Drugs List got through with great deal of

interaction with various eminent Ayurvedic Physicians in Government and private sectors in

different parts of the country. Due care was undertaken to include experts from all fronts of

Ayurveda, like institutionally & non-institutionally qualified Ayurveda experts, old & new

Ayurvedic doctors, dispensary and hospital doctors, college and pharmacy attached

doctors, graduates and postgraduates. The response from these experts was compiled,

analysed and put in a systematic format. Then a core group comprising technical officers of

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the department and a renowned Ayurvedic expert as a private sector representative

discussed in details for final selection of essential drugs for Ayurvedic dispensaries and

hospitals, on the basis of availability, reliability, cost-efficacy and therapeutic efficacy of the

medicines. Due scrutiny was done for short-listing. Ample care was taken to cover

maximum disease conditions treatable with Ayurvedic medicines. Classical Ayurvedic texts,

formulary of Ayurvedic drugs published by Govt. of India and personal experience of the

Vaidyas were considered for finalising the list.

The present publication aims at providing ready reference for selection or procurement of

Ayurvedic drugs for dispensaries and hospitals of various levels. Its utility is much higher

for the learners and practitioners of Ayurveda as it will provide a window to peep into the

wide range of Ayurvedic medicines required for setting up their professional

establishments. The single drug preparations in the end of the list are incorporated to fill

the gaps left in the original list for different kinds of uses of simple remedies in a cost

effective manner.

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A- List of essential Drugs for various ailments.

Sl. NO Name of the Drug Dose

(1) JWARA (FEVER)

1:1 Navajwara (Acute fever)

1. Tribhuvan Kiriti Ras 125 to 250 mg.

2. Sanjivani Vati 125 to 250 mg.

3. Godanti Mishrana 125 to 250 mg.

1:2 Visamajwara (Malarial fever)

4. Ayush 64 500 mg. To 1 gm.

5. Saptaparna ghana Vati 250mg. To 500 mg.

6. Sudarshana Churna 3 to 6 gm.

1:3 Vat shaishmak Jwar (Viral Fever)

7. Laksmi Vilas Ras 125 to 250 mg.

8. Samsamani Vati 500mg. to 1 gm.

1:4 Jirna jwara (Chronic fever)

9. Pratap Lankeshvar Ras 125 to 250 mg.

10. Mahasudarsana Churna 3 to 6 gm.

11. Amritarishta 20 to 30 ml.

1:5 Sannipatika jwara (Typhoid fever)

12. Nardiya luxmi Vilas Ras 250 to 500 mg.

13. Bhunimbadi Kwath 10 to 20 ml.

(2) DISORDERS OF RESPIRATORY SYSTEM

2:1 Kas (Cough)

14. Gojihvadi Kvath 20 to 40 ml.

15. Sitopaladi Churna 5 to 10 gm.

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16. Kantakaryavaleha 5 to 10 ml.

2:2 Kapha nissarana (Expectorant)

17. Tankana Bhasma 500 mg. to 1 gm.

18. Talisadi Churna 3 to 5 gm.

19. Vasavaleha 5 to 10 gm.

2:3 Svasanika Soth (Bronchitis)

20. Laghu malini Vasanta 125 to 250 mg.

21. Lavangadi Churna 3 to 5 gm.

22. Chounsath prahari pipal 500 mg. to 2gm.

2:4 Rajyakshma (Tuberculosis)

23. Raj Mrigank Rasa 125 to 250 mg.

24. Svarna Basant Malati Ras 125 to 250 mg.

25. Abhrak Bhasma Shatputi 0.75 to 125 mg.

26. Mukta Panchamrit 125 to 250 mg.

27. Shilajatwadi louha 250 to 500 mg.

2:5 Pratisyaya (Common cold)

28. Hinguleshwar Rasa 125 to 250 mg.

29. Panchakola Churna 2 to 5 gm.

2:6 Peenas (Sinusitis)

30. Shadbindu Tel 2 to 5 drops in nose

31. Dashmula Rasayanam 5 to 15 gm.

2:7 Tundikeri sotha (Tonsilitis)

32. Ksara Madhu Throat paint Local application

33. Khadiradi Vati Chewable

34. Vyoshadi Vati 2 to 4 tab.

2:8 Shvasa (Asthma)

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35. Dhanvantar Gutika 1 to 2 pills

36. Pushkarmula Churna 5 to 15 gm.

37. Shringyadi Churna 5 to 15 gm.

38. Kanakasava 10 to 30 ml.

39. Vasarishta 10 to 30 ml.

(3) DISORDERS OF CARDIO-VASCULA RSYSTEM

3:1 Hrid-Daurabalya (Cardiac weakness)

40. Nagarjunabhra Rasa 250 to 500 mg.

41. Muktapisti 125 to 250 mg.

42. Jwahar Mohra 125 to 250 mg.

43. Arjunarishta 10 to 30 ml.

3:2 Rakta Chap (Hypertension)

44. Yogendra Rasa 50 to 125 mg.

45. Sarpagandha Mishran 2-4 Pills

3:3 Raktabhar Alpta (Hypotension)

46. Makaradhvaja gutika 50 to 125 mg.

47. Kasturi bhairav Ras 50 to 125 mg.

3:4 Hritshoola (Angina)

48. Sringa Bhasma 125 to 250 mg.

49. Mahavat Raj Ras 75 to 125 mg.

(4) BLOOD DISORDERS

4:1 Pandu (Anemia )

50. Punarnavadi Mandura ½ to 1 gm.

51. Lohasava 10 to 30 ml.

4:2 Raktpitta/Raktsrav (Haemorrhagic Tendency and Bleeding Disorders)

52. Trin Kantmani Pisti 250 to 500 mg.

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53. Lakshadi Churna 5 to 10 gm.

54. Usheerasava 15 to 30 ml.

4.3 Rakta Dushti (Blood impurity)

55. Nimbadi Kvatha 20 TO 40 ml.

56. Panchanimba Churna 5 to 10 gm.

57. Manjisthadi Churna 5 to 15 gm.

58. Sarivadyasava 15 to 30 ml.

59. Khadirarishta 15 to 30 ml.

(5) DISORDERS OF DIGESTIVE SYSTEM

5.1 Atisara (Diarrhoea)

60. Karpoora Rasa 50 to 125 mg

61. Jatiphaladya Churna 5 to 10 gm.

62. Karpoorasava 10 to 20 drops

63. Babbularishta 15 to 30 ml.

5:2 Pravahika (Dysentery)

64. Panchamrit Parpati 250 to 500 mg.

65. Bilwadi Churna 5 to 10 gm.

66. Bilwadi Kwath 20 to 40 ml.

67. Kutajarishta 15 to 30 ml.

5:3 Amlapitta (Hyperacidity)

68. Kamdudha Ras 125 to 250 mg.

69. Dhatri Rasayana 5 to 15 gm.

70. Madhuyastyadi Churna 5 to 10 gm.

71. Avipattikara Churna 5 to 10 gm.

5:4 Samgrahani (Colitis/Ulcerative Colitis)

72. Samkhodar Ras 75 to 150 mg.

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73. Sutsekhar Ras 125 to 250 mg.

74. Bilwadi Avaleha 5 to 10 gm.

75. Mocharas Churna 3 to 5 gm.

5:5 Yakrit roga (Liver disorders)

76. Arogya Vardhini 500 mg. To 1 gm.

77. Navayas Louha 250 to 500 mg.

78. Phalatrikadi kwatha 15 to 30 ml.

79. Sarbat phalasa 30 to 50 ml.

80. Daruharidra phala churna 5 to 10 gm.

81. Rohitakarishta 15 to 30 ml.

5:6 Shoola (Abdominal colic)

82. Shankha bhasma 250 to 500 mg.

83. Shankha Vati 2 to 4 tab.

84. Lasunadi Vati 2 to 4 tab.

85. Hingu vachadi Churna 3 gm. to 5 gm.

86. Narikel lavana 250 to 500 mg.

5:7 Adhman (Flatulence)

87. Kankayan Vati 500 mg. to 1 gm.

88. Hingvastaka Churna 5 to 10 gm.

89. Ark Ajmod 5 to 15 ml.

90. Lavana Bhaskar Churna 5 to 10 gm.

5:8 Chhardi (Vomiting)

91. Mayur pichha bhasma 50 to 125 mg.

92. Bilvadi leham 1 to 3 gm. 2 hrly

93. Eladi Churna 2 to 5 gm.

5:9 Ajirna (Indigestion)

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94. Yavani Sandhav Churna 5 to 10 gm.

95. Shivakshara pachana churna 3 to 5 gm.

96. Chitrakadi Vati 2 to 4 tab.

5:10 Agnimandya (Anorexia)

97. Agnitundi Vati 250 to 500 mg.

98. Vaishvanara Churna 3 to 5 gm.

99. Panchakola Churna 3 to 5 gm.

5:11 Vibandh (Constipation)

100. Ichhabhedi Ras 125 to 250 mg.

101. Panchasakara Churna 5 to 10 gm.

102. Svadista Virechana Churna 5 to 10 gm.

103. Abhayarishta 15 to 30 ml.

104. Isabgol Husk 10 to 20 gm.

105. Haritaki Churna 10 to 15 gm.

5:12 Arsha-Bhagander (Piles and Fistula-in-ano)

106. Shigru guggul 500 mg. to 1 gm..

107. Bol baddha ras 125 to 250 gm.

108. Pranada Vati 2 to 4 tab.

109. Rasanjana Vati ½ to 1 gm.

110. Kasisadi tel 2 to 5 ml.

111. Jaya Vati 250 to 500 mg.

112. Kshar Sutra & Kshar Varti Q.S. for Kriya

5:13 Krimi Rog (Helminthiasis)

113. Vidangadi louha ½ to 1 gm.

114. Palash beej churna 3 to 6 gm.

115. Kampillaka yog 2 to 4 gm.

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(6) DISEASES OF CENTRAL NERVOUS SYSTEM

6:1 Medhya (Brain Tonics for concentration, memory, sleep disturbances)

116. Brahmi Vati 2 to 4 tab.

117. Tagaradi Churna 3 to 5 gm.

118. Brahmi Rasayana 5 to 10 gm.

119. Saraswatarishta 15 to 30 ml.

120. Brahami Ghrita 5 to 10 gm.

6:2 Nadi Dourbalya (Nervine Weakness)

121. Krishna Chaturmukh Ras 125 to 250 mg.

122. Dhanvantara tel Q.S. for body Application

123. Mahanarayana tel Q.S. for body Application

124. Eranda pak 5 to 15 gm.

125. Balarishta 10 to 30 ml.

6:3 Kampavat ( Parkinsonism)

126. Chaturbhuj Ras 125 to 250 mg.

127. Kaunch Churna 2 to 5 gm.

6:4 Sirasula (Migrain)

128. Sirah shooladi Vajra Ras 250 mg. to 1 gm.

129. Chandrakant Ras 125 to 250 mg.

130. Godanti praval yog 500 mg. to 1 gm.

131. Pathyadi kwath 10 to 20 ml.

6.5 Pakshaghat (Hemiplegia)

132. Yogendra Ras 125 mg

133. Ksheer Bala Tail 5-10ml Internal/external

134. Ksheer Bala Tail (Aavarti) Nasal- 5-10 drops

(7) PHYCHIATRIC PROBLEMS

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7:1 Anidra (Insomnia)

135. Nidrodaya Ras 125 to 500 mg.

136. Jatamansi kwath 10 to 20 ml

137. Madananand Modak 5 to 15 gm.

138. Aswagandha Churna 5 to 10 gm.

139. Him sagar Tel Q.S. for Head

7:2 Akshepa (Convulsive Disorders)

140. Svarna bhasma 15 to 30 mg.

141. Panchagavya ghrita 5 to 15 ml.

142. Aptantrakari Vati 125 to 250 mg.

7:3 Unmad (Psychosis)

143. Unmad gajkesari Ras 125 to 250 mg.

144. Maha paishachik ghrita 5 to 15 gm.

145. Maha chaitasa ghrita 5 to 15 gm.

146. Manas mitra vatak 125 to 250 mg.

7:4 Vishad (Depression)

147. Jyotismati Tel 10-20 drops

148. Smriti Sagar Ras 125-250 mg

149. Vacha Churna (shudh) 75-125 mg

(8) JOINT DISORDERS

8:1 Amavata (Rheumatic/Rheumatoid Arthritis)

150. Amavatari Ras 125 to 250 mg.

151. Trayodashang guggulu ½ to 1 gm.

152. Kottamchukadi Tel Q.S. for application on body

8:2 Vat Rakta (Gout)

153. Kaishore guggulu ½ to 1 gm.

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154. Maharasnadi kwath 5 to 15 ml.

155. Pinda Tel Q.S. for application on body

8:3 Sandhi Vat (Osteoarthritis)

156. Simhnad guggulu ½ to 1 gm.

157. Yograj guggulu ½ to 1 gm.

158. Panchaguna Tel Q.S. for application on joints

8:4 Sandhigat Vat (Arthralgia)

159. Vatari guggulu ½ to 1 gm.

160. Sameergaj keshari Ras 125 to 250 mg.

161. Maha vishgarbh Tel Q.S. for topical use

(9) DISEASES OF URINARY SYSTEM

9:1 Alpa Mutrajanana (Oliguria/Anuria)

162. Punarnavastaka kwath 20 to 40 ml.

163. Panavirladi bhasma 5 to 20 gm.

164. Punarnavasava

9:2 Ashmari (Urolithiasis)

165. Pasan Bhedadi Kwath 20 to 40 ml.

166. Hajaral yahood bhasma 250 to 500 mg.

167. Kulathadi ghrita 10 to 20 ml.

9:3 Mutrastheela (prostatic hypertrophy)

168. Varunadi guggulu ½ to 1 gm.

169. Shilajtwadi Vati ½ to 1 gm.

170. Punarnavadi Guggulu ½ to 1 gm.

9:4 Mutravishmayata (Uraemia)

171. Sarbato Bhadra Ras 50 to 250 mg.

172. Veeratarvadi kwath 20 to 40 ml.

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173. Trina panchmula kwath 20 to 40 ml.

174. Kanmad bhasma 500 mg. to 1.5 gm.

175. Vastyamayantaka ghrita 5 to 15 gm.

9:5 Mutra krichra (Dysurea)

176. Svarna Bang 125 to 250 mg.

177. Chandrakala Ras 250 to 500 mg.

178. Traikantakadi kwath 20 to 40 ml.

(10) DERMATOLOGICAL DISORDERS

10:1 Twak Roga (Skin Disorder),Kushtha (Dermatoses)

179. Ras Manikya 125 to 150 mg.

180. Gandhaka Rasayana 250 mg. to 500 mg.

181. Eladi Tel Q.S. for topical use

182. Kustha Rakshasa Tel Q.S. for topical use

10:2 Twak-Karshnya (Hyperpigmentation)

183. Kumkumadi Tel Q.S. for topical use

184. Dashanga Lepa Q.S. for topical use

10:3 Kandu (Pruritus)

185. Haridra Khand 5 to 15 gm.

186. Bilwadi gutika 1 to 2 pills for topical use

187. Nalpamaradi Tel Q.S. for topical use

188. Maha Marichyadi Tel Q.S. for topical use

10:4 Twak Vaivarnya (Skin Discolouration)

189. Chalmongra Tel Q.S. for topical use

190. Sidhmahara Lepa Q.S. for topical use

191. Markava Rasayanan 10 to 20 gm.

10:5 Keshya (Hair Tonic for Poor Hair Growth)

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192. Bhringaraja Tel Q.S. for head & hair

10:6 Khalitya (Premature Hair fall)

193. Dhasturpatra Ker Tel Q.S. for head & hair

194. Durvadi Ker Tel Q.S. for head & hair

195. Kayyonyadi Ker Tal Q.S. for head & hair

10:7 Palitya (Premature greying of hair)

196. Neeli Bhringyadi Ker Tel Q.S. for head & hair

197. Kuntal Kanti Tel Q.S. for head & hair

10:8 Svitra (Vitiligo)

198. Kakodumbarikadi Kwath 10 to 40 ml.

199. Markava Rasayana 5 to 15 gm.

200. Avalgujadi Lepa Q.S. for topical use

201. Gomutrarishta 10 to 20 ml.

(11) FEMALE DISEASES

11:1 Asrigdara Menorrhagia-Metrorrhagia)

202. Pradarantak Ras 250 to 500 mg.

203. Patrangasav 10 to 30 ml.

204. Lodhrasava 10 to 30 ml.

205. Ashokarishta 10 to 30 ml.

11:2 Svet Pradara (Leucorrhoea)

206. Kukkutand Twak Bhasma 1 to 3 gm.

207. Pusyanug Churna 5 to 10 gm.

208. Supari Pak 5 to 15 gm.

209. Satavari gud 5 to 15 gm.

210. Panchavalkala kwath 10 to 30 for douche

11:3 Rajah Krichra (Dysmenorrhoea)

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211. Rajah Pravartini Vati 250 to 500 mg.

212. Kumarika Vati 250 to 500 mg.

213. Kumaryasava 10 to 30 ml.

11:4 Yoni Vyapat (Vaginal Disorders)

214. Subhakari Vati ½ to 1 gm.

215. Somanath Ras 125 to 250 mg.

216. Soubhagya Vardhana Tel 5 to 10 drops for Tampon

11:5 Rajah Purva Tanav (Premenstrual Tension)

217. Yavakshara Yog 500 mg. To 1.5 gm.

218. Saptasaram Kasayam 10 to 20 ml.

11:6 Garbhapat (Habitual Abortion)

219. Garbhapal Ras 250 to 500 mg.

220. Garbh Raksini Gutika 2 to 4 tab.

11:7 Raktla Yoni (Dynfunctional Uterire Bleeding D.U.B.)

221. Kaharuva Pisti 250 to 500 mg.

222. Ashok Ghrita 5 to 15 gm.

223. Lakshmana Louha 500 mg. To 1 gm.

11:8 Stanya alpata (Hypo lactation)

224. Stanya janana kashaya 10 to 20 ml.

225. Shatavaryadi Churna 5 to 10 gm.

11:9 Sutika Roga (Postpartal Disorders)

226. Soubhagya Sunthi 5 TO 10 gm.

227. Dashmularishta 15 TO 30 ml.

11:10 Bandhyatva (Primary Sterlity)

228. Phala Kalyan Ghrita 5 to 15 gm.

229. Palash puspasava 15 to 30 ml.

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230. Lakshmanarishta 15to 30 ml.

11:11 Stri Beej Pranali Dushti (Hypo-ovarianism/Poor ovarian funcion)

231. Puspa Dhanva Ras 250 to 500 mg.

11:12 Beej Kosh Puti (Ovarian Cyst)

232. Siggru Gugglu ½ to 1 gm.

233. Sobhanjanarishta 10 to 30 ml.

234. Punarnava Mandur 250 to 500 mg.

(12) VAJEEKARANA (SEXUAL WEAKNESS/LOSS OF LIBIDO)

235. Manmath Rasa 125 to 250 mg.

236. Akarkarbhadi Gutika 1 to 2 tab

237. Asvagandhadi Leha 5 to 15 gm.

238. Sukrastambhana Rasayana 5 to 15 gm.

239. Srigopal Tel For topical use

240. Kamini Vidravana Ras 250 to 500 mg.

(13) RASAYANA (GERENTOLOGICAL CONDITIONS)

241. Brahm Rasayana 5 to 15 gm.

242. Chyavan Prasha Avaleha 5 to 15 gm.

243. Brinhani Gutika 1 to 2 tab.

(14) VRANA ROPANA (WOUND HEALING)

244. Jatyadi Tel For topical use

245. Marma Gutika 250 to 500 mg.

246. Triphala Guggulu 250 to 500 mg.

247. Lakshadi Guggulu 250 to 500 mg.

248. Yashad Malhar Q.S. For topical use

249. Manjishtadi Tel Q.S. For topical use

(15) DISEASES OF EYE AND ENT

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15:1 Netra Roga (Opthalmic Disorders)

250. Saptamrit Louha 2 to 4 tab.

251. Maha triphala Ghrita 5 to 15 gm.

252. Chandrodaya Varti Q.S. For topical use

253. Elaneer kuzhampu 2 to 5 drops topical use

254. Shatpatryark (Gulab Arka) 2 to 5 drops topical use

15:2 Nasa Roga (Nasal Diseases)

255. Anu tel 2 to 5 drops as nassal drop

256. Nasika Churna ½ to 1 gm. topical use

257. Chitrak haritaki 5 to 15 gm.

258. Katphal Churna ½ to 1 gm. topical use

15:4 Galganda (Goitre)

259. Kanchanara Guggulu 500 mg. To 1 gm.

15:5 Mukh Rog (Oral Disorders)

260. Pitaka Churna Q.S. for gargle

261. Sudh Soubhagya Q.S. for paint

262. Irimedadi Tel Q.S. for paint

263. Brihatyadi Kwath Q.S. for gargle

15:6 Dant Roga (Dental Problems)

264. Dasana Samskar Churna Q.S. for local rubbing in tooth &

gum

(16) PRAJANAN SAMSTHAN DUSTHTI (REPRODUCTORY PROBLEMS)

16:1 Purush Prajanan Akshamta (Male sterility)

265. Jund Vadastar Vati 2 to 3 pill

266. Puspadhanva Ras 125 to 250 mg.

16:2 Stri Prajanan Akshamta (Female sterility)

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267. Jiyapota Churna 5 to 15 gm.

268. Sivalingi Beej 3 seed daily for 28 days

16:3 Parivar Niyojana (Contraception)

269. Pipplyadi Yog 2 to 4 gm.

270. Neem Tel 2 to 5 ml.

(17) DAURBALYA (General weakness/Asthenia/Loss of strength)

271. Drakshasava 5 to 30 ml.

272. Sudh Shilajit 250 to 500 mg.

273. Phalasava 10 to 30 ml.

274. Tapyadi Louha 250 to 500 mg.

(18) METABOLIC DISORDERS)

18:1 Madhumeha (Diabetes mellitus)

275. Trivanga Bhasma 125 to 250 mg.

276. Vasant Kusumakar Ras 125 to 250 mg.

277. Nisha Katakadi Kwath 10 to 30 ml.

278. Nyagrodhadi Churna 5 to 15 gm.

279. Jambavadyarishta 10 to 30 ml.

280. Ayaskriti 10 to 30 ml.

18:2 Visama Meda (Dyslipidaemia)

281. Medohara Churna 5 to 15 gm.

282. Medohar Vidangadi Louha 1 to 2 gm.

18:3 Sthaulya (Obesity)

283. Navak Guggulu 2 to 4 tab.

284. Triphala Churna 5 to 15 gm.

18:4 Shotha (Oedema/inflammation)

285. Rasna-erandadi Kwath 10 to 20 ml.

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286. Shigru Varun Kwath 10 to 20 ml.

287. Gomutrarka 5 to 10 ml.

288. Kansa Haritaki 5 to 10 gm.

289. Shoth Kalanal Ras 125 to 250 mg.

290. Grihdhoomadi Lepa For topical use as poste

291. Kokilakshak kashaya 10 to 20 ml.

18:5 Sleepada (Filariasis)

292. Nityanand Ras 250 to 500 mg.

293. Shakhotak Kwath 20 To 40 ml.

294. Sapta parna ghan Vati 500 mg. to 1gm.

18:6 Krimi-upsarg (Infective/Septic conditions)

295. Rasanjana Vati ½ to 1 gm.

296. Shudh Gandhak 250 to 500 mg.

297. Nimbadi Tel For topical use

298. Nimbadi Vati 500 mg. to 1 gm.

299. Jaya Vati 250 to 500 mg.

(19) BAL-ROG (PAEDIATRIC PROBLEMS)

300. Dantodbheda gadantaka Ras 125 to 250 mg.

301. Balark Ras 62.5 to 125 mg.

302. Kumar Kalyan Ras 62.5 to 125 mg.

303. Bal Chaturbhadra Churna 250 mg. 1 gm.

304. Ras Pipari 250 mg. 500 gm.

305. Gopi Chandanadi Gutika 250 to 500 mg.

306. Tambula Leha 2 to 5 gm.

307. Sankhpuspi Tel For head

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308. Arvindasava 5 to 15 ml.

309. Kamal beej gatta churna 1 to 3 gm.

310. Sudha vacha 125 to 250 mg.

311. Jatiphal Churna ¼ to ½ gm.

312. Lakshadi Tel For massage

313. Blal Rasayana 1 to 3 gm.

314. Ayush Ghutti ½ to 1 gm.

315. Ark Pudina 3 to 5 ml.

316. Ark Ajwayan 1-2 ml

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(B) MULTI PURPOSE-BHASMA

S.No. Name Eng.Name Properties

1. Svarn Makshik Bhasm Copper pyrites Anaemia, urticaria, hyperacidity,

tonic

2. Sphatika Suddh Alum Haemorrhage, cough, fever,

antiseptic

3. Tankan Bhasm Borax Cough, tonsillitis, fever

4. Shankh Bhasm Conche Gastrointestinal disorders

5. Kapardika Bhasm Covries Earache, wound healing,

intestinal colic

6. Mandoor Bhasm Pig iron bhasma Anaemia, jaundice, oedema

7. Lauh Bhasma (30 puti) Iron bhasma Anaemia, general debitity,

pregrancey

8. Mayur puchha bhasm Pea cock feather

bhasma

Hic cough, irritating couth,

vomiting

9. Godanti bhasma Gypsum bhasma Cough, cold, fever bodyoche

10. Sringa bhasma Stag horn

bhasma

Fever, sinusitis, bronchitis,

preumonia

11. Abhrak bhasma Mica (Biotite) Hyperacidity, anaemia,

respiratory disorder

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(C) EMERGENCY AYURVEDIC DRUGS

S.No. Name of the Drugs Uses

1. Karpoor Ras For acute diarrhoea

2. Vedanantak Ras For severe pain of musculo-skeletal or visceral

origin

3. Siddha-makardhwaj For peripheral circulatory failure.

4. Jwaharmohra For palpitation, syncope, cardiac tonic

5. Mutka pisti For acute tachycardia, palpitation, cardiac

problems

6. MaHavatraj ras For neurogenic shock, angina

7. Sameer gajkesari ras Neurological shock, angina, neuro-muscular pains

8. Shvaskaschinlamani ras For severe dyspnoea of pulmonary origin

9. Suvarn sameer pannag ras For acute dyspnoea, arthralgia

10. Mritsanjivani sura For high grade fever, with delirium, shock

11. Dhanwantar gutika For acute respiratory distress

12. Manasmitra vatak For mental disorders, insomnia

13. Marma gutika For pain and inflammation in vital parts

14. Gorochanadi vati For cardio respiratory problems, fever

15. Murivenna oil Local application for traumatic pain and

inflammation etc.

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