of Existing LRs Include Past performance and future requirement while finalizing Develop budget worksheet Prepare Budget Review Past Performance Calculate future requirement Any future increase in delivery load ID: 1048397
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2. Process of Budgeting for Standardization of Existing LRsInclude Past performance and future requirement while finalizingDevelop budget worksheetPrepare BudgetReview Past PerformanceCalculate future requirementAny future increase in delivery loadAddition of new technologyDeletion of old technologyDelivery loadShort supply of any itemsNon- availability of items or equipmentSpace or infrastructure requirement for care as per guidelines
3. ConsumablesPractices and protocolSpace and layoutHuman resourceEquipment and accessoriesGuidelines Focus on Five Important AreasWill discuss in detail on three areas:Space. Equipment and Consumables
4. Space and Layout: Major Focus areas
5. Space and Layout: Components for Conventional Labor Room ComplexWaiting/Registration areaTriage/Examination room Staff roomLabour and delivery areaNewborn care areaDoctor’s duty roomNursing stationStoreClean Utility AreaDirty Utility Area
6. Suggested Methodology for Budgeting for Standardization of Space and Layout
7. Major costs incurred while standardizing space and layout of LRsCost of expansion of space (new construction/removal of walls to merge spaces/shifting to new space)Cost of upgradation of ambience: wall tiles, floors, paint, seepage removal, etc. Costs of fixing broken windows, doors, partitions, etc.Costs of upgrading services such as washrooms and utility areasCosts of adding missing structures such as handwashing station, nursing station, storage areasCosts of upgrading lighting and ventilation
8. Example of costs for civil work (approximate costs)ItemApproximate costPartition 4000010000 per partition, size 8*6, Made up of aluminium and ACC sheetShifting of wall to make LR more spacious and convenient for provider20000(wall size 10*12, 9 inch thick)Construction of new LR1,00,000(for a LR of 10*12)Waiting area with sitting facility1,00,000(for a area of 10*12)Building of new toilet in vicinity of LR45000(size 4*6, tile upto 6 feet, separate septic tank)Floor of the labor room is constructed of anti-skid vitrified tiles18000LR size 10*12, 150 rs per sq feet (150*120=18000)Walls of labor room have wall tiles of white color40500Upto 6 feet
9. Example of costs for civil work (approximate costs) ItemApproximate costMain doors has 2 frames, one large (3/5th of width) & another small (2/5th of the width)10000Size 7*4, made with aluminium and glassWindows having outside panel fixed & should have half ground glass & half mesh. The second panel should be moving with frosted glass & a lock20000 5000 per windowHand washing area A steel sink and Two elbow operated taps with 24*7 running water supply5000With stainless steel sinkCurtain for privacy5000For 6 LT, 3 windows and 1 door
10. Suggested Budgeting for Ensuring Availability of Essential Equipment and InstrumentsStep 1 : Calculate the desired number of equipmentAs per load and level of facilitySee section equipment & accessories, page 32Use equipment calculator Step 2: Assess of the number of functional Instrument and equipment in the existing LRStep 3: Calculate the Gaps (2 - 1)Step 3 : Request for unit cost from the State Equipment Management Unit (SEMU)/ other similar bodyStep 4 : Multiply the gaps with the UNIT cost so as to calculate the total cost estimate
11. Sl NoItemsRequired as per normUnit CostCost Estimated1Number of labor tables 6300001800002Stepping Ladder for Pregnant Women 650030003McIntosh or disposible draw sheet18200/meter108004Kelly's pad750035005Stainless Steel IV rod6120072006 Yellow biomedical waste bin6130078007 Stool for birth companion650030008Curtains in LR181800324009Ceiling mounted lights230000060000010Shadow Less Light62100012600011Fan 620001200012Air Condition 1420004200013Refrigerator1200002000014The facility has power back-up160000060000015No. of Functional Radiant Warmer25000010000016Ambu bag for babies(240 ml) with both pre & term mask (size 0,1)21500300017Functional oxygen cylinder (with wrench) with new born mask250001000018Doppler/fetoscope in labor room / admission area250001000019Mucus Extractor (De Lee's)143042020Adult Weighing scale11500150021Baby weighing machine1150001500022Thermometer (Adult)210020023Thermometer (Baby)21700340024BP Apparatus2550110025Stethoscope2500100026Suction device135003500Example: List of equipment-calculated for labor room with approx. 400 deliveries per month
12. Sl NoItemsRequired as per normUnit CostCost Estimated27Wall clock with seconds hand2500100028Examination table with step24000800029Examination tray21200240030Measuring tape210020031Delivery trolley680004800032Delivery tray 820001600033Emergency drug tray1500005000034Sterile scissors8500400035Artery forceps16500800036Sponge holding forceps168001280037Sims Speculum 81000800039Episiotomy scissor81000800040Allis forceps8700560041Toothed forceps8800640042Needle holder830002400043Needle (round body and cutting)85040044Thumb forceps 8500400045Anterior vaginal wall retractor 21000200046Posterior Vaginal wall retractor21000200047MVA syringe and cannulas23000600048MTP cannulas210020049PPIUCD Insertion Forceps22000400050Autoclave1300003000051Protocol posters1610001600052Wheelchair and/or stretcher16000600053Table & chair for Service provider1100001000054Communication1240002400055Washbasin2500010000 Total Estimated cost 2115020
13. Budgeting for ConsumablesUsually non Budgetary ItemsForecast demand for the year and for various months based upon historical trendsUse LR supply calculatorEnsure planning of quantities based upon the perishable nature of the suppliesBudget for supplies based upon the forecastsFacility to have contingency funds for ensuring 24 X 7 - in case of inadequate supply
14. Example: List of essential Supplies-calculated for labor room with approx. 400 deliveries per monthSl NoItemsRequired as per normUnit CostCost Estimated1Gloves1320101584002Cotton rolls422051033203Gauze (10 Meter)33150594004Sanitary napkins 66010792005Sterile pads13 06Apron334502004007Thread331039608Towels for receiving new borns66014011088009Chromic Catgut "0"165 010IV Fluids330207920011IV drip sets3305019800012Foleys Catheters331254950013Cord clamp330103960014Disposable Syringes (2 and 5 ml)330103960015Disposable Syringes 10ml337277216Delivery kit for HIV positive women4017Povidone Iodine (500 ml)33652574018Magnesium Sulphate 47663427219Antibiotics for mother402009600020Antibiotics for baby80500480000
15. Sl NoItemsRequired as per normUnit CostCost Estimated21Oxytocin (5/10 IU per ml)13201015840022Vitamin K (1mg/ml or 1 mg/0.5 ml)330023Antiretrovirals1 024Tab Misoprostol49563564025Nevirapine Syp and Tab.1 026Inj Dexamethasone7542027Uristix for Protienuria and Glucose42012764008028Glucometer220004800029Family Planning options 030Soap and Running water031Washbasin 2000032Utility Gloves120507200033Bleaching Powder/Sodium Hypochlorite solution3505021000034Plastic tubs for 0.5% Chlorine solution6500300035Coloured bins 9500450036Hub cutter115015037Puncture proof container3500150038MCP Card330103960039Safe Motherhood Booklet330207920040Partograph3301396041IUCD client card330519800 Total Estimated cost 4074414
16. Thank you
17. Page 32 onwards of guidelines