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DISTRICT PROFILE - VARANASI (2009) Introduction district is the place where Lord Buddha delivered his first sermon. city, also known as Benares is one of the seven sacred cities of Hindus. The city is famous for its temples and is situated on the bank of the river Ganga. The city is considered as holy city by many religions of India. The city is also famous for its silk Sarees. The district headquarters are located in city. The district is surrounded by St Ravidas Nagar district in the east, Chandauli district in the west, Jaunpur district in north, and Mirzapur district in the south. Further details of the district can be seen as under: Area (Sq. km.) 1,577,091 Total Population (Census 2001) 3,691,085 - Urban (%) 44.9 - Rural (%) 55.1 - Male (%) 54.8 - Female (%) 46.2 - Scheduled Caste (%) 20.7 - Scheduled Tribe (%) 3.4 Sex Ratio (M:F) 10.9 No. of Nyay Panchayats 108 No. of Gram Sabha 702 No. of Villages 1,262 Total No. of School Data not available - Primary 1,208 - Junior High School 865 - High School 346 - Intermediate 112 - Graduate 14 - Post Graduate 03 No. of Urban Slums 227 No. of JJ Cluster Data not available Literacy Rate (%) 69.5 Male Literacy Rate (%) 39.5 Female Literacy Rate (%) 30.5 No. of homes of persons affected by leprosy Data not available No. of persons affected by leprosy living in these homes Data not available Health Facilities in District The rural health care system is a three-tier structure. It has Sub-center at the most peripheral level, Primary Health Centre at the intermediate level and Community Health Centre at the secondary level. The population covered by a Sub Centre, Primary Health Centre and Community Health Centre are 3,000-5,000, 20,000-30,000 and 100,000, respectively. In addition, there are Private Voluntary Health Facilities, also. As per UP government organizational set up, the district is headed by a District Magistrate, who is also the chairperson

of the Integrated District Health Society of district. The district health set up of UP government is headed by the Chief Medical Officer followed by an Additional CDMO as second-in-command. The Chief Medical Superintendent looks after the UP government hospitals in the district. There are 379 government health care facilities in the district, as can be seen from the table given below. Category Number District Hospitals (Male & Female) 03 No. of CHC 05 No. of PHC 08 No. of APHC 22 No. of FW/MCH Centres 293 Female Hospitals 01 Regional Diagnostic Centres 01 Urban Health Posts/ Maternity Centres 15 Leprosy Hospitals (Temp. Hospitalization Wards) 02 Other allopathic Hospital 12 Ayurvedic Hospitals 07 Homeopathic Hospitals 03 Medical Colleges 02 ANM Training School 02 Nursing Training School 02 Other govt. health training Institute 01 Staff Position in the District Following is the list of health personnel employed under Uttar Pradesh government. Figures related to other health agencies are not available. Category Sanctioned In Position Leprosy Training received ( No. trained ) Medical Officers 167 88 Not Provided Pharmacist 43 42 DPMR Training Health Supervisor (F) 119 112 Data not available Health Supervisor (M) 62 46 Data not available Health Worker (F) 364 363 Data not available Health Worker (M) 112 43 Data not available NMS 10 11 Data not available NMA 51 53 Data not available ASHAs 1900 1900 Data not available

Epidemiological picture of the district Prevalence rate and Annual Case detection rate have declined steadily since 2004-05. However, there is no remarkable change in the proportion of MB Cases, Gr 2 cases, and Female Cases amongst new cases over these five years. The proportion of Child Cases amongst new cases over these past 5 years has decreased. Graph 1 & 2: Epidemiological Indicators of district (2005 2009) PR & ANCDR MB, Female, Child & Gr 2 Disability Proportion 3 50 2.5 40 2 30 1.5 20 1 10 0.5 0 2004-05 2005-06 2006-07 2007-08 2008-09 ANCDR PR 0 2004-05 2005-06 2006-07 2007-08 2008-09 MB Proportion Child Proportion Gr 2 Proportion Female Proportion Treatment Completion Rate (TCR) in the District Multibacillary cases registered in the year 2005-06 90.8% Paucibacillary cases registered in the year 2006-07 97% The TCR of both Paucibacillary and Multibacillary cases is very good; however more efforts should be made to improve it further especially of Multibacillary. SUPPORT Programme Support NLR has placed a senior Leprosy Programme Advisor (LPA),at to cover 7 districts in the area including being the headquerter for the LPA. He is a medical doctor with training in leprosy and long experience of working in public health activities. The LPA is visiting this district and transferring his skills, and providing guidance to District Nucleus (DN) so that DN improves their supervisory activities and in turn quality of leprosy services are improved, which will be provided through GHC staff. Through support from this LPA, following support activities have been completed in in the year 2008 On the basis of information available in the district, LPA has prepared the district profile of. During first quarter of 2008, situational analysis of functioning of District Nucleus (DN) was conducted. On the basis of this analysis, weaknesses, of the functioning of DN, were identified and following activities were planned to overcome these weaknesses Support in Supervision: NLR LPA initiated & motivated DN for the preparation of an Advance Tour programme, Activity Undertaken Report

and Checklist for Supervision. The LPA supports the District Nucleus and visits a sample of peripheral health care facilities along with District Nucleus Team and provides them on the job with technical support in carrying out supervision of the peripheral GHC staff. LPA also assists and transfers his skills required in preparation of Annual Plan of Action and monitoring of activities in the district DN team of was supported by LPA, in preparation of monthly reports including Quarterly Performance Reports and Monthly Reporting Formats. MDT management workshop for pharmacists was supported and facilitated by LPA of. 30 pharmacists were trained out of 42 pharmacists in the district. Outcome Preparation of ATP will be done in future also. Preparation of Gantt Chart and Supervisory Report in future also. Cohort study for the reporting year 2007-2008 (MB-90.78% & PB-96.96%) Improvement in record keeping. Improvement in MDT management Improvement in technical skill of D.N. Improvement in Retrieval of Absentees. Improvement in Healthy Contact and Validation. Preparation of need based result oriented POA for the year 2009-2010 REHABILITATION Promotion of self care On the basis of experience in other countries, NLR India has initiated the support to the District Nucleus in providing guidance, support and motivation to Persons affected by Leprosy living in leprosy colonies/settlements. This support is provided for promoting self care of the anesthetic eyes, hands and feet, by the persons themselves. NLR has provided one Non Medical Supervisor, working as SCG coordinator to provide support to DN and supervise the functioning of self care groups in colonies. This page contains information of the progress made so far in the district. The progress made, in self care, will be updated regularly There one colony for Persons Affected by leprosy in. Brief of this colony is as under: No. inhabitants of colony No. persons affected by leprosy 2008 2008 Disability status (including Gr. 1 & Gr. 2) Eyes Hands Feet Preocess yet not started

As per NLR Self Care Group (SCG) Guidelines, following activities have been completed in this ashram. Identification of Government NMS as Facilitator from District Nucleus Training of facilitator Stake holder s meeting Meeting with inhabitants of Identified Persons Affected by Leprosy homes. Disability assessment Group formation Selection of group leaders Training of Group leaders

Contact Addresses of District Officials 1. Dr. R.S. Singh CMO CMO Office Durgakund 2. Dr. Diwakar Singh DLO Pt. Din Dayal Hospital Pandeypur 3. Sh. B.L. Verma NMS Pt. Din Dayal Hospital Pandeypur 4. Mr.A. Ahmad NMS Pt. Din Dayal Hospital Pandeypur 5. Dr. S. N. Pandey Leprosy Programme Advisor Netherlands Leprosy Relief S-2/656 D6 A4 Sikraul UP 221 002 Mb.09919887964 Email nlr_vns@rediffmail.com