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Tonrhmorissa.gov.in/writereaddata/PIP/Malkanagiri2016... · 2017. 11. 23. · • NVBDCP Rs. 58.33 Lakh • NLEP Rs. 1.86 Lakh • RNTCP Rs. 75.04 Lakh • NPCB Rs. 12.63 Lakh •

Feb 28, 2021

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  • SIH & FW, Annex Building, Nayapalli, Bhubaneswar- 751012 Phone/Fax: 0674- 2392479/80, E-mail: [email protected]. web: www.nrhmOdisha.gov.in

    Letter No. OSH & FWS/8198 Date: 08/07/2016 From

    Smt. Shalini Pandit, I.A.S. Mission Director, NHM. Odisha

    To The CDMO-cum-District Mission Director Malkanagiri

    Sub: Approved resource allocation for the district under NHM PIP, 2016-17. Madam/Sir,

    The approved resource allocation for the district of Malkanagiri for the year 2016-17 is Rs. 1934.27 Lakhs. The Details of component wise break up are as follows.

    • RCH Flexi Pool Rs. 895.96 Lakh • Mission Flexi pool Rs. 711.45 Lakh • Immunization Rs. 57.79 Lakh • NIDDCP Rs. 0.76 Lakh • NUHM Rs. 11.67 Lakh • IDSP Rs. 10.69 Lakh • NVBDCP Rs. 58.33 Lakh • NLEP Rs. 1.86 Lakh • RNTCP Rs. 75.04 Lakh • NPCB Rs. 12.63 Lakh • NPCDCS Rs. 55.65 Lakh • NTCP Rs. 14.10 Lakh • NPHCE Rs. 28.33 Lakh • NMHP Rs. 0.00 Lakh

    The above approval is subject to the certain mandatory requirements as detailed in “Terms & Conditions“ mentioned at subsequent pages. Please note that non-compliance of any of the cluse mentioned in Terms & Conditions may entail audit objections & may result in with holding of grant to the district.

    It is therefore requested to utilise the funds as per the guidelines issued by the State & ensure effectiveness & efficiency in programme implementation for desired result.

    I look forward to hear from you on the progress against the approvals.

    Yours faithfully,

    Mission Director, NHM, Odisha

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    Department of Health & Family Welfare, Government of Odisha.

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  • Terms & Conditions

    The approval (Financial envelop) is subject to the following mandatory requirements. Please note that non-compliance to any of the following requirement may entail audit objections & may result in withholding of release to the district.

    � The implementation of District PIP shall be the responsibility of the Zilla Swasthya Samittee. Therefore, the ZSS executive committee should hold its meeting within a fortnight for necessary ratification of the approved PIP. However, the ongoing activities may continue till the ZSS meeting is held. The district may propose additional proposal/s if any for necessary approval in the supplementary PIP.

    � The districts shall finalize the Block PIP in line with the District PIP for undertaking approved activities & disseminate the same within a month from receipt of respective PIP.

    1. Strengthening Financial Management System: The following conditionalities must be adhered to strictly for ensuring sound Financial Management.

    1.1 Fund Release to sub-district level facilities:

    � Funds to be released quarterly in Flexible-pool mechanism after adjusting the unspent balances.

    � Funds must be released within 7 days of receipt of the same from State.

    � Fund release has to be ensured through PFMS only.

    � Audited Utilization Certificates against the grant released to the District up to 2015-16 for releasing funds beyond 75% of BE.

    1.2 Financial Management Report (FMR) & Statement of Fund Position (SFP):

    � CHC/SDH to Districts:

    � To be furnished by 30th of the month. � PIP based FMR & SFP should be furnished. � BRS is mandatory along with FMR & SFP.

    � District to State:

    � To be furnished by 5th of the following month. � PIP based FMR & SFP to be furnished separately. � BRS is mandatory along with FMR & SFP.

    NB: The financial data in the FMR must be as per the books of accounts and the physical data as per HMIS/MCTS/ any other manual rports collected for the purpose .

    � Record Keeping:

    � Cash books, ledgers, advance registers, asset registers etc. along with relevant documents must be maintained as prescribed in the Financial Management guideline.

    � The records must be authenticated by the DDO without delay. � All the financial transactions must be entered in the FAMS.

  • � Concurrent audit:

    � Concurrent audit must be taken up in time as per the terms & conditions in the contract. � The observations of the auditor must be complied in action before taking up the audit of

    next month. � The executive summary must be submitted to State on quarterly basis.

    � Financial progress:

    � Progressive expenditure status at the end of each quarter has to be as per the norms mentioned below. Quarter 1: 15%, Quarter 2: 45%, Quarter 3: 65% and Quarter 4: 100%.

    � Age of advance:

    � Age of advance under any scheme under NHM has to be less than 12 months at the end of the year for getting further grants of current year.

    � Ageing of advance analysis must be prepared on quarterly basis for all facilities to identify long pending advances.

    � All long pending advances must be followed-up rigorously for liquidation.

    � Monitoring & Supportive supervision:

    � Monitoring of the financial management processes must be done as per the comprehensive monitoring plan.

    � If required, handholding support must be provided on the spot. � Financial records & documents of all facilities must be examined as per the checklist in the

    fixed day review meeting of BPMU staff at district level and corrective measures be ensured accordingly. The detailed guidelines provided in this regard must be followed strictly.

    � Corrective actions must be ensured based on the recommendations of the monitoring team. 1.3 Other conditionalities

    � Delegation of financial Powers under OSH&FW Society: In absence of regular DDOs at District & Sub-district level to avoid any interruption in taking up the approved activities under NHM shall be adopted as per following norms:

    � Collector & DM shall accord financial & administrative powers at district level � CDMO concerned will accord financial powers for officers at Sub-district level � It would be a temporary arrangement till regular position is filled up by the Govt. or financial

    powers are formally issued by Govt. in favour of the person in-charge. � It shall only be delegated to the person in charge of that position � In absence of regular CDMO-cum-District Mission Director, the Collector & District

    Magistrate may accord approval for sub-district level DDO positions. � For making payment/incurring expenditure/release of funds, the delegation of

    administrative & financial powers applicable for different levels must be followed strictly.

  • � Guideline for utilization against demand driven & Non-demand driven activities:

    � Funds required for demand driven activities like JSY, Sterilization, JSSK, VHND, Sector level meeting of ASHAs, remuneration of staff etc. has to be released as per the actual requirement irrespective of the allotment in PIP. However, the unit cost of each activity has to be as per approved budget.

    � Additional expenditure on demand driven activities, if any, does not deprive a district from taking up other approved activities due to want of funds.

    � In case the expenditure against the demand driven activities exceeds the approved budget, the MD, NHM should be requested to release more funds for the same.

    � Non-demand driven activities must be taken up as per approved PIP.

    � In PIP 2015-16, the approved budget against some activities is less than 100%. In such cases, the districts can spend (max upto 100%) based on the approved unit cost and physical targets.

    � Items like engagement of new manpower, operationalization of MHTs, NRCs, NBCs, NBSUs, SNCUs, Maternity Waiting Homes, VGP& PHC(N) management initiatives, all procurement (Kind & services) & civil works, even if proposed in later part of the year in the PIP, may be taken up from 1st qr.

    � Unit Costs in relation to various procurements of equipments and printing etc. are only indicative for the purpose of estimations. However, actual expenditure must be incurred after following rules and due processes.

    � The district has to ensure that no personal advance is given for taking any programmatic activities such as trainings, printings, organizing camps etc. All expenditure should be incurred by way of direct payment to concerned agencies. However, if any advance is given in case of emergencies (to be justified in file), the same at district / sub-district level must be settled within 45 days of completion of the activity. In case of non-settlement, the advancee should be issued a notice for settlement of the advance in next seven days. However, if the same is not settled within the stipulated time, the advance should be recovered from his/her salary. The guideline provided in this regard under the signature of MD, NHM & DHS, Odisha must be followed strictly.

    � No due certificate / clearance from concerned programme management units must be insisted at the time of handing over the charges / relieve from the post held by Govt. officers on account of retirement / transfer as directed by Govt. vide resolution No. – 14434, dt,11.06.12.

    � The district must ensure due diligence in expenditure and observe, in letter and spirit, all rules, regulations, and procedures to maintain financial discipline and integrity particularly with regard to procurement; competitive bidding must be ensured and only need-based procurement should take place.

    � The accounts of the grantee institution/organization shall be open to inspection by the sanctioning authority, internal as well as statutory auditors and by the Comptroller & Audit General of India under the provisions of CAG (DPC) Act, 1971.

  • � Action on the following issues would be looked at while considering the release of second

    tranche of funds:

    � Compliance with key conditionalities & incentives mentioned in point no 10. � Physical and financial progress made by the district, communicated through the FMR. � Timely submission of Statutory Audit Report for the year 2014-15.

    2. Programme Priorities:District would seek to provide following range of services to attain goals envisaged under NHM :

    2.1 Range and delivery of services � Prioritize achievement of universal coverage for Reproductive Maternal, Newborn, Child

    Health and Adolescents (RMNCH+A) services, National Disease Control and Non Communicable Diseases programmes in rural and urban areas.

    � Focus beyond maternal and child survival to ensure quality of life for women and children.

    � Expand focus from child survival to development of all children 0-18 years through a mix of Community, Anganwadi and School based health services.

    � Build an integrated network of all primary, secondary and a substantial part of tertiary care, providing a continuum from community level to the district hospital, with robust referral linkages to tertiary care and particular focus on strengthening the Primary Health Care System including outreach services in urban slums.

    � Strengthening existing health care system to address the rising burden of Non-Communicable Diseases

    � Ensure that all public health care facilities or publicly financed private care facilities provide assured quality of health care services.

    2.2 Equity � Ensure differential financial investments and technical support to blocks, and cities, with

    higher proportions of vulnerable population groups, including urban poor and destitute, and with difficult geographical terrain that face special challenges to meeting health goals.

    � Address shortages of skilled workers in remote, rural areas, urban slums, and other under-served pockets through appropriate monetary and non-monetary incentives.

    � Reduce out of pocket expenditure on health care, eliminate catastrophic health expenditures and provide social protection to the poor against the rising costs of health care, through cashless services delivered by public health care facilities, supplemented by contracted-in private sector facilities where-ever necessary.

    2.3 Health system strengthening � Ensure Quality Assurance for improved credibility of public health services.

    � Empower the ASHA to serve as a facilitator, mobilizer of community level care.

    � Strengthen Health Management Information Systems as an effective instrument for

  • programme planning and monitoring, supplemented by annual district level surveys and a strong disease surveillance system.

    � Ensure universal registration of births and deaths with adequate information on cause of death, to assist in health outcome measurements and health planning.

    � Create system & processes to strengthen Behaviour Change Communication efforts for preventive and promotive health activities, action on social determinants and to reach the most marginalized.

    � Strengthen AYUSH system, so as to enhance choice of services for users and learning from and revitalizing local health care traditions.

    � Strengthen partnerships with the not-for-profit, Non Governmental Organizations in all aspects of health care and with the for-profit, private sector to bring in additional capacity where needed to close gaps or improve quality of services.

    � The district shall not make any change in the names of the National/State initiatives such as Janani Shishu Suraksha Karyakram, Rashtriya Bal Swasthya Karyakram etc.

    � Establish Accountability Frameworks at all levels for improved oversight of programme implementation and achievement of programme goals.

    3. Programme Management and Human Resource � All posts under NHM shall be on contract basis and for a term of 11 months only.

    � Clinical manpower sanctioned under RCH-II would be engaged exclusively at Delivery Points. Irrational deployment would render the expenditure ineligible under NHM.

    � For SCs DP with 2 ANMs, population to be covered will be divided between them. Further, one ANM to be available at the sub-centre throughout the day while the other ANM undertakes field visits; timings for ANM‟s availability in the SHC to be notified & displayed.

    � It is noted that sanctioned position of ANM is less in most of the districts than ANM in-position. In such case/s, surplus ANM in position can be continued. But, if vacancies arise anytime during this financial year, the said position/s should not be filled up till manpower in position is less than sanctioned nos. However, the expenditure incurred on the same head shall be booked under the same line item.

    � In case the appointment of manpower has been done in ahead of the targeted quarter, then the additional funds required for the same can be met from the concerned line item.

    � OPD in Ayush clinics have to be monitored & validated on sample cases on quarterly basis. Every effort should be made to increase OPD cases at each AYUSH unit.

    � Ayush medical officers should increasingly be involved in the implementation of National Health Programmes and for the purpose of supportive supervision and monitoring in the field. They should be encouraged to oversee VHND,FID and other outreach activities and in addition, programmes like school health, weekly supplementation of iron and folic acid for

  • adolescents, distribution of contraceptives through ASHA, menstrual hygiene scheme for rural adolescent girls etc.

    � Performance Incentive to Clinical & management manpower must be provided as per existing guidelines till online performance management system is in place.

    � Renewal of contract will be done as per existing guidelines.

    � All activities except remuneration of PMU staff can be taken up as per approved PIP. The revised remuneration and increment projected in the PIP will be drawn after receipt of separate order from Mission Director, NHM in this regard. However, remuneration & PI can be drawn as per existing norm.

    � PMU should ensure regular meetings of DLVMC/DHM/DHS/RKS/GKS at their respective levels.

    � PMU should ensure compliance of all statutory and PIP conditionalities

    � All necessary processing of file for settlement of PI, increment, leave as applicable & renewal of contractual manpower under NHM is to be done at DPMU level.

    4. Procurement: Strict compliance of procurement procedures for purchase of medicines, equipments etc as per state guidelines to be maintained. � All the equipment’s are to be procured through competitive bidding as per the specification

    provided by the State. Any additional funds required following the said process may be met out of the concerned line item.

    � Only need based procurement to be done strictly on indent/requisition by the concerned facility.

    � Procurement to be made well in time & not to be pushed to the end of the year.

    � Audit of equipment procured in the past to be carried out to ensure rational deployment and wage.

    � Annual Maintenance Contract (AMC/CMC) to be built into equipment procurement contracts.

    5. Infrastructure � In all new constructions of SCs, care should be taken to ensure that the locations of these

    facilities are such that beneficiaries can access them easily. They should preferably be located in the habitation as decided by GKS and definitely not in outskirts of villages or in unhygienic environment under any circumstances.

    � Any shift in the approved new proposals for DPs is not permissible. However, in case of NRC, location may be changed with the approval of CDMO. Further, the place of NBSU & BSU may be changed within the DPs of L3 facilities taking prior approval from MD, NHM following proposals with adequate justification.

    � All buildings, vehicles & other assests supported /created under NHM should prominently carry NHM logo and adhere to the prototypes communicated by MD,NHM.

  • � Works must be completed within a definite time frame. For new constructions upto CHC level, a

    maximum of two years and for a District Hospital a maximum period of 3 years is envisaged. Renovation/ repair should be completed within a year. Requirement of funds should be reflected accordingly. Funds would not be permissible for constructions/ works that spill over beyond the stipulated timeframe.

    � The district shall strengthen implementation arrangement to monitor all civil works being undertaken, on a monthly basis, to ensure quality of work and completion as per schedule. The district should also ensure up-dation of data in CMS on monthly basis.

    � Any deviation from the above conditionality would be treated as ineligible expenditure under NHM.

    6. RBSK

    The quality of screening by MHTs and smooth management of identified cases will also be focused during the year. Activites need focused attention.

    � Increase in screening coverage with focus on screening 100% new born and 0-6 year children at AWCs.

    � Mentoring MHTs for proper screening of children as per RBSK norm.

    � New born screening at all delivery points, SNCU and NRCs. Initially new born screening to be initiated at all DHHs.

    � Operationalize all DEICs at district level and establishing convergence of DEIC activities with DDRCs, DRCs, NCD and other programmes.

    � Roll out of RBSK software in the State with focus on real time reporting by MHT and child wise tracking of identified cases.

    � Establishing linkage with Tertiary facilities like AIIMS, SVNIRTAR, AYJNIHH & MC&Hs for management of Birth defect and critical cases.

    7. PPP Initiatives:

    Irrespective of commencement of NGO projects during a particular financial year, each project period ends on 31st March of the same financial year to bring the uniformity in contract/agreement period of all ongoing NGO projects. The duration of the NGO projects shall be on financial year basis only.

    � Adhere to revised norm on NGO contribution for PHC-N management projects i.e. 5% of the programme cost.

    � Ensure bank guarantee for all NGO projects except PHC (N) management Projects i.e. 2% of project cost/released amount to be deposited with respective ZSS before release of funds to the NGO.

    � The District NGO Committee should review the performance of all the NGO projects in health

  • at district level and sort out issues therein, apart from deciding on selection and renewal of implementing agencies.

    � The system of monitoring and supervision of NGO projects must be strengthened at the District and Block level. The work certificates of the PPP PHC(N) staff manged by NGOs should be certified by the concerned Block MO I/c every month to check absenteeism.

    � A calendar stipulating timelines for stage-wise processing and endorsement by District NGO Committee, in respect of renwal and termination of contract, the following calendar shall be adhered to for the sake of timely and qualitatively execution of projects on regular basis.

    Sl No Details of activities Timeline

    1 Assessment of ongoing NGO led health programmes by District level Assessment Team (desk & filed level assessment)

    1st week of January

    2 Meeting of the District NGO Committee of Dist. Health Society.

    By 15th January

    3

    Submission of the recommendation of District NGO Committee on ongoing NGO led health projects or any new partnership proposals to Mission Directrate for decision in the State NGO Committee meeting.

    By 20th January

    4 Renwal of contract in respect of ongoing NGO led health programmes at district level after approval of the State NGO Committee.

    By 20th March

    � For ensuring timely release of funds to the NGOs by the District, and submission of UCs/SoEs by the NGOs, timeline and condition as fixed below should be adhered to;

    Year of operation

    Funds release procedure Timeline and condition for release of funds to NGOs by district

    1st year operation

    1st installment: 50% of the approved project cost of the current year to the NGO.

    Within 7-days of signing of the MoU and after deposit of the NGO contribution / bank guarantee (applicable to project specific).

    2nd installment: Rest 50% of the approved project cost to the NGO.

    Within 7 days of receipt of the SOE/UCs for 75% (minimum) of 1st installment.

    2nd year operation

    3rd installment: 50% of the approved project cost of the current year to the NGO.

    (i) Within 10 days of renewal of MoU. Prior to that, performance assessment by the District Authority with support of Concurrent Auditor, and recommendation of District NGO Committee for renewal of contract should be done.

    (ii) After receipt of the SOE/UC of 2nd installment

  • Year of

    operation Funds release procedure Timeline and condition for release of funds to

    NGOs by district and deposit of the NGO contribution / bank guarantee (applicable to project specific).

    4th installment: Rest 50% of the approved project cost to the NGO after obtaining satisfactory mid-term evaluation report by external evaluating Agency.

    Within 10 days of receipt of the mid-term evaluation report from State, receipt of the last year annual audit report and annual progress report of the concerned project along with SOE/UCs for 75% (minimum) of 3rd installment.

    3rd year operation

    5th installment: 50% of the approved project cost of the current year to the NGO.

    (i) Within 10 days of renewal of MoU. Prior to that, performance assessment by the District Authority with support of Concurrent Auditor, and recommendation of District NGO Committee for renewal of contract should be done.

    (ii) After receipt of the SOE/UC of 4th installment and deposit of the NGO contribution / bank guarantee (applicable to project specific).

    6th installment: Rest 50% of the approved project cost to the NGO after obtaining satisfactory final evaluation report by external evaluating Agency.

    Within 10 days of receipt of the final evaluation report from State, receipt of the last year annual audit report and annual progress report of the concerned project along with SOE/UCs for 75% (minimum) of 5th installment.

    4th year operation

    7th installment: 50% of the approved project cost of the current year to the NGO.

    (i) Within 10 days of renewal of MoU based on satisfactory report of final evaluation. Prior to that, performance assessment by the District Authority with support of Concurrent Auditor, and recommendation of District NGO Committee for renewal of contract should be done.

    (ii) After receipt of the SOE/UC of last installment and deposit of the NGO contribution / bank guarantee (applicable to project specific).

    8th installment: Rest 50% of the approved project cost to the NGO.

    Within 10 days of receipt of the last year annual audit report and annual progress report of the concerned project along with SOE/UCs for 75% (minimum) of 7th installment.

  • Year of

    operation Funds release procedure Timeline and condition for release of funds to

    NGOs by district From 5th year onwards

    Approved funds as per NHM PIP shall be released in two installments (six month basis)

    (i) For 1st 50% release: Within 10 days of renewal of MoU. Prior to that, performance assessment by the District Authority with support of Concurrent Auditor, and recommendation of District NGO Committee for renewal of contract should be done.

    (ii) For 2nd 50% release: Within 10 days of receipt of the last year annual audit report and annual progress report of the project along with SOE/UCs for 75% (minimum) of last installment.

    N.B: (i) Each installment contains six months duration. (ii) Mid-term evaluation (one time) to be conducted after completion of one year of project

    operation (specif projects only). (iii) Final evaluation (one time) to be conducted just before or after completion of three years of

    project operation (specif projects only). (iv) District has to regularly conduct audit of the NGO projects by the Concurrent Auditor. There

    is no limit to conduct audit of any NGO projects by Concurrent Auditor at district level.

    � Payment of remuneration to project staff by the NGOs should be ascertained at the Block and District level.

    � It is the discretion of the district to decide whether to take up PVTG project through the Deptt. or on PPP mode in PVTG areas only. Final decision with this regard has to be taken with the approval of Collector-cum-Chairman, EC,ZSS.

    8. Training � All training on RMNCH+A must be linked with functionalization of delivery points.

    � Name based training micro plan to be prepared to cover the required functionaries at delivery points (DPs) and promising DPs.

    � Venue wise monthly training calendar of the District must be developed.

    � Institution wise individual training data base should be updated after completion of different training programmes at District level.

    � Certification /accreditation of the training sites is mandatory.

    � Performance of each trained staff must be maintained and monitored on regular basis.

    � Selected MBBS doctors (Asst. Surgeons) must be deputed for EMOC/LSAS training & must be relieved as per GoO orders at the earliest to operationalize FRUs.

  • � To optimize skill utilization of the trained manpower, mentoring support is emphasized in

    2015-16 PIP. Each mentor would be assigned fixed number of DPs for mentoring visit.

    � District training team (DTT) needs to monitor the quality of training at different levels.

    � TIMS (Training Monitoring Information System) must be updated on monthly basis at District level.

    9. Supportive Supervision � Supportive supervision system to be strengthened with identification of nodal

    persons/mentors for both facilities/Community level interventions. Defined checklists provided by State to be used while monitored any institution/Community level intervention.

    � All facilities to maintain visitor’s registers. All supervisors should write their main observations and agreed action/recommendation. Supervisors should sign with their name and post (written legibly) with date of visit.

    � The field visit report is essential for settlement of TA/DA. The expenditure in this head without record of evidence would render ineligible under NHM. Details of Tour reports in the desired format, need to be hosted in the website under mandatory disclosure. The next year allocation under M&E will depend on percentage of expenditure in the same head in the current financial year.

    � Remote/ hard to reach/ high focus areas to be intensively monitored and supervised � All supervisors under NHM, both Technical & Management Consultant, have specific & well

    defined TORs with definite no. of days for visit as detailed below, which need be strictly adhered to for strengthening programme implementation.

    Sl No

    Designation No of Tour

    days(min)/PM Remarks

    1 Districts level

    2.1 Programme Management Unit

    At district level, for regular monitoring, cross domain composite teams with minimum five members led by Programme Officer visit at least once a week/ four days per month as team to any selected block/s. Rest of the month monitoring is done on individual basis as per PIP conditionality. Field visit reports are mandatory for the team members. The reports and findings are reviewed by CDMO in district monthly review meeting. Sharing is done with Collector cum DM.

    2.1.1 District Programme Manager 10 man days 2.1.2 District Accounts Manager 7 man days 2.1.3 District Data Manager 7 man days 2.1.4 Dy. Manager RCH 10 man days 2.1.5 Asst. Manager ASHA 10 man days 2.1.6 Asst. Manager GKS 10 man days

    2.1.7 Engineer Average (1 JE /3 Blocks)

    30 man days

    2.1.8 DPHCO 6 man days Total 90 man days 1.2 Technical 1.2.1 CDMO 4 man days

  • Sl No

    Designation No of Tour

    days(min)/PM Remarks

    1.2.2 ADMO(FW) 6 man days Blocks are to submit action taken report based on the observations of FMT. Finally, Prog Associate at DPMU is assigned for tour report compilation and for following up with the blocks for action taken report.

    1.2.3 DPHN/ Sister tutor 10 man days

    Total 20 man days 2 Block level

    2.1 Programme Management Unit

    At block level, for regular monitoring, cross domain composite teams visit at least one Sub-centre per week. Rest of the month monitoring is done on individual basis as per PIP conditionality.

    2.1.1 Block Programme Manager 10 man days 2.1.2 Block Accounts Manager 7 man days 2.1.3 Block Data Manager 7 man days 2.1.4 BPHCO 6 man days Total 30 man days 2.2 Technical 2.2.1 MO I/c 10 man days

    2.2.2 BPHN/ LHV (Hqr) Not in position

    10 man days

    Total 20 man days

    3 Sector Level

    3.1 Technical 3.1.1 AYUSH 8 man days 3.1.2 LHV/ Male Supervisor 16 man days Total 24 man days

    � Vehicle provided up to block level for facilitating field visits whereas allowances provisioned in the PIP for supervisors (MPHS-M & MPHS–F at sector level) for independent mobility.

    � Supervisors are to be supported by PMUs at various levels, to provide operational support related to cross cutting functions and are enabled for data analysis and use.

  • Mandatory Disclosure

    The following conditionalities shall be adhered to by the States and are to be treated as

    nonnegotiable:

    Mandatory disclosures:

    1. The District must ensure mandatory disclosures on the state NHM website of the following and act on the information:

    � Facility wise deployment of all HR including contractual staff engaged under NHM with name and designation. This information should also be uploaded on HMIS

    � Facility wise service delivery data particularly on OPD, IPD, Institutional Delivery, C-section, Major and Minor surgeries etc. on HMIS.

    � Patient Transport ambulances and emergency response ambulances- total number of vehicles, types of vehicle, registration number of vehicles, service delivery data including clients served and kilometer logged on a monthly basis.

    � All procurements- including details of equipment procured in specified format

    � Buildings under construction/renovation –total number, name of the facility/hospital along with costs, executing agency and execution charges (if any), date of start & expected date of completion in specified format.

    � Supportive supervision plan and reports shall be part of mandatory disclosures. Block-wise supervisory plan and reports should be uploaded on the website.

    � NGOs/PPP funded under NHM would be treated as 'public authority' and will fall under the ambit of the RTI Act 2005 under Section 2(h). Further, details of funds allotted /released to NGOs/PPP to be uploaded on website.

    � Facility wise list of package of services being provided through the U-PHCs & U-CHCs

    2. District to ensure that JSY payments are made through Direct Benefit Transfer (DBT) mechanism through AADHAAR enabled payment system, through NEFT under Core Banking Solution.

    3. Timely updation of MCTS and HMIS data including facility wise reporting

    4. Line listing of high risk pregnant women, including extremely anaemic pregnant women and Low Birth Weight (LBW) babies.

  • Key Conditionalities

    The following key conditionalities would be enforced during the year 2016-17.

    SL. No.

    Conditionality Description Incentive/Penalty

    1 Reduction in IMR

    Percentage decrease over last year

    Maximum incentive of 5% � If decrease less than 5% – No

    incentive � If decrease between 5-7%–

    Incentive of 3% � If decrease greater than 7% –

    Incentive of 5% 2 Reduction MMR

    Percentage decrease over last year (only for 16 States for which IMR is available)

    Maximum incentive of 5% � If decrease less than 5% – No

    incentive � If decrease between 5-10%–

    Incentive of 3% � If decrease greater than 10% –

    Incentive of 5% 3 Full Immunization

    Coverage

    During the current FY, as on December 31st – Infants fully immunised vs estimated beneficiaries

    Maximum penalty and incentive of 5%. � If coverage less than 40% –

    Penalty of 5% � If coverage between 40-50% –

    No penalty � For coverage above 50% up to

    100% – Incentive up to maximum of 5%, calculated as

    Coverage above 50% 10 I.e. if coverage is 65%, then incentive of 1.5%; and if coverage is 87%, then Incentive is 3.7%.

    4 Functionality of FRUs/ CEmOC facilities (excluding Medical Colleges)

    Adequacy of “functional” FRUs (conducting C-sections)

    Maximum penalty and incentive of Compared to required number of FRUs: On a State-wide basis � If 50-75% FRUs “functional” –

    3% penalty

    � If less than 50% FRUs

  • SL. No.

    Conditionality Description Incentive/Penalty

    “functional” – 5% penalty

    � On a State-wide basis, if more than 75% FRUs “functional”, AND in HPDs-

    � If less than 50% FRUs “functional” – 5% penalty

    � If 50-75% FRUs “functional” – 3% penalty

    � If 75-90% FRUs “functional” – 3% incentive

    � If more than 90% FRUs “functional” – 5% incentive.

    5 Quality Certification

    Percentage of District hospitals and CHCs quality certified by State level body.

    Maximum incentive of 5%. � 3% incentive if at least 50% of

    DHs certified

    � 2% incentive if at least 25% of CHCs / Block PHCs certified.

    6 Governance: Quality of Services and functionality of public health facilities

    Star rating of facilities Based on the extent to which CHCs/PHCs meet the benchmark on key indicators. Five Star indicator Criteria: 1. Human Resource and

    Infrastructure 2. Service availability 3. Drugs and supplies 4. Client Orientation 5. Service Utilization.

    Maximum penalty of 5 %. � To avoid penalty minimum 50 %

    of CHCs to have 3 or more star rating

    7 Implementation of Free drugs Services Initiative

    Free drugs to be implemented as per GOI mandate

    Maximum incentive of 5% 90% and above institutions effectively implementing free drugs & diagnostic services – 5% 60% to 90% institutions effectively implementing free drugs & diagnostic services – 3%

  • SL. No.

    Conditionality Description Incentive/Penalty

  • Funds available at the State level for ongoing activities to be executed out of unspent

    balance during Financial Year 2015-16 (Rs. In lakh)

    Budget Head Name of the Components

    Funds to be spent

    Out of Advance

    Out of bank

    balance

    Total amount to be spent against ongoing

    activities 1 NRHM-RCH Flexible Pool 9,383.45 230.81 9,614.26 A RCH Flexible Pool - - -

    A.1 Maternal Health - - - A.2 Child Health - - - A.3 Family Planning - - - A.4 Adolescent Health and Gender (RKSK) - - - A.5 RastriyaBalSwasthyaKaryakram(RBSK) - - - A.6 Tribal Health - - - A.7 PNDT & Sex ratio - - - A.8 Infrastructure and Human Resource - - - A.9 Training - - -

    A.10 Programme Management - - - B Mission Flexible Pool 9,383.45 230.81 9,614.26

    B.1 ASHA 154.26 - 154.26 B.2 Untied Fund 814.58 - 814.58 B.3 Rollout of B.Sc (Community Health) - - - B.4 Hospital Strengthening (Infrastructure) 5,894.30 - 5,894.30 B.5 New Construction / Renovation &Setting up 528.16 - 528.16 B.6 Implementation of Clinical Establishment Act - - - B.7 District Action Plan - - - B.8 Panchayati Raj Initiatives 34.81 - 34.81 B.9 Mainstreaming of AYUSH - - -

    B.10 IEC/BCC NRHM - 60.50 60.50 B.11 Mobile Medical Unit - - - B.12 National Ambulance Service - - - B.13 PPP/NGOs - - - B.14 Innovations 180.54 - 180.54 B.15 Planning, Implementation &Monitoring 180.59 - 180.59 B.16 Procurements 781.79 170.31 952.10 B.17 Drugs Ware Housing 812.42 - 812.42 B.18 New Initiatives/ Strategic Interventions - - - B.19 Health Insurance Schemes - - - B.20 Research Studies 2.00 - 2.00 B.21 State level Health Resource Center - - -

  • Budget Head Name of the Components

    Funds to be spent

    Out of Advance

    Out of bank

    balance

    Total amount to be spent against ongoing

    activities B.22 Support Services - - - B.23 Other expenditure - - - B.24 Collaboration with Medical Colleges and

    Knowledge partners - - -

    B.25 National Programme for Prevention and control of deafness

    - - -

    B.26 National Oral Health Programme - - - B.27 National Program for Palliative Care (New

    Initiatives under NCD) - - -

    B.28 Assistance to State for Capacity building (Burns & injury)

    - - -

    B.29 National Programme for Fluorosis - - - C RI&PPI - - -

    C.1 Routine Immunization - - - C.6 Pulse Polio - - - 2 Communicable Diseases Control Flexible Pool 1,252.01 0.68 1,252.68 A National TB Control Programme(RNTCP) 598.00 - 598.00 B National Leprosy Eradication Programme

    (NLEP) 58.16 0.68 58.83

    C National Disease Surveillance Programme (IDSP)

    109.00 - 109.00

    D National Vector Borne Disease Control Programme (NVBDCP)

    486.85 - 486.85

    3 Non-Communicable Disease Flexible Pool 716.50 91.92 808.42 A National Programme for Control of Blindness

    (NPCB) 178.00 91.92 269.92

    B National Mental Health Programme (NMHP) - - - C National Programme for Health Care of the

    Elderly (NPHCE) 142.00 - 142.00

    D National Tabacco Control Programme (NTCP) - - - E National Programme for

    Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS)

    396.50 396.50

    4 NUHM Flexible Pool 1,930.46 51.54 1,982.00 Grand Total 13,282.42 374.95 13,657.36

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