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  • Ms. Arti Ahuja, IAS Commissioner–cum–Secretary Health & Family Welfare Department Government of Odisha Bhubaneswar - 751001

    Phone Office :(0674)2536632/ 2322403 Residence: (0674)2392507

    Fax : (0674)2395235 E-mail : [email protected]

    Dated 23rd November, 2014

    Foreword

    Odisha is committed towards ensuring better health care to the public. Several strategic

    interventions are initiated to further integrate services through infrastructure development, procurement of equipment & instrument and multi skilling of service providers. The major goal envisaged by the State is health for all following the guiding principles of equity, transparency, accountability, social protection and patient’s satisfaction. Providing equitable health care to vulnerable, marginalized, rural and urban poor population of the State with ‘zero’ out-of- pocket expenditure has been a major target.

    The National Health Mission (2014-17) Perspective Plan envisages an implementation trajectory

    for the important health interventions over the forthcoming years founded on the underlying principle of 'Equity First'. The PIP (2014-15) stands out in view of district health action plans for ‘High Priority Districts (HPDs)’ based on gap analysis to address specific areas. This PIP has also laid ample thrust on Quality Assurance both at the facility and the community.

    The focus has been on holistic development through bottom up approach emphasizing on differential planning based on vulnerability vis –a- vis performance in an integrated manner to reach the un-reached; strengthening participation of local self-governance bodies; better utilization of IT services; recognizing the good work of service providers etc. This year, the State seeks to expand the areas of health entitlements like free drugs & diagnostic services. Supportive supervision mechanisms are in place at State, district & block level and these are being strengthened continuously to ensure quality service delivery at all levels.

    It is expected that this progressive PIP will enable quality of care, while ensuring equity in the

    public health service delivery.

    Commissioner-cum-Secretary to Govt. Health & Family Welfare Deptt.

    Odisha

    er-cum-------------------------------------Secret

  • 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/18152 (554/13) Date:19/11/2014 From

    Smt. Roopa Mishra, I.A.S. Mission Director, NHM, Odisha

    To

    All Directors/ Lead Agencies

    Sub: Approved resource allocation for the State under NHM PIP, 2014-15.

    Madam/Sir,

    The approved resource allocation for the State of Odisha for the year 2014-15 is

    Rs.112,890.01 Lakhs. The Details of component wise break up are as follows.

    • RCH -Rs. 37062.90 Lakh

    • NRHM Initiatives -Rs. 45161.11 Lakh

    • Immunization -Rs. 3376.20 Lakh

    • NIDDCP -Rs. 155.00 Lakh

    • NUHM -Rs. 2,707.96 Lakh

    • NVBDCP -Rs. 5169.76 Lakh

    • IDSP -Rs. 503.02 Lakh

    • RNTCP -Rs. 2,556.83 Lakh

    • NLEP -Rs. 583.84 Lakh

    • NPCDCS -Rs. 1,497.92 Lakh

    • NTCP -Rs. 235.50 Lakh

    • NPPCD -Rs. 385.00 Lakh

    • NPCB -Rs. 1,814.96 Lakh

    • Infrastructure Maintenance -Rs. 11,680.00 Lakh

    The above approval is subject to the following mandatory requirements. Please note that

    non-compliance to any of the Terms & Conditions prescribed in PIP may entail audit objections &

    may result in withholding of grant to the implementing agency.

    Mission Director NHM, Odisha

    MMii ssss ii oonn DD ii rr ee cc tt oo rraa tt ee National Health Mission, Odisha

    Department of Health & Family Welfare, Government of Odisha.

    Missssssssssssssssssssssssssssssssssion Directo

  • Terms & Conditions

    The approval is subject to the following mandatory requirements. Please note that non-

    compliance to any of the following requirement may entail audit objections & result in with-

    holding / curtailment of grant to the implementing agency.

    1. All expenditure under this sanction should be incurred with reference to the financial &

    programme guidelines prescribed by the Govt, of India/Govt. of Odisha/Mission

    Directorate. A certificate to this effect should accompany the UC in due course.

    2. The transactions of all the programmes under NHM, including payment to beneficiaries,

    must be through PFMS at all levels.

    3. The Implementing Agency shall not make any change in allocation amongst different

    components/ activities without prior approval of Mission Director, NRHM.

    4. All approvals are subject to the observations made in this document.

    5. The activities which could not be taken up during any quarter due to any reason can be

    shifted to next quarter but not to the next financial year. All care should be taken to

    implement the activities as per the given time line which ensures completion of the same

    within the financial year. However, in cases where activities are initiated but not completed

    for any valid reasons and due to which funds could not be released, the amount payable in

    such cases shall be treated as committed expenditure for the next financial year. Such

    committed liabilities must be refleceted against the respective activities in the FMR of the

    subsequent year.

    6. The implementing agency shall follow all the financial management guidelines in

    operation under NHM and submit Audit Reports, Quarterly Summary report, Concurrent

    Audit Report, FMRs, Statement of Fund Position, as and when they are due.

    7. Implementing agency shall ensure submission of details of unspent balance indicating,

    inter alia, funds released in advance and funds available. The implementing agency

    shall also intimate the interest amount earned on unspent balance. The interest money

    accrued under a programme is treated as GIA and can be spent against the approved

    activities of that particular programme only.

    8. The implementing agency shall ensure submission of quarterly report on progress against

    targets & expenditure including an analysis of adverse variances & corrective action

    proposed to be taken.

    9. Before asking for the next release, the statement of expenditure for the earlier releases

    should be provided to MD, NRHM by the implementing agency.

  • 10. Release of funds for the year 2014-15 would be contigent on the agency providing UC

    upto 2013-14.

    11. Timely submission of statutory audit report for the year 2013-14 is must for release of

    2nd tranche of funds.

    12. The concurrent audit must be undertaken as per the guideline. The action on the

    avservations of the auditor must be in time and Action Taken Report (ATR) on the

    observations must ve furnished to the State on monthly basis along with the quarterly

    summary report.

    13. The implementing agency has to ensure that the personal advances given for different

    activities at their level are 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, NRHM & DHS, Odisha must be strictly followed.

    14. Compliance to the observations of auditor of any audit (con-current / statutory / C&AG)

    must be furnished within 10 days with a copy to the Mission Directorate.

    15. The accounts of the grantee institution/ organization shall be open to inspection by the

    sanctioning authority, internal as well as statutory auditors & by the Comptroller & Audit

    Generl of India under the provision of CAG (DPC) Act, 1971.

    16. The expenditure on the following items are disallowed

    a) Creation of departmental/ district level posts & resultant payment of

    salaries.

    b) Purchase of new vehicle.

    c) Expenditure on accounts of activities sanctioned under the State budget.

    d) Any activity not approved in the PIP for this year.

    Mission Director NHM, Odisha

    Missiooooooooooooooooooooooooooooooooooooooooioooooooooooooooooooooooooooooooooooooooooooooooooooooooooon nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnn DDiDDDDiDDirereerrrererrrrrerrrreeeeeeerrrrerrrrrrreeeeeeeeeeeeeeeeeeeeector

  • Key Conditionalities and Incentives

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

    negotiable:

    1. Mandatory disclosures

    1.1 The State 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 (as per directions of CIC

    which have been communicated to the States by this Ministry vide letter No

    'No.Z.28015/162/2011-H' dated 28th November 2011.) 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

    1.2 State/UT to ensure that JSY payments are made through Direct Benefit Transfer (DBT)

    mechanism through AADHAAR enabled payment system, through NEFT under Core Banking

    Solution or through A/C payee check (Cash payment or bearer cheque payment is categorically

  • disallowed across the States unless specifically agreed in case of certain areas in hilly States and

    NE States where presence of bank network is inadequate).

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

    1.4 Line listing of high risk pregnant women, including extremely anaemic pregnant women and Low

    Birth Weight (LBW) babies.

    2. Key Conditionalities

    2.1 The following key conditionalities would be enforced during the year 2014-15:

    � Rational and equitable deployment of HR1 with the highest priority accorded to high

    priority districts and delivery points and facilities located in slum and low-income

    neighborhoods in urban area.

    � Introduction of Human resource Information Management System for regular and

    contractual staff in a manner that salary bill is generated through the HRIS web

    portal, which ensures that the HR deployment information remains updated.

    � Facility wise performance audit" and corrective action based thereon.

    � Performance Measurement system set up and implemented to monitor

    performance of regular and contractual staff.

    � RBSK to be rolled out in at least 30% of the districts.

    � Baseline assessment of competencies of all SNs, ANMs, Lab Technicians to be done

    and corrective action taken thereon.

    o Many states have put in a place an HR policy which lays down norms of transfer and posting.Itis expected that the States case load, posting of specialists in teams (eg.

    Gynaecologist and Anaesthetist together), posting of EmOC/ LSAS trained doctors in

    FRUs, optimal utilization of specialists in FRUs and above and filling up vacancies in

    peripheral facilities in high focus/ remote areas.

    o Facility wise performance audit will also include the facility wise score card being developed.

    � State should ensure expenditure upto 15% by June 2014 and another 30% by September

    2014 of their approved budget under each pool in the FY 2014-15.

    � Expand the Governing Body (GB) and the Executive Committee of the State Health

    Mission/Society to include Minister(s) in charge of Urban Development and Housing, and

    Secretaries in charge of the Urban Development and Housing departments.

    � Urban Health planning cell should be established in the State Health Society (SPMU) .

    However, the thematic areas will be appropriately strengthened at the State Health Society ate HeHeHeeeHeHeHHHHHeeHeHeHeHeHeHHHHeHeHeHeHHHHHeHeHeHHHHeHHHeHHeHHHeeHeHHHHHeHHHHeHeeeeeHHeeeeeHeHeHeHeeeHHHHHHeeeHHHHeHHeeeeHeHHHeHHHHeeHHeHHeHeeeeeeHHHHeeeeHeHHeeeeeeHHHHHHeeeHHHHeeeeHHHeHHHeeHHHHHHHeeeHHHeeHHHeeeHHHeeeHHHeHHHeHHeHHHeHHHHealth Socie

  • and District Health Societies to support both NUHM and NRHM. Parallel structures shall not

    be created for NRHM and NUHM.

    � State/UT will adopt Competency based Skill Tests and transparency in selection and

    recruitment of all doctors, SNs, ANMs and LTs sanctioned under NHM.

    � All services under National Health Programme/Schemes should be provided free of cost.

    � Investments in U-PHCs must lead to improved service offtake at these facilities, which should

    be established through a baseline survey & regular reporting through HMIS.

    � The UPHCs should provide the whole range of services enumerated in the NUHM

    Implementation Framework.

    3. Incentives Under NRHM-RCH Pool

    3.1 Initiatives in the following areas would draw additional allocations by way of incentivisation of

    performance:

    � Responsiveness, transparency and accountability (upto 8% of the outlay).

    � Quality assurance (upto 3% of the outlay).

    � Inter-sectoral convergence (upto 3% of the outlay).

    � Recording of vital events including strengthening of civil registration of births and

    deaths (upto 2% of the outlay).

    � Creation of a public health cadre (by states which do not have it already) (upto 5% of

    the outlay).

    � Policy and systems to provide free generic medicines to all in public health facilities

    (upto 5% of the outlay).

    � Timely roll out of RBSK (upto 5% of the outlay).

    � Timely roll out of RKSK (incentive of upto 5%> of the outlay).

    � Regular supportive supervision and corrective action based on reports of visits. (Incentive of

    upto 5% of the outlay).

    � Enacting/adopting a bill like the Clinical Establishment Act, 2010 as per their requirement, to

    regulate the quality and cost of health care in different public and private health facilities in

    the State (upto 5% of outlay).

    � States providing more than 10% increase in its annual health budget as compared to the

    previous year will attract additional incentive.

  • 4. Disincentives Under NRHM-RCH Pool

    � Gaps in implementation of JSSK may lead to a reduction in outlay upto 10% of RCH base

    flexipool.

    � Gaps in introduction of Human Resource Information Management System may lead to

    reduction in outlay of upto 10%.

    � Gaps in roll out of RBSK in at least 30% of the districts may lead to reduction in outlay of

    upto 5%.

    Note: Incentives and disincentives are not applicable under NUHM

  • CONTENTS

    Sl. No Component Page

    PART- I (NRHM & RMNCH+A Flexipool)

    1. RCH-II 1-69

    2. NRHM Initiatives 70-109

    3. Immunisation 110-112

    4. NIDDCP 113-114

    PART- II (NUHM Flexipool)

    5. NUHM Flexipool 115-125

    PART- III (Flexipool for Disease Control Programme)

    6. NVBDCP 126-171

    7. IDSP 172-176

    8. RNTCP 177-186

    9. NLEP 187-188

    PART- IV (Flexipool for Non-Communicable Disease)

    10. NPCDS 189-193

    11. NTCP 194-195

    12. NPCB 196-203

  • ANN

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    Rem

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  • ANN

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    A.1.

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    A.1.

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    Non

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    1. In

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    Diet

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    Pag

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    03

  • ANN

    EX 3

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    Rem

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    Pag

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    03

  • ANN

    EX 3

    e

    Rem

    arks

    Uni

    t of

    Mea

    sure

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    t Cos

    t (R

    s)

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    3246

    3.42

    1562

    .73

    Pag

    e 8

    of 2

    03

  • ANN

    EX 3

    e

    Rem

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