Transcript NATIONAL RURAL HEALTH MISSION

NRHM DISTRICT ACTION PLANS
PARTICIPATORY & EVIDENCE BASED
PLANNING PROCESS
WHY EMPHASIS ON DISTRICT
ACTION PLANS?
• Mechanism to partner with community
• Planning based on local evidence and needs
• Area specific strategies to achieve NRHM
goals
• Cost effective and practical solutions
• Move from budget based plans to outcome
oriented plans
• Requirement of GoI – no funds if no plans
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WHY EMPHASIS ON
PARTICIPATORY PLANNING
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Promote community ownership
Greater ownership of health functionaries
Harness benefits of community action
Bring accountability of health functionaries to
community members
• Draw together elements that are determinants
of health
• Share resources and opportunities with
partnering departments – convergent action
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ADDITIONAL PROVISIONS AND
NORMS UNDER NRHM - 1
ANNUAL UNTIED FUNDS FOR LOCAL HEALTH ACTION:
Village Health Water & Sanitation Committee
Rs. 10,000
Gram Panchayat Health Committee
Rs. 10,000
PHC Level Rogi Kalyan Samiti
Rs. 50,000
Block Untied Fund
Rs. 50,000
ASHA Workers per 1000 population –
Rs. 5,000
Gram Panchayat level revolving advance
CHC Rogi Kalyan Samiti
Rs. 1,00,000
DH/SDH Rogi Kalyan Samiti
Rs. 5,00,000
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ADDITIONAL PROVISIONS AND
NORMS UNDER NRHM - 2
1 ASHA Sahyogini for 1000 population
2 ANMs per Sub Centre
2 Medical Officers per PHC (1 AYUSH) – Mainstreaming
AYUSH
3 Staff Nurses per PHC
7 Specialists per CHC
9 Staff Nurses per CHC
Rs. 20 lakhs for Staff Quarters as per IPHS standards
1 Mobile Medical Unit in each district
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Planning Process…
State
Planning &
Appraisal
Committee
STATE
District
Health
Committees
Facilitated by
EPOS Health India
Integrate
Integrate
DIST
Facilitated by
6 TA Agencies
DIST
Integrate
Block Health
Committees
BLOCK
BLOCK
Facilitated by
6 TA Agencies &
NGOs
BLOCK
Integrate
Village
Health
Committees
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V
GP
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GP
GP
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GP
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Facilitated by
NGOs
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V
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Components of District Action Plan
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Background
Planning Process
Local Priorities
Annual Plans for Each Health Institution based on facility surveys
Community Action Plan
Financing of Health Care
Programme Management Structure
Partnerships for Convergent Action
Human Resource Plan
Capacity Building Plan
Procurement and Logistics Plan
Non Governmental Partnerships
Community Monitoring and Evaluation Framework
Action Plan for Demand Generation
Sector Specific Plans for Maternal Health, Child Health, Adolescent Health,
Disease Control, Disease Surveillance, Family Welfare
 Budget
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IMPORTANCE OF FACILITY SURVEYS
 NO ROUTINE ALLOCATION OF RESOURCES UNDER NRHM.
 EVERY HEALTH FACILITY WILL HAVE TO DEVELOP A BASELINE
AND AN ANNUAL PLAN.
 FUNDS WILL BE RELEASED ONLY AFTER OUTCOMES ARE
GUARANTEED BY ADDITIONAL FUNDS
 EVERY HEALTH FACILITY NEED WILL BE SPECIFICALLY ASKED
FOR IN THE ANNUAL DISTRICT ACTION PLAN AND BUDGET.
 FACILITY SURVEY SHOULD FOCUS ON:
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MAIN BUILDING
STAFF QUARTERS
EQUIPMENT
FURNITURE AND FIXTURES
CLEANLINESS AND SANITATION
HUMAN RESOURCES
NEEDS FOR MEDICINES AND SUPLIES
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Role of EPOS Health India
• Review of secondary data, consultations with Department officials to
prepare common guidelines and resource material
• Facilitate the planning exercise and support the State Planning cell
• Orientation of Health and FW Department Officials
• Orientation of State Planning and Appraisal Team
• Development and management of Monitoring System for Dist.
Planning
• Orientation Workshop for Technical Supporting Agencies
• Field level support to technical Supporting Agencies
• Monitoring and review of the field level activities
• State level Coordination – Progress Monitoring , Reporting
• State, District & Block Level Plan Appraisal Support
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Role of Technical Support
Agencies in each district
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Orientation of District Health Missions and Societies
Training of District Planning and Appraisal Core Groups (DCGs)
Training of Block Planning and Appraisal Core Groups
Training of NGOs in the Districts allocated to them
Support to multi-stakeholder consultation workshops at block
level
Support to NGOs for conducting village level participatory
planning
Assist health facility surveys
Assist consolidation of Block Action Plans (BAPs)
Assist appraisal and approval of block action plans by the DCGs
Assist in preparation of District Action Plan based on BAPs
Assist in approval and state level appraisal of DAPs
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Role of Medical, Health & FW
Department Functionaries
• Reviewing RCH-I lessons learnt & the existing programme strategies.
• Compiling the information, data, reports and evidence from existing
records at various levels, as the basis for planning
• Reviewing the existing management systems and identifying gaps
• Development of locally relevant strategies and suggesting changes in
systems to strengthen NRHM programme management
• Provide lead to the consultation and participatory planning processes
at various levels, facilitated by the Technical Support Agencies
• Carry out assessment of strengthening needs of health facilities as
per prescribed GoI norms
• Consolidate Block Action Plans (BAPs)
• Prepare District Action Plans based on Block level plans
• Appraise and approve District Action Plans at the State level
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Role of NGOs
• Orientation of Village Health Water and Sanitation
Committees
• Involvement of women’s groups and community based
organisations
• Support to multi-stakeholder consultation workshops
at block level
• Assist health facility surveys
• Assist consolidation of Block Action Plans (BAPs)
• Participate in the functioning of Block Core
Group/Health Committee for planning, programme
implementation and monitoring support to the Block
Health Plan
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Important Role of PRIs…
Phase 1
15 Gram Panchayats taken up for village level participatory
planning in each district
Phase 2
All Gram Panchayats to be taken up for participatory planning
Block Level
Panchayat Samities and Pradhans lead the planning process as
part of Block Core Groups
District Level
Health and Nutrition Committees of Zila Panchayats lead the
planning process as part of the District Core Groups
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Important Role of PRIs…
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Support implementation of Village Health Plans
Organise monthly review meetings
Report progress to Block Health Planning and
Appraisal Committees
Draw attention of emerging needs and call for
support from the Health, WCD, IPH, RD
Departments
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Institutional Framework for
Convergent Action
State Health Mission/Society
District Health Mission/Society
Block Water & Health Sanitation Committee
Village Water & Health Sanitation Committee
Partners and Members in above mentioned Societies and
Committees– DWCD; PRI/RD; Education; PHED and AYUSH
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NRHM Support to Convergence
• Planning process and Joint Action Plan
• Sharing of Information
• Regular Joint Reviews
• Funds for Gap filling - Untied Funds at
various levels
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Key Enabling Actions
to begin the process of planning
under NRHM….
Constitution of State Health Mission
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Constitution of State Planning & Appraisal
Committee
Constitution of District Planning Teams & their
training
Constitution of Block Planning Teams & their
training
Forming of Village Health, Water and Sanitation
Committees
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Key Enabling Actions
to begin the process of Planning
under NRHM….(2)
Nominating selected functionaries to the State,
District and Block Planning Committees/Teams for
leading the planning process
Preparing clear guidelines on core NRHM strategies
for planning teams at District and Block levels
Communicating fund availability, allocations and the
flow of funds to the Districts and other levels as per
NRHM guidelines.
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DISTRICT
PLANNING
PROCESS
District Plans Ready for 32 Dists.
District Planning Begins in 26 Dists.
District Plans Ready in 6 Dists.
District Plan Preparation Begins
Block Plan Preparation Begins
Orientation of District Health Societies
and Core Groups Begins in 5 Districts
Block Consultations & Village Planning Begins
Orientation of BCG & NGOs in 1 District
30 NOV. 06
19 Oct. 06
17 Oct. 06
4 Oct. 06
23 Sept. 06
18-21 Sept.
15-16 Sept.
13-14 Sept.
Orientation of District Health Societies and Core
11 Sept. 06
Groups Begins in 1 District
Orientation of State Plng. & Appraisal Team
2 Sept. 06
Orientation of District Coordinators of TA Agencies &
4-7 Sept. 06
District Prog. Mgrs. (NRHM) – 2 Batches
Preparation of District Planning Guidelines
State Level Consultation
1 Sept 06
28 Aug 06
Thank You