Formulation of District and Divisional Health Partners Forum

STATE INNOVATIONS IN FAMILY PLANNING SERVICES PROJECT AGENCY Formulation of District and Divisional Health Partners Forum (The downward replication of the State level Health Partners Forum concept) June 2016

Setting up District and Divisional Health Partners Forum Background The National Health Mission (NHM) is an integrated approach for bringing about a dramatic improvement in health systems and the health status of the people, especially who live in rural and urban areas. The mission seeks to provide universal access to equitable, affordable and quality health care services, which is accountable and responsive to the needs of the people. The mission is committed to help achieve goals set under the National Health Policy and the Sustainable Development Goals. Government is putting efforts across the State, and Non- Governmental Organizations (NGOs) have also been working for improving UP's health scenario. At the State level, the efforts under the National Health Mission (NHM), Uttar Pradesh and other organizations including the World Bank, Unicef, CARE, FHI, PSI, MI, PATH etc. have been integrated by formation of a Health Partners Forum at the state level. The Forum has helped NHM's state unit in gathering successful health practices and for scale up of the best practices in larger interest. The primary role of the health partners forum is to use the network for technical assistance such as capacity building and feedback. However, no financial support from the National Health Mission is expected by the member agencies. In due course of time, a system has been set in place that is useful in developing interventions and programmes and also helpful in implementation of various health schemes in the State of Uttar Pradesh. Agencies in State Health Partners Forum Name of the Programmatic Area Districts Agency MCHIP/ USAID Immunization, Newborn care Banda, Gonda and Varanasi Urban Health Maternal and Infant survival Initiative (UHI) and Family Planning in urban areas, PATH Raibareli, Sant Kabir Nagar, Bahraich. Jhansi, Basti, Balrampur, Barabanki, Hardoi, Gorakhpur Page 2

Name of the Agency SAHAYOG Aga Khan Foundation Catholic Services Relief Micronutrient Initiative (MI) Programmatic Area Women's reproductive health and rights, maternal health, adolescent health and gender issues Community development Early childhood care, Maternal, new born and child health Rural drinking water systems and sanitation Natural resources management and rural livelihoods Civil Society strengthening. Emergency Relief Services and Disaster Response Maternal, Neonatal and Child Health and Nutrition (MNCHN) Agriculture and Livelihood HIV care and support Women and Child Protection Micronutrients Vitamin A, Zinc, Iodine and Iron and Folic Acid Districts Azamgarh, Chandauli, Gorakhpur, Lalitpur, Jhansi, Mau, Lucknow, Kushinagar, Chitrakoot, Mirzapur, Bareilly, Saharanpur, Muzaffarnagar Banda,, Mahoba, Ambedkarnagar and Jaunpur Bahraich Saharanpur (CGPP) Mau (CGPP) Shahjahanpur (CGPP) Sitapur (CGPP) Kaushambi (ReMiND Pilot Project) Barabanki, Faizabad, Sultanpur, Ambedkarnagar, Moradabad, Shajhanpur, Barielly, Rampur, J.P. Nagar, Bijnore, Saharanpur, Muzaffarnagar, Merrut, Ghaziabad, Bulandshahar, Bagpat, Allahabad, Kaushambi, Banda, Chitrakoot, Varanasi, Jaunpur, Ghazipur, Chandauli, Jhansi, Jalaun, Mahoba, Hamirpur, Kanpur, Ramabai Nagar, Etawah, Kannuj, Auriya, Azamgarh, Deoria, Gorakhpur, Ballia and Mau Lucknow, Unnao, Sitapur, Hardoi, Barabanki, Faizabad, Sultanpur, Ambedkarnagar, Barielly, Badaun and Sahjahnpur. (Source: NHM UP website) Apart from the above, several other organizations such as Global Health Strategies, PHFI, BBC Media Action Group, ICDS, FPAI, JSI, CHAI, HLFPPT, Abt Associates, CRS, PACS, MI, Save the Children etc. are working in the State. However, the details about the programmes and areas of their project is being compiled by NHM. Page 3

Functioning of Health Partners Forum i. Formation of Thematic Support Groups (TSG) At the State Level Health Partners Forum several Thematic Support Groups (TSG) have been created, wherein representatives of the organisations in the Health Partners Forum are members. One organisation can be member of multiple TSGs and share their inputs. The members also share the work done by them in each of the thematic area(s). TSG is created on the following thematic areas: a. Maternal Health b. Community Processes c. Child Health d. Routine Immunization e. Family Planning f. PCPNDT g. Adolescent Health h. Nutrition i. BCC/IEC j. HMIS/MCTS k. Urban Health l. Training m. HRH n. Logistics Management Under TSG, Discussion Board/Knowledge Sharing Platform has been created to share views and to develop a synergy to foster ideas and knowledge sharing. ii. Quarterly Meetings The meetings of the forum are organised on a quarterly basis, wherein the presentation by the TSG is made to showcase the activity carried out in the past by the organisation as well as the future plan of action in the set thematic area. Page 4

The meeting is chaired by the Principle Secretary, MH&FW and/or Mission Director- NHM/Executive Director-SIFPSA along with the other key functionaries of the state i.e. Addl. Mission Director NHM, Addl. Executive Director SIFPSA, ED TSU, DG MH, DG FW etc. One of the member organisation of the HPF is designated as the nodal agency to organise the Forum s meeting on rotation basis. Advantages/ Achievements realized of Health Partners Forum at the state i. Support in organizing large public events ii. Data Compilation and generating Reports iii. Monitoring and implementation support iv. No separate cost borne by the government. v. Information sharing on national and global innovations and strategies and smooth implementation. Rationale for Constitution of District and Divisional Health Partners Forum The health partners forum formed at the state level has yielded positive results. Efforts have been made to channelize the resources and combine efforts towards achievements of the goals and objectives of various health programmes as per the requirement of the State. The sharing of ideas and vision also benefitted in proposing smart interventions as well as in better implementation of the schemes. The Organizations that are existing in the State are doing some direct activities at the district level too and many of them are implementing projects and other activities as per the mandate of their organization. At present several interventions are being implemented parallel to each other and are working in silos. If systems and efforts are channelized under the State leadership, the same can give better results. Page 5

In view of the above, it is proposed to develop the similar model of Health Partners Forum at the district level to provide technical assistance and implementation support to the District Health Society. And at the divisional Level, the review and coordination system shall be strengthened through the divisional Health Partners Forum. The proposed systems of two tier Health partners forum are expected to help in better coordination in programme implementation and also in optimum utilization of existing resources. Support can be sought through the Forums in organizing the activities related to Community mobilization, Research & data collection, hand holding of FLW, supervision support, documentation, trainings and workshops etc. Divisional PMU of SIFPSA/NHM will be responsible for coordinating the activity of Health Partners Forum in the respective districts of their division in coordination with SIFPSA and SPMU-NHM, Lucknow. Formulation of Health Partners Forums: A. District Health Partners Forum (dhpf) B. Divisional Health Partners Forum (dvhpf) Page 6

A. District Health Partners Forum (dhpf) 1. Background District Health Partners Forum (dhpf) shall be constituted at the district level consisting of the Health Partners/ organisations working in the district. The forum will closely work in coordination with District Health Society(DHS) of NHM. The dhpf is expected to extend support to DHS/ health department at the district level to increase the effectiveness of the programmes in the areas of Community mobilisation, Research & data collection, hand holding of FLW, supervision support, documentation, trainings and workshops etc. The dhpf will function under the Chairmanship of the District Magistrate (DM) and Chief Medical Officer (CMO) will be the Vice-chairman of the dhpf. Concerned Divisional Project Manager will be the Coordinator and concerned District Project Manager (DPM), NHM will be the Member Secretary of the dhpf. The dhpf will have three types of members: i. Permanent Members The permanent members of the dhpf are DM (Chairman), CMO (Vice Chairman), Div PM, DPM. In addition, the forum will consist of the Dy CMO/ ACMO (Nodal), DCPM, PO-ICDS, PO DUDA as permanent members. The Chairman can also nominate other district officials of the development departments as permanent members of the dhpf. One nodal officer in the rank of Dy CMO/ACMO shall be nominated by the CMO who will coordinate with the members of the dhpf on behalf of the CMO. Page 7

ii. Associate Members The designated representatives of the National/International organisations working in the district on any of the programmatic area that helps in improvement of the health indicators will be the associate members of dhpf. Since, presence of development partners is generally based on the activities/projects being implemented having a certain objective and fixed duration, therefore they will be the associate members of the dhpf. However, they will have the equal and effective membership of the forum as long as they are the members of the dhpf. iii. Special Invitee Special invitees can also be nominated to the dhpf on case-to-case basis as per recommendations of the CMO/Div PM/ DPM and approval by the Chairman. The special invitees may consist of experts of any programmatic area, representatives from the state (SIFPSA, SPMU, Directorate etc.) or any official/person as per the requirement and as per consent of the Chairman dhpf. 2. Nomination of the member organisation The permanent members will be notified for their ex-officio membership through an official communication by Div PMU/CMO/DPM with the consent of the Chairman. However, in case of associate members, membership will be granted through a nomination procedure as defined in the subsequent para. The Divisional PMU shall be the first contact office for dhpf for the development organisations. Divisional PM shall coordinate with the national and international organisation (development partners) working in the any of the respective district of the division for their nomination in the District Health Partners Forum. The list of Health Partners Forum at the state level shall be provided to the Div PM. Page 8

However, Div PM shall further explore the presence of development partners in their respective divisions. The nomination of the agency is subject to solicitation by the development partner working in the district or planned to initiate project activities in the district. The organisation will submit a request to the concerned District Magistrate along with the organisation information sheet through Divisional PM. The Div PM will prepare a proposed list of district health partners and communicate it to the respective CMOs and further, to the District Magistrate (Chairman) for approval. Annexure A and Annexure A1: The format of Request for membership in District Health Partner Forum and Member Organisation Information Sheet. In case of special invitee, they can be called in the forum as member, if dhpf understands the need of the same on case-to-case basis. 3. Broad criteria for the Development Partners for dhpf membership The Health Partners/organisation shall be nominated based on the following broad criteria: Organisation should be the member of the Health Partner Forum constituted at the state level. Actively working/implementing interventions in at-least one of the blocks or across the district. The duration of the project being implemented by the agency in the district shall not be less than 6 months. Should have a team of professionals and/or office in the district and implementing the project/activity in the district or any part of the district. Should have their state or country representative office in Lucknow and/or in New Delhi. Page 9

Any other national or international agency as per the discretion of the Chairman. 4. District Thematic Action Group (dtag) In line with the health partners forum at the state level, the Thematic Action Group (TAG) may also be constituted at the district level e.g. Family Planning, Maternal Health, Nutrition, Supportive supervision etc. The members of each dtag will be the representatives/members in dhpf working in that thematic area(s). The selection of the topics of the TAG shall be decided as per the recommendations of the members including the CMO and DPM as per the need and requirement of the respective district. 5. dhpf Meeting Protocol The dhpf meeting shall be organised on a quarterly basis under the Chairmanship of the District Magistrate. In case of non-availability of the District Magistrate (Chairman) the Chief Medical Officer (Vice Chairman) may chair the meeting on directions/concurrence of the Chairman. However, in whichever case the dhpf meeting would not be clubbed with the DHS-GB meeting and/or the DHS-EC meeting. One of the main section of the dhpf meeting is combined presentation by the one or two dtag as per instruction of the Chairman/Vice Chairman. The presentations by dtag shall be decided at the time of making the agenda and finalisation of the date of the dhpf. The presentation will be based on one of the thematic area and will discuss the status, achievements, issues, support and recommendations to the DHS. Respective DPM will finalise the draft agenda in consultation with CMO/ Div. PMU before submitting it to the Chairman for approval. Page 10

Apart from the presentations, the implementation of the schemes/projects by the development partner organisations shall also be discussed, so that efforts can be optimised to achieve the desired results. The innovations, replicable models in the district etc. will also be discussed. If required, more than one dhpf meeting may be organised in a quarter. Moreover, monthly review meetings shall also be organised under the Chairmanship of the Chief Medical officer to review the progress. The minutes of the quarterly meeting shall be drafted by the DPM in consultation of the Dy. CMO/ACMO nodal and shall be approved by the Chairman. District Project Manager (NHM) will have the responsibility of drafting the agenda, coordinating meetings with CMO or organising monthly meeting with CMO, whenever required. In addition to the quarterly meeting, the members of dhpf can meet once in a month under the chairmanship of the CMO for better coordination and to review the progress. This will help in better coordination and fruitful results as per discussions and decisions of the dhpf. 6. Meeting arrangements (sponsorship) on rotation Amongst the development partners who are a member of the dhpf, one organisation will be selected as sponsoring organisation and will be responsible for organising the dhpf. The sponsoring organisation will take care of the logistic arrangements, coordination and networking, invitation and will bear expenses related to organizing the dhpf as approved by the Chairman. The organisation will be selected on rotation basis with common consensus. Page 11

Any other dept/system can also be given responsibility for logistics, sponsoring and support in organising the meeting as desired by the Chairman. In case no organization comes forward to sponsor the dhpf quarterly meeting, then the Div PM will be responsible to organise the meeting from the funds made available by SIFPSA HQ. 7. Compliance and Follow-up The decisions taken in the dhpf will be circulated in the form of minutes to all the members and special invitees for compliance and follow up. The status of the minutes, in the form of Action Taken Report shall be put up in next dhpf. However, mid-course follow-up shall be done in the monthly meetings with CMO. 8. Exit policy/termination of the membership The exit policy/termination of the membership will be based on the following criteria: a. The project/activity of the organisation is completed in the district and no representative is existing to represent in the dhpf, such membership will stand cancelled. b. If an organisation is not willing to remain in the dhpf anymore, the member organisation has to submit a request to the Chairman to this effect with due reasons. c. If Chairman, considers the activities of an organisation/special invitee/official is not supporting in the achievement of the overall health indicators of the district. Page 12

B. Divisional Health Partners Forum (dvhpf) 1. Background In line with the District Health Partners Forum (dhpf), Divisional Health Partners Forum (dvhpf) shall be constituted at the Divisional level consisting of the national and international development organisations working in the field of health in the respective division. The dvhpf will function under the Chairmanship of the Commissioner and Additional Director (FW) will be the Vice-chairman of the dvhpf. Concerned Divisional Project Manager will be the Member Secretary. The dvhpf will have three types of members: i. Permanent Members The permanent members of the dvhpf are Commissioner, CMO of the respective districts, Div PM. The Chairman can also nominate other district officials of the development departments as permanent members of the dvhpf. ii. Associate Members The designated representatives of the National/International organisations working in the division on any of the programmatic area(s) that helps in the improvement of the health indicators will be the associate members of the dvhpf. Since presence of development partners is generally based on the activities/projects being implemented having a certain objective and fixed duration, therefore they will be the associate members of the dvhpf. However, they will have equal and effective membership of the forum as long as they are the members of the dvhpf. Page 13

The nomination of the members shall follow the same procedure as dhpf. However, in case of dvhpf the authority will be Additional Director (FW) as Vice Chairman and Commissioner as Chairman. iii. Special Invitee Special invitees can also be nominated to the dvhpf on case-to-case basis as per recommendations of the AD/CMO/Div PM and approval by the Chairman. The special invitees may consists of experts of any programmatic area, representatives from the state (SIFPSA, SPMU, Directorate etc.) or any official/person as per the requirement and consent of the Chairman dvhpf. 2. Nomination of the associate member organisation The Divisional PMU shall be the first contact office for dvhpf for the development organisations. Divisional PM shall coordinate with the national and international organisation (development partners) working in the any of the respective district of the division for their nomination in the Divisional Health Partners Forum. The nomination of the agency is subject to solicitation by the development partner working in the division or planned to initiate project activities in the division. The organisation will submit a request to the concerned Commissioner along-with the organisation information sheet through Divisional PM. The Div PM will prepare a proposed list of health partners working in the division and communicate it to the respective AD and further, to Chairman for approval. Annexure B and Annexure B1: The format of Request for membership in Divisional Health Partner Forum and Member Organisation Information Sheet. Page 14

3. Exit policy/termination of the membership The exit policy/termination of the membership will be based on the following criteria: d. The project/activity of the organisation is completed in the division and no representative is existing to represent in the dvhpf, such membership will stand cancelled. e. If organisation is not willing to remain in the dvhpf anymore, the member organisation has to submit a request to the Chairman to this effect with due reasons. f. If Chairman, considers the activities of organisation/special invitee/official is not supporting in the achievement of the overall all health indicators of the division. 4. Broad criteria for the Development Partners for dvhpf membership The organisation shall be nominated based on the following broad criteria: Organisation should be the member of the Health Partner Forum constituted at the state level. Actively working/implementing interventions in at-least one of the district of the Division. The duration of the project being implemented by the agency in the district shall not be less than 6 months Should have a team of professionals and/or office in the Division/district implementing the project/activity in the division or in the district. Should have their state or country representative office in Lucknow and/or in New Delhi. Any other national or international agency as per the discretion of the Chairman. Page 15

5. Divisional Thematic Action Group (dvtag) In line of the health partners forum at the state level, some Thematic Action Group (TAG) will be constituted at the divisional level e.g. Family Planning, Maternal Health, Nutrition, Supportive supervision etc. The members of the dvtag will be the representatives/members in dvhpf working in that thematic area(s). 6. dvhpf Meeting Protocol The dvhpf meeting shall be organised on six monthly basis under the Chairmanship of the Commissioner. The state or national level representation is essential in the dvhpf on behalf of the associate members. A representative from NHM/SIFPSA HQ will also attend the meeting. One of the main section of the dvhpf meeting is presentation by one or two dvtag on one of the thematic areas as per decision of the Chairman/Vice Chairman. The presentations by dvtag shall be decided at the time of making the agenda and finalisation of the date of the dvhpf. During the presentation on one of the thematic areas focus will be on the status, achievements, issues, support and recommendations that are viable and relevant for the division. Respective Div PM will finalise the draft agenda in consultation with Additional Director (Vice-Chairman) before submitting it to the Commissioner (Chairman) for approval. Apart from the presentations, the implementation of the schemes/projects by the development partner organisations shall also be discussed, so that efforts can be optimised to achieve the desired results. The minutes of the half yearly meeting shall be drafted by the Div Project Manager in consultation with the AD and shall be approved by the Commissioner Page 16

(Chairman). Div Project Manager will have the responsibility of drafting the agenda, coordination with AD for dates and organising the meeting. In addition to the half-yearly meeting under the Chairmanship of the Commissioner, the members of dvhpf shall meet once in a month under the chairmanship of the Additional Director (Vice Chairman) for better coordination and to review the progress. This will help in better coordination and fruitful results as per discussions and decisions of the dvhpf. 7. Meeting arrangements (sponsorship) on rotation Among the development partner members who are a member of the dvhpf, one organisation will be selected as sponsoring organisation and will be responsible for organising the dvhpf. The sponsoring organisation will take care of the logistic arrangements, coordination and networking, invitation and will bear expenses related to organizing the dvhpf as approved by the Chairman. The organisation will be selected on rotation with common consensus. Any other dept/system can also be given responsibility for logistics, sponsoring and support in organising the meeting as desired by the Chairman. In case no organization comes forward to sponsor the dvhpf quarterly meeting, then the Div PM will be responsible for organizing the meeting from the funds made available by SIFPSA HQ. 8. Compliance and Follow-up The decisions taken in the dvhpf will be circulated in the form of minutes to all the members and special invitees for compliance and follow up. The status of the minutes, in form of Action Taken Report shall be put up in the next dvhpf. However, mid-course follow-up shall be done in the monthly meetings with AD. Page 17

C. HPF Coordination with State Divisional Project Manager (SIFPSA/NHM) will be the main link between the dvhpf, the dhpf, SIFPSA and SPMU (NHM-UP). The Divisional Project Manager will submit quarterly Health Partners Forum status report to General manager (REMI), SIFPSA which will be put up to Mission Director, NHM-UP for information about the status of the activities/ meetings of dvhpf and the dhpf. The DPM and other member partners will give necessary support in preparation of the quarterly Health Partners Forum status report by the respective Div PM. The concerned CMO and Additional Director shall also be informed about the report submission. Mission Director/Executive Director will designate a representative from the state to attend the bi-annual dvhpf meeting. He may also designate a representative to attend the quarterly dhpf on behalf of NHM/SIFPSA. The reporting quarter will consists of January March, April- June, July- September, and October December. Report shall reach SIFPSA within 15 days of completion of the respective quarter. The General Manager, REMI, SIFPSA will be responsible for establishing coordination between State HPF (shpf), Divisional HPF (dvhpf) and District HPF (dhpf). Further, relevant directions of the Mission Director/Executive Director shall always be taken into the consideration and will be appraised to the dvhpf /dhpf during its meetings. The reporting format is attached at annexure C-1 (dvhpf) and C-2 (dhpf) Page 18

Annexure A Request for membership in District Health Partner Forum (dhpf) To, The District Magistrate District... Through Divisional Project Manager Division... (on letter head) Dear sir, The organisation... is/will be working in the district...since/from... (date) in the areas of...(fp/immunisation/nutrition / safe motherhood/ hygiene, sanitation/ IEC etc.). the organisation is represented in the district by Mr./Ms.... The details of the organisation and the activity is attached as per the format, required to submit to be the member of the District Health Partner s Forum. May like to accord approval. Name Designation Page 19

Annexure A-1 District Health Partner Forum (dhpf) District... Member Organisation Information Sheet 1. Name and address of the organisation 2. Names of the heads of the organisation State Head... Contact No. National Head Contact No. 3. Programmatic area 4. Coverage Block name(s)... Population... 5. Details of the project in the district Objective Duration Budget 6. Team in the district Name and designation of the district project staff 1 2. 3. 4. 7. Contact details at the district 8. Website 9. Whether. Organisation is member of Health Partner Forum at State Level. 10. Any other Information Page 20

Annexure B Request for membership in Divisional Health Partner s Forum (dvhpf). To, The Commissioner Division... Through Divisional Project Manager Division... (on letter head) Dear sir, The organisation... is/will be working in the district...since/from... (date) in the areas of...(fp/immunisation/nutrition / safe motherhood/ hygiene, sanitation/ IEC etc.). the organisation is represented in the district by Mr./Ms.... The details of the organisation and the activity is attached as per the format, required to submit to be the member of the Divisional Health Partner s Forum (dvhpf). May like to accord approval. Name Designation Page 21

Annexure B-1 Divisional Health Partner Forum Division... Member Organisation Information Sheet 1. Name and address of the organisation 2. Names of the heads of the organisation State Head... Contact No. National Head Contact No. 3. Programmatic area 4. Coverage District (s) Block (s)... Population 5. Details of the project in the district Objective Duration Budget 6. Team in the district Name and designation of the district project staff 1 2. 3. 4. 7. Contact details at the district 8. Website 9. Whether. Organisation is member of Health Partner Forum at State Level. 10. Any other Information Page 22

Annexure C-1 Status/Progress Report Health Partners Forum Division... A. Divisional Health Partners Forum (dvhpf) Date of the dvhpf created... 1. Details of Recent Meeting held a. Date b. Chaired by c. Participant organisation d. Other key officials e. Key decisions/ highlights of the meeting 1 2 3... n 1 2 3... n Pl attach minutes f. Minutes approved on (date) g. Any suggestions a. Date Minutes submitted to ED/MD (Y/N) b. Date Minutes submitted to ED/MD (Y/N) Enclosures 1 2 3 Date of submission 2. Details of previous meetings held Div Project Manager Page 23

Annexure C-2 Status/Progress Report Health Partners Forum Division... B. District Health Partners Forum (dhpf) Date of the dvhpf created... 1. Details of last meeting held Particular District 1 District 2 District 3 District 4 a. Date b. Chaired by c. Participant organisation 1 2 3... n d. Other key officials 1 2 3 4... n e. Key decisions/ highlights of the meeting f. Minutes approved on (date) g. Any suggestions Pl attach minutes Pl attach minutes Pl attach minutes Pl attach minutes a. Date Minutes submitted to ED/MD (Y/N) b. Date Minutes submitted to ED/MD (Y/N) Enclosures 1 2 3 4 Date of submission 3. Details of previous meetings held Div Project Manager Page 24