TOT OF ZONAL AGENCIES
To evaluate the impact of NRHM interventions, by Agencies outside the Government, and make recommendations on: The institutional mechanisms and monitoring systems that have been put in place. Programme designs for consistency, feasibility and effectiveness with respect to goals of NRHM. Operationalisation of the programme elements of NRHM, identifying managerial and design constraints. Capacities available and adequacy building efforts. Programme outcomes with the respect to the phase of the programme in each State. 2
Distrust to trust Employment to service guarantee Inflexibility to flexibility Centralized to decentralized action Funds, functions, functionaries for service Monitoring against institution specific goals Institution specific recruitment Building capacities at all levels
Resident, skilled, community health worker Quality of services from public systems Enhancing accountable Nursing services Partnerships with non governmental sector Streamlined procurement and logistic systems in States like TNMSC Meeting the challenge of skill development Increasing the density of accountable and skilled human resources for health in rural areas Adequate and flexible financing of health care Making PRI/Community institutions and activities fully functional in each village/institution
Time line for activities
Activity Phasing and time line Outcome Monitoring 1 Fully trained Accredited Social Health Activist (ASHA) for every 1000 population/large isolated habitations in 18 Special Focus Statest 50% by 2007 100% by 2008 Quarterly Progress Report 2 Village Health and Sanitation Committee constituted in over 6 lakh villages and untied grants provided to them. 30% by 2007 Quarterly Progress 100% by 2008 Report 3 2 ANM Sub Health Centres 30% by 2007 Annual Facility strengthened/established to provide service guarantees as per IPHS, in 1,75000 places. 60% by 2009 100% by 2010 Surveys External assessments 4 30,000 PHCs strengthened/established with 3 Staff Nurses to provide service guarantees as per IPHS. 5 6500 CHCs strengthened/established with 7 Specialists and 9 Staff Nurses to provide service guarantees as per IPHS. 30% by 2007 60% by 2009 100% by 2010 30% by 2007 50% by 2009 100% by 2012 Annual Facility Surveys External Assessments Annual Facility Surveys External assessments.
6 1800 Taluka/ Sub Divisional Hospitals strengthened to provide quality health services. 30% by 2007 50% by 2010 100% by 2012 Annual Facility Surveys External assessments. 7 600 District Hospitals strengthened to 30% by 2007 provide quality health services. 60% by 2009 100% by 2012 Annual Facility Surveys External assessments. 8 Rogi Kalyan Samitis/Hospital Development Committees established in all CHCs/Sub Divisional Hospitals/ District Hospitals. 50% by 2007 100% by 2009 Annual Facility Surveys External assessments. 9 District Health Action Plan 2005-2012 50% by 2007 Appraisal process prepared by each district of the country. 100% by 2008 External assessment. 10 Untied grants provided to each Village Health and Sanitation Committee, Sub Centre, PHC, CHC to promote local health action. 50% by 2007 100% by 2008 Independent assessments Quarterly Progress reports.
11 Annual maintenance grant provided to every Sub Centre, PHC, CHC and one time support to RKSs at Sub Divisional/ District Hospitals. 50% by 2007 100% by 2008 Independent assessments Quarterly Progress Reports. 12 State and District Health Society established and fully functional with requisite management skills. 50% by 2007 100% by 2008 Independent assessment. 13 Systems of community monitoring put in place. 14 Procurement and logistics streamlined to ensure availability of drugs and medicines at Sub Centres/PHCs/ CHCs. 50% by 2007 100% by 2008. 50% by 2007 100% by 2008. Independent assessment. External assessment. 15 SHCs/ PHCs / CHCs / Sub Divisional Hospitals / District Hospitals fully equipped to develop intra health sector convergence, coordination and service guarantees for family welfare, vector borne disease programmes, TB, HOV/AIDS, etc. 30% by 2007 50% by 2008 70% by 2009 100% by 2012. Annual Facility Surveys. Independent assessments.
16 District Health Plan reflects the convergence with wider determinants of health like drinking water, sanitation, women s empowerment, child development, adolescents, school education, female literacy, etc. 30% by 2007 60% by 2008 100% by 2009 Appraisal process Independent assessment. 17 Facility and household surveys carried out 50% by 2007 Independent in each and every district of the country. 100% by 2008 assessment. 18 Annual State and District specific Public Report on Health published 30% by 2008 60% by 2009 100% by 2010. Independent assessment. 19 Institution-wise assessment of performance 30% by 2008 against assured service guarantees carried 60% by 2009 out. 100% by 2010. Independent assessment. 20 Mobile Medical Units provided to each 30% by 2007 Quarterly Progress district of the country. 60% by 2008 100% by 2009. Report.
By Independent Agencies including PRCs To cover all Districts within 1.5 years in Rounds First Round (R I & SR I) to cover over 200 Districts from all States/UTs (29% of Districts) Revisit after completion of Rounds 10
Field edagencies es one for each State/Sub State (UP, MP) 5 Zonal Agencies one for 5 6 States National IIPS 11
INDIA Zones for Concurrent Evaluation All
North Zone HP J&K UK UP Delhi Punjab & Chandigarh Haryana 13
North East Zone Assam Arunachal Pradesh Sikkim Meghalaya Tripura West Bengal Mizoram Manipur Nagaland 14
West Zone Gujarat Rajasthan Madhya Pradesh Daman & Diu Goa Maharashtra ht 15
South Zone Karnataka Andhra Pradesh Puducherry Andaman & Nicobar Islands Kerala Lakshadweep Tamil Nadu 16
Central Zone Jharkhand Bihar Chhattisgarh Dadra & Nagar Haveli Oi Orissa 17
MoHFW National agency (One at national level) Zonal agencies (Five in all group of States) Field agencies (One for each State, except MP & UP)
Desk review Consultation with key stakeholders Undertake evaluation as per the methods Collection, collation & analysis of data using recommended tools Provide data in prescribed format to Zonal agency Coordinate with Zonal agency & prepare state reports Complete the field work in 3 months and submit final report within one month after that 19
Field test & finalize tools in consultation with MOHFW Training of Field Agencies in Zone Support field Agencies in data validation, compilation, data analysis, report generation Coordinate regularly with field agencies to organize field survey, training, data compilation etc Cross/back check data of field edagencies es Recommending payments Coordinate State Reports Ensure final report from field agencies within 4 months and submit to MOHFW agency within 1 month after that 20
Overall monitoring and coordination for Evaluation Work including field work data flow report generation District/ State/ National reports Thematic Evaluation Training of Zonal Agencies Monitoring i the quality assurance of survey results Develop data entry package and tabulation software for use by all Zonal and Field Agencies Legal support for contractual commitments and obligations Evolving framework for performance appraisal of agencies 21
Overall coordination of Concurrent Evaluation Monitoring Cross/back checking data 22
Dr. P.M. Kulkarni, JNU Chairperson Dr. Arvind Pandey, NIMS Member Addl. DG (Statistics) Member Chief Director(Statistics) Member Director (NRHM) Member Director(Statistics) Member Representative from UNFPA Member Representative from World Bank Member Representative from UNICEF Member Representative from WHO Member Representative from PRC IEG, Delhi Member Representative from PRC ISEC, Bangalore Member Representatives from all Zonal Agencies Member IIPS Coordinator / Project Manager Member Joint Director (Statistics) Member (Convener) 23
To oversee and coordinate various activities in the Concurrent Evaluation. To address technical issues relating to finalization of schedules, hdl tabulation plan, data quality aspects, etc. To review the progress of the Concurrent Evaluation on a periodic basis and ensure its timely completion. 24
State HQ District HQ and Hospitals Two (2) CHCs in each district Four (4) PHCs (2 PHCs per CHC) Twelve (12) sub centers (3 SCs per PHC) Twelve (12) gram panchayats 24 ASHAs 1,200 households All Eligible Women in selected household Exit Interviews (IPD & OPD) 25
1. Agencies to visit States 2. Canvass State Schedule 3. Canvass District Schedules/ Facility Schedule hdl 4. Interview Health functionaries 5. Interview Households 6. Examine systems and efficacy of ASHAs, RKS, Untied funds etc 26
Inception report: within 15 days of 1 st installment Baseline report Secondary data Interaction with key stakeholders khld Mid project progress report End report Case studies and Observation reports Photographs h Hard and scanned copies of interview schedule Any presentations Final Report
All mails to be invariably marked to eval nrhm@nic.in in All the Zonal Agencies to maintain updated Contact Details of Field Agencies National Agency should maintain record of Contact Details of all the Agencies All Zonal Agencies to develop Timeline for TOTs with Field Agencies Training Calendar of ZONAL/Field to be developed 28
National Agency Plans for TOT for Data Entry Monitoring Protocols Plan for Desk Review Report Zonal Agency Timelines Facilitation Field Agency Training Calendar for TOT of Field Agencies Field Work Plan 29
Ministry: http://mohfw.nic.in hf i Web page pg of National Rural Health Mission HMIS Portal http://nrhm mis.nic.in h i i