National Health Mission, Haryana

NRHM Framework

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Organizational Structure of the Scheme
State Health Mission
Constituted by Govt. Notification No. 49/71/2005-6HBII dated 27th June 2005

General Body
Chairperson: Chief Minister
Co-Chairperson: Minister of State Health, Medical Education and Ayurveda
Convener: Financial Commissioner & Principal Secretary Govt. Haryana, Health, Medical Education and Ayurveda
Member Secretary: Director General Health Services

Members:

Minister, Development & Panchayats
Minister, Rural Development
Minister Planning
Minister, Finance
Minister of State Social Welfare and Welfare of SCs and BCs
Minister, Urban Development
Minister, Urban Development
Minister, Public Health
MLAs to be nominated by the State Government
Nominated Block and Village Panchayat and Urban Bodies

(women may be adequately representatives)

Official representatives

Chief Secretary
Financial Commissioner & Principal Secretary, WCD
Financial Commissioner & Principal Secretary, (B&R)
Financial Commissioner & Principal Secretary, Development & Panchayats
Financial Commissioner & Principal Secretary Urban Development
Financial Commissioner & Principal Secretary, Finance
Financial Commissioner & Principal Secretary, Planning
Commissioner, Public Health
Special Secretary, Rural Development
Representatives to be nominated by Ministry of Health and Family Welfare, Department of Family Welfare, Government of India
Health Experts to be nominated by the State Government
Representatives of the Medical Association to be nominated by the State Government.
Representatives of the NGOs to be nominated by the Government

14 Representatives of the Development partners.

State Health Society, Haryana (SHSH)
A. Governing Body of State Health Society

Constitution & Members

Chairperson- Chief Secretary, Haryana
Vice-Chairman- Financial Commissioner & Principal Secretary, Govt. Haryana, Health, Medical Education & Ayurveda
Member Secretary- Mission Director (NRHM), Haryana
Members-

Secretary, Finance
Secretary, Women & Child Development
Secretary, PWD B&R
Secretary, Rural Development & Panchayat
Secretary, Urban Development & Local Bodies
Secretary, Planning
Secretary, Water Supply & Sanitation
Secretary, Town & Country Planning
Secretary, Environment
Secretary, Education
Director, PGIMS Rohtak
Director General, Health Services, Haryana
Project Director (NRHM), Haryana
Director AYUSH .Hrayana
Representative(s) to be nominated by MOH&FW, Govt. of India.
President, IMA (Haryana), State Branch.
Secretary, State Red Cross Society
Any other member who is deemed fit for as per need

Ordinary Business of the Governing Body

Approval/ Endorsement of Annual State Plan for the NRHM.
Consideration of proposals for institutional reforms in the Health Sector.
Review of implementation of Annual Action Plan
Inter-Sectoral coordination: All NRHM related sector and beyond e.g. Administrative Reforms across the State
Status of follow up action on the decisions of State Health Mission.
Co-ordination with NGOs/ Donor/ other agencies/ organizations.
Any other issues with permission of Chair.

B. Executive Committee of State Health Society
The Executive Committee would ensure execution of integrated NRHM State Action Plan, follow up action on decision of State Health Mission.

Constitution & Members
Chairperson- Financial Commissioner & Principal Secretary, Govt. Haryana, Health, Medical Education & Ayurveda.
Member Secretary- Mission Director (NRHM), Haryana
Members-

Director, Development & Panchayat
Chief Administrator, HUDA
Chairman, Haryana Pollution Control Board.
Special Secretary, Finance dealing with Health.
Director, Primary Education.
Project Director, Sarv Shiksha Abhiyan.
Engineer-in-Chief, Water Supply & Sanitation
Engineer-in-Chief, PWD B&R
Director General, Health Services, Haryana
Director Health Services, Family Welfare
Project Director (NRHM), Haryana
Director Health Services, Malaria
Director, AYUSH, Haryana
Project Director, State AIDS Control Society
Director, Urban & Local Bodies
Director, Women & Child Development
Secretary, Red Cross Society, Haryana
Representative(s) of GoI
Economics & Statistical Adviser, Haryana
Non official member nominated by the Govt. Haryana
Any other member by the permission of Chairperson

Ordinary Business of the Executive Body

Detailed expenditure and implementation review.
Approval of proposals from districts and other implementing agencies/ District Action Plans.
Execution of the approved State Action Plan, including release of funds for programmes at State level as per Annual Action Plan.
Release of funds to the District Health Societies
Finalization of working arrangements for intra-Sectoral and inter-Sectoral co-ordination.
Follow up action on decisions of the Governing Body of State Health Mission
Any other issues related with the permission of Chair.

District Health & Family Welfare Society

A. Governing Body of District Health & Family Welfare Society

Constitution & Members

Chairperson- Deputy Commissioner.
Member Secretary- Civil Surgeon
Members-

Commissioner/ Secretary of Municipal Corporation/ Committee
Additional Deputy Commissioner
Executive Engineer PWD and B&R
Executive Engineer Water Supply & Sanitation
Estate Officer HUDA
Distt. Medical Officer, AYUSH
XEN, Panchayati Raj
District Social Security Officer
District Welfare Officer for SCs/BCs.
District Development & Panchayat Officer
District Education Officer
District Primary Education Officer
Secretary, District Red Cross Society
Programme Officer (ICDS)
Representative of District IMA
NGO Working for Health as approved by Chairperson
Representative of Beopar Mandal
Any other member deemed to be necessary as decided by chairperson with a view to associate Civil Societies Groups working in the area of health.

Objective
The Society shall assist District Health Administration in the implementation of various health programmes and projects in the district with special emphasis on priority sectors like Reproductive and Child Health, implementation of health programmes and National Rural Health Mission (NRHM) in the district, Population Control, Control of Malaria. TB & Leprosy and Prevention of Blindness and Malnutrition etc.

5. Frequency of Meeting:
The meeting of Governing Body of District Health & Family Welfare Society will be held every 3 months & earlier, if necessary.

6. Term of Members

Ex-officio members shall be permanent members of the society. The term of other members will be for 2 years.

7. Ordinary Business of the Governing Body

Approval of Annual District Plan for the NRHM.
Consideration of proposals for institutional reforms in the Health Sector.
Review of implementation of Annual Action Plan
Inter-Sectoral coordination: All NRHM related sector and beyond eg. Administrative Reforms across the district.
Status of follow up action on the decisions of State/ District Health Mission.
Co-ordination with NGOs/ Donor/ other agencies/ organizations.
Any other issues with permission of Chair.

Scope of Functions

To achieve the above objectives, the Society shall direct its resources towards performance of the following key tasks: -

To act as the nodal forum for all stake holders –line departments, PRI and NGOs- to participate in planning, implementation and monitoring of the various health and family welfare programmes and projects in the district.
To receive, manage and account for the funds received from the State Government (including State level Societies in the health sector) for implementation of Centrally Sponsored Schemes in the district.
To strengthen the technical / management capacity of the District Health Administration through recruitment of individual / institutional experts from the open market.
To facilitate preparation of integrated district health development plans, for health and its various determinants like sanitation, nutrition and safe drinking water, etc.
To guide the functions related to ‘Total Sanitation Campaign’ at the District level.
To mobilise financial and non-financial resources for complementing/supplementing the health and family welfare activities in the district.
To assist hospital management societies in the district.
To undertake such other activities for strengthening health and family welfare activities in the district as may be identified from time to time, including mechanisms for intra and inter-sectoral convergence of inputs and structures.

Powers & Functions of Governing Body

The Governing Body of the SOCIETY shall be the highest decision making body of the Society. It shall have the following powers and functions:

Consider and approve the annual District Action Plan(DAPs) & District PIP .
Consider and approve the annual budget and authorize expenditure for each activity included in the action plan submitted to it by the Executive Committee of the society. Expenditure shall be incurred only as per the provision of the bye-laws
Make, amend, or repeal any bye laws relating to administration and management of the affairs of the Society subject to the observance of the provisions contained in the Act, provided that such amendments are brought to the Governing Body after obtaining endorsement / approval from the State Government
Consider and approve the audited accounts of the society.
Consider and approve the progress report of the society submitted by the ber Secretary every year.
Issue policy guidelines/ directions to the Executive Committee with regard to implementation of the various health activities & programmes.
Approve formation of various groups/sub committee for various purposes related to the implementation or monitoring and delegate suitable powers to such groups/sub committees.
To make authorization to the Member secretary of the Governing Body or to any other office bearer of the Executive Committee to sue or defend the Society in legal affairs and sign documents or plaints submitted in courts on the behalf of the society.
To approve byelaws relating to service matters administration and financial matters of the society on the recommendation of the Executive Committee.
To ensure the mandatory meetings of the Executive Committee or sub-committee/expert groups whenever constituted are held and the minutes of the meeting are recorded and maintained.
To ensure that in the Tripartite Review Meeting the following documents are placed- (a) Audited Accounts for the preceding financial year (b) the updated physical and (c) financial progress of the project and the plan of action for the ensuing year.
Accept donations and endowments or give grants upon such terms as it thinks fit.
Develop and adopt its own rules and regulations for recruitment and appointment of experts and administrative / technical staff and set its own compensation package for such experts / staff to be recruited from the open market and/or deputation basis.
Do generally all such acts and things as may be necessary or incidental to carrying out the objectives of the Society or any of them, provided that nothing herein contained shall authorize the Governing Body to do any act or to pass any bye-laws which may be repugnant to the provisions hereof, to the powers hereby conferred on the Governing Body and other authorities, or which may be inconsistent with the objectives of the Society.

B. Executive Committee of District Health Society

The Executive Committee would ensure execution of integrated NRHM District Action Plan, follow up action on decision of State/District Health Mission.

Constitution & Members
Chairperson- Civil Surgeon
Member Secretary- Dy. Civil Surgeon, NRHM/ RCH Officer
Members-

All Dy. Civil Surgeons/ Programme Officers
Senior most SMO CHC in the district
Senior most MO I/c PHC in the district
Executive Engineer PWD and B&R
Executive Engineer Water Supply & Sanitaion
Distt. Medical Officer, AYUSH
District Primary Education Officer
Secretary, District Red Cross Society
Programme Officer (ICDS)
Any other member deemed to be necessary as decided by chairperson with a view to associate Civil Societies Groups working in the area of health.

Frequency of Meeting
The meeting of Executive Committee of State Health Society, Haryana will be held every month & earlier, if necessary.

Term of Members
The term of official members will be the time they hold the office by virtue of which they are members. The term of other members will be for 2 years

Ordinary Business of the Executive Body

Detailed expenditure and implementation review.
Approval of proposals from PHC/CHC/ Sub-Centre and other implementing agencies/ District Action Plans.
Execution of the approved State Action Plan/ DAP, including release of funds for programmes.
Finalization of working arrangements for intra-sectoral and inter-setoral co-ordination.
Follow up action on decisions of the Governing Body of State Health Mission/ District Health Mission.
Training & Capacity of all Medical Officers, Staff Nurses, Paramedics & other stake holders as envisaged in the DAP.
Strengthening of District Training Centres.
Monitoring & Evaluation of the implementation of DAP
HR Planning, Development & Employment.
Any other issues related with the permission of Chair.

Powers & Functions of Executive Body

The Executive Committee of the Society shall have the following powers and functions for appropriate working of the Society:

To prepare the NRHM Programme Implementation Plan (PIP) & Annual District Health Action Plan for approval by the Governing Body of the Society.
To make appointments to various posts/position approved by the Governing Body.
Scrutinize annual plans and the budget proposal placed before it by the Member Secretary and ensure that it should reflect all activities, provisions for each activity, anticipated receipts and payments out of the fund of the Society, and summit them to body for approval.
To formulate bye-laws on administrative and financial matters and submit to the Governing Body for approval.
Approve appointment of the auditor for the annual statutory audit of accounts of the society in accordance with bye-laws.
Constitute sub-committee for different activity under the project.
Review the working/functioning of sub-committees constituted by the Governing Body or the Executive Committee as per laid down norms and guidelines for each of them.
To issue guidelines/directions to the Member Secretary for proper administration of the funds of the Society.
To take all necessary steps to ensure proper execution of the plan, scheme or activity approved by the Governing Body.
To undertake any activity or function or liability delegated or entrusted by the Governing Body of the Society from time to time.

Swasthya Kalyan Samiti (SKS) at CHC and PHC

Swasthya Kalyan Samiti have been constituted in all the 336 PHCs, 91 CHCs/ 26 Sub-Divisional Hospitals, (SDH) & 21 District HQ Hospital. All the societies are registered and functioning effectively.

Swasthya Kalyan Samiti (SKS) PHC

Swasthya Kalyan Samiti is a simple yet effective management structure. This committee, which would be a registered society, acts as a group of trustees (for the hospitals/PHCs) to manage the affairs of the hospital/PHCs. It consists of officials from Government sector and members from local Panchayati Raj Institutions and community.

Constitution and members

Composition

A. Swasthya Kalyan Samitis at PHC Level

MO I/c of PHC – Chairman & Convener
All MOs including AYUSH – Members
Sarpanch of village where PHC is located - Member
1 Sarpanch by rotation from other villages (Tenure 1 year) - Member
1 SMS head of the PHC village – Member
1 SMS head of the PHC village by rotation (Tenure 1 year) – Member
Head of the Village level Committee(VLC) cum VHSC of PHC Village – Member
1 member of VLC cum-VHSC by rotation (Tenure 1 year)- Member
ANM of the PHC village - Member
ASHA & AWW of PHC Village– Members
1 ANM, ASHA, AWW by rotation from other villages (Tenure 1 year) – Members
Supervisor, ICDS of PHC Village - Member
Head Master of the PHC village – Member
Dental Surgeon – Member Secretary

Objectives the SKS

The following could be the broad objectives of the SKS:

Ensure compliance to minimal standard for facility and hospital care and protocols of treatment as issued by the Government.
Ensure accountability of the public health providers to the community;
Introduce transparency with regard to management of funds;
Upgrade and modernize the health services provided by the hospital and any associated outreach services;
Supervise the implementation of National Health Programmes at the hospital and other health institutions that may be placed under its administrative jurisdiction;
Organize outreach services / health camps at facilities under the jurisdiction of the hospital;
Display a Citizens’ Charter in the Health facility and ensure its compliance through operationalisation of a Grievance Redressal Mechanism;
Generate resources locally through donations and other means;
Undertake construction and expansion in the hospital building;
Improve participation of the Society in the running of the hospital;
Ensure scientific disposal of hospital waste;
Ensure proper training for doctors and staff;
Ensure subsidized food, medicines and drinking water and cleanliness to the patients
Ensure proper use, timely maintenance and repair of hospital building equipment and machinery;

Functions/ Powers of SKS
The Swasthya Kalyan Samitis (SKS- PHC) shall monitor, evaluate and co-ordinate the work at PHC level under its jurisdiction and will serve as link to the Distt. Health Society. It will review the progress in implementation of NRHM and various heath schemes and policies & shall ensure inter-sectoral convergence and integrated planning.

The Swasthya Kalyan Samiti shall perform the following functions in respect of the PHC area for which it is setup, namely-

the Samiti will review the punctuality & performance of staff falling under PHC jurisdiction as per Annexure ‘A’. In case of unsatisfactory conduct/performance, the recommendation for appropriate action would be made to Distt. Health Society.
will review the status of funds available with the PHC- untied funds under NRHM, user money & other State schemes and utilization status thereof. The scheme-wise availability of funds, expenditure and outcomes will be planned & reviewed.
will review status of collection & utilization of User Charges at PHC level.
will review the fixed day outreach schedule and its performance.
will develop the Village Health Plan
will take care of cleanliness, sanitation and maintenance of PHC and shall review the working of Village Level Committee-cum-VHSC and take remedial steps about filing up the gaps.
will monitor the health related activities of SMS & develop IEC strategy
it will review the availability & consumption of medicine and stock position thereof.
will review the other development works of Health Department in respect of its estimated cost, date of commencement & completion of project. The work of agency shall also be reviewed in the meeting.
will take special measures for preventative & promotive health activities.
mainstreaming of AYUSH
any other issue related to promotion of Health & Sanitation activities.the Citizen Charter shall be displayed for public information.

suggestion/ Complain Box shall be placed in the PHC premises.
list of medicines available at PHC will be displayed.

Swasthya Kalyan Samitis at CHC Level (SKS)

SMO I/c of CHC – Chairman & Convener
All PHC I/cs & AYUSH at CHC– Members
Sarpanch of CHC Village – Member
Head Master of the CHC village – Member
2 Sarpanches by rotation (Tenure 1 year) - Members
SMS head of the CHC village – Members
2 SMS head of the PHC village by rotation (Tenure 1 year) – Members
Head of the CHC Village level committee-cum-VHSC - Member
2 head of the village level committee-cum-VHSC by rotation (Tenure 1 year) - Members
CDPO, WCD – Member
Representative of the Deptt. of Water Supply & Sanitation – Member
Secretary, Municipal Committee (wherever applicable)- Member
BDPO of the area
Dental Surgeon – Member Secretary

Functions/ Powers of SKS (CHC)
The Swasthya Kalyan Samitis shall monitor, evaluate and co-ordinate the work at CHC level under its jurisdiction and will serve as link to the Distt. Health Society. It will review the progress in implementation of NRHM and various heath schemes and policies & shall ensure inter-sectoral convergence and integrated planning.

The Swasthya Kalyan Samiti shall perform the following functions in respect of the area for which it is setup, namely-

the Samiti will review the punctuality, attitude & performance of staff falling under CHC jurisdiction.
will review the status of funds available with the CHC- untied funds under NRHM, user money & other State schemes and utilization status thereof. The scheme-wise availability of funds, expenditure and outcomes will be planned & reviewed.
will review status of collection & utilization of User Charges at CHC level.
will review the fixed day outreach schedule and its performance.
will develop the Village Health Plan
will take care of cleanliness, sanitation and maintenance of CHC and shall review the working of Village Level Committee-cum-VHSC and take remedial steps about filing up the gaps.
will monitor the health related activities of SMS & develop IEC strategy
it will review the availability & consumption of medicine and stock position thereof.
will review the other development works of Health Department in respect of its estimated cost, date of commencement & completion of project. The work of agency shall also be reviewed in the meeting.
will take special measures for preventative & promotive health activities.
mainstreaming of AYUSH
any other issue related to promotion of Health & Sanitation activities.

Note:

the Citizen Charter shall be displayed for public information
suggestion/ Complain Box shall be placed in the CHC premises.
list of medicines available at CHC will be displayed

In the monthly meeting, the complaint/suggestion box shall be opened and the remedial steps for improvement will be initiated at the level of Samiti. The expenditure will be met out of the Untied funds kept at the disposal of CHC by the Swasthya Kalyan Samiti & the matter will be referred to the Distt. Health Society, wherever required.