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Presentation PIP appraisal criteria. STRUCTURE OF THE PRESENTATION. Key aspects to be addressed in appraisal of state PIPs ( based on last year’s experience) Detailed criteria for appraisal of PIPs Appraisal Process. 1. KEY ASPECTS TO BE ADDRESSED. ALLOCATIONS AND BUDGETING
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Presentation PIP appraisal criteria
STRUCTURE OF THE PRESENTATION Key aspects to be addressed in appraisal of state PIPs ( based on last year’s experience) Detailed criteria for appraisal of PIPs Appraisal Process
1. KEY ASPECTS TO BE ADDRESSED ALLOCATIONS AND BUDGETING Base- flexi pool The total envelope available for 08-09 for RCH II base flexi pool is: Allocation for 08-09 as communicated in letter dated March 5, 2007 Plus expected unspent balance as at April 1, 2008. Activities budgeted for, but not implemented in 07-08 should be reflected in the PIP for 08-09. The above envelope can include procurement of items (eg Boyle’s apparatus, minor equipment, drugs) which are not currently provided in kind as apart of various kits ). Compensation schemes For JSY, Sterilisation compensation, and NSV camps, states should estimate requirements which would be over and above Base flexi pool. Amounts required for laparascopes can again be separately budgeted.
1. KEY ASPECTS TO BE ADDRESSED (contd) ALLOCATIONS AND BUDGETING (contd) Items to be budgeted under RCH II As a general principle, any cost which is directly attributable to RCH should be first booked under RCH II Flexi-pool. Ensure that : Quarterly financial targets are in line with workplan targets and not annual budget divided equally across the quarters . As far as possible, details of costs for activities are provided (Large lump sum amounts are not desirable) Double budgeting i.e. booking of similar items under RCH II as well NRHM Additionalities does not take place. Activities/ strategies are budgeted as per budget heads specified in the Operating Manual.
1. KEY ASPECTS TO BE ADDRESSED (contd) DISTRICT PLANS While, more than 400 district plans have been prepared, the state PIPs for 07-08 are , typically not a consolidation of district plans. Further , fund release to districts are not against the district plan. However, for 08-09, some states such as Orissa are consolidating the district plans into the state PIP. Key aspects to be addressed are : By 2008-09, all state PIPs should be a consolidation of district plans. If not, states should make a clear commitment on way forward . Criteria for allocation of resources to districts ( to be weighted in favour of the districts with the worst indicators) should be in accordance with DHAP Manual.
1. KEY ASPECTS TO BE ADDRESSED (contd.) DISTRICT PLANS (contd.) Districts should be allocated , say 10% against which district schemes could be planned District plans should be approved by respective health societies; state should have a formal approval process. Funds to be released to districts in line with the district plan
1. KEY ASPECTS TO BE ADDRESSED (contd) SETTING OF TARGETS In 07-08, all states had set themselves targets for outcomes (IMR, MMR, TFR) and intermediate indicators (e.g. institutional deliveries). However, states had typically not assessed the matching capacity/ inputs required for achieving the targets. Essential to ensure that : Targets set are in line with the NRHM goals Inputs/ capacity required to reach the goals are reflected in the PIP The basis for target setting is spelt out eg an increase in institutional deliveries from say x % to y% translates into an increase in z number of institutional deliveries; and to meet this demand what is the number of additional facilities to be operationalised either in government or through PPP.
1. KEY ASPECTS TO BE ADDRESSED (contd) COORDINATED PROVISION OF INPUTS /MICRO-PLANNING Full operationalisation of facilities (FRUs,24x7 PHCs), implies that all inputs (trained staff, equipment, drugs/ consumables, etc ) are available and subsequently, the requisite IEC takes place. In practice , there are a number of facilities, which do not have the full complement of inputs and as a result service delivery is not upto the mark. For operationalisation of facilities the PIP should articulate steps for preparation of micro-plans for each facility. Prerequisites are : A facility survey including availability of staff( trained/ untrained) and patient load Redistribution of staff amongst facilities The microplan should provide inputs for identification of staff to be trained, infrastructure upgradation, procurement of equipment , etc leading to a realistic time-line for full operationalisation of facilities such that there is a rapid increase in delivery and utilisation of services
1. KEY ASPECTS TO BE ADDRESSED (contd) HUMAN RESOURCES Human resources is the key constraint and essential for PIPs to spell out : Number of staff (by back ground/ specialisation) extent of training/ skill set , current place of posting, utilisation/ patient load handled. This should also be provided for the private sector . On the basis of the above, identify (1)options for redistribution of staff , including scope for PPP/ outsourcing (2) training poriorities. This should also lead to better utilisation of specialists working as PGMOs.
1. KEY ASPECTS TO BE ADDRESSED (contd) INTERNAL INCONSISTENCIES Typically, most PIPs have one or more of the following internal inconsistencies : Targets provided for activities in the narrative do not match the targets provided for the same activities in the budget. Targets for physical activities in the budget not matching with the targets for intermediate indicators Quarter-wise physical targets / financial targets do not tally with the figures provided in the summary budget Strategies/ activities planned but not budgeted Activities budgeted for but not reflected in the workplan/ narrative (SPM to ensure an internally consistent PIP)
2. APPRAISAL PROCESS Within 24 hours of receipt of a PIP, a quick review should be carried out to check whether the following has been provided : Targets for Goals, Outcomes and Intermediate indicators Workplan as per given format Budget as per given format Strategy for vulnerable groups IMEP Operational Plan Other wise, the PIP is treated as non-responsive and this could be communicated to the state. 2. Programme divisions send comments (time frame?) to DC Division (other than on programme management/ institutional strategies). DC Division consolidates comments and prepares report.