Format of Fund Accountability Statement of Ngos - PowerPoint

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					  User guideline on
MIES reporting Format



  Statistics Division,
  MoHFW, New Delhi
        The objectives of user guideline

   To   ensure     uniformity    and     consistency     in
    understanding of the monitoring indicators across States
    and Districts;

   To    facilitate   standardized      compilation      and
    calculation of the various indicators at various levels of
    health care system;

   To facilitate the programme managers and other
    stake-holders in tracking monitoring indicators through
    use of standardized definition of indicators.

   To facilitate peripheral staff who are engaged in the
    data collection to clearly fill the information without any
    ambiguity.
                                                         Contd..
The guideline will help in
      compiling good and robust data
       arriving at reasonable estimates of monitoring
       indicators and
      comparisons between different points in time.


National     and    State programme     Managers,
Demographers, Mission Directors, CMOs etc .can also
use these guidelines
    for monitoring the performance,
    making comparisons across states and districts and,
   provide insight to taking recourse to mid term
    corrections in the health programmes.
                    Organisation of the
                      User Guideline

CHAPTER - 1   Monthly reporting format from state to
              centre
CHAPTER – 2
              Quarterly reporting format
CHAPTER – 3   Annual reporting format
CHAPTER – 4   General concepts and definitions
CHAPTER – 5   Indicators for local level health planning
              List of references
              Important links / websites
 Chapter -1 monthly reporting format
        from state to centre
The Monthly reporting format of the MIES contains data relating to :

    The special information on CHC and PHC up-gradation,
    Reproductive and Child Health indicators and
    Inventory status.

These suggested indicators should be tracked on a monthly basis.

This Chapter has three main sections:

    Section 1A covers “Special Information on NRHM agreed indicators”
    given in items M100 to M400 of the MIES monthly format.

    Section 1B provides information on “Reproductive Health” related
    information covered in M1 to M16 and

    Section 1C provides information on “Monthly Inventory Status” covered
    in items M17 to M19 of the MIES Monthly format.
       1A.     art A. Special Information
Part A of the monthly format contains some special
information with regard to the performance of the public
facilities such as

   CHC upgraded as FRUs

   PHCs functioning as 24 hrs RCH services

   Total number of FRUs, CHCs and 24 hrs PHCs that
   are conducting at least 10 Wet mount tests per month
   and stock certain critical items.
      M-100 Performance of CHCs
          upgraded as FRUs

This section deals with capturing information on the
performance of CHCs that have been upgraded as FRUs.

As this is a separate compilation, there would be a certain
level of duplication on a few items like the no. of
deliveries, C-Section etc. being captured in item no M2
(2.2) & M3 (3.1) which is for all the CHCs whether they
are FRUs or not. This duplication is intentional.
                First Referral Unit (FRU)
An existing facility (district hospital, sub-divisional hospital, community health
centre etc.) can be declared a fully operational First Referral Unit (FRU) only if it
is equipped to provide round-the-clock services for Emergency Obstetric and New-
born Care, in addition to all emergencies that any hospital is required to provide.

Minimum services to be provided by a fully functional FRU

    24-hour delivery services including normal and assisted deliveries
    Emergency Obstetric Care including surgical interventions like Caesarean
    Sections(*) and other medical interventions
    New-born Care(*)
    Emergency Care of sick children
    Full range of family planning services including Laproscopic Services
    Safe Abortion Services
    Treatment of STI / RTI
    Blood Storage Facility (*)
    Essential Laboratory Services
    Referral (transport) Services
    (*): Critical determinants of functionality
         M-200.Performance of PHCs
       functioning as 24 hr RCH centres
This section deals with capturing information on the
performance of PHCs that are functioning as 24 hr
RCH Centre.

This is a separate compilation, there would be a
certain level of duplication on a few items like the no.
of deliveries, C-Section etc. being captured in item
no M2 (2.2) & M3 (3.1) which is for all the PHCs
whether they are functioning as 24 hr. RCH Centre or
not.
                   24 x 7 PHC



NRHM envisages that all the Primary Health
Centres should function as a 24x7 centre in a
phased manner

to improve the availability of health care
services and

also promotes the conduct of institutional
deliveries at these centres.
                                             Contd..
A 24 hour PHC :provides Basic Essential
Obstetric Care and reproductive health services
which includes
(i)24 hour delivery services (assisted +normal),
(ii)Essential new born care,
(iii)Referral for emergency
(iv)Routine ANC
(v)PNC and
(vi)Safe Abortion services
(vii)Family planning
(viii)Prevention and management of RTIs/STIs.
(ix)Essential lab services.
The steps that may be needed are as follows:
   Conduct an institution specific facility survey and identify the gaps.

   In order to make the PHC   24x7 delivery of services,

        There should be     at least 4 Staff Nurses          (to perform rotation duties
        round the clock. )

        To improve the institutional deliveries, appointment of at least three Staff
         Nurses may be recruited on contractual basis to fill the gaps.

       A labour room with appropriate equipments and drugs with

       Round the clock referral transport support either managed by the
          PHC or by the NGOs / CBOs for referring patients in case of emergency is
          essential.

        Appointment of two Medical Officers (MBBS)
            preferably one lady MO), and
            one AYUSH practitioner, either by relocation or on contractual basis.

        All effort should be made to see that all the PHCs have the Medical Officers.
                                                                                 Contd..
PHC buildings should be made environment friendly,
disabled friendly, with a good source of water supply, electricity / solar
power / other alternative energy sources and telephone.

Utilization of untied fund for strengthening the functioning of
PHCs.
Utilization of Annual Maintenance Grant for strengthening
the infrastructure and basic necessities
Each PHC must have a Rogi Kalyan Samiti (RKS) and display of
the Citizens’ Charter that should spell out the details of the health
services available at the centre.
Once a specific PHC has achieved the 24x7 / IPHS status, the district
authority / state authority should declare the institution as 24x7 / IPHS
and continuously monitor that these standards are being maintained on a
regular basis.
                   M -300.

M -300.
Total number of FRUs, CHCs and 24 hrs PHCs that
conducted at least 10 wet mount test (Refer
4.21 Chapter 4) per month is to be recorded

(This is one of the agreed indicators that are to be
monitored monthly.)
                              M-400.

This provides Monthly Stock of Critical items (viz.
Injection Oxytoxin, Gloves, MVA Syringes, Tab. Fluconazole, Blood
transfusion sets, Tubal rings, Gluteraldehyde 2%, Oral pills, Measles
vaccine, Vitamin A Solution, Ad Syringes etc.).

The Logistic Management Information System has
to be need-based and a mechanism of buffer stock
management has to be in place at all levels of the health system.

Number of Districts having stock-outs(Refer 4.22 Chapter 4) for
these critical items (400.1 to 400.11) at any time during the month to be
recorded
                   4.22 Stock-outs
Sufficient stock is defined as the quantity required meeting
estimated consumption needs for the following period
(month/quarter/year). No facility can afford to keep sufficient
stock to meet every demand. Inability to meet a demand due
to lack of inventory is called Stock-out.

Unit of measurement : Stock out percentage
It is calculated as the % of number of orders which could not
be satisfied to the total number of orders.

For items (400.1 to 400.11) take the monthly stock average
of an item during last financial year. Thus if Stock available at
the time of recording is less than one-third of the monthly
average it should be considered as Stock-out.
     1B.      Part B: Reproductive Health
Disaggregated data by SC, ST and Others to be
recorded for the reporting month for item M1 to M16

M1    ANTE NATAL CARE SERVICES

M2    DELIVERIES

M3    NUMBER OF CAESAREAN (C-SECTION) DELIVERIES PERFORMED

M4    PREGNANCY OUTCOME

M5    NUMBER OF CASES OF PREGNANT WOMEN IDENTIFIED WITH
       OBSTETRIC COMPLICATIONS AND ATTENDED

M6    MATERNAL DEATHS / DEATHS OF WOMEN (NUMBERS)

M7    POST PARTUM CARE

M8    MEDICAL TERMINATION OF PREGNANCY (MTP)
                                                    Contd..
       1B.    Part B: Reproductive Health
                    ......Contd..
M9     RTI/STI CASES

M 10   CONTRACEPTION

M11    NUMBER OF ELIGIBLE COUPLES ACCEPTING PERMANENT
        METHODS FOR CONTRACEPTION

M12.   JANANI SURAKSHA YOJANA (JSY)

M13    CHILD IMMUNIZATION

M14    NUMBER OF VITAMIN A DOSES ADMINISTERED BETWEEN
       9 MONTHS AND 3 YEARS

M 15   NUMBER OF CHILD HOOD DISEASES REPORTED DURING
        THE MONTH

M 16   NUMBER OF INFANT/CHILD DEATHS IDENTIFIED
     1C.          PART C : Monthly Inventory
                        Status
Part C of the monthly format provides information on the inventory status of
certain critical items.


M17       This provides information on Vaccine Stock Position during
the month. One of the objectives of the UIP multi year strategic plan is to ensure
an efficient and vaccine and injection equipment and management logistics

17.1 to 17.6 Record the stock position of DPT, OPV, TT, DT, BCG & Measles
vaccine in the respective column

M 18 Stock position of other drugs such as Vitamin A solution,
ORS Packets, Vaccine Carriers are to be provided in 18.1, 18.2 and 18.3.

M 19 Stock of AD syringes (0.1 ml, 0.5 ml and 5 ml) is to be
recorded in 19.1, 19.2 and 19.3.
   CHAPTER -2 QUARTERLY REPORTING
               FORMAT

The Quarterly format contains data relating to the
status of
      • health infrastructure,
      • manpower,
      • logistics and
      • institutional reforms under NRHM.

This format is basically for assessing the progress of
various initiatives under NRHM.


                                                Contd..
The strategy under NRHM involves wide ranging sectoral and
              systematic reforms in the health sector, like

       Intersectoral convergence,

       Pooling of funds /Societies of Health and Family Welfare programmes
        under National/State/District Mission,

       Strengthening of public health infrastructure by involving the Panchayat
        Raj Institutions,

       Increased accountability of doctors and paramedical staff at distrct/sub-
        distrct level,

       Constitution of Hospital Committee empowered to levy user free,
        involvement of private sector in the health delivery ,

       Strengthening of village health delivery by providing additional manpower
        etc.

Thus, it is paramount to track progress of NRHM for every quarter.

The quarterly format provides a brief summary of the progress achieved
under NRHM during the four quarters.
                                                                            Contd..
This Chapter has Six main sections:

Part A of this format is related the status of health
infrastructure            such as Community Health Centers (CHC),
Primary Health Centre (PHC), Sub-Centers (SC), District Hospitals,
Medical Colleges etc. NRHM envisages bringing up the services of
all health facilities to the Level of Indian Public Health Standards.

Part B of this format deals with status of human
resource availability-           staffing status of some selected
positions,

Part C gives information on Training of Programme
managers and various categories of staff
members. Information on the type of training programme, the
number of trainees identified and the number actually trained should
be recorded.
Part D provides information on Details of Camps Held.

Part E Indicate status of equipments.

Part    F    provides    information    on     Additional      NRHM
Components         viz. State/District Health Missions, Health Societies,
Rogi Kalyan Samitis, ASHAs and Functioning of VHC etc.

Part    G   provides    information    on    the   National    Health
Programmes.
    This data is already being collected by the respective nodal health
     officers and no fresh data collection is necessary.

    These officers have already been instructed to share this
     information with the State/District mission Director for NRHM.
       CHAPTER –3 ANNUAL REPORTING
                  FORMAT

This annual reporting format is to be submitted every year by the state to
GOI and status of the data to be recorded is as on 1st of April every year.

This gives a summary of health profile of the state and has
following Sections:

3A. : DEMOGRAPHIC (A1      to A7)
3B. : FROM THE ELIGIBLE COUPLE REGISTER (ECR)(A8 to A10)

3C. : SELECTED INDICATORS      (A11 to A15)

3D. : URBAN HEALTH    (A16 )
   CHAPTER – 4 GENERAL CONCEPTS
          AND DEFINITIONS


This chapter provides brief discussion on general
concepts and definitions applied throughout the
Guidelines.
These definitions are given in bullets 4.1 to 4.28 of
the user guideline.
A care has been taken to follow latest definitions as
per MoHFW/NRHM
    CHAPTER –5 INDICATORS FOR LOCAL
        LEVEL HEALTH PLANNING




This chapter provides discussion on various health and
family planning indicators to enable readers and district level
health programme managers to understand the concept that
are used to monitor and evaluate health programmes and
translate these concepts into local level health planning.
(Page 62)
     Methodology for Monthly Performance
           Report on FW Statistics
  I. Sterilization:
  a. Total No. of Eligible Couples @ in the beginning of year:

  (EC = Projected population during the year X Rate*)

  (* Rate = estimated eligible couples per 1000 population On the basis
      of 2001 census)

  @ = Eligible couples are those couples whose wife is in the age group
     15-45 years. Females are not eligible for sterilization after 45 years
     of age.

  b. Unsterilized couples are calculated: (Total no. of estimated
      eligible couples minus Estimated Sterilized Couples $ as per NFHS
      II/III)

  $ Estimated Sterilized Couples are Calculated:
                                                                  Contd..
  (Estimated eligible couples multiplied by %age current users of Ster.)
Sterilization (Contd..)

c. Current Year performance : As per the monthly report received
    from States/UTs about the total number of operations done

d. Last year performance of corresponding month for which report
    is prepared.

e. % change in current month performance over corresponding
   month.

f. Estimated Unsterilized Couples exposed to higher order births
    3 & 3+: (Estimated No. of EC Unsterilized multiplied by %age no.
    of Couples who have 3 or more children               Source NFHS
    II/II)

g. Sterilization per 10,000 unsterilized couples exposed to
   higher order of birth 3 & 3+ = (Current Sterilization divided by
   Est. unsterilized couples exposed to higher order of birth multiplied
   by 10000)

                                                               Contd..
II. IUD Insertions:

a. Total No. of eligible couples unsterilized in the beginning of year as taken
     in Sterilization statement

b. Performance of particular month during current year

c. Performance of particular corresponding month during last year %
    Change

d. Current IUDs divided by Est. unsterilized couples exposed to higher order
    of births multiplied by 10,000)




                                                                       Contd..
III. Eq. Condom Users:

a.   Total No. of eligible couples unsterilized in the beginning of year as
     taken in Sterilization statement

b.   Performance of particular month during current year. Condom users are
     calculated : (No. of Condom pieces (Net) / 72 ) X (12 / 1..2..3 for April,
     May, June)

c.   Performance of particular corresponding month during last
     year……same methodology as above

d.   % Change

e.   Current Condom users divided by Est. unsterilized couples exposed to
     higher order of births multiplied by 10,000)

f.   Note: Eq. Condom users are cumulative users as one beneficiary who
     uses 72 condoms pieces in a year is counted one user.


                                                                       Contd..
IV. Eq. Oral Pill Users:
   a.   Total No. of eligible couples unsterilized in the beginning of year as
        taken in Sterilization statement

   b.   Performance of particular month during current year. Oral Pill users
        are calculated : (No. of OP Cycles/ 13 ) X (12 / 1..2..3 for April, May,
        June)

   c.   Performance of particular corresponding month during last
        year……same methodology as above

   d.   % Change

   e.   Oral Pill Users per 10,000 unsterilized couples during current year

   f.   Note: Eq. Oral pill users are cumulative users as one beneficiary
        who uses 13 cycles in a year is counted one user.



                                                                      Contd..
Methodology for Monthly Performance
Report on Immunization Statistics
 I.   DPT Immunisation for children (0-1 Years) 3rd Dose:

      a. Prop. Need Assessed during the current financial year :
           Prop. Need assessed are calculated:
                        i. Live Birth = (Projected mid-year population X Crude Birth Rate)
                        ii. Children 0-1 years = (Live Births – (Live Birth X IMR)/1000
      b. Cumulative performance upto the month during current year
      c. Cumulative performance upto month of last year
      d. % Change

 II. POLIO (3rd Dose) 0-1 Years children: (same as per DPT above)

 III. B.C.G. (One Dose) 0-1 year children:                   - do –

 IV. Measles (One Dose) 9-12 months:                          - do –


                                                                                             Contd..
V. D.T. (Diptheria Tetanus) 5 Years Dose

    a. Prop. Need Assessed during the current financial year :
         Prop. Need assessed are calculated:
                        i. Projected mid-year population X
                                           proportion of children in the age of 5 years as per SRS Bulletin)

                   b. Cumulative performance upto the month during current year
                   c. Cumulative performance upto month of last year
                   d. % Change
                   e. % Achievement of prop. Need assessed

VI/VII. T.T. 10/16 Years Dose

    a. Prop. Need Assessed during the current financial year :
         Prop. Need assessed are calculated:
                       i. Projected mid-year population X
                                       proportion of children in the age of 10/16 years as per SRS Bulletin)

                   b. Cumulative performance upto the month during current year
                   c. Cumulative performance upto month of last year
                   d. % Change
                   e. % Achievement of prop. Need assessed




                                                                                                     Contd..
VIII. Vitamin ‘A’ (Prophylaxis against blindness due to Vit ‘A’ deficiency) Ist dose and
      2nd-5th dose

IST DOSE (0-1 YEARS)

         a. Annual Need Assessed (Total No. of Infants during current year)
         b. Achievement Cumulative (Ist Dose) during current year)
         c. Achievement of the same period during last year
         d. % Change
         e. % Achievement of Need assessed

    2-5th DOSE (1-3 YEARS)

         a. Annual Need Assessed (Total No. of Children aged 1-3 Years during current
              year)
         b. Achievement Cumulative (2-5th Dose) during current year)
         c. Achievement of the same period during last year
         d. % Change
         e. % Achievement of Need assessed of Vit „A‟ (2-5 dose) worked out by taking (2
              X 1.9 times) of Children (1-2 years)

    * Earlier half of doses initiated, continuing and completed were taken to get the total
         no. of beneficiaries.

				
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