Minutes of the 12th Joint Steering Committee NIPI Programme · The Chair of the Joint Steering Committee, Union Secretary of Health, Mr P K Pradhan opened the meeting and highlighted

Joint Steering Committee, December 10, 2011

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Minutes of the 12th Joint Steering Committee NIPI Programme Date: December 10, 2011 Time: 11.00 to 13.15 hrs

Venue: Conference Hall, 1st Floor, Ministry of Health & Family Welfare, Nirman Bhawan, New Delhi

The Chair of the Joint Steering Committee, Union Secretary of Health, Mr P K Pradhan

opened the meeting and highlighted the need for a focus on 3 main initiatives which were

initiated by the NIPI Programme and now taken up as National Government of India

programme. These 3 main initiatives included:

o Sick New Born Care Units (SNCUs): Government of India has brought out the

Operational Guidelines for adaptation by the States of India. He urged the NIPI

Partners to work on a streamlined monitoring system and format and also provide

technical support to the Government to ensure proper trained deployment of

Human Resources in the SNCUs.

o Home Based Post Natal Care: Home Based Post Natal Care started by the NIPI

Programme has now been adopted by the Government of India as Home Based New

Born Care (HBNC). This calls for a uniform format for HBNC and also there is a need

to link the incentives to ASHAs to child survival and not just coverage.

o National Child Health Resource Centre (NCHRC): Serious thought needs to be given

to the fact of how to make NCHRC located within NIHFW, sustainable. There is a

need to put a mechanism in place by way of which the role of NCHRC is better

understood in the States and consequently utilised in a better way.

The Co Chair, Deputy Ambassador Royal Norwegian Embassy (RNE), Mr. Aslak Brun

congratulated Mr Pradhan for his appointment as the Union Health Secretary. He expressed

satisfaction with the way NIPI has been functioning as a Partnership with the Ministry of

Health & Family Welfare (MoHFW) and all the implementing partners. Mr Brun was pleased

to see headway being made with the way NIPI coordinates with Union Government and with

the States.

He was also encouraged to see how gender is being mainstreamed through NIPI activities,

e.g. the development of a Gender Manual for the State of Rajasthan. Another example cited

by Mr Brun was strengthening midwifery and nursing initially started in the State of Bihar.

He also made a mention of the improvements noticed in the overall M&E reporting of the

Partnership indicators and through the results from the two Operational Research (OR)

studies which have been recently completed.

Furthermore, Mr Brun noted that while some NIPI interventions have worked well, few

others have not done so well. This should be taken note of. Also, he would like to see more

1. OPENING REMARKS


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concise formats on overall indicators. He appreciated the single page financial reporting,

which enables quick decision making.

Although there has been progress under ‘Gender Mainstreaming’, he requested for more

sex disaggregated data reporting wherever possible. Finally, a mention was made of the

need to improve documentation and visibility of the NIPI programme including its history.

There is an urgent need to update and improve the NIPI website.

Dr Paul Fife mentioned that current work on 5 year plans in India is exciting and would like

to discuss how NIPI can work within this broader framework.

The agenda of 12th JSC was adopted.

The Minutes of the 11th Joint Steering Committee were taken note of by the members.

The Action Taken report (ATR) was tabled.

Point for Discussion from ATR Update

WHO Compendium of Different Models for

Management of Severe Acute Malnutrition

(SAM) among children in India

MoHFW has requested for a detailed note on the

same from WHO. The concept note which was

developed by WHO for the last JSC held in May

2011, has been shared with the Mission Director

(MD) Madhya Pradesh, Dr Agnani.

WHO stated that the draft version of the

compendium shall be ready by March 2012.

MUAC Study: WHO The Chair requested WHO to roll out the study

without delay.

Guidelines for Quality Assurance of all RCH

services across all MCH levels: WHO and

UNICEF

To be discussed during the current JSC (12th)

Pilot an intervention model to delay 1st

pregnancy and spacing of second child among

married adolescents and young adults: WHO

This is ongoing. Results shall be available by the

next PMG

UNOPS LFA funding and inclusion of 3 months

buffer to match with Government financial

cycle: UNOPS LFA

Approved

2. ADOPTION OF AGENDA OF 12TH JOINT STEERING COMMITTEE MEETING

3. ADOPTION OF MINUTES OF 11TH JOINT STEERING COMMITTEE MEETING

4. ACTION TAKEN REPORT


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Save the Baby Girl (STBG) review Review in underway focusing on 1st the clinical

and technological perspectives

All the members took note of the 12th PMG Minutes.

RNE raised the issue of the PMG minutes lacking the item of budget discussions in the PMG , with

recommendation for the JSC. The Chair agreed that the minutes including the recommendations

should be in the main body of the minutes.

UNICEF’s proposal update on Baseline assessment of quality of maternal-newborn care was based

on the PMG’s recommendations to shift from assessment of quality to improvement of quality.

Phase I would involve expanding quality improvement from District Hospital (DH) to Community

Health Centres (CHCs) and medical colleges. Mentors from Mentor Cells would visit facilities every 3-

4 months, identifying gaps in the delivery of quality health services and mapping these on a spider

graph for the facility managers’ action. These Mentor Cells would comprise Nursing staff and

Obstetricians. Experience in Rajasthan with establishing such mentoring cells have shown good

results, e.g. bringing still births down from 24 to 12 per 1,000. The Joint Secretary was interested in

how scalable the model would be. She said GoI is looking for a universal model for Quality Assurance

(QA) and from where one could find the right people to be part of these mentoring cells. The Chair

acknowledged that this model fits very well into the supportive supervision approach and it was a

good intervention. Mentors’ skills themselves will be upgraded by participating in this exercise.

Phase II would take lessons from UNICEF’s Madhya Pradesh SNCU quality of care follow-up

approach, from institutional to community level. It would use survival, growth and development as

key indicators. Uttar Pradesh also has its comprehensive child survival programme where child

health managers identify areas where line supervision is weak then identify partners who can

provide appropriate support.

The Joint Secretary said the key issues would be who would be the supervisors, how do you keep

them motivated, how do you incentivise their participation, and what would be the number of

supervisors (e.g. 5 or 6).

The Joint Secretary suggested that after phase I in the 44 Districts UNICEF can share the trialled

model by end of March 2012 with GoI with the view of going to scale. The Chair said a budget line

could be put in the state PIPs for this purpose so the States can then take this up on their own.

5. TAKING NOTE OF THE 11TH

PROGRAMME MANAGEMENT GROUP (PMG) MINUTES

6. UNICEF PROPOSAL – ASSESSING QUALITY MATERNAL AND NEWBORN CARE


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Resolution

USD 500,000 was approved for the model development intervention, then subsequent funding

would depend on outcome of the baseline. The Joint Secretary said that this should include the

cost of sensitising other Development Partners to this model so that they can take this up in those

States where they are functioning. This additional budget will be shared with the NIPI Secretariat

Dr. Paul Fife mentioned the trend of shifting focus from coverage to quality assurance in health

services is an international phenomenon and it is exciting to see India taking this up also. It is also by

any means not an easy approach to monitor, as it has to do with a variety of aspects including

measurement, human resource management, customers’ perceptions and how they view health

services as a right. He requested the 44 districts include the NIPI focus districts. UNICEF responded

that they were included in NIPI focus States.

With regards to the budget, Phase I would require USD 500,000 where costing of Phase II would

depend much on the baseline results from Phase I. Phase I would, be completed by March 2012. The

full impact of Phase II would be seen only after a period of 2-3 years.

A National Child Health Resource Centre (NCHRC) 5 year plan was submitted on the basis that the

NCHRC remain within NIHFW. The Acting Director, Prof Bhattacharya, outlined the previous and

current activities of the centre including the extended scope of their work. She pointed out that the

scope of the NCHRC is such that it can be subsumed with the National Health Portal. The Joint

Secretary said linking NCHRC to National Health Portal under NIHFW is a policy decision and will be

dealt with separately. The Chair requested the Director NIHFW ensure the internal funding systems

were in place to take over NCHRC once NIPI funds ceased.

RNE raised the issue of projected human resources costs and salaries, which should match the

existing government rates and conditions so there is no disparity once the centre is handed over to

NIHFW.

The WR, WHO mentioned that WHO has had experience of setting up resource centres in the HIV

field especially, where professional resources are needed to the raise the profile and make such

centres more effective.

Dr. Paul Fife stated that in NIPI’s piloting of various interventions it should not automatically be

assumed the pilot was successful, and some activities which have proved to be less than effective

should be let go. He said State Child health Resource Centres (SCHRC)s would be one example of

this.

7. NATIONAL CHILD HEALTH RESOURCE CENTRE & SCHRC


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Resolution

RNE agreed to funding NCHRC as far as the 12th budget plan, then only short term bridging

funding after that if for some reason there was a delay in GoI picking up funding support.

The Chair requested NIPI engage a professional to raise the visibility of NCHRC and make it more

functional as a resource centre.

The budget of NCHRC would remain at the same level for the next 6 months. SCHRCs will not

receive NIPI funding after April 2012. The Joint Secretary said that the focus should be on

strengthening the National Child Health Resource Centre (NCHRC). States may take up supporting

SCHRCs should they feel they are contributing to the goals of NRHM.

Resolution

The Chair mentioned that the NIPI Secretariat could be placed in their new setting by the 1st week

of January 2012.

GoI recommended relocating NIPI Secretariat closer to government and NIHFW was suggested as a

suitable location. NIHFW has agreed to offering the space. The Co-chair Aslak Brun was grateful for

offering this space to NIPI and said RNE were looking forward to a more defined and independent

presence for the NIPI Secretariat.

The Secretariat’s update included alignment of reporting on NIPI outcomes and outputs with that of

Government of India through HMIS, Annual Health Survey, District Level Household Surveys and NIPI

Partners reporting. Documentation of NIPI programme will be centred on a web-server which is

being built and housed within the Secretariat.

Support to GoI included consultants to MoHFW, production of video film on neonatal health and

radio jingles, print media on declining sex ratio.

Operational Research is well underway, with Indian research agencies being connected with

Norwegian counterparts. Two OR studies have been completed a) the ASNI study from PHFI and b)

the optimal breastfeeding practice and nutrition study from ANSWERS.

Costing of particular NIPI interventions will also be addressed through the recruitment of a health

economist.

Promoting innovation was also a NIPI Secretariat function, whereby the management of NIPI data is

being systematised under the Data Management Information System (DMIS). NIPI Secretariat are

8. NIPI SECRETARIAT PROXIMITY TO GOVERNMENT

9. NIPI SECRETARIAT UPDATE


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Resolution

JSC approved of this budget assessment.

Resolution

The JSC approved the Budget of USD 5,300,000.

working with UNICEF on one aspect of DMIS, which is integration of the Guna SCNU software model

to shift to an online platform under DMIS. The Joint Secretary also requested a review of Save The

Baby Girl STBG, which NIPI Secretariat is coordinating.

Finally NIPI Secretariat is working to integrate gender and equity into the NIPI Programme. This is

being done by direct assistance to the Government of Rajasthan by way of creating a gender manual

for grassroots health workers. NIPI Secretariat was also represented in a core group to develop

minimum standards for Mother and Baby Friendly Services and Perinatal Care during Transport.

Gender mainstreaming efforts supported through NIPI semi-annual reporting and contributing to an

all UN forum on declining sex ratio lead by UNFPA .

WHO

The WR WHO remarked that much of their budget projection for 2012 was linked to the Country

Cooperation Strategy (CCS) which was just being finalised with GoI.

Three main pillars of the CCS were Scaling up, Quality and Human Resourcing. There was to be an

alignment of the CCS with existing NIPI activities.

No new proposals were there to be presented but WHO envisages that by the next PMG and JSC

there will be a number of new initiatives for consideration.

WHO are budgeting for USD 875,000 but no funds required at this time.

UNICEF

The total budget envelope was for USD 6,000,000 but given that they already have USD 700,000, a

request for USD 5,300,00 was made.

RNE commented that the budget was arranged per activity while the expenditure was arranged

State wise. They requested for some consistency.

NIPI LFA Budgets for 2012

UNOPS LFA is seeking for USD 5,849,000 in the year 2011.Utilisation certificates from States

amounted to 9.9 million USD (or 70% of the total disbursements) to Sept 30, 2011.

10. BUDGETS


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Resolution

The Chair approved that the budget is settled bilaterally between the NIPI LFA and RNE.

(Annex 1)

Resolution

The Chair approved that the budget is settled bilaterally between the NIPI Secretariat and RNE.

(Annex 2)

RNE were not convinced of the need to retain the 3 month funding buffer addition for 2013

An updated budget can be found as an annexure.

NIPI Secretariat Budgets for 2012

Dr. Paul Fife raised queries on certain increased budget for 2012 based on expenditure from 2011.

Questions on the “Other” budget category were also raised. It was explained that budgets do not

consider cash in hand carry over from the previous financial year. A more appropriate comparison

would be “funding required.”

Plans to hold the next JSC abroad account for an increase in the travel budget, coupled with an

increase in the number of consultants engaged under the Secretariat.

UNICEF

The UNICEF Representative reported participation in the recent meeting in Hanoi on sex ratio at

birth. Addressing the issue of declining sex ratios required cross ministry engagement. The UNICEF

representative suggested that NIPI be used as a forum for declining sex ratio discussion. She also

suggested community based interventions in malnutrition would be needed to break the cycle of

deprivation.

The Joint Secretary Madam Anuradha Gupta supported the idea of inter ministry consultation and to

integrate this into 5 year programme.

Also, UNICEF Representative raised the question on NIPI’s stand on extending the programme

beyond 2013.

NIPI beyond 2013

Dr Paul Fife said budgets needed to be assessed in the spirit of austerity which was now prevalent

throughout most of Europe. He further informed that NIPI funding would likely to be extended past

the current committed term into a new phase, perhaps to 2015 as only 60% of the committed

funding of NOK 500 million has been spent. He suggested this would be the main topic of discussion

11. OTHER BUSINESS


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at the next JSC. He proposed the date as the 14-18 May 2012 and the venue to be in Oslo. This

would leave time leading up to the next JSC to assess current status and options for NIPI.

Closing Remarks from the Chair

MDG4 has 2015 as its target. This would be the NIPI goal also, continuing to use NIPI interventions as

catalytic, technical support inputs. The details may be worked out in the next 6 months, with a

formal request for extension pending.

The 12th JSC meeting closed at 1.15 pm


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NIPI LFA Budget

NIPI LFA Fund Requirement for the year 2012 (In USD)

States

Unspent Balance by Dec'11

(in USD) (A)

Budget for the Year 2012 (Jan-Dec) (in USD)

(B)

Fund required for (Jan-Dec 2012)

(in USD) (B-A)

M.P. 1,533,480

1,626,742

93,262

Orissa 912,087

1,335,270

423,183

Rajasthan 953,496

2,269,222

1,315,726

Bihar 1,369,062

1,042,127

(326,935)

Total 4,768,125 6,273,361 1,505,236

Opening Balance as

on Jan 2011 (in USD)

(A)

Funds received in

2011 (in USD)

(B)

Total Funds Available in the

Year 2011 (in USD) C=(A+B)

Expenditure as on

Nov'11 (in USD)

(D)

Expected Expenditure for Dec'11 (in USD)

(E)

Total Expected

Expenditure from Jan-

Dec'11 (in USD) F=(D+E)

Unspent Balance

by Dec'11 (in USD) G=(C-F)

1,774,852.11 3,497,414.18 5,272,266.29 2,208,609.12 2,255,441.44 4,464,050.56 808,215.73

ANNEX 1


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Fund Requirement for 2012 Amount (in USD)

State Grants 1,832,171.04

National level 1,082,080.92

Grants to Partner Agencies, contracts and travel of state officers

1,588,484.80

Four state office

468,756.90

Total Fund Required 4,971,493.66

Less Expected Unspent Amount for the year 2011

808,215.73

Overall Fund requirement 2012 4,163,277.93

ANNEX 1


MINUTES

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NIPI Secretariat Budget

BUDGET 2012

Award ID 00045792

Project Title- NIPI Secretariat

Project

#

Key

Activities

Accounts Budget Description Approximate budget

2012

00054184

61100 Salary NP Staff 12,000.00

Act

ivit

y 1

NIP

I S

ecre

tari

at

61200 Salaries GS Staff 58,104.67

61300 Salaries IP staff 258,075.00

62000 Recurrent payroll cost- NP Staff 25,659.00

62200 Recurrent payroll cost- GS Staff 16,661.00

62300 Recurrent Payroll cost- IP Staff 33,300.00

63400 Learning Costs 10,000.00

63500 Insurance and Security Cost 41,510.00

64300 Staff Mgmr Cost IP -

71200 International Consultant -

71300 Local Consultants 339,133.33

71600 Travel 162,222.22

72100 Contractual Services- Companies 71,843.23

72200 Equipment & Furniture 63,333.33

72400 Communication and audio Visual Equipment 13,361.11

72500 Supplies 4,500.00

72600 Grants 227,355.56

72700 Hospitality 8,333.33

72800 Information technology Equipment 35,555.56

73100 Rental & maintenance- premises 31,222.22

73200 Premises Alterations 33,333.33

73300 IT Equipments 50,000.00

73400 Rental & Maintenance of other Equipments 5,555.56

74200 Publishing & Print Products 50,000.00

74500 Miscellaneous Expenses 8,888.89

75100 Facilities and Administration 77,997.37

SUB-TOTAL 1,637,944.71

Act

i

vit

y

4

OP

ER

AT

I

ON

AL

RE

S

EA

RC H

72100 Contractual Services- Companies 306,450.00

ANNEX 2


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75100 Facilities and Administration 15,322.50

SUB-TOTAL 321,772.50

GRAND TOTAL 1,959,717.21

Proposed budget summary

Contract 605,648.79

Staff costs 794,443.00

Travel 162,222.22

Rent 31,222.22

Others 272,861.11

F& A 93,319.87

Total 1,959,717.21

ANNEX 2


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12th Programme Management Group (PMG) on 22nd November 2011

S.No. Name of Participant Department

1 Mr. P.K. Pradhan CHAIR (JSC) & SECRETARY HEALTH &FW

2 Ms. Anuradha Gupta MOHFW

3 Dr. Ajay Khera MOHFW

4 Mr. Sharad Kumar Singh MOHFW

5 Dr. Madhulekha Bhattacharya NIHFW

6 Ms. Karin Hulshof UNICEF

7 Dr. Pavitra Mohan UNICEF

8 Mr. Paul Fife RNE/ NORAD

9 Mr. Aslak Brun RNE

10 Ms. Inger Sangnes RNE

11 Dr. Ashfaq Bhat Ahmed RNE

12 Dr. B. Dash Mohaptra NIPI State Bhubaneswar

13 Dr. M.P. Budania NIPI State Rajasthan

14 Mr. D.K. Samantray NIPI State Madhya Pradesh

15 Dr. Nata Menabde WHO

16 Dr. Paul Francis WHO

17 Dr. Archana Choudhury WHO

18 Dr. Kaliprasad Pappu LFA NIPI

19 Mr. Tony Cameron NIPI Secretariat

20 Dr. Urvashi Chandra NIPI Secretariat

21 Ms. Shanti Moktan NIPI Secretariat

22 Ms. Prasanna Narayanan NIPI Secretariat

23 Mr. Aditya Mishra NIPI Secretariat

ANNEX 3

Documents

Minutes of the 12th Joint Steering Committee NIPI Programme · The Chair of the Joint Steering Committee, Union Secretary of Health, Mr P K Pradhan opened the meeting and highlighted