Public Private Partnership (PPP)

The Government of Arunachal Pradesh, in order to overcome the shortcomings in the health care delivery system in the remote health facilities in the state and to further improve the health facilities, the Government of Arunachal Pradesh implemented Public Private Partnership (PPP) in 2005 in which one Primary Health Centre (PHC)/Community Health Centre (CHC) in the State is managed and operated through a selected Non Government Organization (NGO); and the project is successfully sustaining till date.  The strategic objective of the project is to provide quality clinical and preventive health services to the people residing in the Primary Health Centre area and at the same time effectively implementing National Rural Health Mission (NRHM) and other National programs including IEC activities, and promotion of community based disaster preparedness. Under the project, the management of 16 Health Facilities is handed over to  selected 5 Non Government Organization (NGO)  for a period of 1 (one) year and extendable subject to the approval of Government of India.

Sl. No.	Name of the NGO	No. of Health Facilities managed by the NGO
1	Karuna Trust	11
2	Future Generations Arunachal	2
3	JAC Prayas	1
4	N.N. Charitable Society	1
5	M.M Charitable Trust	1

The funds made available per annum, to the Agency for operating and managing the PHC/CHC would be as follows:
ANNUAL BUDGET  FOR MANAGEMENT OF ONE HEALTH FACILITY

	Budget Head	Unit	Monthly Budget	Annual Budget	Head wise annual budget
A	Medicines, Healthcare consumables
1	Medicines	1	25000	300000
2	Surgical Items	1	5000	60000	438000
3	Laboratory Items & diagnostic kits	1	3500	42000
4	Hospital Materials & supplies	1	3000	36000
B	Maintenance, Furniture, equipments
1	Repairs & Maintenance of PHC/SCs	1	5000	60000	120000
2	Equipments & Furniture	1	5000	60000
C	Administrative Expenses
1	Water & Electricity	1	2000	24000
2	Talephone, internet, postage	1	1000	12000
3	Vehicle Repairing	1	5000	60000
4	Vehicle fuel	1	5000	60000	302000
5	Travelling expenses	1	3000	36000
6	Transportation cost	1	2500	30000
7	Outreach Health camp expenses	1	2167	26000
8	Printing, Stationeries & IEC	1	2500	30000
9	Staff Training & orientation	1	2000	24000
D	Personnel Cost
1	Medical Officer	2	39500	948000
2	Pharmacist	1	16000	192000
3	Staff Nurse	2	16000	384000
4	Lab Tech	1	13000	156000	3720000
5	ANM, (3 in SCs, 2 in PHC)	8	13000	1248000
6	Health Assistant (male)	2	13000	312000
7	Driver	1	8000	96000
8	Group D(Including SCs)	4	8000	384000
TOTAL					4580000

	Budget Summary
A	Medicines & Healthcare consumables	Rs. 438000
B	Maintenance, Furniture	Rs. 120000
C	Administrative Expenses	Rs. 302000
D	Personal Cost	Rs. 3720000
TOTAL		Rs. 4580000

Rupees Forty Five lakhs Eighty Thousand only per health facility per annum. The Agency will contribute 10 percent from its own sources towards the project cost.

Health facilities Managed under PPP:

NGO	Name of the district	Name of the PHC/CHCs	Sub Centres under the PHC
	Anjaw	PHC Walong	Yasong	Kibitho
	Changlang	PHC Khimiyong	Yanam	Jongi Havi
	Dibang Valley	PHC Etalin	Arzoo	Anelih
	Kurung Kumey	CHC Sangram	Pagba	Leel	0 Point
	Tawang	PHC Dungdugarh		Phongleng
	Papum Pare	PHC Tarrasso
Karuna Trust	Upper Siang	PHC Jeying	Bine	Sibuk	Pongging
	Papum Pare	PHC Mengio	Kamrung	Nyopang	Pilla
	Tirap	PHC Wakka	Nginu	Khanu
	East Kameng	PHC Bameng	Lada	Paksa camp	Marjingla	Pakke
	Lower Dibang Valley	PHC Anpum	Keba	Paglam	Bizari
Future Generations, AP	East Siang	PHC Sille	Sika-Bamin	Mangnang
	West Kameng	PHC Thrizino	Palizi	Subu
J.A.C PRAYAS	Lohit	PHC Wakro	SC Medo
N.N Charitable Society	Lower Subansiri	PHC DEED Neelam	SC Dem	SC Miya	SC Sito	SC Pania
M.M. Charitable Trust	Upper Subansiri	PHC Siyum	Page Nalloh	Bogia Siyum	Eru	Laklam	Jingba rai

MEMORANDUM OF UNDERSTANDING (MoU)

This Memorandum of Understanding (MoU) is signed between on this______ day  of _________2016 Governor of Arunachal Pradesh (hereinafter referred to as “State Government” represented by the Director of Health Services/Mission Director (NHM), (which expression shall include his successors, assigns and administrators) on the one part and NGO______________________________ (hereinafter referred to as “Agency”) represented Mr./Ms./Dr.___________________________(which expression shall include his / her assigns, successors and administrators) on the other.

Whereas the Government of Arunachal Pradesh, in order to further improve the health services in the State, has decided to continue with the project, which was earlier taken up on pilot basis, wherein few Primary Health Centres (PHC)/ Community Health Centres in the State shall be managed and operated through a selected Non Government Organization (NGO)  for a period of 1 (one) year and extendable subject to the approval of Government of India. Now, therefore, it is agreed by and between the parties as follows:

1. Number and location of PHCs/CHCs

   The “Agency” shall operate/manage the PHCs/CHCs as per details in Schedule ‘A’ to the MoU and management of Sub Centres under the jurisdiction of the PHC/CHC would also be the responsibility of the Agency. The Government may, in public interest, change the PHC/CHC being run by the Agency provided, however, any such change will be within the same district and with prior consultation with the Agency.

2. Modalities of Implementation
   

   2.1.The building and physical infrastructure of the PHC(s) /CHC shall be handed over to the Agency along with the existing equipment, furniture, etc. and an inventory of the same would be made jointly by the State Government and the Agency. The condition of the building/equipment handed over will be duly recorded. The Agency shall maintain the said building/equipment with due care as would be reasonably expected.

The existing records such as medical data / statistics, case records etc available with the PHC/CHC shall also be handed over to the Agency so as to maintain continuity.  The Agency would preserve these records carefully and hand over the same to the State Government at the time of exiting from the project.

2.2.The Agency shall provide all the critical determinants of a facility being a 24 hour functioning Primary Health Centre as per clause 3.3, to the local population residing in the geographical area under the jurisdiction of the said PHC(s) /CHC. The Agency will engage its own Medical/Paramedical/other staff for providing these services and will ensure that these personnel are always available at the pre-decided timings. The said personnel would also reside locally. In case of leave or absence of any personnel, the Agency would be duty bound to provide an alternative so that the PHC/CHC does not, at any point in time, become non functional due to the lack of the required personnel.

2.3. The Agency shall be responsible to provide, interalia, the following services

1. 24 hours Emergency/Casualty Services,.
2. 6 days OPD service.
3. 4 to 6 functional beds.
4. Ante-natal care and Post natal care.
5. 24 hrs labour Room and Essential Obstetrics facility both normal and assisted.
6. Early and safe abortion services (including MVA).
7. Prevention and management of RTIs/STIs.
8. Essential New Born Care.
9. Routine immunization services
10. Family Planning services.
11. Adolescence Reproductive and Sexual Health Services
12. Essential laboratory services.
13. 24 hrs Ambulance Facility, referral for emergencies.
14. Essential medicines as per Schedule D to the MoU and the Agency would be encouraged to keep in stock such additional medicines as are found necessary after assessing the field situation.
15. Participation in and implementation of National and State Programs of Health & Family Welfare including, inter alia, NRHM, RNTCP, NVBDCP, NACP etc.
16. Outreach camps

2.4.To provide the services as described in Para 3.3 above, the minimum staff deployed would be as under. Any changes in the above pattern would be effected only with the approval of the State Government.
The Agency will engage personnel with requisite qualifications appropriate for the job description. The said qualification would be as per Government norms.

Sl No	Category of staff	No of posts
1	Medical Officer	2
2	Pharmacist	1
3	Staff Nurse	2
4	Lab Tech	1
5	ANM **	2 (PHC /CHC )
		5 (SCs) *
6	Health Worker (male)	3
7	Driver	1
8	Group D(Including SCs)	4

* The number of ANMs would be decided on the basis of Sub Centres under the jurisdiction of the PHC/CHC.

** Experienced and adequately trained ANM may be considered.

2.5.   The personnel engaged by the Agency will not be paid at rates exceeding those envisaged in the funding pattern to this MoU and any change in the rates, if necessary, may be effected only with the approval of the State Government.  The personnel should also be suitably trained for the jobs they are expected to perform.  Personnel engaged by the Agency will be the sole responsibility of the Agency and would have no claim at any time whatsoever, by virtue of their contract with the Agency or for any other reason, for being absorbed into Government service at a later date.

2.6.   The existing Sub Centres, under the jurisdiction of the PHCs/CHCs, would  also be similarly run by the said Agency. The services provided by and through the Sub Centres will be as per the GoI guidelines. The Agency shall similarly run any additional Sub-Centres which may be notified by the Government within the geographical jurisdiction of the PHC/CHC.

2.7.   The Agency will provide the Laboratory test facilities at the PHC/CHC level as described in Schedule B to the MoU.

2.8. The Agency will provide all services free of cost. However, if recommended by the PHC/CHC Management Committee and approved by the Government, user charges could be considered. Any such charges collected would be used only for the improvement of the PHC/CHC and for meeting the cost of referral services.

2.9 The Agency shall strive to provide quality services and  keep the PHC/CHC and its immediate environment clean. Agency shall also display a sign board at a prominent place informing about OPD timings, services provided by the PHC /CHC / SC (Citizens charter), and referral facility. A waiting area for patients / relatives, drinking water, toilet facility, suggestion box, clean linen in the ward and such other infrastructure / facilities as would be normally expected would be made available at the PHC/CHC.

3. Project commencement and duration

The duration of the project will be 1(one) year.  However, in the event the State Government or the Agency desire to terminate the project before the expiry of the said period, a notice period of 3 (three) months will be given to the other Party. The period of one year will be calculated from the date on which, the immediately preceding MoU for the PHC/CHC between the State Government and the Agency expired. The term of the project can be extended further subject to mutual consent for the same between the State Government and the Agency.

4. Review and monitoring structure

4.1. A PHC/CHC Management Committee which will also function as a Rogi Kalyan Samiti (RKS) would be constituted for the PHC/CHC.The said committee will include the Agency representatives, District Medical Officer, District RCH Officer, Deputy Commissioner or his nominee (not below the level of SDO), Zilla Parishad Member, two representatives from Anchal Samiti and two each from each Gram Panchayat in the area served by the PHC/CHC. The names of these PRI members will be communicated through the Deputy Commissioner. At least one of the two nominees from the Anchal Samiti and from each Gram Panchayat would be a lady. The local MLA of the area would be a permanent Special Invitee to the PHC/CHC Management Committee. Such other officers, in addition to those already included in the RKS, as required and necessary (for example, Child Development Project Officer, Assistant/ Junior Engineer from Works Department) can also be special invitees to the said Committee.

The PHC/CHC Management Committee / RKS would meet at least once in every two months and will be responsible for guiding/monitoring the project as per guidelines issued by GoI / State Government.  The committee shall address local issues and problems as are normally expected from such a Committee.

4.2.   At the State level, a Steering Committee chaired by the Commissioner & Secretary (Health) along with suitable representation from all stake holders including the Agencies in the 16 districts, State Government Departments and Central Government will be formed.  This State level Steering Committee will meet at least once, every 6(six) months.  It will review the work done at the PHCs/CHC, suggest suitable improvements and midcourse corrections, and resolve the difficulties faced by the Agencies in running of the PHCs/CHC.

5. Records & Reporting

5.1   The Agency would be expected to maintain records and to furnish reports, in time, as normally expected from any PHC/CHC in the Government system.  The reports will be furnished on monthly basis to the DMO / DRCHO with a copy to MD (NRHM) in the format at Schedule C, Any other reports required by the Government, from time to time, will be intimated to the Agency in writing.

The Agency will maintain register at the PHC/CHC and SC for all activities performed pertaining to Maternal health (ANC, PNC, Delivery, Maternal death), Child Health including Routine Immunization, Family planning, JSY, OPD, IPD, Outreach camps, Medico-legal case, Injections, Stock Register and other registers as specified by the Government from time to time.

5.2.    The Agency shall maintain a record of proceedings of the meetings of the PHC /CHC Management Committee / RKS.The Agency shall also maintain a Visitor Book where authorized Government functionaries can record their views/suggestions after conducting an inspection.

6. Standards of hygiene and health safety.

6.1.   The Agency shall maintain and run the PHC/CHC in a hygienic manner conforming to the standard norms of health safety.  Auto destructive syringes will be used for immunization and autoclaved glass syringes with disposable needles will be permitted for other injections.   The hospital waste shall be disposed of in conformity with the recognized and acceptable norms as specified by the State Pollution Control Board from time to time.

7. Purchase of drugs and consumables

The procurement of drugs/consumables from the funds allotted by the Government will be made in a transparent and economical manner.  Only Government approved quality drugs of generic nature will be procured as per the list at Schedule D.  Proprietary/branded drugs may be procured, only in exceptional cases, and with the prior consent of the State Government.  Normally the price of procurement for the Agency for any drug/ consumable by the Agency should not exceed the price at which the same drug is procured by the State Government.  Care shall be taken by the Agency to use the drugs/consumables within the relevant expiry dates.

8. Diet for inpatients, scale and quality

The diet for inpatients in terms of quality and scale should not be less than the standards set in Government run PHCs/CHC.

9. Asset Creation

Any assets created at the PHC/CHC from the funds of this project or from funds collected from the community will be the property of the State Government/community and will be handed back to the Government,  after the project duration is over.  Moveable assets created by the Agency from its own funds (that is funds beyond the 10% share to be provided by the Agency) will remain the property of the Agency and can be disposed of by the Agency after the expiry of the Project, as per its own policy.

10. National and State Programs.

The Agency will be a part of the Health Delivery System of the State.  Accordingly, the various National Disease Control Programs or other State Government programs planned for the PHC/CHC area will be implemented by the Agency in coordination with the existing field staff, if any, specifically appointed by the State Government for implementing such programs. Apart from implementing all National Programs and campaigns (such as Pulse Polio Immunization, Cancer detection, Immunization camps etc) the Agency will also undertake outreach activities by conducting camps, VHND involving ASHA etc.

Any drugs/equipment/vaccine made available by the Central Government under any National Programme for use at PHCs/CHC / SCs will also be provided to the Agency run PHC/CHC / SCs at par with other Government run PHCs/CHC / SCs.

11. Specialized expensive treatment

Patients requiring expensive and specialized treatment not normally expected at the PHC/CHC level will be referred to the District Hospital/General Hospital.

12. Medico legal cases and Post mortem examination.

The doctors engaged by the Agency at the PHC/CHC would attend to Medico legal cases and may also be required to conduct Post Mortem examination.

13. Funding

13.1.   The Agency will receive funds from the Government, towards meeting the cost of Personnel, Drugs (Medicines), Reagents, Surgical Material, Health Care Consumables, Administrative Charges, Civil Works, Furniture, Equipment (including Surgical Equipment), to the extent and as per details at Schedule E to this MoU.

13.2   The Agency would meet from its own sources not less than 10% of the Project cost, as reflected in the Statement of Expenditure and submit Accounts duly certified by a Chartered Accountant.

13.3. The disbursement/release of funds by the State Government to the Agency would be in two installments every year that is by June and November. However in the current financial year, the funds will be released as per mutually agreed schedule after signing of the MoU.

14. Audit and Accounting

14.1.   Each PHC/CHC (which also includes the Sub Centres under its jurisdiction) shall be treated as an independent and separate entity for accounting purposes. Accordingly, separate Accounts shall be maintained for each PHC/CHC.  A Statement of Expenditure (SOE) and Utilization Certificate (UC) duly certified by a Chartered Accountant will be furnished by the Agency to the State Government on half yearly basis. For the months April-September, the SOE/UC will be given by 31^st October and for the months October-March, by 30^th of April every year. In addition, annual audit of the PHC/CHC accounts would be undertaken through a qualified Chartered Accountant and the audit report and accounts for the year would be furnished to the Government by 31^st May of the succeeding year.

14.2  The State Government reserves its right to get a special audit conducted of the accounts of the PHC/CHC after giving at least 30 days notice to the Agency.

15. Performance Monitoring and Standards of Service

15.1. The performance of the Agency shall be monitored largely on the basis of output based indicators, a list (not exhaustive) of which is at Schedule F to this MoU. These indicators and performance standards can be suitably expanded and/or modified after mutual consultation and in the interest of better service delivery to the general public.

15.2.   The indicators and standards specified in this MoU for the health delivery expected from the Agency are as per GoI guidelines.  The Agency shall endeavour  to serve as a role model and to provide services at a much higher standard.

16. Evaluation

The Government would evaluate the success of the project in providing improved health services to the people. Evaluation will also facilitate identification of intervention areas for removal of difficulties. For this purpose, external evaluation can be done after a period of 6 months from  the commencement of the project. Concurrent evaluation would also be permissible after completion of one year of the project life. The Agency will also be encouraged to undertake internal evaluation.

17. Dispute Resolution and Court jurisdiction

17.1   Any dispute or differences of interpretation between the Government and the Agency vis-à-vis this MoU will be taken up before the Commissioner / Secretary (Health), Government of Arunachal Pradesh for resolution.  In case the resolution is not possible amicably between the parties, this will be taken up before the Chief Secretary, Government of Arunachal Pradesh whose decision shall be final and binding on both the parties.

17.2  In case of any legal dispute arising out of this MoU, the parties shall be under jurisdiction of the courts in Arunachal Pradesh and the laws as applicable in the state.

18. Extension of the NGOs under the Project

18.1        Extension of the NGOs under the Project PPP shall be subject to recommendation by the concern District Health Societies and on the basis of the Physical and Financial performance which shall be reviewed half yearly by the State Health Society.
18.2 The extension of the Project as whole shall be subject to the approval of the Project by the Ministry of Health and Family Welfare, Govt. of India.

19. Miscellaneous

19.1The Agency shall not indulge in, promote or encourage any religious or political activity and shall be sensitive to the local sensibilities and the tribal culture.

19.2.The Agency will not be permitted to further sub-contract or engage other NGO(s)/ Organization(s) for performing in full or in part any of the activities expected from the Agency as per this MoU.

19.3. The Government reserves their right to give directions to the Agency, in Public interest, regarding the management and operation of the PHC/CHC or for any other matter related to the PHC/CHC.
19.4 The Agency will be duty bound to assist the Government for controlling any epidemic or medical emergency in the area.

20. Saving

Any changes in any clause(s) of this MoU can be carried out by the Government, in public interest, after due consultation with the Agency. Further, if any aspect of the arrangement between the Government and the Agency as also the obligations of the Government/Agency has been left out in this MoU, the same can be included, in  due course, after mutual discussion between the Government and the Agency.

25. A G R E E M E N T

This MOU is signed on this ___________ day of ___________ 2015 at __________________India.

Name:                                                                                                  Name:

Designation:                                                                                       Designation:

For and on behalf of the Governor                                                  Company

of Arunachal Pradesh

In witness whereof, the parties hereto have signed this MOU on this ________________ day of _________________, 2015 at ____________________

Witness:

1. Name:                                                                                           2.Name

Address                                                                                               Address

SCHEDULE – A

Assignment of Health Facilities to NGO
(CLAUSE 2)

1. NGO name                 :

Numbers of Health Facilities       :

Sl.No.	DISTRICT	Selected Health Facility

SCHEDULE – B

Lab tests facilities to be provided

1. Blood routine examination ( Hb%, TLC, DLC, ESR)
2. Blood grouping and Rh typing.
3. Blood for MP test, widal test.
4. Stool routine examination (Physical, chemical and microscopic).
5. Urine routine examination (Physical, chemical and microscopic).
6. Urine for pregnancy test.
7. Sputum for AFB.
8. Blood sugar.
9. Blood for VDRL.
10. Rapid tests for pregnancy
11. Any other test recommended/in place through other programmes

SCHEDULE – C

1. M&E Monthly report for PHC/CHC/SC: – The NGOs will submit regularly the Monthly M&E Reports in the prescribed formats of the GoI. The reports shall be submitted to the concern District Health Society.
2. MCTS: – The NGOs will submit the MCTS reports regularly in the prescribed MCTS formats. The reports shall be submitted to the concern District Health Society. Regular tracking of Mother and Child will be ensured with provision of services
3. Monthly Personnel Availability:- The NGOs will submit monthly attendance sheet of the Personnel available during the month in the Health Facility as per the below mentioned format. This will be submitted to the MD (NRHM).

   Category	Nos. appointed	Nos of days on duty
   Medical Officer
   Pharmacist
   Staff Nurse
   ANM
   Sub Centre I
   Sub Centre II
   Sub Centre III
   LHV
   Lab Technician
   Driver
   Health Assistant (HW Male)
   Group D (detail)

4.  The NGOs will submit any other reports not mentioned above, as and when required by the MD (NRHM)/District Health Society.

   Schedule D

   Purchase of drugs and consumables  

   Essential Drug List / surgical items / Laboratory items for PHC

   Sl No	Name of Drugs	Sl No	Name of Drugs
   1	Acetylsalicylic acid tab-75 mg, 300 mg	93	Norfloxacin 400 mg
   2	Albendazole tab 400 mg	94	Nitrofuragene oint
   3	Albendazole Suspension	95	ORS
   4	Amoxycillin tab 250mg, 500 mg	96	Oxygen
   5	Amoxycillin Susp	97	Oxytocin Inj
   6	Ampicillin cap 250mg,500 mg	98	Paracetamol tab 500 mg
   7	Ampicillin Powder for susp.	99	Paracetamol syp
   8	Ampicillin Inj	100	Pantaprazole 40 mg tab
   9	Aminophylline Inj	101	Povidone Iodine Sol & oint
   10	Alprazolam tab 0.25 mg	102	Phenytoin Sodium tabs-100mg
   11	Artesunate tab	103	Promethazine Sodium tab 25 mg
   12	Artether inj	104	Primaquine tab 7.5 mg & 2.5 mg
   13	Adrenaline Bitartrate inj	105	Prednisolone 5 mg tab
   14	Aciclovir 200 mg tab	106	Quinine tab
   15	Amlodipin tab 5 mg	107	Quinine inj
   16	Avil inj	108	Ranitidine tab
   17	Atropine sulphate inj	109	Ranitidine inj
   18	Ascorbic acid tab 100mg	110	Salbutamol tabs-4mg
   19	Acriflavin+Glycerin lotion	111	Silver sulphadiazine oint
   20	Atenelol tabs-50mg	112	Tetracycline hydrochloride eye oint
   21	Anti rabies Vaccine (OARB)	113	Vit K inj
   22	Anti Sanke venom Serum	114	Vitamine A cap
   23	Buscpan inj	115	Water for inj 5/10ml
   24	Betamethosone tab	116	Xylocaine inj 2 %
   25	Betamethasone valerate oint	117	Xylocaine oint
   26	Betamethosone inj	Fluids
   27	B complex inj	1	DNS
   28	B complex tab	2	Dextrose 5%
   29	Benzathine penicillin Inj	3	Ringer Lactate
   30	Benzyle Penicillin Inj	4	Normal saline
   31	Bisacodyle tab	Surgical items
   32	Benzoic acid + Salicylic oint	1	Glass van Syringes- 2ml/5ml/10ml
   33	Benzyle benzoate lotion 25 %	2	Disposable Needle- 21/22/23/24
   34	Bleaching powder	3	I.V Canula no-18
   35	Cetirizine tabs	4	Ryles Tube- Paed/Adult (No 8,10&16)
   36	Ciprofloxacin Hydrochloride tab- 250 & 500 mg	5	Vasofix-20G,22g & 26g
   37	Ciprofloxacin Hydrochloride eye drops 0.3%	6	Drip-set- Macro/Micro
   38	Ciprofloxacin ear/ eye drops	7	Surgical Gloves - 6, 6 ½,7, 7 ½, 8, 8 ½,
   39	Ciprofloxacin syrup	8	Cotton –500gm
   40	Chloramphenicol cap 250 mg, 500 mg	9	Bandage Roll- Big/Small
   41	Chloramphenicol eye drop/oint	10	Phenyle-4.5 ltrs
   42	Chloropheneramine maleate tab 4 mg & inj	11	Hydrogen Peroxide-100ml/200ml
   43	Cotrimoxazole hydrochloride tab(80+400mg)	12	Surgical Blade- No-11,22 &24
   44	Cotrimoxazole syrup	13	Surgical Spirit-400ml
   45	Calsium lactate tab	14	Suture Thread with gauze
   46	Ceftrioxone 250 inj, 500 mg, 1 gm	15	Adhesive Plaster-small/Big
   47	Chloroquine Phosphate tabs 250	16	Formaldehyde-4.5ltrs/100ml
   48	Chloroquine Phosphate syrup	17	Rubber Sheet-50mts/20mts/10mts
   49	Chloroquine inj	18	Gloves powder
   50	Cifotaxim inj 250, 500, 1 gm	19	Pot.Permanganate—250gms
   51	Calcium Gluconate inj 10 ml	20	Suturing needle- Cutting/Round Body
   52	Diazepam tabs-5mg	21	Gloves Powder
   53	Diazepam Injection	Laboratory Items
   54	Doxycycline Hydro-tab-100mg	1	Acetone
   55	Digoxin tabs & inj	2	Ammonium sol.
   56	Dicyclomine HCL tab	3	Acetic acid
   57	Dicyclomine Hydrochloride Inj	4	Ammonium sulph.
   58	Dexamethasone sodium phosphate inj	5	Benedicts sol
   59	Diclofinac tab 50 mg	6	Benzidine sol
   60	Diclofenac inj 25mg/5 ml	7	Benzidine powder
   61	Duvadilan tab	8	Ba-Chloride sol.
   62	Etophylline + Theophylline - Inj	9	Cotton roll
   63	Etophylline + Theophylline tab	10	Distilled water
   64	Etamsylate inj	11	EDTA sol./Crystals
   65	Etamsylate oint	12	Eosinophil diluting fluid
   66	Ethambutal hydro 400/800mg tab	13	Erlichs aldehyde
   67	Framycetine Sulphate cream	14	Fouchest reagent
   68	Fortified procaine penicillin inj	15	Gentian violet
   69	Furazoladine tabs	16	Grams iodine
   70	Frusemide inj	17	Hydrochloric acid N/10
   71	Famotidine tab 20 mg	18	JSB stain-I
   72	Gama benzene lotion	19	JSB stain-II
   73	Gentamycin inj	20	Lugols iodine
   74	Gentamycin eye/ ear drops	21	Lysol
   75	Hydrocortisone Succinate inj	22	Leishman’s stain
   76	Hydrogen peroxide	23	Liquid paraffin
   77	Hydralazine tab	24	Methylene Blue
   78	Iron folic acid tab small	25	Methyl violet
   79	Iron folic acid tab big	26	Nitric acid
   80	Iron Sucrose Inj	27	RBC / WBC diluting fluid
   81	Ibuprofen tab 200, 400 mg	28	Sulphasalicylic acid
   82	Metronidazole – Syrup	29	Sodium chloride
   83	Metronidazole tab 400 mg	30	Surgical spirit
   84	Metformine tabs	31	Sulphuric acid (Conc)
   85	Methyl ergometine tab 125 mg	32	Sulphur powder
   86	Methyl ergometine inj	33	Sodium nitropruside
   87	Miconazole Ointment	34	Sodium metabisulphate
   88	Misoprostol tab	35	Platelet diluting fluid
   89	Metchlopromide tabs-10mg	36	Test tube (Glass)
   90	Metchlopromide HCL inj	37	Micropippetes
   91	Metron infusion	38	Cover slip
   92	Multi vitamin cap	39	Lancet/Needles
   		40	Filter paper

   
    

   Schedule E
   Funding pattern
   The funds made available by the Government, per annum, to the Agency for operating and managing the PHC/CHC would be as follows (subject to change as per the RoP approval)

   Public Private Partnership in Arunachal Pradesh
   ANNUAL BUDGET  FOR MANAGEMENT OF ONE HEALTH FACILITY

   	Budget Head	Unit	Monthly Budget	Annual Budget	Head wise annual budget
   A	Medicines, Healthcare consumables
   1	Medicines	1	25000	300000	438000
   2	Surgical Items	1	5000	60000
   3	Laboratory Items & diagnostic kits	1	3500	42000
   5	Hospital Materials & supplies	1	3000	36000
   B	Maintenance, Furniture, equipments
   1	Repairs & Maintenance of PHC/SCs	1	5000	60000	120000
   2	Equipments & Furniture	1	5000	60000
   C	Administrative Expenses
   1	Water & Electricity	1	2000	24000	302000
   2	Talephone, internet, postage	1	1000	12000
   3	Vehicle Repairing	1	5000	60000
   4	Vehicle fuel	1	5000	60000
   5	Travelling expenses	1	3000	36000
   6	Transportation cost	1	2500	30000
   7	Outreach Health camp expenses	1	2167	26000
   8	Printing, Stationeries & IEC	1	2500	30000
   9	Staff Training & orientation	1	2000	24000
   D	Personnel Cost
   1	Medical Officer	2	35000	840000	2892000
   2	Pharmacist	1	12000	144000
   3	Staff Nurse	2	12000	288000
   4	Lab Tech	1	10000	120000
   5	ANM, (3 in SCs, 2 in PHC)	8	10000	960000
   6	Health Assistant (male)	2	10000	240000
   7	Driver	1	7000	84000
   8	Group D(Including SCs)	4	4500	216000
   TOTAL					3752000

   Budget Summary
   Medicines & Healthcare consumables	438000
   Maintenance, Furniture	120000
   Administrative Expenses	302000
   Personal Cost	2892000
   TOTAL	3752000

   
   Rupees Thirty Seven lakhs Fifty Thousand only per health facility per annum.
   Note:    The Agency will contribute 10 percent from its own sources towards the project cost.

   Schedule F
   Performance Monitoring and Standards of Service

   Performance Indicators

   Type of Service	No. of Days Functional	Average Attendance and / or Usage
   1. OPD
   2. IPD
   3. Minor OT
   4. Labour Room
   5. Casualty/Emergency
   6. Ambulance
   7. Injection Room
   8. Clinical Lab – Hb%

   Preventive / Promotive Indicators
   

   Sl. No.	Category	baseline	After 6 months		After 1 year
   			Nos	Rate	Nos	Rate
   1	Ante Natal Cases registered
   2	Institutional Deliveries
   3	Post Natal Cases
   4	Full Immunization
   5	Referral to higher centres
   6	IUCDs inserted
   7	OCPs distributed
   8	Condoms distributed
   9	VHNDs held
   10	Nos of ASHA meeting/day held
   11	Nos of RKS meeting held
   12	Citizen's charter in position
   13	Monitoring by RKS
   14	RKS fund used as per guidelines
   15	RCH outreach sessions
   16	Other camps organised
   17	Number of Patients treated
   18	Nos of cases not provided medicine