Organisation

State Health Mission

At the State level, a State Health Mission headed by the Chief Minister has been constituted with similar composition, as that of the National Steering Group.

State Health Mission’s roles include the following:

Support District level planning, implementation and monitoring	State level planning, implementation and monitoring	Provide Training support to districts
The State will provide support in preparation of health plans by districts in accordance with the GoI guidelines through mobilization of technical assistance. The District Action Plans will be assessed on the basis of appropriate evaluation criteria that have to be made available to the districts in advance. A system for monitoring performance of districts against their own work plans and comparison across districts will also be developed.	The State Health Plan (long term/annual) has been developed in accordance with the GoI Guidelines and necessary approvals from GoI and signing of a Memorandum of Understanding (MoU) with the MoHFW need to be taken. Implementation will have to be facilitated in line with the approved plan, monitor and take corrective action as and when necessary and carry out independent impact assessment studies (base-line, periodic) and take appropriate corrective action.	Various training programmes are being developed including management training modules for the programme managers and the staff of the State and district societies, designing “multi-skilling” training packages for doctors (e.g. anesthesia training for MBBS doctors) and paramedical workers (e.g. “multi-skilling” of lab technicians) and facilitate selection and training.
Coordination across relevant departments	Actively undertake Policy & Institutional Reforms to enable effective implementation of NRHM	Management of cash flows
Mechanisms have been put in place to ensure coordination across Departments especially Health and Family Welfare, AYUSH, Department of Women and Children, and the Public Health and Engineering Department; to identify bottlenecks for effective delivery of services and to take necessary action through government orders or other means.	The State will review and amend existing policies (cadre management arrangements, financial and administrative authority at various levels, role of PRIs, procurement and logistics systems etc.) to ensure that the policy environment is consistent with the Mission objectives. Additional resources to be provided to the states under the Mission would require policy reforms to be in place.	Processes are being put in place for annual/ quarterly cash flow projections; closely monitoring and highlighting, well in advance, anticipated temporary shortage of funds. It will be ensured that funds are released to districts in accordance with the agreed district plans. The State will ensure that districts send their expenditure reports and other consolidated statements to GoI/ concerned agencies. Stringent monitoring mechanisms will be in place to ensure that all conditions are met for subsequent release of fund tranches.
Financial accounting/ administration	Sharing of experiences across districts
The State will ensure maintenance of necessary books of accounts and ensure adherence to procedures laid out for procurements and payments. They will carry out audits of a sample of districts in each quarter, and facilitate the sharing of audit findings across all districts.	Workshops will be conducted during various phases to disseminate experiences/ innovations/ lessons learnt across districts.

In order to meet the above objectives/ outcomes and carry out necessary tasks, the state has registered a single State Health Society through merger of all state level societies in the Health and Family Welfare sector, except the State Aids Control Society. These Societies will maintain separate Bank Accounts even under the unified structure. Funds for separate programmes would continue to flow under Sub-Budget Heads of the omnibus NRHM Budget Head. The Integrated State Health and Family Welfare Society has a full-time secretariat to act as the State Programme Management Support Unit (SPMSU), headed by a full time Executive Director. The SPMSU will (a) assist the Directorate of Health & FW in implementation, (b) act as the coordinating agency with other Departments for the Mission and (c) perform the role of the secretariat of the State Health Mission.

Arunachal Pradesh State Health Society

Name of Society

The Name of the Society shall be “Arunachal Pradesh State Health Society,” hereinafter referred to as the “Society”.

Area of operation

The area of operation of the Society shall be whole of the State of Arunachal Pradesh

Office

The Society shall have its office at Naharlagun in the State of Arunachal Pradesh with liberty to establish one or more subordinate offices or outlets elsewhere in the State, if so required.

Objectives

The Society shall serve in an additional managerial and technical capacity to the Department of Health and Family Welfare, Government of Arunachal Pradesh for the implementation of National Rural Health Mission (NRHM) in the State.

Scope of functions

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

Function as a Resource Centre for the Department of Health & Family Welfare in policy/situational analysis and policy development (including development of operational guidelines and preparation of policy change proposals for the consideration of Government).
Strengthen the technical / management capacity of the State Directorate as well as of the Districts Societies by various means including through recruitment of individual / institutional experts from the open market (with total programme management costs for the State as a whole not exceeding to 6 percent of the total programme costs).
Receive, manage (including disbursement to implementing agencies e.g. Directorate, District Societies, Non Government Organizations etc.) and account for the funds received from the Ministry of Health and Family Welfare, Government of India.
Mobilize financial / non-financial resources for complementing/supplementing the NRHM activities in the State.
Organize training, meetings, conferences, policy review studies / surveys, workshops and inter-State exchange visits etc. for deriving inputs for improving the implementation of National Rural Health Mision in the State.
Manage the Non Government Organization / PPP (public–private partnership) components of the National Rural Health Mission in the State, including execution of contracts, disbursement of funds and monitoring of performance.
Undertake such other activities for strengthening National Rural Health Mission in the State as may be identified from time to time, including mechanisms for intra and inter-sectoral convergence of inputs and structures.

For performing the above tasks, the Society shall:

Establish and carry out the administration and management of the Society’s Secretariat through a State Programme Management Support Unit (SPMSU), which will serve as the implementation arm of the Society.
Create administrative, technical and other posts in the Secretariat of the Society as deemed necessary.
Establish its own compensation package and employ, retain or dismiss personnel as required.
Establish its own procurement procedures and employ the same for procurement of goods and services.
Make rules and bye-laws for the conduct of the activities of the Society and its Secretariat and add, rescind or vary them from time to time, as deemed necessary.

First members of the Governing Body

The names, addresses, occupations and designations of the First Members of the Governing Body of the Society to whom by the rules and regulations of the Society, the management of the affairs of the Society is entrusted as required under section 2 of the Societies Registration Act, 1860 (No. XXI of 1860) are as follows

Sl. No.	Designation	Status in Governing Body
1	Chief Secretary	Chairperson
2	Commissioner & Secretary, Health & Family Welfare	Vice-Chair
3	Director of Health Services	Convener
4	Jt. DHS (FW)	Co-convener
5	Commissioner & Secretary, Finance	Members
6	Commissioner & Secretary, Planning
7	Secretary, PHE & WS
8	Secretary, Panchayati Raj,
9	Secretary, Rural Development,
10	Secretary, Urban Development
11	Jt.DHS (P & D)
12	Incharge, AYUSH Nominee of Ministry of H & FW, GOI

District Health Mission

At the district level all existing societies have been merged into the District Health Society with its apex body performing the functions of the District Health Mission(DHM). NRHM envisages financial autonomy and delegation of powers at the district level, to the District Health Mission led by the Zila Parishad. The DHM controls, guides and manages all public health institutions in the District. The NRHM hasl assisted in setting up the full time secretariat of the DHS. It is envisaged that the Secretariat of the District Health Society should have a small but dedicated unit for inter-sectoral co-ordination, which may directly report to the CEO, Zilla Parishad.

Roles and Responsibilities of District Health Mission includes:

District health planning, implementation and monitoring

Districts would have to ensure preparation of a District Action Plan (long term/ annual) in accordance with the guidelines provided by the State and obtain necessary approvals from the State Health Mission. Districts would have to facilitate implementation in line with the approved Plan. They would have to establish a system for monitoring performance against the approved plan, review monitoring reports, identify corrective action to be taken and follow up to ensure implementation. Monthly and quarterly progress reports would be sent to the State Mission while a block-wise monthly report will have to be provided to the members of the Governing Board of the District Health Mission.

Coordination across relevant Department

The DHM will have to ensure coordination across Departments especially Health and Family Welfare, AYUSH, Department of Women and Children, Rural Development, and the Public Health and Engineering Department, identify bottlenecks to effective delivery of services and take necessary action through government orders or other means.

Management of cash flows

Districts will have to prepare annual/ quarterly cash flow projections; closely monitor and highlight, well in advance, anticipated shortage of funds. The DHM will have to follow up with State Mission to ensure that funds are released as per schedule.

Financial accounting/ administration

Districts will have to ensure maintenance of necessary books of accounts and ensure adherence to procedures laid out for procurements and payments. Districts will provide necessary assistance to the auditors in carrying out their functions as and when required.

Governing Body District Health Society

1.	Deputy Commissioner	Chairperson
2.	Chiarman, Zila Parishad	Co-Chair person
3.	DMO	Chief Executive officer & Convenor
4.	Project Director, DRDA	Member
5.	President, Anchal Samiti	Member
6.	SDO/ ADC	Member
7	Medical Superintendent, DH/GH	Member
8.	Executive Engineer-PHED	Member
9.	Executive Engineer-POWER	Member
10	Executive Engineer-PWD	Member
11.	Executive Engineer- RWD	Member
12.	Dy. Director, School Education	Member
13.	Dy. Director, SWWCD	Member
14.	All Ditrict programme Officer (Health)	Member
15.	Chairperson, District Women Welfare Society	Member
16.	2.-Representative of local NGOs	Member
17.	State Representative to be nominated by GB	Member
18.	Member of Development Partner	Member

District Health Society

Members of District Health Society

1.	Deputy Commissioner	Chairperson
2.	District Medical Officer	Vice-Chair person
3.	DRCHO	CEO-Cum-Convenor
4.	Medical Superintendent GH/DH	Member
5.	All District Programme Officer (Health)	Member
6.	Executive Engineer-PHED	Member
7.	DDSE	Member
8.	CDPO	Member
9.	2- Member from Zila Parisad.	Member

State Programe Management Unit (SPMU)

In response to the lessons learnt from RCH-I and programme management support needs of RCH-II and National Rural Health Mission, the State Programme Management Unit (SPMU) have being established. The main objective of establishing this unit is to strengthen the existing management structures/functions at the state and district levels respectively as RCH-II is characterised by allocation of flexible funds to states, preparation of programme implementation plans by States and districts and performance linked disbursement based on MOU. Consultants recruited under SPMU are expected to improve the performance levels of the public health infrastructure and functionaries and to make the system more responsive and transparent. All these positions are on contract basis.

The SPMU consists of following four positions:-

State Programme Manager
State Finance Manager
State Accounts Manager
State Data Officer

Role of SPMU

The SPMU is responsible for the overall state level planning and monitoring for NRHM, management of flexipool funds, initiation of health sector reforms, continuous process improvement and for secretarial functions to the State Health Mission and State Health Society.

Organogram of State Programme Management Unit (SPMU)

All the position under SPMU are filled as on date and is fully functional.

District Programme Management Unit(DPMU)

In districts, the cornerstone for smooth and successful implementation of NRHMI programme is dependent on the management capacity of District Programme Managers, smooth functioning of District RCH Society and empowerment of the programme implementation structure. The District Health Society is being strengthened through the integration of all societies in the district and this society will be responsible for project management in districts. While the Collector would continue to be the Chairperson of District RCH Society, suitable manpower resources for programme management and finance/accounts functions has been provided. The district level functions include planning, implementation and monitoring of all EAPs including RCH II, finance and accounting, training and capacity building, MIES and district plans etc.

The district PMU is composed of three skilled personnel i.e. Programme Manager, Accounts Manager and Data Assistant have been provided in each district. These personnel are there to provide the basic support for programme implementation and monitoring at district level. The District Programme Manager is responsible for providing support to all programmes and projects in the Districts, planning, implementation and monitoring of all EAPs including RCH II, training and capacity building, MIES, development of district plans, regular reporting and feedback,. The District Accounts Manager is responsible for the finance and accounting function of District RCH Society including grants received from the state society and donors, disbursement of funds to the implementing agencies, preparation of submission of monthly/quarterly/annual SoE, ensuring adherence to laid down accounting standards, ensure timely submission of UCs, periodic internal audit and conduct of external audit and implementation of computerized FMS. The Data Assistant in close consultation with district officials has to facilitate working of District RCH Society, maintain records, create and maintain district resource database for the health sector, inventory management, procurement and logistics, planning and monitoring and evaluation. District Data Assistant is responsible for MIS and data collection and reporting at district level.

Organogram of District Programme Management Unit (DPMU)

All the position under DPMU are filled as on date and is fully functional.