eoi-public private partnership (ppp)project for primary health centres

GOVERNMENT OF PUNJABDEPARTMENT OF HEALTH & FAMILY WELFARENATIONAL RURAL HEALTH MISSION5 TH FLOOR, PRAYAAS BUILDING, DAKSHIN MARG, SECTOR 38-B, CHANDIGARH-160036Tel. No. 0172-4012011-13, 4012030 (Telefax)PUBLIC PRIVATE PARTNERSHIP (PPP)PROJECTFOR PRIMARY HEALTH CENTRESInvitation for Expression of Interest ( EOI )Government of Punjab intends to outsource the services to be provided atPrimary Health Centres (PHCs) in districts Barnala, Ferozepur, Mansa, Moga,Muktsar, Nawanshahar, Sangrur & Ropar in State of Punjab through reputedNGOs/Voluntary Agencies/Non Commercial Hospitals or Trusts which will beresponsible for the Service Delivery in the PHC area, including achieving theobjectives of National Rural Health Mission (NRHM ) and other NationalHealth/Family Welfare programmes. Interested and eligible agencies havingexpertise and experience may send their Expression of Interest to the StateHealth Society latest by 15 th July, 2011. The details about the project can bedownloaded from the official website www.pbnrhm.org. Enquiries may beaddressed to e-mail ngo.ppp123@gmail.com or phone 0172-4012005 andMobile 09417019041.Mission DirectorNRHM, Punjab

GOVERNMENT OF PUNJABDEPARTMENT OF HEALTH & FAMILY WELFARENATIONAL RURAL HEALTH MISSION5 TH FLOOR, PRAYAAS BUILDING, DAKSHIN MARG, SECTOR 38-B, CHANDIGARH-160036Tel. No. 0172-4012011-13, 4012030 (Telefax)PUBLIC PRIVATE PARTNERSHIP (PPP) PROJECT FOR IMPROVEMENT OF THEHEALTH DELIVERY SYSTEM IN PUNJABApplication Form for Expression of Interest (EOI) by NGOs/ VoluntaryOrganisations / Non-Commercial Hospitals to run Primary Health Centre1. Name of the Agency :2. Legal Status (Society, Trust etc….):Registration Details in India.3. Please enclose a copy of Byelaws and the:Memorandum of Association4. Please enclose the details of top Management/:Executive Board5. FCRA Permission, if any, please gives details:6. Location of Headquarters in India:7. Existing Geographical Areas of Operation:8. Please enclose details of functional areas of:operation and major works/projects undertakenin India, State wise in the last 3 years.9. Please furnish details of the Income and Expenditurefor the last 3 years:10. Please separately detail the organization structureand personnel employed on regular/ contractbasis in different States in India:11. Please mention your specific experience in the :area of Health and Family Welfare :12. Resource (Financial/Human/others) which can be :committed by the NGO per year for the proposedproject in PunjabSignature(Authorised Signatory)Note :1. Please send this form duly filled in along with the relevant details to theMD-NRHM, Department of Health & Family Welfare, Government of Punjab,so as to reach latest by 15 th July, 2011, O/o Mission Director, National RuralHealth Mission, Prayas Building, 5 th Floor, Sector-38-B, Chandigarh.

2. Advance Copy can be sent by FAX (0172-4012030, 4012013).3. Enquiries, if any, can be made fromEmail : ngo.ppp123@gmail.comphone No. : 0172-4012005, 4012015Mobile No. : 09417019041

PUBLIC PRIVATE PARTNERSHIP (PPP) IN HEALTH: OUTSOURCINGOFPRIMARY HEALTH CENTRES IN PUNJAB1. IntroductionThe Government of Punjab intends to outsource the services to be provided at PrimaryHealth Centres (PHC) in districts Barnala, Ferozepur, Mansa, Moga, Muktsar, Nawanshahar,Sangrur & Ropar in the State through reputed NGOs/Voluntary Agencies/Non CommercialHospitals or Trusts in PPP mode. It is prop osed that five PHCs in the State of Punjab would behanded over to reputed NGO/Voluntary Agencies/ Private Agencies (collectively referred to as“Agency”) for, inter alia, providing clinical and preventive health services, implementation ofthe National Rural Health Mission (NRHM) and other National Health & Family WelfareProgrammes, Health & Family Welfare related IEC activities. The selection of the “Agency” willbe on an “All India” basis after calling for “Expressions of Interest” (EOI).2 Strategy for the Initiation of PPP project:2.1 The Private Partner( NGO/Private Agency) shall be selected in a transparent manneron an all India basis. The required advertisement calling for Expression of Interest (EOI) shallbe published in the leading national dailies.2.2 The State government will short list the PHCs and a consultation meeting with the saidshort listed NGOs will be held. Government of India representatives will also be invited in thesaid meeting. Final selection of the Agency shall be done in consultation with the representativeof the Government of India, or NHSRC representative.2.3 After discussions and consultations with the Agency and other stake holders, and afteraddressing the concerns of the Agency, a Contract Agreement shall be signed with the Agency.3. Modalities of Implementation3.1. The State Government shall hand over the building and physical infrastructure of the PHC(s) tothe Agency along with the existing equipment, furniture, etc. and an inventory of the same would bemade jointly by the State Government and the Agency. The conditions of the building/equipmenthanded over will be duly recorded. The Agency will maintain the said building/equipment with due careas would be reasonably expected.3.2. The Agency shall provide all the Health/Medical/Family Welfare Services, curative andpreventive/promotive, as are normally expected from any Primary Health Centre, to the local populationresiding in the geographical area under the jurisdiction of the said PHC(s). The Agency will engage itsown Medical/Paramedical/other staff for providing these services and will ensure that these personnelare always available at the pre-decided timings. The personnel would also reside locally. In case of leaveor absence of any personnel, the Agency would be duty bound to provide an alternative so that the PHCdoes not, at any point in time, become non functional due to the lack of the required personnel. Theexisting staff at PHC would be suitably redeployed by the State Government to other PHCs/ healthfacilities centres.3.3. The Agency shall be responsible to provide, interalia, the following services:a) OPD service for six days per week as per the timings specified by the State Government.

) Ante-natal care and routine immunization services for children and pregnant women (besidesfixed day services).c) 5 to 10 Bed inpatient facility.d) 24 hrs labour Room and emergency Obstetrics facility.e) Essential New Born Care.f) Minor Operation Theatre Facilityg) 24 hrs Ambulance Facility, referral for emergencies.h) Early and safe abortion services (including MVA).i) Family planning services.j) Prevention and management of RTIs/STIs.k) Essential laboratory services.l) Make available essential medicines. The Agency would be encouraged to keep in stock suchadditional medicines as are found necessary after assessing the field situation.m) Participation in and implementation of National Programs of Health & Family Welfare includingthe National Rural Health Mission. Outreach/IEC activities by conducting medical camps3.4. To provide the services as described in Para 3.3. above, the minimum staff deployed would be asunder. Any changes in the above pattern would be effected with the approval of the State Government.Sl No Category of staff No of post1 Medical Officer (One Female) 22 Pharmacist 13 Staff Nurse 34 ANM 2 (PHC)6 (SCs) *5 LHV 16 Lab Technician 17 Driver 18 Group D4(Including Sanitary Assistant)* The number of ANMS would be decided on the basis of Sub Centres under the jurisdiction of the PHC3.5. The personnel engaged by the Agency will not be paid at rates exceeding those envisaged in thefunding pattern (schedule C attached). They will possess the required qualifications which will beintimated by the Government to the Agency. The personnel should also be suitably trained for the jobsthey are selected. Engagement of Personnel will be the sole responsibility of the Agency and employeeswould have no claim at any time whatsoever, by virtue of their contract with the Agency or for any otherreason, for being absorbed into Govt. service at a later date.3.6. The existing Sub Centres, under the jurisdiction of the PHCs, would be similarly handed over tothe said Agency. The services provided by and through the Sub Centres will be as per thestandard/normal guidelines and in conformity with the activities of the PHC.3.7. The Agency will provide the Laboratory test facilities at the PHC level as described in Schedule B.4. Funding4.1. 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 ScheduleC.4.2 The Agency would meet from its own sources not less than 10% of the Project cost, as reflectedin the Statement of Expenditure duly certified by a Chartered Accountant and the duly auditedAccounts. In other words, the Agency would contribute not less than 10% from its own sources towardsthe Project Cost.4.3. The disbursement/release of funds to the Agency would be in two installments every year that isby May and November. However in the current financial year, the funds will be released as per mutuallyagreed schedule after signing of the MOU.5. Audit and Accounting5.1. Each PHC (which also includes the Sub Centres under its jurisdiction) will be treated as anindependent and separate entity for accounting purposes. Accordingly, separate Accounts will bemaintained for each PHC. A Statement of Expenditure (SOE) and Utilization Certificate (UC) dulycertified by a Chartered Accountant will be furnished by the Agency to NRHM on half yearly basis. Forthe months April-September, the SOE/UC will be given by 31 st October and for the months October-March, by 30 th April every year. In addition annual audit of the PHC accounts would be undertakenthrough a qualified Chartered Accountant and the audit report and accounts for the year would befurnished to the Government by 31 st May of the succeeding year.5.2 The State Government reserves its right to get a special audit conducted of the accounts of thePHC after giving at least 30 days notice to the Agency.6. Project commencement and durationThe duration of the project will be three years. However, in case NRHM or the Agency desire toterminate the project before the expiry of the said period, a notice period of three months will be givento the other Party. The period of three years will be calculated from the date of physically handing overthe PHC to the Agency. It is possible that different PHCs are handed over to the Agency on differentdates depending on the field level situation and the preparedness of the Agency to take over the PHC.7. Performance Monitoring and Standards of Service7.1. The performance of the Agency will be monitored largely on the basis of output basedindicators, a list (not exhaustive) of which is at Schedule D. These indicators and performance standardscan be suitably expanded and/or modified after mutual consultation and in the interest of better servicedelivery to the general public.7.2. The indicators and standards specified for the health delivery expected from the Agency are theminimum standards. The Agency would be encouraged to serve as a role model and to provide servicesat a much higher standard.8. Review and monitoring structure8.1. A PHC management committee(RKS) would be constituted at the PHC level comprisingrepresentatives of the Agency, Civil Surgeon of the District, PHC MO I/C, Local NGO/CBO, twomembers of village Panchayat- one male and one female.The Committee would meet at least once, every three months and will be responsible forguiding/monitoring the project. It will address local issues and problems as are normally expected fromsuch a Committee.

8.2. At the State level, a Steering Committee chaired by the Principal Secretary Health and FamilyWelfare Secretary (Health) along with suitable representation from all stake holders including :Mission DirectorPrivate PartnerRegional Director Health-GOIMaternal Health SpecialistState Programme ManagerRepresentative fromTechnical Resource Centre RRC-MAMTAState NGO-PPP CoordinatorVice ChairpersonMemberMemberMemberMemberMemberMember SecretaryThis State level steering committee will meet at least once in every six months. It will review thework done at the PHCs, suggest suitable improvements and midcourse corrections, and resolve thedifficulties faced by the Agency in running of the PHC.9. Records & Reporting9.1 The Agency would be expected to maintain records and to furnish reports, in time, as arenormally expected from any PHC in the Government system. The periodicity of reports and the recordsto be maintained will be intimated to the Agency in writing by the Government. The existing recordsavailable with the PHC will also be handed over to the Agency so as to maintain continuity. The Agencywould preserve these records carefully and hand over the same to the State Government/NRHM at thetime of exiting from the project.9.2. The Agency will maintain a record of proceedings of the meetings of the PHC ManagementCommittee. Government may authorize officers to conduct inspections at the PHC. The Agency shouldalso maintain a Visitor Book where authorized Government functionaries can record theirviews/suggestions after conducting an inspection.10. Standards of hygiene and health safety10.1. The Agency will maintain and run the PHC in a hygienic manner conforming to the standardnorms of health safety. Auto destructive syringes will be used for immunization. Autoclaved glasssyringes and disposable needles will be used for other injections. The hospital waste will be disposed ofin conformity with the recognized and acceptable norms as specified by the State Pollution ControlBoard from time to time.10.2. The Agency will be duty bound to assist and follow directions issued by the Government forcontrolling any epidemic or medical emergency in the area.11. Purchase of drugs and consumablesThe procurement of drugs/consumables from the funds allotted by the Government will bemade in a transparent and economical manner. Only Government approved quality drugs of genericnature will be procured. Proprietary/branded drugs may be procured, only in exceptional cases, butwith the prior consent of the State Government. Normally the price of procurement for the Agency forany drug/ consumable should not exceed the price at which the same drug is procured by the State

SCHEDULE - AAssignment of PHC(s) to Agency(clause-2)1. NGO name :Numbers of PHC :SL. NO. DISTRICT SELECTED PHCSCHEDULE – BTests for the PHCs(clause-3.7)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.

SCHEDULE – CProject Funding(clause-3.5, 4.1)The funds made available by the Government, per annum, to the Agency for operating andmanaging the PHC would be as follows.Sl.N Itemso.1 Medicines and other Healthcare Consumables.Medicines - Rs.3,00,000/-Materials & Supplies - Rs. 30,000/-Laboratory Reagents, - Rs. 10,000/- Kits.Surgical Items - Rs. 10,000/-Maximum Fund per annumRs.3,50,000/-2. Maintenance, Furniture, EquipmentUntied Grant : 25000/-Annual Maintenance Grant : 75000/-Rs. 5,50,000/-RKS Funds --: Rs.1,00,000/-Surgical Equipments : Rs. 3,50,000/-3. Other Administrative ChargesWater & Electricity - Rs. 10,000/-Traveling Allowances - Rs. 20,000/-Ambulance Services - Rs. 70,000/- Rs. 1,00,000/-4. Personnel CostSr No Category of staff Salaryper post1 Medical Officer(One Female)Rs30000/-No of postsper annumMaximum fund2 Rs 720,0002 Pharmacist 8500 1 Rs 1020003 Staff Nurse 8500 3 Rs 3060004 ANM 6900 2 (PHC)6 (SCs)Rs 1,65600Rs 4,968005 LHV 9200 1 Rs 1104006 Lab Tech 9200 1 Rs 1104007 Driver 5500 1 Rs 660009 GroupD(Including SA)4500 4 Rs 2,16000Rs 22,93,200Total maximum fund per annum : 1 + 2 + 3 + 4= Rs.3, 50,000/- + Rs. 5, 50,000/- + Rs. 1, 00,000/- + Rs. 2293200/-= Rs.3293200Note:Say Rs.2293200/-1. The Agency will contribute 10 percent from its own sources towards the project cost.2. Maximum funding figures indicate the maximum amount which the Government willprovide under the respective head.

Schedule DPerformance Indicators(clause-7.1)Type of Service No. of Days Functional Average Attendance and / orUsage1. OPD2. IPD3. Minor OT4. Labour Room5. Casualty/Emergency6. Ambulance7. Injection Room8. Clinical LabPersonnel AvailabilityCategory Nos. Presence Number ofdays/monthDoctorStaff NurseANMANM atSub CentresSub Centre ISub Centre IISub Centre IIIPharmacistLab TechnicianAmbulance DriverOthersMedicines & Consumables (M&C)

Number ofPatientsTotalExpenditure onM&C dispensedAverageExpenditure onM&C made perpatientDistribution ofExpenditure bycategory ofMedicineNumber of caseswhere therequired medicinecould not be madeavailableCases Referred to District/General HospitalCategory of DiseaseNumber of Patients ReferredPreventive / Promotive IndicatorsSl.No.Category1. IMR2. MMR3. Immunization Rate* BCG* DPT* OPV* MeaslesFigures inthe yearZeroAfter 6 monthsAbsoluteNumbers4. Institutional Deliveries * *5. Referral to FRUs6. Ante Natal Cases ** **Rate7. Post Natal Cases *** ***8. Sterilization CasesMale / FemaleAfter 1yearAfter 2 year* No of Institutional deliveries out of the total pregnant women in the area.** No of 3ANC attended out of the total pregnant women in the area.*** No of PNC attended in the area out of the total pregnant women.

Outreach ActivityTime PeriodNumber ofCampsNumber of VHSCscovered out of totalVHSCsTypes of camps by categoryand number of patients seen /attendedA X B X C X D X0 – 3 months3 – 6 months6 – 9 months9 – 12 monthsA -B -C -D -X -RCH CampCancer detection campBlindness control campsOthers (more categories can be added)Number of patients seen / attended.Coordination with National/NRHM ProgramAs per actual activity under the said National / NRHM Programs conducted by the State Government.

Schedule-ESN . District PHCs SN. District PHCs1 Barnala Mahal Kalan 34 Muktsar Alamwala2 Barnala Talewal 35 Muktsar Kanian Wali3 Barnala Bhathlan 36 Muktsar Mallan4 Barnala Dhilwan(RH) 37 Muktsar Badian5 Ferozepur Kassoana 38 Muktsar Pani wala6 Ferozepur Makhu 39 MuktsarGuru Sarmandhir(RH)7 Ferozepur Lakho Ke Behram 40 Nawanshahar Sahiba8 Ferozepur Talwandi Bhai 41 Nawanshahar Sujjon9 Ferozepur Mudki 42 Nawanshahar Takarala10 Ferozepur Jiwan Arain 43 Nawanshahar Kaman(RH)11 Ferozepur Taliwal Bodhla 44 Ropar Kiratpur Sahib12 Ferozepur Baluana 45 Ropar Bharatgarh13 Ferozepur Malan Wala 46 Ropar Dher14 Ferozepur Kheowali Dhab 47 Ropar Pukhrali15 Ferozepur Jandwala Bhimeshah 48 Ropar Sahjowal16 Ferozepur Ladhuka Mandi 49 Ropar Khan Pur Khuhi17 Mansa Boha 50 Ropar Bhallan18 Mansa Joga 51 Sangrur Moonak19 Mansa Ubha 52 Sangrur Khanauri Kalan20 Mansa Jaurkian 53 Sangrur Gowara21 MansaPhapre Bhai Ke (RuralHospital)54 Sangrur Manvi22 Mansa Jhunir 55 Sangrur Chhajli23 Mansa Kularian 56 Sangrur Jakhepal24 Moga Badhani 57 Sangrur Kup Kalan(RH)25 Moga Dharamkot26 Moga Manuke27 Moga Fatehgarh Panjtoor28 Moga Bilaspur29 Moga Patto Hira Singh30 Moga Lopon31 Moga Kishan Pur Kalan32 Moga Sukh Nand33 Moga Malianwala(RH)