DISTRICT HEALTH MISSION GANDHINAGAR · July 21, 1986. Formation of district level societies each in Surat and Bharuch districts soon followed as being high endemic areas for Leprosy

DDIISSTTRRIICCTT HHEEAALLTTHH MMIISSSSIIOONN

GGAANNDDHHIINNAAGGAARR

I n s t i t u t i o n a l M e c h a n i s m s

Department of Health & Family Welfare

G ov ernment of G u j arat J u ly 2 0 0 5

Gandhinagar District Health Mission- July 2005

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DISTRICT HEALTH MISSION DISTRICT: GANDHINAGAR, GUJARAT

INSTITUTIONAL MECHANISMS

Particular Page No.

1. 1.1 1.2 2. 3. 3.1 4. 4.1 5. 5.1 6. 6.1 6.2 6.3 6.4

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II III

Abbreviations Background Goal of Gujarat State Health Mission Organization of State Health Mission District Health Mission- Gandhinagar District Organization of District Health Mission, District Health Society and District Programs Composition of District Health Mission District Health Society Objectives of the Society Integration of District Health Society, District Health Mission and District Programs Process of merger of existing societies into integrated District Health Society District Health Society Governing Body (GB) Executive Committee – District Health Society District Program Committee for Health & FW Sector (Sub Committees) District Health Mission Secretariat and District Program Management Unit Appendix Memorandum of Association for the District Health Society (Gandhinagar) Rules and Regulations of District Health Society (Gandhinagar) Bye-laws of the District Health Society (Gandhinagar)

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3 3 4

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8 9

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12 12 17 18

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Abbreviations AIDS : Acquired Immune Deficiency Syndrome ANC : Ante Natal Care ANM : Auxiliary Nurse Midwifes BHO : Block Health Officer CDMO : Chief District Medical Officer CNAA : Community Need Assessment Approach CPR : Couple Protection Rate CSSM : Childhood Survival & Safe Motherhood DHM : District Health Mission DHS : District Health Society DM : District Magistrate (District Collector) DMO : District Malaria Officer EC : European Commission FHS : Female Health Supervisor (Lady Health Visitor) FHW : Female Health Worker (Synonyms ANM) FOGSI : Federation of Obstetric and Gynecology Society of India. FRU : First Referral Unit GB : Governing Body GR : Government Resolution IAP : Indian Academy of Pediatrics ICB : International Competitive Bidding ICPD : International Conference on Population and development IDHFW : Integrated District Health and Family Welfare Society IMA : Indian Medical Association IMNCI : Integrated Management of Nutrition and Child Illness IMR : Infant Mortality Rate IPHA : Indian Public Health Association LCB : Local Competitive Bidding LHV : Lady Health Visitor (Now Female Health Supervisor) MCH : Maternal & Child Health MDT : Multi Drug Therapy MHW : Multipurpose Health Worker MMR : Maternal Mortality Rate MPS : Multipurpose Supervisor. NAMP : National Anti Malaria Program NCB : National Competitive Bidding NFPP : National Family Planning Program NMCP : National Malaria Control Program NMEP : National Malaria Eradication Program NVBDCP : National Vector Borne Diseases Control Program PNC : Post Natal Care RCH : Reproductive & Child Health RNTCP : Revised National Tuberculosis Control Program SIP : Sector Investment Program STD : Sexually Transmitted Diseases TFA : Target Free Approach UIP : Universal Immunization Program


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District Health Mission Institutional Mechanisms for Implementation 1. Background

Recognizing the importance of Health in the process of economic and social development and improving the quality of the citizens, the Government of India has resolved to launch the National Rural Health Mission (NRHM) to carry out necessary architectural correction in the basic health care delivery system. The Mission adopts a synergistic approach by relating health to determinants of good health viz. segments of nutrition, sanitation, hygiene and safe drinking water. It also aims at mainstreaming the Indian systems of medicine to facilitate health care. The plan of Action includes increasing public expenditure on health, reducing regional imbalance in health infrastructure, pooling resources, integration of organizational structures, optimization of health manpower, decentralization and district management of health programs, community participation and ownership of assets, induction of management and financial personnel into district health system, and operationalising community health centers into functional hospitals meeting Indian Public Health Standards in each Block of the Country.

The National Rural Health Mission (2005-12) seeks to provide effective health care to rural population throughout the country. It aims to undertake architectural correction of the health system to enable it to effectively handle increased allocations as promised under the National Common Minimum Program and promote policies that strengthen public health management and service delivery in the country.

At the National level, the NRHM has a Mission Steering Group (MSG) headed by the Union Minister for Health & Family Welfare and an Empowered Program Committee (EPC) headed by the Union Secretary for Health & FW. The EPC will implement the National Rural Health Mission under the overall guidance of the MSG.

In this context, the Government of India has requested to the Gujarat State Government to constitute State Health Mission to achieve the goals of National Rural Health Mission by improving the determinants of good health in the State.

In accordance with National Mission, the Government of Gujarat plans to set up a State and District Health Missions for achieving the goal. In order to implement the Mission, state and district level institutional mechanisms are required. The following is the Goal and mechanisms at the state level for the Health Mission.

1.1 Goal of Gujarat State Health Mission

The Goal of the Mission is to improve the availability of and access to quality health care by people, especially for those residing in rural areas, the poor, women and children in the state.


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1.2 Organization of State Health Mission

In Gujarat, the Mission would function under the overall guidance of the State Health Mission headed by the Chief Minister of the State. The functions under the Mission would be carried out through the State Health & Family Welfare Society. The structures of the Mission and Society and their linkages are mentioned in the following chart and paragraphs.

Organogram of the State Health Mission

2. District Health Mission - Gandhinagar District

District Level Institutional Mechanisms for Implementation

In order to achieve the goals of State Health Mission, Gujarat, it is proposed to constitute District Health Missions for each district to cover the entire state, and set institutional mechanisms for implementing the Mission by integrating all vertical societies into one integrated district society called “District Health Society”.

SPMU & Mission Secretariat

(State Health Mission Director)

Executive Committee (Principal

Secretary-H&FW)

State Health Society-

Governing Body (Chief Secretary)

Program Committees (Additional Directors)

State Health Mission (Chief Minister)


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3. Organization of District Health Mission, District Health Society and District Programs

In accordance with the State Health Mission, every district will have a ‘District Health Mission’ headed by the President, District Panchayat as a Chairperson of the Mission. It will have the Chairperson of the Health Committee, District Panchayat and Regional Deputy Director as Co-Chairs, District Collector as a Vice Chair, District Development Officer (CEO of the District Panchayat as a Convener and Chief District Health Officer as Member Secretary & District Health Mission Director.

3.1 Composition of District Health Mission

• Chairperson : President, District Panchayat • Co-Chair : Chairperson, Health Committee, District

Panchayat • Vice Chair : District Collector • Convener : District Development Officer • Member Secretary : Chief District Health Officer and District

Health Mission Director

District Health Mission (President, District Panchayat)

District Program Committees

(District Program Officers)

DHS Secretariat / DPMU

(Chief District Health Officer)

Governing Body

(District Collector)

Executive Committee (District Development

Officer)

4. Training

3. Medical

1. Health

2. FW (RCH)

1. TB, Leprosy, Malaria, & Disease surveillance

2. Maternal Health, Child Health, Family Planning

3. AIDS & Blindness control 4. All training institutes and

programs of H & FW of the district


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• Members :

Taluka Presidents from the district, Chair-persons of the Standing Committees of the District Panchayat, Project Officer (DRDA), Chair-persons of the Panchayat Samitis and Hospital Management Societies, District Program Coordinators/Officers for health, PHED, ICDS, Education, Social welfare, Panchayati Raj, State representative, representatives of MNGO/NGO, District Program Coordinator (DPMU) etc.

Adequate representation of women in this committee will be ensured.

Frequency of meetings: Bi annual- once in every six months

Ordinary Business:

Providing health system oversight, consideration of policy matters related to health and family welfare sector including determinants of good health, progress review of the DHM implementation, convergence, district plan allocations, advocacy measures required to promote SHM visibility. The Chairperson and Mission will ensure intra-sect oral and inter-sect oral coordination to achieve the mission objective. An issue of the irregular or inadequate attendance or a poor participation & non-coordination of member or a particular sector or section will be addressed by the Chairperson.

Existing Institutional Mechanisms at District Level At present different societies are operational in the districts for implementing various health and family welfare programs. Presently in Gujarat six different health societies are working for six different health programs viz - District Leprosy Society (1988), District Blindness Control Society. (1993), District Malaria Control Society (1997), District Reproductive & Child Health Society (1998), District Tuberculosis Control Society (An extension of Leprosy Society in the 1998) and District AIDS Control Unit (1998) Evaluation of Health and family welfare Societies in Gujarat 1. The first ever state and district level society for health and family welfare

sector was formed for Leprosy Elimination Program vide state government resolution (GR) dated December 15, 1988 in pursuance of the instructions from the Central Government received vide letter no. T.11011/1/86-CCD, July 21, 1986. Formation of district level societies each in Surat and Bharuch districts soon followed as being high endemic areas for Leprosy prevalence. District Development Officer is given the responsibility as a chairperson of the society and District Leprosy or TB Officer as a Member Secretary as the case may be.

2. District Blindness Control Society was formed in 1993 followed by State level structure in the year 2000. District society is chaired by the Collector cum District Magistrate with District Program Officer (Ophthalmic Surgeon) as a Member Secretary.


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3. Thereafter, State and District Malaria Control Societies came into being following issuance of Government Resolution dated November 12, 1997.

4. Immediately after that a State Empowered Society for RCH was formed at state level and Additional Director (Family Welfare) was assigned the responsibility of a Project Director for RCH. (Vide GR Dated 19/1/98) and first district RCH society is constituted in 1998. District Development Officer is given the responsibility as a chairperson of the society and CDHO as a Member Secretary.

5. TB Control Society was affiliated with the existing Leprosy Society and designated as Leprosy cum TB Control Society in October 1998. District Development Officer is given the responsibility as a chairperson of the society and District TB Officer as a Member Secretary.

6. State AIDS Control Cell which was working since 1992 is transformed as State AIDS Control Society in the Year 1998 with District AIDS Control Unit chaired by the Collector cum District Magistrate with CDMO as a Member Secretary.

Experience in implementing programs through multiple societies More and more societies for vertical programs have come up with more or less

same members and office bearers causing duplication of efforts and also resources. Out of six Societies, District Development Officer (DDO) is Ex-Officio Chairperson in four societies (Leprosy, Tuberculosis, Malaria & RCH) and the District Collector chairs two societies (Blindness and AIDS control). Both of them are the key district officials and chair several committees and boards. This has resulted into duplication of efforts, inputs and other resources. There is a need to have uniform approaches to all programs including rules, administrative/financial guidelines, infrastructure and manpower, optimum resources to perform the tasks that are necessary to function effectively.

Rationale for merging all vertical Societies into one integrated Society- “District Health Society”

To overcome the problems faced by vertically functioning district societies, it has proposed to integrate all societies of districts into a single society with the following justifications.

1. Health cannot be considered in isolation. All activities of the health should be

viewed under one umbrella to ensure coordination amongst them. Any particular issues may be of high magnitude and require to be adequately addressed for which vertical approach may be necessary like leprosy elimination, polio eradication etc. For such issues the concerned executive committees can certainly emphasize more on individual program point of view but its working has to be streamlined under one banner in form of a Governing Body. Hence, integration of all the health activities is necessary.


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2. The integration is expected to help in reduction of duplication of the work. The integration of programs will bring about a desirable optimization of inputs, better convergence of services and so as to achieve a desirable outcome. It will build a feeling of ‘Health Team’ rather than ‘disease-program specific team’.

3. National Health Policy 2002 also advocates the gradual convergence of health services pertaining to different health programs under a single field administration. Recognizing the importance of health in improving the quality of life of people, Government of India has launched the National Rural Health Mission (NRHM) to bring in synergy in various determinants of health viz. sanitation, nutrition, hygiene and safe drinking water. In its core strategies, it is envisaged to bring in integration in vertical health and family welfare programs at National, State, District and Block level.

4. District Health Society

To support the District Health Mission, the districts will have an integrated District Health Society (DHS) and all the existing societies for different health Programs will be merged with it. The DHS will be responsible for planning and managing all the health and family welfare Programs in the district, both in the rural as well as urban areas. Implications of this include district planning to take note of both treasury and non-treasury sources of funds, even though it may not be handling all sources directly. Secondly, its geographical jurisdiction will be the entire district1 (including urban and rural).

Ensuring Inter-sect oral convergence and integrated planning should be a specific task for the Governing Body of the DHS. DHS will provide the platform where the three arms of governance – urban health management and district health administration/ district program officers of NRHM sectors get together to decide on health issues of the district and delineate their mutual roles and responsibilities.

The DHS will help to strengthen the capacity of district administration, particularly for planning, budgeting and budget analysis, development of operational policy2 proposals, and financial management etc. DHS will set up a District Program Management Unit, which has adequate contingent of staff and experts. It will have rules, regulations and procedures for hiring the staff and

1 The 74th Amendment provides for creation of a District Planning Committee to consolidate the plans prepared by Panchayats and Municipalities in the district and to prepare a draft development plan for the district as a whole. However, the DPC’s role is limited to planning only and does not include management functions. 2 At the district level, operational policy will relate to decisions about procedures, priorities etc. that set the precedent about what management actions are to be followed by the Program managers. For example, the HS may be authorised to relocate all or some categories of staff within the district. The DHS will be required to evolve and approve a procedure to be followed by the Program managers in this regard.


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experts both from the open market on contract base, on consultancy as well as on deputation from the Government. The DHS is not an implementing agency; it is a facilitating mechanism for the district health administration and convergence as also the mechanism for joint planning by NRHM related sectors.

4.1 Objectives of the Society

The ultimate objective of District Health Society is to ensure effective planning, implementation and monitoring all the health and family welfare programs in the district with decentralized and integrated efforts to achieve the Mission goals.

In pursuance of the above goal, the objectives of the society are:

1. To frame in the rules and regulation of the society, to reconsider administrative and financial powers to be given to the concerned health officials and establish health care service system to achieve the objectives of National Health Policy-2002 and State Population Policy – 2002.

2. To have integrated planning and implementation of various health programs for the effective and efficient planning and implementation of the health programs.

3. To make the health system responsive to the needs of the community.

4. To minimize duplication of efforts through optimization of inputs and resources by consolidating all program efforts under one institution mechanism.

5. To encourage effective community participation and improve inter-sectoral coordination though decentralization process.

6. To provide equitable, affordable and acceptable quality care of health services to the people with accessibility as near as possible to the door step of the community

7. To provide supportive & effective supervision for implementation of various health programs.

The Guidelines for Integration of the Societies 1. District Health Society (DHS)

1.1 Name of the Society The name of the society will be District Health Society (DHS) for the district of Gandhinagar. This Society will also work as the District Health Mission under the new program of National Rural Health Mission.

1.2 Office of the Society The registered office of the Society will be at the premises of the Health Branch, District Panchayat, Gandhinagar in the state of Gujarat.


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1.3 Components of the Society DHS will consist of

Governing Body Executive Committee Program Committees

1.4 Definition 1. State Government or GoG means the Department of Health and

Family Welfare, Government of Gujarat. 2. Central Government or GoI means the Ministry of Health & Family

Welfare, Government of India. 3. Society means District Health Society (District Health Mission-

DHM). 4. Governing Body means Governing Body constituted under the

constitution of Society Act, which is the decision- making general body of DHS.

5. Executive Committee means committee constituted for executing the Society decisions and programs.

6. Chairperson means Chairperson of the Society 7. Secretary means Member Secretary (District Health Mission Director)

of the Governing Body or Member Secretary of Executive committee of concerned program.

8. Member means Member of the Governing Body or Executive Committee and Program committees.

1.5 Functions of the Society

The followings would be the major functions by the society to fulfill its objectives. These will be carried out as per the approved district action plan. (i) To have a situational analysis, prepare, approve and implement

comprehensive district health plan, locally relevant and appropriate to the local needs by the executive committees.

(ii) To carry out need assessment for the training and undertake relevant training and retraining activities with emphasis on basis of technical skills including communication skills and on newer concepts and newer equipment.

(iii) Improve the access to services and ensure referral services. Regular, good preventive maintenance, prompt repairs, renovate and upgrade various types of health facilities. To ensure availability of different equipment, supplies, drugs to provide good quality services.

(iv) Initiate and undertake education and communication activities to increase the demand and utilization of health services through area specific IEC activities. To ensure complete Registration of births and deaths and to create awareness regarding adverse female sex ratio.

(v) Ensure observance of the financial rules framed by the state health society / central government / governing body including statutory audit of accounts of the Society on annual basis. To send consolidated monthly statement of expenditure to state as well as


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the program specific statement of expenditure quarterly as per the norms set by the specific executive committees. To send consolidated report on activities undertaken to state as well as the program specific report on activities undertaken as per the norms set by the executive committees. To prepare and submit the Annual Report of the Society.

(vi) To launch adequate surveillance and containment measures against locally endemic diseases. To review reports of different executive committees and send consolidated reports to State. Ensure assessment of progress by an independent Society at least once in three years.

(vii) To oversee formation and functioning of Village Health Committees.

(viii) In addition to the above, to undertake any other activity that contributes to the attainment of the objectives and goal of the Society.

5. Integration of District Health Society, District Health

Mission and District Programs

The District Health Mission Secretariat and the State Health Society are inter-linked in terms of a common secretariat/District Program Management Unit.

District Program Committees (Respective District Program

Officers)

District Health Mission Secretariat & DPMU

(Chief District Health Officer)

Executive Committee, District Health Society

(District Development Officer)

FW (RCH) [Maternal

Health, Child Health, FP]

Medical [AIDS & Blindness control]

Training [All training institutes and

programs of H & FW of the

district]

Health [TB, Leprosy,

Malaria, & Disease

surveillance]


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5.1 Process of merger of existing societies into integrated District Health Society

After the District Health Society has been registered, a special meeting of the Governing Body of existing district societies in the health sector has to be convened to adopt the following resolutions: “Resolved that the existing District Societies for RCH, Blindness Control, Malaria, Leprosy, TB, and AIDS Control dissolved with immediate effect and that all assets and liabilities of the said society shall stand transferred to the District Health Society, Gandhinagar.”

A signed copy of the above resolution has to be then filed with the Registrar of Societies to complete the process of merger.

6. District Health Society 6.1 Governing Body (GB)

The Governing Body is the highest decision-making and main controlling body of the Society (DHS). For all purpose GB should be considered as General Body of DHS. The first members of the DHS who have signed the memorandum will be the first Governing Body of the Society. They will select the additional members of the Governing Body as suggested in the constitution.

• Chairperson : District Collector • Co Chair : District Development Officer • Vice Chair : Regional Deputy Director • Member Secretary : Chief District Health Officer & District Health

Mission Director • Members :

Sr. Designation Status in the GC Selection 1. District Collector Chairperson Ex-officio 2. District Development Officer Co-Chair Ex-officio 3. Regional Deputy Director (Health &

Medical Services) Vice Chair Ex-officio

4. Chief District Health Officer District Health Mission Director

Member Secretary

5. Chief District Medical Officer Member Ex-officio 6. Additional District Health Officer Member Ex-officio 7. District RCHO, District Tuberculosis

Officer, District Leprosy Officer, District Program Officer- NPCB and ICDS, District Malaria Officer

Members Ex-officio


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Sr. Designation Status in the GC Selection 8. Professor & Head, Community

Medicine, of nearby Medical College (or nominated by him but not below the rank of Associate Prof)

Member Ex-officio

9. Superintendent of All FRUs Member Ex-officio 10. One Block Health Officer by rotation

to be nominated by CDHO Member Ex-officio

11. District Information Officer (I&B Dept.), District IEC Officer, District Planning Officer, District Primary Education Officer, District Social Welfare/Defence Officer

Members Ex-officio

12. Executive Engineer (R&B), Executive Engineer (WS&SB), Executive Engineer (Jilla Panchayat)

Members Ex-officio

13. President of Local Branch of IMA (or) His nominee, President of Local Branch of IAP (or) His nominee, President of Local Branch of FOGSI (or) His nominee

Members Ex-officio

14. Medical Officer DTT Member Ex-officio 15. State Liaison Officer of the district Member Ex-officio 16. Principal Nursing School Member Ex-Officio 17. MNGO (working in the field of H &

FW), One NGO (working in the field other than Health)

Members Nominated by Chairperson

18. One woman MLA, One woman President Taluka Panchayat, One woman President of Local Body, One Leading Private Medical Practitioner

Members Nominated by Chairperson

19. District Program Coordinator, DPMU Member Invitee Frequency of meetings:

Quarterly – Once in three months and preferably prior to District Health Mission meetings

Ordinary Business of the Governing Body Meeting:

• Approval of District Action Plan and resource allocations including Urban Health Plan and Submit the same to Executive Committee at State level for final approval and for getting funds from the state to carry out the activities to achieve the goals of the District Health Mission.

• Program reviews, recommendations and revisions, if required. • Cross cutting issues and guidance to related departments for NRHM

implementation at the district level • Consideration of proposals for institutional reforms in the H&FW

sector. • Progress review of implementation of the Annual District Action Plan.


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• Inter-sectoral co-ordination: all NRHM and SHM related sectors and beyond (e.g. administrative reforms across the district, convergence and common programming, joint reviews, resource sharing, etc).

• Follow up actions on decisions of the District Health Mission. • Co-ordination with NGOs, Development Partners and other relevant

organizations.

Memberships There shall be the following methods of selection of the members of the Society 1. Ex-officio Members: All the members who are holding the post mentioned in

the constitution will become automatically the member of the governing body of the Society.

2. Special invitee members : The governing body of the Society may co-opt any individual who commands prestige in the field of health and family welfare and can represent the issues concerning health of the community may be invited as a special invitee member for the relevant concerned agenda, but they would not have voting rights.

Term of the members of the Governing Body 1. The term of office of an ex-officio member shall continue so long as S/he

holds the office by virtue of which be/ she is such a member. 2. The terms of office of a special invitee member shall be for a period of two

years and on the expiry of said period, S/he shall be eligible for re-nomination.

Termination of Membership Any member who leaves his/her designated post or resigns will cease to be a member. Any member found working against the interests of the Society/committee, or legally prosecuted, whose act harms the image or functioning of the Society may be terminated by 2/3 majority voting in the governing body meeting out of members present in the meeting. Powers of the Governing Body It is a local authority empowered to take all measures considered necessary for the attainment of the objectives of the DHS within the guidelines from National or State level pertaining to the concerned program. Role and Responsibility of the Governing Body It shall have following responsibilities. 1. Create, monitor and guide the executive committees and other subcommittees

as the case may be. Regularly assess the health situation in the district, review the community needs, plan and give directives to the executive committees to fulfill the unmet needs.

2. Consider and approve the comprehensive annual action plan of the society based on the action plan of all District Executive Committees. Accord due sanction to the justifiable proceedings of the Executive Committees and modify if the need be. And also coordinate activities between various executive committees. Frame a policy and issue guidelines/directions to the Executive Committees with regard to implementation of the various activities of the action plan.


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3. The body will meet once in three months and review and approve the quarterly work report by the Member Secretary of each District Program Committees.

4. Approve the annual budget for the district as approved in the Executive Committee, State Health Society and authorize expenditure for each activity included in the action plan. The expenditure shall be incurred as per the provision of bye laws and as per constitution of the Society.

5. Delegate appropriate powers to the Executive Committee, Member Secretary (District Health Mission Director) to function as Chief Executive of the Society/ Committee for its smooth functioning. Appoint contractual staff as per the guidelines decided/recommended up to the optimum strength (need based). Hire short term contractual subject experts for training, IEC, MIS, evaluation and health audit to supplement efforts of the fulltime specialists already working.

6. Appoint the Auditor for the annual statutory audit of accounts of the Society in accordance with the bye-laws/Government instructions. Approve the audited accounts of the society. Ensure that in the Review Meeting (for any aided project- donor project) following documents are placed: Audited Accounts for the preceding financial year and quarterly such report of a current year, the update physical and financial progress of the project and the plan of action for the ensuing year.

7. Approve bye-laws relating to service matters, administration and financial matters of the Society on the recommendation of the Executive Committee in accordance with program guidelines issued by Government. Ensure that the mandated meetings of executive committees or subcommittee/expert groups whenever constituted are held and the minutes of the meetings are recorded and maintained and got approved

8. To take decisions in matters that may be referred to it, by the Central or State Government or by the Chairperson and undertake any activities those are consistent with the objectives of the society.

9. Authorize Member Secretary (District Health Mission Director) of the body or to any other office bearer of the Executive Committee to sue or defend the Society in legal affairs, and sign documents or complaints to be submitted in the appropriate courts on behalf of the Society.

Office bearers of the Society Chairperson, Co Chair, Vice Chair District Collector will work as the Chairperson and District Development Officer as Co-Chair and Regional Deputy Director of the concerned region will be the Vice Chair. The Chairperson, Co Chair and Vice Chair will be selected by virtue of holding their respective posts in the region / district, they will be ex officio chairperson / Vice Chair of the Society and on relieving from the post will cease to be so with immediate effect. Power of the Chairperson S/he is the highest decision making office bearer of the Society which co-ordinate and control the activities and functioning of society as per the constitution.


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Roles and Responsibilities of the Chairperson 1. S/he will preside over all the meetings of the body and will ensure that all

members of the Body take active part and contribute at their best to reach the collective decisions. S/he will decide issues unanimously or by majority of votes.

2. S/he shall have a power of casting a vote and also performs the functions/responsibilities as entrusted by the Body from time to time.

3. S/he shall assign functions /responsibilities to Co Chair, andVice- Chair on behalf of him/her to attain the objectives of the Society.

Powers, Roles and Responsibilities of the Co Chair and Vice Chair

1. Co Chair will preside over the meetings of the body in case of absence of the chairperson. In absence of Co- chairperson, the Vice Chair will preside. In the absence all the three, the members present would select the chairperson for that meeting.

2. Disburse funds and monitor its expenditures as per the rules and regulations approved by the Body/program guidelines.

3. To take all necessary steps to ensure that proper program guidelines are followed and carry out execution of the plan, scheme or activity approved by the Body.

4. RDD will ensure that National and State Program guidelines are followed.

Member Secretary/District Health Mission Director Chief District Health Officer will be the Member Secretary (District Health Mission Director) of the Society. He will be selected by virtue of holding his post in the district and on relieving from the post will cease to be so.

Powers of the Member Secretary/District Health Mission Director All executive and financial powers of the society shall rest with the Member Secretary who shall be responsible for coordinating the functions of District Program Executive Committees. Roles and Responsibilities of the Member Secretary/District Health Mission Director: 1. Make all executive, logistic and financial arrangements to ensure effective

and smooth functioning of the Society. 2. Preparation of agenda items along with their notes to be placed before the

Governing Body 3. Maintain the records and proceedings of all meetings of the Governing Body.

Ensure actions on the decisions taken in the meetings of the Governing Body and reporting back their compliance.

4. Administer and operate the funds of the Society in accordance with the decisions or policy guidelines approved by the Governing Body in accordance with the bye-laws.

5. Timely submission of the consolidated periodical reports as well as the program specific reports in the approved formats.

6. Undertake any activity or function or liability delegated or entrusted by the Governing Committee of the Society from time to time.


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Emergency Powers of the Chairperson and Member Secretary/District Health Mission Director Nothing in these rules and regulations shall prevent the Chairperson and Member Secretary (District Health Mission Director) from exercising all powers of the Governing Body in case of emergencies and epidemics for achieving the objectives of the Society. Action taken shall be reported for approval at the next meeting of the Governing Body.

Remunerations to the Chairperson, Member Secretary and Members Neither the Chairperson nor any other member/office bearer of the Society shall be entitled to any remuneration, except that the non-government office bearers of the Society are entitled to get TA/DA as per the State Government rules while they are on tour for the Society.

6.2 Executive Committee – District Health Society

• Chairperson : District Development Officer • Vice Chair : Chief District Health Officer • Member Secretary : Additional District Health Officer • Members :

Program Officers of Health and Family Welfare, District Program Officer- ICDS, DTT MO, Civil Surgeon of district hospitals, Superintendent of FRUs, CHC Superintendents, Block Medical Officers, Block Health Officers, Block PHNs, Block IECOs, Urban Hospital Superintendents, District Program Coordinator (DPMU), etc

Frequency of meetings:

Quarterly- Once in three months and one meeting should just prior to the governing body meetings of the District Health Society.

Ordinary Business:

• Approval of the Annual District Action Plan. • Execution of the approved Annual District Action Plan, including

release of funds for programs at district level as per Annual District Action Plan.

• Approval of the activity wise fund/budget for the activities to be carried out at district level as per Annual District Action Plan.

• Activity based progress review based on performance bench marks/ process indictors.

• Review of budget versus expenditure (utilization of funds against allocations)

• Approval of proposals from local NGOs, private health facilities and other implementing agencies/ partners, etc.

• Monitoring of integrated working arrangements for intra-sectoral and inter-sectoral co-ordination for achieving mission objectives.

• Follow up action on decisions of the Governing Body


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6.3 District Program Committee for Health & FW Sector (Sub Committees)

The Governing Body will propose and approve various Program Committees for Health, FW (RCH), AIDS and Blindness Control, Training as a subcommittees for the Society. • Chairperson : Chief District Health Officer • Vice Chair : Additional District Health Officer • Member Secretary : Concerned District Program Officer Composition of the District Program Committees

Sr#

Area Programs Chair Members

1. Health TB, Leprosy, Malaria, & Disease surveillance

Chief District Health Officer

Member secretary- Concerned district program officer, State H& FW official designated for the district, one faculty from the concerned program/department, Concerned HOD in respective programme from medical college, Urban Health Officers, Superintendent of one Community Health Centre, Two Block Health Officers, one village health committee chairperson, one NGO (working in the concerned field of health), JSA member, District Program Coordinator (DPMU), District Accounts Officer, etc

2. FW (RCH)

Maternal Health, Child Health, Family Planning


Member secretary- Concerned district program officer, State H& FW official designated for the district, one faculty from the concerned program/department, Concerned HOD in respective programme from medical college, Urban Health Officers, Superintendent of one Community Health Centre, Two Block Health Officers, one village health committee chairperson, one NGO (working in the concerned field of health), JSA member, District Program Coordinator (DPMU), District Accounts Officer, etc


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Sr#

Area Programs Chair Members

3. Medical AIDS & Blindness control

Chief District Medical Officer

Member secretary- Concerned district program officer, State H& FW official designated for the district, one faculty from the concerned program/department, Concerned HOD in respective programme from medical college, Superintendent of one Community Health Centre, Two Block Health Officers, one village health committee chairperson, one NGO (working in the concerned field of health), JSA member, Urban Health Officers, District Program Coordinator (DPMU), District Accounts Officer, etc

4. Training All training institutes and programs of H & FW of the district


Member secretary- DTT MO, One faculty designate for the district form SIHFW, DTT faculty, FHW training Centre, DTC, one faculty from the concerned program/ department, Superintendent of one Community Health Centre, Two Block Health Officers, one village health committee chairperson, one NGO (working in the concerned field of health), JSA member etc

Frequency of meetings:

Monthly- Once in a month and one meeting should just prior to the meeting of Executive Committee, District Health Society

Ordinary Business:

• Review of program progress as per approved work plan and budget • Assessment of technical and quality aspects of the program

implementation • Assessment of training need of health service providers and district

managers • Technical review of program proposals/partner agencies competency • Assessment of program activities versus program objectives • Program coverage amongst remote, BPL and other indigent sections • Program reviews and recommendations to Executive Committee,

District Health Society


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6.4 District Health Mission Secretariat and District Program Management Unit

The District Health Society Secretariat will consist of all district program officers supported by a core team of 4 full time contractual program support staff (DPMU), to support District Health Mission as under

• District Program Coordinator • District Accounts Officer • Finance Assistant • Monitoring & Evaluation Assistant Once the Secretariat is operationalised (i.e., the above staff is in place and the office is set up), the District Program Officer posts sponsored under the Centrally Sponsored Schemes and the contractual staff/consultants under the various Health Programs and bilateral/multi-lateral funding Programs may be brought under the District Health Mission Secretariat/District Program Management Unit. These staff will be on contract with the State Health Society, to work for the District Health Mission. The Driver will be contracted by the district society. The District Program Coordinator is seen as the key player not only in setting up and operationalising the DHS secretariat, but also in arranging managerial and supportive assistance to the district health administration, including general management and logistic support. The staff on contract will play a supportive role in implementing District Health Mission and responsibility of the implementation will be with the respective district program officers/district administration.

The specific responsibilities of the District Program Coordinator, DHS will include, but not be limited to the following:

Management of DHS Secretariat

(a) Facilitate the working of the DHS as per the bye-laws of the Society. (b) Maintain administrative, technical and financial files, records of the

society. (c) Support District Health Mission Director in organising meetings of the

Governing Body and Executive Committee including preparation of agenda notes, circulation of minutes and compilation of action taken reports etc.

(d) Organise audit of the society funds and preparation of quarterly and annual reports of the DHS as required.

(e) Preparation of monthly, quarterly and annual progress reports (both physical and financial), submission of the report to Executive Committee and State Program Management Unit


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Planning, Monitoring and Evaluation

(a) Create and maintain district resource database for the health sector including manpower, buildings, equipments and other support infrastructure. And provide it to SPMU as and when required.

(b) Assist the Chief District Health Officer and district program officers of the health and family welfare programs in developing the ‘District Work Plan’ based on the State Health Mission goals and programs.

(c) Organise activities related to health initiatives (d) Undertake regular monitoring of initiatives being implemented in the

district and provide regular report and feedback to the Society and others who are entitled to receive Reports of the Society [District Collector, Chairperson, District Panchayat, designated authority State Government, etc] through District Health Mission Director.

(e) Ensure compilation, analysis & presentation of relevant information in meaningful formats and assist the Chief District Health Officer and/or DDO in making informed discussions.

(f) Develop strategies/plans to improve the quality of services and present to the Society for approval.

Inventory management, Procurement & Logistics

a) Facilitate preparation of District Logistics Plan for optimal allocation of resources at each facility.

b) Ensure timely collection and compilation of ‘demands’ and their timely dispatch.

Appendices to facilitate creation and functioning of District Health Societies Memorandum of Association for the District Health Society (Gandhinagar) (Appendix-I) Rules and Regulations of District Health Society (Gandhinagar) (Appendix-II) Bye-laws of the District Health Society (Gandhinagar) (Appendix-III)


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Appendix-I

MEMORANDUM OF ASSOCIATION FOR THE DISTRICT HEALTH SOCIETY- GANDHINAGAR

1. Name of the Society The Name of the Society shall be “District Health Society, Gandhinagar or DHS (Gandhinagar)”

2. Area of operation The area of operation of the Society shall be whole of district Gandhinagar.

3. Location The Society shall have its office at the office of Chief District Health Officer, Gandhinagar district, situated at District Panchayat, Health Branch, Sector: 17, Gandhinagar 382 017 Gujarat

4. Objectives The Society shall assist district health administration in the implementation of various health Programs and projects in the district, with special emphasis on priority sectors like reproductive and child health, population control, control of malaria, TB and leprosy and prevention of blindness and malnutrition etc.

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

• To act as the nodal forum for all stakeholders –line departments, PRI and NGOs- to participate in planning, implementation and monitoring of the various health and family welfare Programs and projects in the district.

• To receive, manage and account for the funds received from the State Government (including State level Societies in the health sector) for implementation of Centrally Sponsored Schemes in the district.

• To strengthen the technical / management capacity of the District Health Administration through recruitment of individual / institutional experts from the open market

• To facilitate preparation of integrated district health development plans, for health and its various determinants like sanitation, nutrition and safe drinking water, etc.

• To guide the functions related to ‘Total Sanitation Campaign’ at the District level.

• To mobilize financial and non-financial resources for complementing/supplementing the health and family welfare activities in the district.

• To assist hospital management societies in the district. • To undertake such other activities for strengthening health

and family welfare activities in the district as may be identified from time to time, including mechanisms for intra and inter-sectoral convergence of inputs and structures.


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6. First members of The names, addresses, occupations and designations of the Governing Body 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:-

Sr. No. Name Occupation and address Status in

Society Signature Attested by

1 Ms Sonal Mishra, IAS

District Collector, M S Building, Opp Civil Hospital, Gandhinagar 382017

Chairperson

2 Mr. M T Joshi, IAS

District Development Officer, District Panchayat, Sector 17, Gandhinagar 382017

Co-Chair

3 Dr Dinkar Raval Chief District Health Officer, District Panchayat, Sector 17, Gandhinagar 382017

Member Secretary

A copy of the rules of the Society certified to be a correct copy by three members of the Governing Body is filed along with this Memorandum of Association.

Dated: __________________ 7. Declaration We, the several persons whose names and addresses are given

below having associated ourselves for the purpose described in this Memorandum of Association do hereby subscribe our names to this Memorandum of Association and set our several and respective hands hereunto and form ourselves into a Society under the Societies Registration Act, 1860 (Act, No.XXI of 1860): this19th day of July 2005 at Gandhinagar.

Sr. No. Designation Status in

Governing Body

1. District Collector Chairperson 2. District Development Officer Co-Chair 3. Regional Deputy Director Vice Chair 4. District Health Officer & District Health Mission Director Member Secretary 5. Additional District Health Officer and District RCH Officer Members 6. Project Officer (DRDA) Member 7. District Officers -TB, Malaria, Leprosy, Ophthalmic, AIDS

control, EMO, MO-DTT, DTC, DIECO, District PHN, etc Members

8. District Officer of PHED, ICDS, Education, Social Welfare, Panchayat, representatives of medical Association, MNGO/NGO representative, Urban Health Officer, Superintendents of district hospitals & FRU, Trustee/ superintendents of trust hospitals, District Program Coordinator (DPMU), etc, etc

Members


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Appendix-II

RULES / REGULATIONS OF THE DISTRICT HEALTH SOCIETY- GANDHINAGAR 1 SHORT TITLE 1.1 These Rules and Regulations shall be called “The Rules and Regulations of the

District Health Society (Gandhinagar)”. 1.2 These Rules shall come into force with effect from the date of registration of the

Society by the Registrar of Societies. 2 DEFINITIONS 2.1 In the interpretation of these Rules and Regulations, the following expressions

shall have the following unless inconsistent with subject or context:

“Act” means Societies Registration Act, 1860. “Central Government” means the Government of India. “DHS” means the District Health Society “Executive Committee” means the Executive Committee as referred to in these Rules. “District Program Officer” means the Program Manager cum Convener of the Society as referred to in these Rules. “Governing Body” means the Governing Body of the Society as referred to in these Rules. “Member” means the Member of the Society as referred to in these Rules. “Rules” means these Rules and Regulations registered along with the memorandum of Association & as may be amended by the Governing Body of the Society from time to time. “Secretariat” means the Secretariat of the Society as referred to in these Rules. “State Government” means the Government of Gujarat “Year” means the financial year, namely from 1st April of a calendar year to 31st March of the next calendar year.

3 OFFICE AND JURISDICTION 3.1 Registered office of the Society shall be situated at the Office of the Chief District

Health Officer, Gandhinagar, having its office at District Panchayat, Health Branch, Sector: 17, Gandhinagar 382 017 Gujarat

3.2 The jurisdiction of the Society shall be the whole of Gandhinagar.


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4 MEMBERSHIP 4.1 The following shall be the members of the Society:

• First members of the Governing Body (As per Appendix-I, Section 6) • Additional ex-officio members of the Governing Body (As per Appendix-I,

Section 7) • The Governing Body may determine representatives of other organizations as

required. • Individuals as may be nominated by the Governing Body from time to time.

4.2 The membership of an ex-officio member of the Society and of the Governing

Body shall stand terminated when S/he ceases to hold the office by virtue of which S/he was member and his/her successor to the office shall become such member.

4.3 Non-official members of the Society will be nominated by the Chair-person with

the approval of the Governing Body. Nominated members shall hold office for a period of three years from the date of their nomination by the Chair-person. Such members will be eligible for re-nomination for another period of 3 years.

4.4 The Society shall maintain a roll of members at its registered office and every

member shall sign the roll and state therein his/her rank or occupation and address. No member shall be entitled to exercise rights and privileges of a member unless S/he has signed the roll as aforesaid.

4.5 All members of the Governing Body shall cease to be members if they resign,

become of unsound mind, become insolvent or be convicted of a criminal offence involving moral turpitude or removal from the post by virtue of which s/he was holding the membership.

4.6 Resignation of membership shall be tendered to the Governing Body in person to its

Member Secretary and shall not take effect until the Chairperson has accepted it on behalf of the Governing Body.

4.7 If a member of the Society changes his/her address S/he shall notify his/her new

address to the Member Secretary who shall thereupon enter his/her new address in the roll of member. But if a member fails to notify his/her new address the address in the roll of members shall be deemed to be his/her address.

4.8 Any vacancy in the Society or in the Governing Body shall be filled by the

authority entitled to make such appointment. No act or proceedings of the Society or of the Governing Body shall be invalid merely by reason of the existence of any vacancy therein or of any defect in appointment of any of its members.

4.9 No member of the Governing Body, except the Member Secretary to be appointed

as per these Rules, shall be entitled to any remuneration.


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5 AUTHORITIES OF THE DHS 5.1 The following shall be the bodies and authorities of the Society:

• Governing Body • Executive Committee • Sub-Committees of the Executive Committee, such as Program Committee

5.2 GOVERNING BODY 5.2.1 All members of the Society as set out in para 4.1 shall constitute the Governing

Body of the Society. 5.2.2 The first members of the Governing Body of the Society shall be those mentioned

in Clause 6 of the Memorandum of Association. They shall hold office until a new Governing Body is appointed according to these Rules.

5.2.3 The management of the affairs of the Society shall be entrusted to Governing

Body and the property of the Society shall be vested in the Governing Body. 5.2.4 The Society may sue or be sued in the name of the Member Secretary of the

Society or of such other members as shall, in reference to the matter concerned, be appointed by the Governing Body for the occasion.

5.3 PROCEEDINGS OF THE GOVERNING BODY 5.3.1 The meetings of the Governing Body shall be held at least twice a year and at

such time and place as the Chairperson shall decide. If the Chair-person receives a requisition for calling a meeting signed by one-third members of the Governing Body, the Chair-person shall call such a meeting as soon as may be reasonably possible and at such place as s/he may deem fit.

5.3.2 Following minimum business shall be brought forward and disposed off in every

meeting of the Governing Body:

• Annual report of the Society relating to last financial year, including (a) income and expenditure account, (b) balance sheet and (c) audit report

• Physical and financial progress of the Programs / projects in the current year • Work Plan (including budget) for the next financial year. • Other business brought forward with the assent of the Chair-person

5.3.3 Every notice calling meeting of the Governing Body shall state the date, time and

place at which such meeting will be held and shall be served upon every member of the Governing Body not less than twenty one clear days before the date appointed for the meeting. Such notice shall be issued by the Member Secretary of the Society and shall be accompanied by an agenda of the business to be placed before the meeting provided that accidental omission to give such notice to any member shall not invalidate any resolution passed at such meeting. In the event of any urgent business the Chairperson may call the meeting of the Governing Body at clear ten days notice.


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5.3.4 The Chair-person shall Chair the meetings of the Governing Body. In his/her

absence, the Governing Body shall elect one from among the members present as Chairperson of the meeting.

5.3.5 One third of the members of the Governing Body, including the substitutes

nominated under Rule 5.3.7 present in person, shall form a quorum at every meeting of the Governing Body.

5.3.6 All disputed questions at the meeting of the Governing Body shall be determined

by votes. Each member of the Governing Body shall have one vote and in case of a tie, the Chairperson shall have a casting vote.

5.3.7 Should any official members be prevented for any reason whatsoever from

attending a meeting of the Governing Body, the Chair-person of the Society shall be at liberty to nominate a substitute to take his place at the meeting of the Governing Body. Such, substitute shall have all the rights and privileges of a member of the Governing Body for that meeting only.

5.3.8 Any member desirous of moving any resolution at a meeting of the Governing

Body shall give notice there of in writing to the Member Secretary of not less than ten clear days before the day of such meetings.

5.3.9 Any business which it may become necessary for the Governing Body to perform,

except the agenda prescribed for the full meeting as set out in para 5.3.2 above, may be carried out by circulation among all its members and any resolution so circulated and approved by majority of the members signing shall be as effectual and binding as if such resolution had been passed at a meeting of the Governing Body provided that at least one third members of the Governing Body have recorded their consent of such resolution.

5.3.10 In the event of any urgent business, the Chairperson of the Society may take a

decision on behalf of the Governing Body. Such a decision shall be reported to the Governing Body at its next meeting for ratification.

5.3.11 A copy of the minutes of the proceedings of each meeting shall be furnished to

the Governing Body members within 2 weeks after completion of the meeting. 5.4 POWERS OF THE GOVERNING BODY 5.4.1 The Governing Body will have full control of the affairs of the Society and will

have authority to exercise and perform all the powers, acts and deeds of the Society consistent with the aims and objects of the Society.


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5.4.2 In particular and without prejudice to the generality of foregoing provision, the

Governing Body may:

• Make, amend, or repeal any bye laws relating to administration and management of the affairs of the Society subject to the observance of the provisions contained in the Act, provided that such amendments are brought to the Governing Body after obtaining endorsement / approval from the State Government3.

• Consider the annual budget and the annual action plan, its subsequent alternations placed before it by the Member Secretary from time to time and to pass it with such modifications as the Governing Body may think fit.

• Monitor the financial position of the Society in order to ensure smooth income flow and to review annual audited accounts.

• Accept donations and endowments or give grants upon such terms as it thinks fit.

• Delegate its powers, other than those of making rules, to the Chair-person, Member Secretary or other authorities as it may deem fit.

• Authorise the Member Secretary to execute such contracts on behalf of the Society as it may deem fit in the conduct of the business of the Society.

• Appoint committees, sub-Committees and Boards etc. for such purpose and on such terms as it may deem fit, and to remove any of them.

• Recruit administrative / technical staff for the Society secretariat as per the Operational Manual of the Society.

• Procure goods and services in accordance with the procedures laid down in the Operational Manual of the Society.

• Do generally all such other acts and things as may be necessary or incidental to carrying out the objectives of the Society or any of them, provided that nothing herein contained shall authorize the Governing Body to do any act or to pass any bye-laws which may be repugnant to the provisions hereof, to the powers hereby conferred on the Governing Body and other authorities, or which may be inconsistent with the objectives of the Society.

5.5 POWERS AND FUNCTIONS OF THE CHAIRPERSON OF THE

GOVERNING BODY 5.5.1 The Chair-person shall have the powers to call for and preside over all meetings

of the Governing Body. 5.5.2 The Chair-person may himself/herself call, or by a requisition in writing signed

by him/her, may require the Member Secretary to call, a meeting of the Governing Body at any time and on the receipt of such requisition, the Member Secretary shall forthwith call such a meeting.

5.5.3 The Chair-person shall enjoy such powers as may be delegated to him by the

Society and the Governing Body.

3 This provision is being made to ensure that the DHS in other districts also benefit from avenues of improvements identified in a district.


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5.5.4 The Chair-person shall have the authority to review periodically the work and

progress of the Society and to order inquiries into the affairs of the Society and to pass orders on the recommendations of the reviewing or inquiry Committee.

5.5.5 Nothing in these Rules shall prevent the Chairperson from exercising any or all

the powers of the Governing Body in case of emergencies in furtherance of the objects of the Society. However, the action taken by the Chairperson on such occasions shall be reported to the Governing Body subsequently for ratification.

5.6 EXECUTIVE COMMITTEE AND ITS SUB-COMITTEES (Program

Committee) 5.6.1 The Governing Body will constitute an Executive Committee which will be

responsible for acting for and doing all deeds on behalf of the Governing Body and for taking all decisions and exercising all the powers, vested in the Governing Body except those which the Governing Body may specifically specify to be excluded from the jurisdiction of by the Executive Committee.

5.6.2 The composition of the Executive Committee shall be as follows:

Sr No. Name / designation Status in Executive

Committee 1. DDO cum CEO, District Panchayat Chairperson 2. Chief District Health Officer Vice Chair 3. Additional District Health Officer Member Secretary 4. Program Officers of Health and Family

Welfare, District Program Officer- ICDS, DTT MO, Civil Surgeon of district hospitals, Superintendent of FRUs, CHC Superintendents, Block Medical Officers, Block Health Officers, Block PHNs, Block IECOs, Urban Hospital Superintendents, District Program Coordinator (DPMU)

Members

5.6.3 The Executive Committee may co-opt additional members and/or invite subject

experts to its meetings from time to time. 5.6.4 Meetings of the Executive Committee shall be convened by the Member

Secretary by giving clear seven days notice in writing along with the Agenda specifying the business to be transacted, the date, time and venue of the meeting.

5.6.5 Meetings of the Executive Committee shall be held at least once every month or

more frequently as necessary. 5.6.6 The minutes of the Executive Committee meetings will be placed before the

Governing Body at its next meeting.


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5.6.7 The Executive Committee may appoint one or more Program-committees for the purpose of day-to-day execution of the various Programs.

5.6.8 The Program Committee will submit a monthly performance / progress report to

the Executive Committee which shall incorporate these into the consolidated progress reports to be placed before the Governing Body.

5.7 SOCIETY SECRETARIAT AND MEMBER SECRETARY 5.7.1 Governing Body, with the assistance of the Member Secretary, will establish a

Secretariat of the Society consisting of technical, financial and management professionals to serve as the District Program Management Support Unit (DPMU) to assist the district health administration.

5.7.2 The Secretariat shall consist of such technical / management units as set out in the

Operational Manual prescribed by the State Government. 5.7.3 The district level officers appointed under on-going projects sponsored by

development partners, if any, shall be physically co-located in the Society Secretariat office4.

5.8 POWERS AND FUNCTIONS OF THE SECRETARIAT 5.8.1 The Secretariat of the Society shall consist of the Member Secretary and Staff of

the Society. 5.8.2 The Secretariat will be responsible for day-to-day management of the Society’s

activities. In particular, it will be responsible for performing all functions of the Society as set out in article 5 of the MoA.

5.8.3 The Secretariat will provide Technical Support to the District Health Mission. It

will also be responsible for financial management of funds of the Society. 5.8.4 The funds sanctioned by the Governing Body/Executive Committee shall be

released by the two authorized signatories and a copy of the sanction order marked to the DPMSU for financial management of the same.

6 FUNDS OF THE SOCIETY 6.1 The funds of the Society shall consist of the following:

• Grant-in-aid from the State Government and/or State Health Society • Grants-in-aid from the Central Government, if it decides to give the whole or

part of grants directly to District Society. • Grants and donations from trade, industry, institutions and individuals. • Receipts from disposal of assets. • The assets and liabilities of all Societies merged into the integrated Society

shall be subsumed within the new Society.


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7 ACCOUNTS AND AUDIT 7.1 The Society shall cause regular accounts to be kept of all its monies and

properties in respect of the affairs of the Society. A Central cash pool system will be developed for the society from where funds will be transferred to each program accounts. A computerized finance management system based on Entrepreneur Resource Planning (ERP) will be introduced for the society in due course of time.

7.2 The Executive Committee may cause separate Bank Accounts in respect of each

scheme or separate ledgers for each scheme under one account. In such an event, the Governing Body shall prescribe written instructions relating to submission of Statement of Expenditure (SoE) for each scheme. The separate Accounts of different Programs could be audited by different auditors, and submitted to Program Units separately. However, the DPMSU will ensure one integrated audit of the District Health Society.

7.3 The accounts of the Society shall be audited annually by a Chartered Accountant

firm included in the panel of Comptroller and Auditor General of India or any qualified person appointed by the Government of India/State Government and any expenditure incurred in connection with such audit shall be payable by the Society to the Auditors. The Office of the Accountant General of State may also, at its discretion, audit the accounts of the society.

7.4 The Chartered Accountant or any qualified person appointed by the Govt. of

India/State Government in connection with the audit of the accounts of the Society shall have the same rights, privileges and authority in connection with such audit as the Auditor General of the State has in connection with the audit of Government accounts and in particular shall have the right to demand the production of books, accounts, connected vouchers and other necessary documents and papers.

7.5 The report of such audit shall be communicated by the auditor to the Society,

which shall submit a copy of the Audit Report along with its observation to the State Government.

7.6 The Auditor shall also forward a copy of the report to the following:

• A designated authority of the State Health Society as may be determined by its Governing Body / Executive Committee

• The District Collector • Chairperson of the Governing Body of the Society and State Government or a

designated authority of the State level society.


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8 BANK ACCOUNT 8.1 The account of the Society shall be opened in a bank approved by the Executive

Committee of the District Health Society as may be specified by the MoHFW, Government of India or Executive Committee of the State Health Society. All funds shall be paid into the Society’s account with the appointed bank and shall not be withdrawn except through a cheque, bill note, other negotiable instruments or through electronic banking (e-banking) procedures signed/electronically authorised by such authorities of the Society Secretariat as may be determined by the Executive Committee. This account should be managed jointly by the District Development Officer (Chairperson of the Executive Committee) and Chief District Health Officer (District Health Mission Director / Member Secretary of Executive Committee).

8.2 The society can open separate program accounts in the bank and approved funds

could be transferred to the program account. Joint signatory of Chief District Health Officer and respective program officer should manage this account (Member Secretary of the respective program committee). The petty cash account is to be managed from the respective program accounts. (Not from the district society account)

8.3 The Society shall switch over to e-banking procedures as and when the MoHFW,

Government of India directs the Society to do so as the principal donor to the Society.

9 ANNUAL REPORT 9.1 A draft annual report and the yearly accounts of the Society shall be placed before

the Governing Body at next meeting for consideration and approval. A copy of the annual report and audited statement of accounts as finally approved by the Governing Body shall be forwarded within six months of the closure of a financial year to the following: • District Collector/DM, • Chair-person, Governing Body, and • Designated authority of the State Government

10 SUITS AND PROCEEDINGS 10.1 The Society may sue or be sued in the name of Society through its Member

Secretary. 10.2 No suit or proceedings shall abate by the reason of any vacancy or change in the

holder of the office of the Chairperson or Member Secretary or any office bearer authorised in this behalf.

10.3 Every decree or order against the Society in any suit or proceedings shall be

executable against the property of the Society and not against the person or the property of the Chairperson, Member Secretary or any office bearer of the Society.


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10.4 Nothing in sub-rule 10.3 above shall exempt the Chairperson, Member Secretary

or office bearer of the Society from any criminal liability or entitle him/her to claim any contribution from the property of the Society in respect of any fine to be paid by him/her on conviction by a criminal court.

11 AMENDMENTS 11.1 The Society may amend these Rules provided that such changes shall not alter the

nature and /or the objectives and/or the purposes for which it has been set up. The proposals for any amendments shall be carried out only through the following process:

11.1.1 Proposals for amendments have been circulated to all members of the Governing

Body and have been duly included in the written agenda of the ensuing meeting of the Governing Body or a special meeting of the Governing Body;

11.1.2 The Governing Body has endorsed the proposal at least 3/5th of the members of

the Governing Body; and 11.1.3 The State Government has communicated, in writing, its endorsements to the

Governing Body resolution for the amendment. 12 DISSOLUTION 12.1 The Governing Body may resolve to dissolve the Society by bringing a proposal

to that effect in a special meeting to be convened for the purpose, provided that the proposal for dissolution has been duly approved /endorsed through the process prescribed for amendment as set out in para 11.1 of these Rules.

12.2 The dissolution proceedings shall be made in accordance with the provisions of

the Act as amended from time to time in its application in the State. 12.3 Upon the dissolution of the Society, all assets of the Society, after the settlement

of all its debts and liabilities, shall stand reverted to the State Government for such purposes as it may deem fit.

13 MISCLELLANEOUS 13.1 CONTRACTS 13.1.1 All contracts and other instruments for and on behalf of the Society shall be

subject to the provisions of the Act, be expressed to be made in the name of the Society and shall be executed by the persons authorised by the Governing Body.

13.1.2 No contracts for the sale, purchase or supply of any goods and material shall be

made for and on behalf of the Society with any member of the Society or his/her relative or firm in which such member or his/her relative is a partner or shareholder or any other partner or shareholder of a firm or a private company in which the said member is a partner or director.


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13.2 COMMON SEAL AND STATIONERY 13.2.1 The Society shall have a common seal of such make and design as the Governing

Body may approve. The society shall use the common letterhead, as approved by the governing body for all its official purposes, including contracts.

13.3 GOVERNMENT POWER TO REVIEW 13.3.1 Notwithstanding anything to the contrary contained in these Rules, the State

Government and/or Ministry of Health & Family Welfare may appoint one or more persons to review the work and progress of the Society and hold enquiries into the affairs thereof and report thereon. The Central Government may also cause the accounts of the Society to be audited by the internal audit parties of the Chief Controller of Accounts, MoHFW, GOI or do Management Audit through the Financial Management Group, and issue directions, as deemed appropriate, to the Society.

13.3.2 The Chair-person of the Governing Body shall have the right to nominate one or

more persons to be part of the review / enquiries. 13.3.3 The progress review reports and / or enquiry reports shall be included in the

written agenda of the ensuing meeting of the Governing Body.

We, the undersigned being three of the members of the first Governing Body of the District Health Society, certify that the above is a correct copy of the Rules and Regulations of the said Society.

Sr

No. Name and address Signature

1 Ms Sonal Mishra, IAS District Collector, M S Building, Opp Civil Hospital, Gandhiangar, Gujarat 382017

2 Mr M T Joshi, IAS District Development Officer, District Panchayat, Sector 17, Gandhinagar, Gujarat 382017

3 Dr Dinkar Raval, Chief District Health Officer, District Panchayat, Sector 17, Gandhinagar, Gujarat 382017

Dated: _________________________


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Appendix-III BYE-LAWS OF THE DISTRICT HEALTH SOCIETY- GANDHINAGAR A Procurement Policy and Procedures

Procurement of goods and services will be organized as per the procedures recommended by the State Society. Commitments made to multilateral/bilateral donor agencies with regard to Procurement Procedures under different Projects would be honored.

B Procedure for release of funds

Funds would be ordinarily released from State Health Society to District Health Society in two branches. The Society funds shall be drawn through cheques and/or bank drafts or through e-banking mechanism as and when the same is introduced.

Two authorized signatories comprising of CDHO and Member-Secretary of the concerned Program committee shall sign all cheques.

All releases will be made on the basis of a written authorization from the Member-Secretary of the concerned Program committee.

Wherever releases are decided to be made through bank drafts and/or through e banking, the concerned authorized signatories shall sign the authorization letter to the bank.

Note: Wherever, under e-banking procedures, releases are to be made through electronic authorization to the bank to issue cheque/draft/account transfer on behalf of the Society, the electronic authorization will be executed by the same two authorized functionaries of the Society secretariat who have been authorized to sign cheques on the basis of a written authorization from the concerned/designated authorities.

B.1 financial powers

The Governing Body may review and revise the financial powers of the office bearers of the bodies of the Society on an annual basis and revise the same, if considered necessary.


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C Financial Powers of the Office Bearers of the Society (Governing Body, Executive Committees, Program Committee) and Member Secretary

Type of expenditure Authority Extent of power

Approval of Plans & Release of Funds 1. Approval of District Plan Governing

Body Full powers (subject to the approval of the State Health Society)

2. Approval of Urban Plans and City plans Executive Committee

Full powers (subject to the approval of the State Health Society)

3. Release of funds to Hospitals/ hospital societies; block Medical Officers and other implementing agencies as per approved norms by State Health Society and/or proposals approved by State. 4. Release of funds for implementation of plans / allocations approved by Governing Body / Executive Committee, as approved by the Executive Committee

District Health Mission Director and Member-Secretary of the concerned Program Committee

Full powers

5. Expenditure proposals not covered under categories A and/or B

Chair-person, Governing Body

Up to Rs 5 lakh per case at a time maximum of Rs 30.00 lakh per annum

5.1: Procurement of goods 5.2: Repairs and minor civil works 5.3: Procurement of services for specific tasks including outsourcing of support services

Chair-person, Executive Committee

Up to Rs. 3.00 lakh per case at a time maximum of Rs 15.00 lakh per annum

Chair-person, Governing Body

Up to Rs. 2.00 lakh at a time subject to a maximum of Rs. 10.00 lakh per annum

Chair-person, Executive Committee

Up to Rs 1.00 lakh at a time, subject to a maximum of Rs. 10.00 lakh per annum

Member-Secretaries of the Program Committee

Up to Rs 50,000/- at a time subject to a maximum of Rs. 5.00 lakh per annum.

FRU/CHC Superintendents

Up to Rs. 25,000/- at a time subject to a maximum of Rs. 2 lakh per annum

5.4: Miscellaneous items not mentioned above such as hiring of taxis, hiring of auditors, meetings and workshops, training, purchase of training material/ books and magazines, payment of TA/DA allowances for contractual staff and/or non-official invitees to DHS meetings and/or officials deputed to meetings outside the district.

MO Up to Rs. 10,000/- at a time subject to a maximum of Rs. 50,000/- per annum (for PHCs and SCs under his/her jurisdiction)


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D Human Resources Policy and Procedures D.1 Recruitment and Appointment

Recruitment would be through either of the following two routes: • Appointments from open market: all such appointments will be on contractual

basis for a fixed tenure of 11 months. • Appointments on “Deputation” basis: all such appointments will be regulated

in terms of State Government rules relating to Deputation.

Recruitment may either be made by the State Health Society [e.g. recruitment of Member Secretary from the open market or recruitment of District program coordinators on deputation basis] OR by the DHS OR a combination of both a may be determined by the State Society.

All appointments would be temporary and would be made for the contract / deputation period as may be determined by the State Health Society.

D.2 Terms of appointment (applicable to Society staff and Consultants)

The terms of appointment of the staff of the Society shall be regulated in terms of the guidelines that may be provided by the State Government.

D.3 Compliance of Statutory Requirements

The Society shall register itself with relevant government agencies for the purpose of complying with the statutory requirements including regulations governing deduction of tax at source relating to the staff, consultants and experts employed by it and/or consultancies / contracts awarded by it in the course of performance of its tasks. D.4 Leave rules

Holidays, Casual Leave, Medical Leave: The Society staff and the full time consultants shall be governed by the State Government rules, in so far as observance of holidays and grant of casual / medical leave is concerned.

Leave without pay: The Society staff (including full time consultants) shall be entitled to take leave without pay in exceptional circumstances. The Member Secretary can sanction this, after recording the reasons. For the Member Secretary, this would have to be endorsed by the District Health Mission Director/Vice Chair, Executive Committee. D.5 Training and capability development

Full time consultants and staff of the Society (including staff on deputation) would be encouraged to take up skill development courses, short term courses, trainings and even correspondence courses which further their employment prospects, enhance their skills, and build up Society capabilities.


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D.6 Travelling / Dearness Allowance (TA/DA) Rules Travel within and outside State: Travel of Society staff (including those who are employed by the Society on deputation/contract basis) shall be governed as per the entitlements given in the table below. Within State travel, the existing TA/DA government rules will apply as per eligibility for respective cadres.

Entitlement District Health Mission

Director & Member Secretary (Category I)

District Program Officers

(Category II)

Junior / clerical staff

(Category III) Entitlement for travel (outside state)

By air By 2nd AC 2nd AC or 3rd AC

Entitlement for road travel (1)

Office Vehicle or Taxi Office Vehicle or Taxi

Bus/Shared taxi (2)

Per-diem when hotel is not used (outside state)

Rs. 500/- per day Rs. 300/- per day Rs. 200/- per day

Per-diem when hotel is used (3) (outside state)

Rs. 1000/- per night (3) Rs 500/- per night (3)

Rs. 300/- per night (3)

Notes: (1) The Society shall create a panel of accredited taxi operators through open tender for hiring the taxis for the travel of Society staff. (2) The District Health Mission Director and/ or Member Secretary can allow the junior staff to use a taxi for undertaking travel as per an approved itinerary. (3) The Society shall identify and negotiate a standard/discounted tariff for its staff / employees with the State Tourism Corporation, guest houses of PSUs and budget / hotels. In the absence the negotiated hotels/ rates, it will be subject to actual.

Travel outside the State: Travel outside the State shall be regulated on a case to case basis in accordance with delegated financial powers as indicated in Section-C above (Financial Powers, item 5.4).

D.7 Deduction of Tax at Source Tax will be deducted at source as per income tax rules and the Society shall register itself with the relevant authorities in this regard.

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Documents

DISTRICT HEALTH MISSION GANDHINAGAR · July 21, 1986. Formation of district level societies each in Surat and Bharuch districts soon followed as being high endemic areas for Leprosy