Euhp_qpr July _sept 09-13-10-09 Pm

7/30/2019 Euhp_qpr July _sept 09-13-10-09 Pm

1/29

Quarterly Progress Report for EUHP

July- September, 2009

Submitted to

EMG- MCH-STAR

4-9, Upper Ground Floor, Mohta Building

4, Bhikaji Cama Place, New Delhi- 110 066

Urban Health Resource Center

B-7/122A Safdarjung Enclave

New Delhi-29


2/29


3/29

ABBREVIATIONS

ACMO Additional Chief Medical Officer

ANM Auxiliary Nurse Midwife

APO Assistant Project Officer

BGMS Bharatiya Grameen Mahila Sangh

BMC Bhubaneshwar Municipal Corporation

BNS Bal Niketan Sangh

CARE

Cooperative for Assistance and Relief

Everywhere, Inc.

CBO Community Based Organisations

CCT Cluster Coordination Team

CECOEDECON

Centre for Community Economics Consultants

Society

CLV Community Link Volunteer

CMHO Chief Medical Health Officer

CMO Chief Medical Officer

CVD Cardiovascular Disease

CV Community Volunteer

DGM-MCH-SPMU

Deputy General Manager-Maternal and Child

Health- State Project Management Unit

DIO District Immunisation Officer

DPM Dstrict Program Manager

DS-UH Deputy Secretary

DTHC D type heath Centre

DUDA District Urban Development Authority

EFC Empowered Finance Committee

EOI Expression of Interest

FIRE-D

Financial Institutions Reform and Expansion

Debt


4/29

GM-MCH-SPMU

General Manager- Maternal and Child Health--

State Project Management Unit

GOI Government of India

HR Human Resource

ICDS Integrated Child Development Services

IDSSS Indore Diocese Social Service Society

IFA Iron Folic Acid

IMC Indore Municipal Corporation

JHU John Hopkins University

JS-UH Joint Secretary- Urban Health

JSY Janani Suraksha Yojana

LHV Lady Health Volunteer

LMO Lady Medical Officer

MAS Mahila Arogya Samiti

MCH Maternal and Child Health

MDG Millennium Development Goals

MNRCHMaternal, Neonatal, Reproductive and ChildHealth

MoHFW Ministry of Health and Family Welfare

MOIC Medical Officer In-charge

M& E Monitoring and Evaluation

MP Madhya Pradesh

NGO Non Government Organization

NIRPHAD

Naujhil Integrated Rural Project for Health and

Development

NREGA National Rural Employment Guarentee Act

NUHM National Urban Health Mission

NUSP National Urban Sanitation Program

OD Operations Director

ORS Oral Rehydration Solution


5/29

PMU Program Management Unit

PO-DUDA

Project Officer- District Urban Development

Authority

PPP Public- Private Partnership

UPHC Urban Primary Health Center

RCH Reproductive and Child Health

RFA Request for Application

RFP Request for Proposal

RMNCH

Reproductive, Maternal, Neonatal and Child

Health

RPC Regional Program Cordinator

SOW Scope of Work

SPMU State Project Management Unit

SUHC State Urban Health Consultant

TOR Terms of Reference

UH Urban Health

UHC Urban Health Centre

UHRC Urban Health Resource Centre

UMMU Urban Mobile Medical Unit

UNICEF Uniter Nation Children's Fund

UP Uttar Pradesh

USA United States of America

USAID

United States Agency for International

Development

USHA Urban Social Health Activist

VAT Value Added Tax

WHO World Health Organization

Table of ContentsBackground


6/29

I. Summary of Quarterly ProgressII. Human Resource ManagementIII. Activities & Sub Activities Progress in the Last QuarterResults Achieved in

the Last Quarter

Component 1: Technical Support to NUHM

1.1. Technical Assistance for effective roll out of National Urban Health Mission1.1.1 Support to the National Urban Health Mission1.1.2 Technical Assistance to State level Urban Health Programminga) Technical Assistance to Government of Uttar Pradeshb) Technical Assistance to Government of Jharkhand

c) Technical Assistance to Government of Madhya Pradesh:

d) Technical Assistance to Government of Delhie) Technical Assistance to Government of Rajasthan

1.2. Strengthen NUHM through program learning

a) Indore

Capacity building of community organizations and health workers

Monthly Outreach Health Camps in partnership with Govt of MP

Technical support to Indore city UH Program

Ward Coordination Committee

Study Tours / Visit to Indore Program

b) AgraCoordination with the government

Capacity Building sessions

Study Tours / Visit to Agra Program

1.3 Increase capacity and resources in India to support NUHM and programmes to

improve the health of the Urban Poor.

1.4. Management and Strategic Dissemination of Urban Health knowledge

a) Websiteb) Data analysis, preparation and dissemination of urban health informationthrough research reports, working papers and articlesc) Advocacy Events / Consultations / Related Activities to promote policy and

program developmentd) Participation in Symposium/ Conference/ Seminars/ Workshop/ Summite) UHRC in Media

Component 2: Improve Basic Water, Sanitation and HygieneServices for the Urban Poor Situation Analysis ofBhubaneswar City

Component 3: Support for Organizational and InstitutionalStrengthening of UHRC

3.1. Collaborations


7/29

3.2. Resource Mobilization Efforts

3.3. Institutional Strengthening

3.4 Finance

3.4.1 Reporting

3.4.2 Audit/ Review

3.4.3 Sub-grants Management

3.4.4 Close Out of EUHP

3.5. Governance, Management, Review

3.5.1. Board Meeting

3.5.2. Core Team Meetings

3.5.3. Staff Meetings

IV. Partnerships Establishment and Coordination Government (National andState Level):

V. Challenges EncounteredVI. Closure Related Activities


8/29

MCH-STAR Initiative

Quarterly Progress Report for Project

[July- September 2009]

Instructions: All instructions are provided in italics. The goal of this report is to

identify the progress on activities; deliverables met; and challenges faced during

this quarter for your specific project. Please note that in if you are partnering with

another SSI for this project a single report can be prepared jointly but copies

should be submitted by both institutions.

Project Title: Expanded Urban Health Programme

Project Partners (ifapplicable):

Task Order Number:

Report Prepared By:

BackgroundUHRC was institutionalized in 2005, and has since grown from a USAID fundedproject initiated in 2002, into an independent organization pursuing its mission ofbringing about sustainable improvement in the health conditions of the urban

poor by influencing policies and programs and empowering the community.UHRC endeavors to strengthen government policies and programs impacting theurban poor by engaging in operations research, evidence-based advocacy, andprovision of technical assistance to central and state-level governments. Citydemonstration programs have been developed in Indore and Agra to provideevidence-based consultative program planning. UHRC has developed a demand-supply linkage approach and a ward-level inter-sectoral coordination approach inIndore, Madhya Pradesh. In Agra, UHRC is supporting the Government of UttarPradesh to operationalize a Public-Private Partnership initiative to expandmaternal and child health and referral services to un-served slum communities inthe city.

As a technical resource to the GOI, UHRC has contributed to focused policy

attention on urban health and strengthened urban health programming. UHRChas been designated as nodal agency by the MoHFW, GOI for urban health. UHRCis currently helping the MoHFW prepare the framework of the proposed NUHM. Itis also involved in technical assistance at the state and city level in seven states,capacity building of policy makers, programmers and practitioners on urbanhealth issues.

Building on its technical expertise and growing evidence base from demonstrationprograms, UHRC has contributed significantly to bridging the knowledge andinformation gaps relating to health of the urban poor. Attention to urban healthhas been enhanced among government, donor agencies, Indian foundations andcivil society organizations through media articles, scientific publications, national-level workshops and sharing experiences in other national and international

forums. These efforts have been able to garner greater policy support for and


9/29

focus on urban health at the national and state level. International and nationaldonors have also begun according greater commitment to urban health.

VII. Summary of Quarterly ProgressPlease provide a one paragraph summary of the major achievements during this

quarter in this project.This quarter witnessed an array of activities on diverse fronts. Thehighlights are summarized below:

Operations Director, HR Officer and Administrative and Procurement

Officer Joined in the month of August 2009.

Efforts are continued to build partnerships with government.

City level demonstration activities in Indore and Agra were continued.

Capacity Building programs for CBOs and USHA Volunteers wereconducted during this quarter.

Progress continued on the organizational development process. Most

of the compliance requirements were met. Closure of EMG MCH STAR Grant was announced and close out related

activities were initiated.

VIII. Human Resource ManagementPlease provide the details on any new persons hired, retired, resigned orreassigned for this project. Please be certain to highlight details of key projectpersonnel positions.

Operations Director, HR Officer and Administrative and ProcurementOfficer Joined in the month of August 2009 as per project requirement andguidance of MCH-STAR.

Accountant and the Urban Health Partnership Officer, Agra resigned owing

to delays in payment of salaries and uncertain situation.

Salaries and fees to staff/consultants have not been settled since July

2009.

IX. Activities & Sub Activities Progress in the Last QuarterA. Please explain in depth the progress of each of the activities that you have

undertaken for this project over the last quarter. Please use your final DetailedImplementation Plan (DIP) for the specific activities and sub activities.

Details on activities and sub activities have been provided in the narrative below.

Component 1: Technical Support to NUHM

1.2. Technical Assistance for effective roll out of National Urban HealthMission

1.1.3 Support to the National Urban Health Mission

Technical assistance was provided for preparation of presentation, preparing

response to questions of Planning Commission to MoHFW for the meeting with


10/29

Planning Commission regarding NUHM held on July 23, 2009.. Data &information support was also provided.

Facilitating and organizing review visit of Joint Secretary, MoHFW to Agra:As

part of the consultation exercise with city health officials and the inhabitantsof slums, for better informing the proposed National Urban Health Mission, theJoint Secretary, MoHFW, GOI Shri. Amit Mohan Prasad along with members of

Urban Health Resource Centre visited Agra on August 1st, 2009. Mr Prasadreviewed Urban Health program and planning of Agra with Chief MedicalOfficer of Agra and other officials. He walkedthrough slums, undertook groupdiscussions with members of Mahila Arogya Samiti, interacted with slum-levelhealth volunteers (USHAs) and visited NGO managed Urban Health Centre.

Support to MoHFW, GOI in connection with meeting on IPHS: A meeting of theIPSH sub-committee for standards on urban healthcare was held onSeptember 17, 2009, under the chairmanship of Dr. Shiv Lal, Special DG(Public Health), Directorate General Health Services, MOHFW and convened bySh. Amit Mohan Prasad, Jt Secretary, MoHFW. The outcome of the meetingwere (a) service package at UHC reviewed and finalized (b) service package atOutreach sessions discussed, revised and finalized and (c) recommendationsregarding constitution of Working Groups/ Sub-committees for follow-upconsultations on specific sub-themes. Technical support was also providedprior to the meeting for finalising outputs of the previous meeting (of June 23,2009).

1.1.2. Technical Assistance to State level Urban Health Programming

f) Technical Assistance to Government of Uttar Pradesh

A visit was made to Jhansi for verification of GIS map.

A Proposal was developed with Remote Sensing Center, Lucknow for

undertaking GIS mapping of 2 cities i.e. Agra and Aligarh. Technical and information support was provided for correction of GIS maps of

Bareilly and Saharanpur.

Documents for baseline survey and health facility assessment were

developed and shared with the government

Support was provided to the department in compiling MPRs for all 71 districts

of the State, reviewing the progress of Lucknow RCH program and inproposals for releasing funds to NRHM.

Coordinated and facilitated the meetings of Dr. Sanjay Pandey with

Government officials and other stakeholders and follow up tasks assigned.

An excel based monthly reporting format was developed for urban health

posts funded by NRHM.

g) Technical Assistance to Government of Jharkhand

Meetings were conducted with the Civil Surgeon East Singhbhum,

Jamshedpur NAC, Jugsalai NAC, Adityapur NAC, ICDS officials, Industrypartners in the district / city to gather information for the preparation of themicro plans for Jamshedpur UH interventions. The effort is in process.

Handing Over / Project Closure- Key officers in the departments (Health, Urban

Development) and the development partners have been informed about theclosure of the project by September end.

Regards the work commitment as next steps that have been made by the

UHRC - state facilitator the officials were informed that they would be


11/29

completed / attended on personal level irrespective of the date of the closureof the project. Some of the priority tasks that need to be worked up are:

o Preparation of the UH details / micro plan for Jamshedpur.

o Facilitation of the UH micro plan preparation for the identified 07

cities.o

Monitoring Plan of the UMMU (Urban Mobile Medical Units)o Route Chart of the Urban Mobile Medical Unit was prepared to

expand the outreach service in Ranchi Urban Agglomeration. 20service delivery points have been identified where the mobilemedical unit would be serving and these points were identified inclose consultation with Mayor, administrator and elected wardcommissioner of Ranchi Municipal Corporation.

All reports, documents, fact sheets, contact points, maps and institutional

history have been handed over to the Project Director EUHP, MCH Starduring his visit to Ranchi.

h) Technical Assistance to Government of Madhya Pradesh: State level planning and review meeting on urban health program at the State

Directorate of Public Health and Family Welfare, Bhopal on September 1,

2009. Matters discussed during the review meeting included: a) progress of

urban health program in the eight cities; b) utilization of funds till date and

stress on expediting program activities; c) input on process of mapping of

slums and facilities in eight cities was provided.

A visit to Ratlam was undertaken by two Muskaan staff to provide technical

support to the District Health Dept, Ratlam on a) mapping of slums and health

facilities in the city; b) initiating new UHC through Public Private Partnership in

un-reached areas of the city.

Meeting was held with JD NRHM, State Directorate of Public Health and Family

Welfare on July 27, to discuss update of urban health programs and technicalsupport provided by Muskaan. Meetings with the State Urban HealthConsultant, Mr. Rambeer Sikarwar, were held at the State DoHFW for theurban health program in different cities. Issues discussed in these meetingsincluded honorarium to link workers, difficulties being encountered by PPPmanaged UHCs, digitizing the maps of all the cities and the need for periodicreview of program progress in the cities.

Technical support was provided to District Health Department, Jabalpur by

designing and facilitating a two-day training of USHA volunteers (linkvolunteers) deployed by the Department in slums. This training session was

conducted on July 16-17 by Muskaan in Jabalpur.

Review meeting of Urban Health Program in Bhopal was held at office of the

District Health Department on 4th September to discuss progress on various

program components: PPP managed UHCs, inter-sectoral coordination through

meetings at UHC (Dispensary) level.

UHC level coordination meetings were facilitated in 3 UHC areas (Kotra Area

Dispensary, Sevaniya Gond Dispensary, Panchseeel Nagar Dispensary) in July

and two each in August and September.


12/29

A cluster level inter-sectoral coordination meeting involving CBO members,

ICDS and Health Dept. workers of 6 slums was held in Navgraha basti to

facilitate strengthened coordination at implementation level. Such

coordination efforts have helped in regularizing immunization day in slums in

coordination with AWCs and health Dept. workers.

Capacity building of basti-level health groups and input during monthly

meetings of the groups was provided to encourage them towards availing of

health services during outreach sessions, at UHCs and hospitals and also avail

of Government schemes such as the Janani Suraksha Yojana. A study tour of

CBO members to Indore was conducted in September to provide first hand

exposure and understanding of activities of stronger CBOs and record

keeping.

Technical support was provided by Muskaan to the District Health Department,

Bhopal through periodic visits and review of program of the PPP managed

UHCs. Input was provided on training of link volunteers, record keeping and

undertaking other program activities.

i) Technical Assistance to Government of Delhi

A meeting with Dr. Dharmendra Deewan, MCH Officer, Delhi State Health

Society was held on July 15th, 2009 regarding UHRCs Maternal and Child

Health initiatives in North East district of Delhi in partnership with Government

of Delhi. Some of the areas in which enhanced support is required from the

State or district health society such as requirement of additional ANMs and

outreach coverage in areas which are not being covered at the moment werediscussed with him. Dr. Deewan assured of all possible support and to take

this up with concerned officials.

The Delhi State Health Society is in the process of contracting out a number

of health facilities to Non-profit organizations. Dr.M.K.Agarwal, State Program

Officer, requested UHRC to provide technical support to help it take forward

the process. Along with other support, some of the relevant documents such

as sample copies of request for expression of interest, case studies of PPP

in health facility management and sample TOR for partner NGOs for

management of facility were provided to Dr. Agarwal to help the process.

Two meetings were held with Dr. Gurpreet Singh, CMO- Planning, Municipal

Corporation of Delhi with regard to his request for information support for

planning health initiatives. He was provided with the map of Both Shahdra and

Narela Zones as well as the vulnerability assessment indicators.

j) Technical Assistance to Government of Rajasthan

Mr. Neeraj Mishra has joined as the state Urban Health consultant for

Rajasthan.

No specific activities were carried out in this quarter


13/29

1.2. Strengthen NUHM through program learning

The following activities took place under the City demonstration and learning

programmes in Indore and Agra:

c) Indore

Capacity building of community organizations and health workers

A Two day training program on routine immunization was organised forpartner NGO partners, CC Team members, ANMs and Health workers fromIndore & Ujjain on 1st and 2nd July. This training was facilitated by Dr. KaranSagar, Country Representative and Dr. Manish Jain, State Representative (UP)from IMMUNIZATION/basics. They visited program field sites to get an insightinto the activities and identify gaps and solutions. They discussed about thecurrent reporting and monitoring mechanism of the program and provided

required recommendations and tools. Two days workshop was organized on 2nd and 3rd Sep, to document Lesson

learnt from Indore Urban Health Program and developing graduation strategy.Two members from each CC Team and Staff of Partner NGOs attended thisworkshop. The Lesson learned section on 2nd September was facilitated byBirgitt and Dr. Sanjay Pandey. On 3 rd September, Dr. Sanjay Pandey and UHRCteam facilitated the process of developing a graduation strategy, which hasbeen documented.

A three day training program was organized for 30 CC Team members from

15th to 17th Sep 09. The objective of this training was to develop acomprehensive understanding of Vision- Mission and formulation of a draftVision Mission Statement for respective CC teams, which are registered as an

NGO. The training also captured issues related to Strategic planning and someaspects of proposal development including budgeting. This training wasfacilitated by Mr. Satya Prakash Arya, Consultant, and UHRC team.

Three days study tour to Panchmari was organized for all the NGO staff and

CC Team members. The original plan was to visit Mumbai to understandfunctioning of Health systems at Governmental and NGO level. However, itwas not possible in the present circumstances. Hence all partner NGOs andUHRC team decided to organize study tour to Panchmari. The objective of thestudy tour was to discuss the draft graduation strategy, finalization of contentsof job aid and discussion on proposal writing for CC teams. The Study tour wasable to accomplish all of its stated objectives.

One day session of interaction between CC Team members and Governing

board members was organized by IDSSS on 21st July 2009. 3 Governing board

members participated in this session. Study tour was organized for 35 CBOs of IDSSS .They visited Shiv Nagar slum

for cross learning. They also visited MY hospital, Collectorate and GPOdispensary. Similar visits were organized by CECOEDECON for 12 CBOsmembers from each CC Team area. They visited Ahirkhedi, Banganga,Mahadev Nagar and Rushtam K Bagicha for cross learning from other CBOs.After this all of them visited Sanyogita Ganj Dispensary.

Exposure visit for CBO members of BNS was organized on 1st Sep to MY

Hospital, Vridavan Dispensary, MTH Hospital and Collectorate.

A 3 days training for CC team members was held at IDSSS on 29th, 30th July

and 1st August 2009. The topics covered were finance management like tocover issues of basic accounting like cash book maintenance, ledger file,

balance sheet, voucher file, Income and expenditure, proposal writing, and the


14/29

linkage with government. All the CC team members participated in thistraining program.

One day capacity building refresher program was organized on immunization

for two clusters of CBO members. Total 119 CBO members participated inthese trainings.

Monthly Outreach Health Camps in partnership with Govt of MP

Monthly outreach health camps are held to leverage additional governmentresources on urban health.17 health camps were held in this quarter too, inpartnership with and partial financial support of District Health and FamilyWelfare Department, Indore, Govt of Madhya Pradesh. These camps aremonitored by District Health Society. Five partner NGOs, CC Teams, slumCBOs as well as ICDS and Indore Municipal Corporation (IMC) officialsconducted extensive community mobilization to maximize communityparticipation in these camps.

Outreach

MCH

Clinics

dated

Area of coverage Beneficiaries

5th July, 2009 6 slum clusters

covering sixty slums

(Khajrana Area,

Dheeraj Nagar,

Jagannath Nagar,

Pawanpuri, Mahadev

Nagar, Musakhedi)

2128 persons including 857 children

(0 to 12 yrs), 358 pregnant women

(ANC) and others received services.

2nd Aug,

2009


(0 to 12 yrs) and 258 pregnant

women (ANC) and others receivedservices.

6th Sep,

2009


(0 to 12 yrs) and 268 pregnant

women (ANC) and others received

services.

Technical support to Indore city UH Program

Supported Department of Health, Indore, in making a presentation of the

activities conducted in the present financial year during the State LevelReview Meeting on 1st September at Bhopal. UHRC team also shared itsexperience of Ward level convergence activities and its effectiveness.

Review meeting with State Health Consultant, Mr. Ramvir Singh, DPM andother Department officials done in the month of 17th-18th Sept which UHRCmade presentation on the progress made under the Indore Urban HealthProgram and supported the consultant in Review of the Ujjain Program.

Ward Coordination Committee

A total of 10 Ward Coordination Committee meetings were organized in various

wards in Zonal Office and chaired by the Ward Councillor. The participants in the


15/29

meeting were officials from IMC, Officials from Narmada water Project, DUDA,

ANM, NGO representatives and UHRC staff.

Study Tours / Visit to Indore Program

Dr. Sanjay Pandey, Rajneesh and Sameer from EMG visited Indore Urban

Health Program for program and financial review of Partners on 14 th and 15July09.

Dr. Sanjay Pandey from EMG, Madhuri Narayan and Nate from Intra Health

visited IUHP on 12th and 13th Aug09 to interact with CBOs and NGO Partners.Others

IDSSS celebrated Safe motherhood day on 7th July 2009 at Solanki nagar with100 women including pregnant and lactating mothers. They took active part inthe programme. Dr. Hemant Kansal was the resource person on the occasion.

Other Competitions held during the quarter are-

o 53 healthy baby competitions were organized by all the NGO partners in

their slums. Total participants in these competitions were 860.

o 65 healthy pregnant women competitions were organized by all the NGOpartners in their slums and total participants in these competitions were818.

o 40 nutrition competitions were organized and 580 participants were

present in these competitions.o 6 Health fair were organized in Bapu Gandhi Nagar, Mayapuri,

Kabitkhedi ,Lodhipura, Malviya nagar and Khajrana. Nutrition competitionand demonstration on the same by CCT members was the highlight ofthese events, which also had a poster exhibition, Video show and streetplay. Pregnant women were asked to bring nutritious food appropriate forthe competition and results were drawn on the basis on ingredients,availability cost, and taste presentation of recipe.

d) Agra

Coordination with the government

A coordination meeting with PO - DUDA was conducted on 21st of July 2009 in

which discussions were made regarding ongoing programme area in differentareas. Certain documents regarding the programme detail were also shared inthe meeting.

A coordination meeting was organized with CARE, UNICEF and WHO on 19 th ofJuly 2009 in which monitoring aspect of Routine Immunization; Bal SwasthyaPoshan Mah was discussed.

Capacity Building sessions

Capacity building of community organizers on supportive supervision,

reporting and MCH in NGO offices were conducted in this quarter.

Training of 100 grass root level workers viz. CLVs were conducted on different

topics of interpersonal skills, RCH, updating and record keeping in registersetc in the months of July, August and September 09 during monthly meetings.

Special training of 44 CLVs of Trans Yamuna area was organized in UHRC

office. These trainings were provided for motivation and guidance to the CLVs.


16/29

Sessions on Janani Suraksha Yojana, MAS fund, CLV register updation and careof new born child were taken by NGO staff and UHRC team.

Besides all the above training, on job training of all staff ( NGOs) and CLVs

were done by UHRC team Agra during field visits and review. Supportivesupervision and handholding with workers of the field was carried out.

During this quarter, three capacity building sessions were conducted asagainst three planned. In-house capacity building session for CLVs wasconducted after assessing the need. Emphasis was given to build up thecapacity on the followings-

o Role of CLVs in case of strengthening the capacities of MAS.

o New Born Care.

o Immunization.

o Nutrition and child health.

o Family Planning.

o Maintaining of slum based register.

Visits/Study Tours

Visit of Joint Secretary, MOHFW, New Delhi-

Joint Secretary Ministry of Health and Family Welfare Sh. Amit Mohan Prasad

visited UHRCs project area along with CMO Agra to observe an outreach camp

which was organized at Azampada. In the camp he interacted with services

providers (like CLV, PC, CO and LMO) and the beneficiaries and tried to

understand the role of community mobilization specially Link Volunteers/USHA

keeping in view of upcoming NUHM programme which has to be launched by

Govt. of India.

Dr. Gita Pillai , FHI visit.

Dr. Gita Pillai from Family Health International visited Transyamuna area. She

observed MAS meeting in Hanuman Nagar and also visited UHC Transyamuna.

Exposure Visit of Embry Howel-

In the month of August 09 an exposure visit of Embray Howell from the Urban

Institute, Washington was conducted in Transyamuna area. Her visit was with the

purpose of documenting lessons from UHRC since inception in 2005 as part of the

USAID Washington planned exchange program between APHRC, Kenya and UHRC.

She visited Indra Nagar and Naraich slums of Agra and observed meeting ofMahila Arogya Samiti and Outreach Camp.

Other Activities:

On 5th of July 2009 an annual day function of the federation was organized in

Telipada area of Shaganj to accolade the federations one year of success. In


17/29

the annual day function a cultural programme was organized by the children

of the communities.

In this quarter distribution of deworming tablet to the children from age two

and a half year to 12 years was continued in both the areas through our CLVs,

ANMs, CO under the guidance of UHCs in Shankarpuri and Trans Yamuna area.

Promotional activities for behavior change regarding health were also

organized in identified critical slums. One baby show, one mother show, 5

health awareness camps and 2 health rally were organized by the NGO staff.

1.3 Increase capacity and resources in India to support NUHM and

programmes to improve the health of the Urban Poor.

Urban health related books and journals were provided to Urban HealthDivision of MoHFW.

1.4. Management and Strategic Dissemination of Urban Health

knowledge

a) Website

UHRC website received 123427 hits and 8047 visitors in this quarter.

The library catalogue was updated.

b) Data analysis, preparation and dissemination of urban health

information through research reports, working papers and articles

MP wall chart has been completed and is ready for printing. Draft wall chart of

Delhi has been prepared.

State of Urban Health reports for Bihar and Jharkhand have been prepared

and ready for submission.

Two Working papers have been prepared on

o Child Under nutrition among urban poor in MP: Status, Efforts and Way

Forward

o Maternal and Child Health in Uttar Pradesh

The scientific article titled Social Determinants of Childrens Health in Urban

Areas in India was resubmitted after incorporating revisions suggested by

reviewers. The revised paper has been accepted for publication in the Journal

of Healthcare for the Poor and Underserved.

A few abstracts have been accepted for oral/poster presentation at ICUH

2009.


18/29

e) Advocacy Events / Consultations / Related Activities to promotepolicy and program development

Two interviews of UHRC Colleagues on Health Conditions and available

Services for the Urban Poor and Importance of Water and Hygiene for Healthy

life were broadcasted by Community Radio of One World South Asia through

All India Radio.

f) Participation in Symposium/ Conference/ Seminars/ Workshop/Summit

A presentation entitled From Vision to Action Towards Better Health Service

Planning; Difficulties & Prospects, was made in the National Consultation on

Geographic Information System (GIS) Mapping of Health Facilities and Services

in India organised by MoHFW, GoI in collaboration with WHO & IIHMR, on

31.08.2009 & 01.09.2009 at India Habitat Centre, New Delhi.

UHRC colleagues participated in the Urban Health Report dissemination

workshop organized by USAID and IIPS on September 11, 2009.

g) UHRC in Media

An article titled Off the Map, highlighting the marginalization of urban poor

migrants, was published in the Indian Express, New Delhi, on July 30, 2009.

Component 2: Improve Basic Water, Sanitation and Hygiene Services forthe Urban Poor

Desktop review and secondary data collection have conducted to access all

available and required data from Bhubaneswar Municipal Corporation,Government of Orissa websites, Public Health Engineering Organization,Census reports, DLHS reports and NFHS data.

Individual meetings and consultations with representatives of public sector

departments and NGOs were conducted to get an idea of the situation fromthe concerned stakeholders.

Slum list obtained from Bhubaneswar Municipal Corporation. Slum visits have

been made in various locations and city map have been collected to completethe situation analysis

Situation analysis of Bhubaneswar city was conducted and the draft situation

analysis report has been prepared.

Various stakeholders were contacted in order to obtain a comprehensive

picture of the Bhubaneswar city.

Component 3: Support for Organizational and Institutional

Strengthening of UHRC

3.1. Collaborations

No new collaborations were made during the period.

3.2. Resource Mobilization Efforts

Efforts were made for generating contributions from small entrepreneurs,business houses and individuals.


19/29

3.3. Institutional Strengthening

Three key positions were filled. Mr. Arun Talwar, Operations Director, Mr.

Surendra Singh, HR Officer and Mr. Johney Reberio, Admin & ProcurementOfficer joined on 3rd of August 2009 as part of compliance under EUHP project.

The authority levels in Tally software were defined in consultation with the

EMG officials, as part of compliance under EUHP project.

Closure Meeting: A closure meeting attended by UHRC staff, EMG/MCH-STAR

officials and Intrahealth Officials with the external consultants (DalarConsultants) appointed by EMG/MCH-STAR was held on 10th September atHotel Vasant Continental, New Delhi. Discussions were held on variousactions, achievements, Challenges and lesson learned during the projectperiod.

Due to non-payment of salary in time and owing to disruption in funding from

time to time, the employees morale went down wiping out some of thebenefits of earlier capacity building exercise.

Despite the support of EMG/MCH-STAR, UHRC was not able to succeed inwinning the RFA issued by USAID for Health of Urban Poor project. This was abig setback for UHRC as well as for MCH-STAR. The project has been awardedto PFI and Dr. Sanjay Pandey who is currently Project Director of EUHP fromMCH-STAR is Chief of Party with PFI for the project.

3.5 Finance

3.5.1 Reporting

Statutory Reporting to regulatory bodies done in timely manner.

Monthly Financial Reports for July and August 2009 submitted to EMG.

Quarterly Financial Report for April-June 2009 was submitted in July.

3.4.2 Audit/ Review

Statutory Audit for Financial Year ended on 31st March 2009 completed.

Review of invoices/vouchers by BHS and Company, EMG-MCH Star appointed

auditor and EUHP Project Director completed for June, July and August 2009as desired by MCH-STAR for release of early payment.

Details of payable to sub-grantee up till 30th September 2009 submitted to

EMG MCH-STAR.

The payment to vendors and staff and statutory payments were delayed due

to non-availability of funds with UHRC under the grant.

3.4.3 Sub-grants Management

Financial review and Capacity Building Training program for the NGOpartners, which was due in the quarter, could not be done owing toscarcity of funds.

3.4.4 Close Out of EUHP

Letter for Close-out of EUHP being sent to NGO Partners.


20/29

EUHP Staff/consultants serviced notice for termination of services in view

of the closure of the project.

Service providers are being given notice for termination of

services/contracts wherever applicable.

In view of the close-out of EUHP and future funds flow of UHRC a

termination notice of the current lease deed of UHRCs Delhi office and

Agra Office has been served.

3.5. Governance, Management, Review

3.5.1. Board Meeting

Dr. H.P.S Sachdev resigned as the Chairman of the Board.

A Board meeting was held on August 22, 2009. In the meeting, Dr. SiddharthAgarwal resigned as member of the board. Also, Board members, Prof.Amitabh Kundu and Mr. Amitabh Behar had a meeting with the staff membersafter the board meeting.

In separate discussions, board members discussed aboutrestructuring/strengthening of the board as per grant requirements. Howeverclosure of grant resulted in dislocation of efforts temporarily.

3.5.2. Core Team Meetings

A core team meeting was held on 3rd July, 2009 with the agenda to discuss theimportant issues of common cost allocation, cheque signatory, closure of cityoffice bank account, reporting line for TA team, .

A core team meeting was held on August 27th wherein it was decided that in

view of the closure of the EMG grant, a notice to all staff and consultantsworking on the project be issued in light of the terms of the employment

contract. In the same meeting, it was also decided that a lower cost officepremises may also be identified.

Another meeting was held on 17th September, 2009 to discuss the work planfor close-out phase in October.

3.5.3. Staff Meetings

A staff meeting was held on 16th July to share team updates and future plans,to share the overview of the RFA submitted, and to discuss the issues relatingto the delay in release of salary.

Another staff meeting was held on 17th August with the agenda to discuss

critical issues like interruption in fund flow, uncertainties after 30 th September,

sustainability of organization, optimizing costs and generating revenue,extension of Current Grants and compliance with current Grant requirements.

A board and staff meeting was held on 22nd August, 2009 to discuss the issues

related to compliance and progress thereon.

Another staff meeting was held on 28th August, 2009 to inform all staff

members regarding the issuing of termination letters.


21/29

X. Results Achieved in the Last QuarterPlease fill in a table with your expected deliverables/results during the quarterand achievement towards deliverables/ results. Please attach all evidence ofresults/ deliverables in an annex of your report.

Expected Deliverable/Result Target Status/Achievementthis quarter

Start up and Implementation

UHRC to provide QPR for the

quarter ending June,09

Quarterly progress

reports submitted to

MCH-STAR within 13

days of end of quarter

QPR submitted

UHRC to submit final report with

deliverables and results to MCH-

STAR

Final report submitted

within 13 days of end of

fiscal year

Final Report with

deliverables submitted.

Component 1: Technical Support for Effective Implementation of the National

Urban Health Mission (NUHM)/Urban Health Component of NRHM or RCH II

Sub-component 1.1: Technical Assistance for effective implementation of

NUHM/Urban component of GOIs health program/other UH programs at

National, State and City levels

Assistance in recruitment & financial

support to at least 2 consultants to

work in the UH Division, MOHFW

Two consultants

contracted and working

with UH Division

It has been taken over

by EMG-MCH Star

Assist the UH Division in reviewing

city plans during review visits

Trip Reports JS, Ministry and Health

and Family Welfare

reviewed the Agra

Program. .

Identify and enhance capacity of

partnered NGO in JMC and conduct

periodic reviews to assess progressin coordination with MCD and

GNCTD to improve reach of services,

and improve planning and

implementation of activities.

Quarterly review

conducted including field

review

Partnership has been

discontinued.

1.1.2. Technical support at the State and City Levels for atleast two states to

prepare State and City Urban Health Plans

Provide Financial support for urban

health consultants in UP, Jharkhand,

Maharashtra and Rajasthan to assist

in developing State urban health

One consultant each in

UP, Jharkhand,

Rajasthan and

Consultants for UP,

Jharkhand and

Rajasthan in place.


22/29

plans Maharashtra in place

Provide TA to State governments for

the development of operational

guidelines for the implementation of

city level urban health PIPs in at

least two states

UH Plan for 2 States

submitted to

Government of India

UH Plans for UP and

Jharkhand submitted to

GoI (This activity was

completed in the last

quarter itself)

1.1.3 Develop Monitoring & Evaluation plans for NUHM and city systems

(subject to roll-out of NUHM)

Draft baseline methodology and

tools

Methodology and

instruments for city

level NUHM baseline

survey

This activity could not

be done.

Provide technical support to states

for holding a meeting with city and

state officials on how to implement

the urban health M&E plans

Meetings held in 2 states

on M&E


be done.

Provide technical support to

MOHFW for organizing and

conducting of the first national

urban health progress reviewworkshop/meeting with state and

city officials.

National Urban Health

Program Review held


be achieved since

MOHFW is discussing

the matter of NUHMwith other GOI agencies

such as the Planning

Commission.

1.1.4. Capacity building activities for select state & city level govt.& non govt.

stakeholders

Organize, support and facilitate

workshop in at least 2 states for

capacity building of key

stakeholders to enable them to dothe situation analysis, organize

consultations and develop the city

level PIPs

Workshop conducted in

two states with

participation of state

and city/ district healthofficials

A State Urban Health

Consultation was held

in Jharkhand. Workshop

in UP was planned inJan but cancelled

Facilitate and support at least 4

study tours of state and city health

officers and select NGO managers

to successful urban health

programs in Agra, Indore or in

states such as

Maharashtra/Karnataka/Tamil

Study tours conducted Planned study tours

completed in last

quarter.


23/29

Nadu/West Bengal.

Sub-component 1.2: Improve NUHM/urban RCH II through Program learning

8 grants to NGOs in Indore & Agra

for demonstration and learning

activities

5 grant in Indore & 3 in

Agra signed grant Task

Orders

5 grants in Indore and 2

in Agra (activity


quarter itself)

Technical and management

oversight to grantees

Field visits and meetings

with NGO partners

Regular meetings with

NGO partners are

ongoing.

Build capacity of NGO grantees to

host and conduct study tours at

program learning sites in Indore

and Agra

Lessons learned

demonstrated to study

tour participants

Lessons learned were

demonstrated to study

tour participants.

Monitor and document lessons

learned from NGO grantees

Indore and Agra lessons

learned documented

Indore and Agra lessons

learned were

documented

Develop a graduation strategy for

Indore sub-grantees aimed to

facilitate continued urban health

work in a sustainable manner

Graduation strategy Draft is ready

Design and plan an external

evaluation of Indore sub-grantee

urban health program

Design and plan for

external evaluation

Completed

Conduct quarterly program review,

including service delivery data, as

part of M&E activities

Quarterly review

conducted

Quarterly review was

not conducted.

Conduct annual program review,

document lessons, and develop

Scopes of work and budget for next

phase

Scopes of work and

budget for next phase

This activity was not

carried out since

funding support was not

available for the next

phase.

Document lessons learned on

Stakeholder Coordination and

Demand Generation Model from

USAID supported work in Indore

Lessons from Ward

coordination cum

demand generation

model.

Lessons were

documented and

lessons from NGOs also

compiled.


24/29

Document lessons learned on

Stakeholder Coordination and

Demand Generation Model from

USAID supported work in Indore

Lessons from PPP

initiatives in Agra

documented

Lessons were

documented.

Document lessons learned from

non-USAID supported activities in

Pimpri Chinchwad Municipal

Corporation in Maharashtra

Lessons from Pimpri

Chinchwad Municipal

Corporation documented


be achieved.

Sub-component 1.3: Increase capacity and resources in India to provide

support to NUHM and improve the health of the urban poor

State-Level NGO grantee

periodically mentored to improvetechnical support to GOMP

State level NGO grantee

responding to requestsfor technical support

Quarterly Report of

Muskaan attached.

UH literature provided to state-

level NGO to strengthen knowledge

Literature and

documents handed over

to NGO

This activity was


quarter itself.

Sub-component 1.4: Ensure management and strategic dissemination of urban

health knowledge

Support the maintenance of UH

library and Website at UHRC

UHRC website and UH

library up-to-date

Catalogue updated.

Prepare and disseminate the State

of Urban Health Report

Maharashtra

State of Urban Health

Report Maharashtra

Report could not be

finalized.

Secondary data analysis on urban

health conducted and disseminated

Data Analysis Delhi wall chart

attached.

Produce and disseminate articles,

fact sheets, wall charts, reports and

publications

Data disseminated MP wall chart attached.

State of UH Report of Jharkhand

prepared and disseminated

Report disseminated to

stakeholders

Jharkhand report

attached.

Publish and disseminate thematic

report on Maternal Child Under

nutrition among urban poor in India

Report disseminated to

stakeholders

Final Report attached.

Increase availability of UH

information and attention to UH

through working papers

Working papers on UH

themes produced and

disseminated

Two working papers

completed.


25/29

UH issues highlighted through

articles in print/electronic media

6 articles to be

published over the year.

Four articles were

published and one sent

for publication.

Remaining one is being

prepared.

Documentation and secondary data

analysis conducted

2 wall chart ready Delhi and MP wall chart

attached.

Develop strategic partnership and

contract with two journals to

increase availability of UH

Knowledge/ information

Partnership with two

journals developed


be achieved.

Sub-component 1.5: Convergence of NUHM with JNNURM or WCD

Identify priority program learning

issue for convergence of NUHM

with JNNURM and ICDS

Program learning issues

on convergence

documented


be achieved.

Develop a TA plan for supporting

convergence with JNNURM at

National, State and City levels

Hard copy of plan This activity could not

be achieved.

Organize study tour and cross visits

to understand convergence related

initiatives

Tour reports with letter

from State Govt. officials


be achieved.

Organize workshop atstate/national level to address key

factors related to convergence

Workshop Organized This activity could notbe achieved.

Identify priority program learning

issues for convergence of NUHM

with JNNURM and ICDS

Program issues on

convergence

documented


be achieved.

Component 2 Improve Basic Water, Sanitation and Hygiene Services for the

Urban Poor

Plan for demonstration and

learning activity to address hygienebehaviors in select slums of

Bhubaneswar

Plan prepared Situation Analysis and

StakeholderConsultation was

carried out during this

quarter. Plan could not

be prepared during this

quarter.

Component 3 Program planning and Institution Strengthening of UHRC for

implementation of the Expanded Urban Health Program

Conduct a board retreat to develop

a long term organizational vision

and 5 year strategy for UHRC and

Organizational vision

and strategy approved

Board reviewed and

approved UHRCs vision


26/29

regular board meetings by Board and strategic plan.

Involve UHRC Technical personnel

in MCH-STAR capacity building,

leadership, advocacy and other

workshops and activities

UHRC invited to CB

activities

This activity was

completed in the

previous quarter.

Close out Activities: Support close

out activities of this one year phase

of EUHP as per required procedures

(Sept-Oct. 2009)

Close out completed Close out activities are

underway.

XI. Partnerships Establishment and Coordination Government(National and State Level):

Have you had meetings with governments or any other key stake holders for thisproject? How did the outcomes of these meetings contribute to the achievementof your deliverables?

Technical assistance was provided for preparation of presentation, preparing

response to questions of Planning Commission to MoHFW for the meeting withPlanning Commission regarding NUHM held on July 23, 2009.

As part of the consultation exercise with city health officials and the

inhabitants of slums, for better informing the proposed National Urban HealthMission, the Joint Secretary, MoHFW, GOI Shri. Amit Mohan Prasad along with

members of Urban Health Resource Centre visited Agra. A meeting of the IPHS sub-committee for standards on urban healthcare was

held on September 17, 2009. The outcome of the meeting were (a) servicepackage at UHC reviewed and finalized (b) service package at Outreachsessions discussed, revised and finalized and (c) recommendations regardingconstitution of Working Groups/ Sub-committees for follow-up consultations onspecific sub-themes. Technical support was also provided prior to the meetingfor finalizing outputs of the previous meeting (of June 23, 2009).

MCH-STAR:Have you participated in any collaboration meetings with MCH-STAR for thisproject? How did the outcomes of these meetings contribute to the achievement

of your deliverables? Meeting with project Director, EUHP held on 9-7-09 to discuss feasibility of

deliverables given the prevailing constraint in fund-flow.

Monthly review meeting to discuss progress on the project was held on August6.

Meeting on August 30th where Project Director informed about the newmodality of reimbursement based payment for the period June 1st onwards, onweekly basis after review of invoices/vouchers by Auditor and approval by PD.

A meeting was held on 16th September 2009 with Dr. Sanjay Pandey, Dr.

Sainath, Mr. Talwar, Dr. Sanjeev, Dr. Aradhana, Ms. Aastha, Ms. Deeksha to

discuss the tasks required to be accomplished by UHRC as part of the close-out


27/29

process. During this meeting it was decided that the activities in the extensionperiod must focus exclusively on close-out. There should be an internalmechanism for monitoring the progress of closure related activities on dailybasis. Only those deliverables which can be completed should be targeted inthe close-out phase. Also, a detailed work plan for the close-out period, alongwith budget should be submitted as early as possible to enable MCH-STAR to

process the extension quickly.

Another meeting on 8th September09 was held with Dr. Sanjay Pandey, Dr.Sainath Banerjee, Dr. Sanjeev Kumar and Dr. Aradhana Srivastava, in which Dr.Pandey shared the outline of the EUHP Final Report and requested the KM teamto begin drafting the report. It was decided that the final report will besubmitted to MCH-STAR after completion, for its branding.

Other Key Stakeholders (i.e. Other Donors, Partner NGOs, district levelgovernance institutions such as Municipal Corporations etc.):Have you developed any partnership with any other organisations for this project?

If so which ones and why?

Partner NGOs:

UHRC works in partnership with NGOs in its demonstration programmes inIndore and Agra. Regular meetings and interactions with NGOs took placefor assistance in programme implementation and to review progress.UHRC also supports one state-level NGO grantee is also assisted inproviding technical support to GOMP.

District Health Departments:

The Indore and Agra urban health programs work in partnership with thedistrict health departments of Indore and Agra respectively. Regularmeetings and interactions were held with them. Technical assistance tothe district health department, Meerut was also provided for developmentof urban health plan for the district.

XII. Challenges EncounteredWhat challenges have you faced in meeting your deliverables for this project thisquarter? How can you overcome those challenges? How can the MCH-STAR teamhelp you overcome those challenges? If you are preparing a joint report, pleaselist the challenges SSI specific challenges.

EMG grants end date was 30th September 2009, though there have beenindications for a month extension. Employees, consultants have been servedtermination letter, which has drastically affected their motivation and output.

Close-out process of EMG MCH STAR has added to the pressure on already

shrunken team of UHRC.Scarcity of funds due to non-release of grant in time resulted in disruption ofUHRC activities. Sub-optimal fund-flow has also resulted in non-payment ofsalaries and consultancy fee since July 2009, payment to sub-grantee and tovendors. Motivation level of staff have been very low owing to thesecircumstances during this quarter.

V. Leveraging of Funds


28/29

Please write in any other funds leveraged over the last quarter. Leveraged fundsrefer to all Non USAID funds raised by your organisation for the project/activity.

S.

No

.

Key Deliverable Area/ Intervention Agency/

Source of

funds

Amount of

Funds in USD

1 Improving the Health of Urban Poor Intra Health $34,000

2 District Resource Centre and Gender

Resource Centre

Mission

Convergence/

SSS

$8,451

3 Indore and Agra Urban Health Program

Activities

Sub-Grantees $ 4,226

XIII. Closure Related ActivitiesPlease highlight any major activities or deliverables planed for the next quarterfor this project. Please include any specific assistance that you may require fromthe MCHSTAR team.

UHRC received a letter from MCH STAR/EMG outlining the close-out relatedrequirements on September 7th, 2009. Subsequently the steps for close-out wereinitiated.. There were several meetings that took place between the UHRC PointPerson for EUHP, OD with the PD of EMG along with UHRC staff; especially withthe point person of the programme.

A plan related to the close out was also handed over to UHRC by Project DirectorEUHP. The specific requirements of close out were discussed.

The closeout was focused at collecting following information /documentsFollowing visits and other activities were made to facilitate the closeout activitiesat the states and the cities

Visits were organized on 1st September to Agra and 2 &3rd September to

Indore and the following close-out related activities were undertaken:o Staff discussions were held related to future of grant, closer related

priorities and closer related deliverables.o Separate meetings were held with NGO partners in order to

intimate them about the closure of EUHP.o Discussions were held to identify lessons learned from this

programme.

o Discussions were held on options available for way forward.o A full day graduation strategy meet was also organized in Indore.

A Visit was organized to Bhubaneswar on 12 th September in which discussions

were held with the point person in order to review the SOW, discussions wereheld on deliverables (what has been achieved and what is left), anddiscussions were held to figure out the plan for the remaining activities in theclose out period.

A close-out budget for October and November was prepared and shared with

MCH-STAR This was finally approved.

SOW for Audit under A-133 circular was prepared and shared with MCH-STAR.


29/29

The finance team is working closely with the auditors (BHS and Company)

appointed by MCH-STAR to finalize the amount due under the grant. So farexpenses of Rs. 54,50,000(approximately) for June to August 2009 have beenreviewed by BHS and Company and the Project Director-EUHP. An amount ofRs. 2,000,000/= received from EMG against the expenses reviewed for June toAugust 2009.