MINISTRY OF HEALTH AND FAMILY WELFARE, RECORD OF PROCEEDING TRIPURA 2024 -25 & 2025-2026 SS. 2 g NATIONAL HEALTH MISSIONPreface ‘The Record of Proceedings (ROP) document provides the budgetary approvals under the National Health Mission(NHM), ‘guiding the states in implementing Program Implementation Plans (PIP) for the fiscal year 2024-25 andFY 2025-26. The ‘next to years will be critical towards the achievement of the National Health Policy targets and will enable the journey towards the Sustainable Development Goals (SDGS), India is firmly committed towards the Elimination of Tuberculosis by 2025. Any deviations brought on by the pandemic will have to be combated with doubling-up efforts fo detect-treat-prevent and build in accordance with theNational and State ve eliminationof Malaria, Lymphatic Strategie Plans, block by block, and district by district. The States need to ach Filariasis, Leprosy, Kala Azar and work consistently towards alleviating the burden of communicable and no communicable diseases in the communities ‘An under-apped resource within our communities are the youthful adolescents, for they possess immense potential to shape the future ofthe world Is vital to actively engage them as Ambassadors, Peer Educators andChange-Makers for a healthier tomorrow. This entails strengthening the adolescent health component of RMNCH+A, while continuing to provide for safe motherhoods and thriving childhoods. From LaQshya certifications of the Labour Rooms to accreditation of the health facility with the National Quality Assurance Standards, I hope the States will also work towards enhancing the quality of care provided, with patient safety being of prime importance. ‘To further strengthen the health infrastructure of the country, the Ministry of Health and Family Welfare (MoHFW) has taken various initiatives in the recent past. The 15" Finance Commission Health Sector Grants (15® FC) and the Pradhan Mantri- Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) are supportingthe development of Critical Care Blocks (CBs), Integrated Public Health Laboratories (IPHLs), Block Public Health Units (BPHUs), Ayushman Arogya Mandir (AAM), diagnostic infrastructure, as well as some Human Resources for Health (HRH). The States should , judiciously utilize the grants and ensure that there is no overlap between the NHM and 15" FC funding. We hope that the simplified budget matrix and reduction of budget linesin the new PIP format will provide sufficient flexibility tothe States. While duplication of any funding sources mustbe avoided, convergence with other schemes may be explored. While implementing the plans, the States should proceed with a clear-sighted vision towards the key deliverables.Stringent review of the processes and immediate outputs should be done to ensure favourable outcomes at the endof FY 2024-25, The activities should be well-regulated and adequately paced throughout the two-year period, incoordination with the proposed fund-release structure. This ime, funds will be released quarterly in four tranches.and the opportunity for a course- corrective supplementary PIP will not be available more than once, [urge the States to not let minor impediments or challenges stall the implementation of the plans. All efforts should be made to achieve and complete as many items on the agenda as feasible, States shouldalso endeavour to undertake supportive supervision to ensure successful operationalization of the approved PIPs.A rigorous monitoring system with mechanisms to handhold the peripheral health functionaries would go a longway in improving the scope and quality of health services provided. Several districts and blocks are outperformingthe others in achievement of their abjectives- What sets them apart? It is important that their Best Practices and Innovations not only be appreciated, but also documented and disseminated across the States fo motivate others. Page | 1 NHM Administrative Approvol for FY 2024-25 and FY 2025-26 of TripuraPage |2 NHM Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraOne of the good practices observed is the creation of a Specialist Cadre and Public Health Cadre. These faclitateattracting Specialists to strengthen the secondary health care services, enable operationalizing First Referral Unitsand help improve the management of Public Health services. Several incentives and provisions for motivating HRH to join the public health system are in place under NHM, specially for the High Priority and Aspirational Districts. The States are urged to leverage them and urgently fill the existing vacancies- after all, the presence ofa motivated and skilled workforce is the backbone of any efficient health system. This fact has been reiterated during the pandemic where our ‘Corona Warriors’ have valiantly been holding the fort, both in the hospitals, and in the communities. One of the key factors enabling the suecess of the COVID-19 Vaccination program has been the untiring efforts of the health workers in motivating and pursuing eligible beneficiaries in the farthest comers ofthe country. It is imperative that HRH management also be strengthened across the county. lization and incorporation of Information Technologyinto The pandemic has also birthed multiple avenues for the u imitations of physical distancing has boostedonline and web- healthcare. The urgency of capacity building coupled with the based teaching-learning modalities. States should continue to leverage digital learning platforms and develop hybrid ng and classroom teaching. Digital academies may be ereated which capacity building systems, imbibing the best of e-lean promote self-paced learning and cultivates an environment of excellence and scientific advancement. With the spirit of “Leaving no one behind’, we are striving to achieve Universal Health Coverage, and expandingthe realms ‘of Comprehensive Primary Health Care through establishment of over 1.6 lakh Ayushman Arogya Mandirs. [tis imperative that all Ayushman Aarogya Mandirs start implementing the 12 expanded package of services to ensure health service delivery to the community at primary level Its time to move beyond the provision of routine curative health services and invigorate the communities with concept of well-being to enable the prevention of non-communicable diseases and mental health issues. Much more emphasis needs to be given to treatment and management of NCDs apart from screening and a ‘much larger space should be given to mental health and wellness, In terms of national vision on targets to be achieved in the coming years, elimination of Tuberculosis by December 2025, ickle Cell anaemia by 2025 and Malaria by 2027 are on the radar and all health systems need to be leveraged to ensure that we succeed. The recently launched PM JANMAN initiative for the PV'Gs also would need focus and thrust during the next two years under the umbrella of NHM, While the MoHFW is navigating the health systems with the formulation of policies and guidelines, it is the program implementors at the State who know what strategies will best be suited to their socio-cultural, demographic, and epidemiological context. The States are always welcome to adopt or adapt them a their ablediscretion and to reach out to us for any support in this regard. Let us move ahead together with a renewed determination to augment our capacity as a sustainable health system and “build back better’. Ms, Lamchonghoi Sweety Changsan Additional Secretary and Mission Director, National Health Mission Page | 3 NHM Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraF.No, M-11011/272024-NHML-UL Ministry of Health and Family Welfare Government of India National Health Mission [iran Bhayan, New Dei Dated: 2" March, 2024 To, Sh Rajib Dutta, Mission Director, NHM, D/o Health & Family Welfare, SIHFW Building, 1st Floor, CMO West Office, Palace Compound, Agartala- 799001, West Tripura, Tripura. Subject: Approval of NHM State Program Implementation Plan for the State of Tripura for the FY 2024-25 & FY 2025-26 Sir. ‘This refers to the Program Implementation Plan (PIP) for the FY 2024-25 & FY 2025-26 submitted by the State of ‘Tripura and subsequent discussions in the NPCC meeting held on 3" November 2023 at Nirman Bhawan, NewDelhi 2. The ROP includes approval of work-plan and budget for two years. For FY 2024-25, against a Resource Envelope of Rs 259.48 Crore an administrative approval is conveyed for an amount of Rs §27.92 Crore(including IM and Immunization Kind Grants) and for FY 2025-26, against @ Resource Envelope of Rs 270.31 Crore (calculated assuming the State share of 10% and an increase of $% over the allocation of 2024-25), an administrative approval is conveyed foran amount of Rs 445.096 Crore to the State of Tripura, Details of resource envelope are provided in Table “A” and "B’ below. Table‘A’: Resource Envelope é (Rs. in Crore) Particulars 2024-25 2025-26 ‘a, Gol Support (Flexible Pool allocation including Cash andKind 15433 162.05 ‘minus fmmunization Kind Grants) '. Gol Support for Incentive Pool based on last year's performance 336 35.28 (assuming no incentive/ reduction on account of performance) ©. Gol Support (under Infrastructure Mainienance) 3861 38.1 4. Gol Support (under Immunization Kind Grants) 639 734 |e. Total Gol support (e=a+b+ctd) 233.53 3.28 £. State Share (10%) = 25.95 27.03 Total Resource Fnvelope(g=e+) 259.48 270.31 Unspent Balance (committed and uncommitted) as on 15 0 0 April 2024 as communicated by the State 1 Resource Envelope including unspent balance F 250A 2701 Page | 4 NHI Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraMaximum Permissible Resource Envelope (including I 310.07 323.37 Immunization Kind Grants, unspent balances) Page | 5 NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura‘TABLE ‘B’: Breakup of Resource Envelope Health System Strengthening, Ni Gol Support (Flexible Pool for RCH & Health Programme and Urban Health n under National Health Mission Tiel 185.23 Kind (atbrerd) 18 25.95 1b 27.03 (a) Immunisation 699 7.34 ()NVBDCP 7.65 804 (@)NTEP 3.10 3.88 (@) NVHCP O17 O18 Infrastructure Maintenance (including 8 | Direction and Administration) sal a ‘C_| Total Resource Envelope (A7B) 23383 | 2598 23.28 7703 nce 3. The Pool wise Summary of the approvals has been given in Annexure-t ‘Note: Assuming 5% increase in all programmes of NHM except Infrastructure Mainte 4. All unspent balance available under NHM with the State as on I April 2024, has become a part of the Resource Envelope of FY 2024-25. Similarly, all the unspent balance available as on 1” April 2025, would become a part of the Resource Envelope for FY 2025-26. If need be, a mid-term review at the end of FY 2024-25 would be cartied out, either at the request of the Ministry or the State/UT concemed, to provide course correction, in case of shifting of priorities. NHI Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura Page | 65, MOHFW has moved towards simplification of NHM budget process in 2022. Major reforms in this eycle of planning were introduction of two-year PIPs, reduction in budget lines to facilitate flexibility and easier implementation of SNA and a shift in focus from mere inputs and outputs to outcomes The major outputs agreed with the State in the form of key deliverables have been placed at Annexure-2, These deliverables along with the agreed targets would be the part of theNHM MOU, 6. The Conditionalities Framework for FY 2024-25 and FY 2025-26 is given as Anmexure-3. It is to be noted that Fulllmmunization Coverage (FIC)% will be treated as the sereening criteria and Conditionalities would be assessed for only those States which achieve 90% Full Immunization Coverage. For EAG, NE and Hilly States, theFIC criteria would be85% The funds received from Incentive pool based on performance shall be utilized against the approved activities only. 7. States/UTs are encouraged to adopt decentralized planning based on local requirement. However, the State must ‘ensure that there is no duplication or overlap between various sources of funds including the recently approved FC-XV Health Grants support and PM-ABHIM for the similar activities. 8. Any reallocation to be conducted by State/UT is to be approved by the Executive Committee and the Governing body of the State Health Society. Maximum budget available for states to reallocate fund is 10% of the total approved budget for that program/aetivity. States must intimate FMG, MoHFW regarding reallocation of fund on quarterly basis along with the ‘Financial Management Reports’ in the following format: The above details are to be submitted to FMG, MoHFW along with a signed letter from the Mission Director and a copy of minutes of meeting held with EC and GB based on which decision has been taken. 9. Thesupport under NHM is intended to supplement and support and not to substitute State /UT expenditure. 10, Human Resources for Health All the support for Human Resources for Health (HRH) will be to the extent of positions engaged over and above theregular positions as per IPHS norms and caseload. NHM aims fo strengthen the health systems by supplementing and hence it should not be used to substitute regular HRH. All States and Union Territories are encouraged to ereate and fill up sanctioned regular positions as per the IPHS requirements. HRH should only be engaged when infrastructure, procurement of equipment ete. required to operationalize the facility or provide services, ae in place. Moreover, HRH can only be proposed and approved under designated FMRs. HRH under any other FMRs or in any lump sum amount of other proposals, would not be considered as approved. Please refer to AS&MD's letter dated 17"" May 2018 in this regard (copy ‘enclosed as Annexure-4a). All approved! HRH under NHM have also been listed in Annexure-4b for ease of reference, Poge | 7 NHM Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraRemuneration of existing posts as a lump sum has been calculated based on the salary approved in FY 2023-24, 5% annval inerement and 3% rationalization amount (ifany) for 12 months, The budget proposed by the State for remuneration of existing staf? has been approved for 12 months in principle. This is to save the efforts of the State in sending any supplementary HH proposals to MoHEW. If there are funds left in HRH budget, it ‘could be used to pay the approved HRH at the approved rate forrest ofthe months. b. The maximum increase in remuneration of any staff is to be within 15% (in total based both on performance and rationalization), Overall increment and rationalization of HRH isto be within the 8%4of HRH budget, In case performance appraisal of NHM stafT is not eartied out by the State, only 5% inerease on the base salary can be given. Salary rationalization exercise (10 be done only in cases where HRH with similar qualification, skills, cexperience,and workload are getting disparate salaries) and its principles including inerements to be approved by SHS GBunder overall framework and norms of NHM. In cases where the salary differences is more than 15%, salary rationalization is to be done in instalments. Increase in salary beyond 15%in any year for any individual will have to be borne by the State from its own resources. d, The States/UTs must ensure that achievement of performance above minimum performance benchmark, as guided by MoHFW and finalized by State Health Society, is included as a condition in the contract letter of every HRHengaged under the NHM. Before renewal of the contract, each employee must be appraised at least against thesebenchmarks. ‘AS we move towards making the approvals more flexible, we expect the States to follow the broad guidelines and administer the HR functions well. To ensure that itis done properly and to document the good practices, HRHicam will undertake HR monitoring of a set number of States/UTs every year £ may be noted that if any of the HRH positions approved (Annexure 4b) remain vacant from 01/07/20 31/03/2026, then all such positions would be deemed to have been dropped/lapsed and a fresh assessment of Positions to be supported under NHM shall be done in the next PIP eyele, IL Finanee the National Health Mission would now be a. As communicated earlier through letter dated 7 January 2 ‘operated through a Single Nodal Agency (SNA), for which a single nodal account must be opened ina scheduled ‘commercial bank authorized to conduct government business, b. Withdrawing limits for all implementing Agencies (IAs), must be defined by the SNA, The bank software should be able o monitor the withdrawals of the implementing agencies, on areal time basis from Single ‘NodalAgeney as and when the payments are made. fo Page | 8 NAIM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura4, The central share must be transferred within 21 days to the Single nodal account. Also, the corresponding state share isto be transferred as early as possible, but not later than 40 days after release of Central share. ‘The interest eamed on the central share must be remitted to the Consolidated Fund of India, Separate budget lines must be maintained for central and state share under NHM. SNA and IAs would need to use the IT module PFMS. SNAS and IAS are to mandatorily use the EAT (Expenditure Advance and ranster) module of PEMS. ‘The SNA must also be mapped with PFMS and integrated with the State treasury. B, Action on the following issues would be looked at while considering the release of first tranche of funds: State should not have more than 25% of the total release (Central+ State Share) as unspent amount State should have completed all the tasks related to SNA and implementing Agencies mapping. State should have deposited all the previous central share and corresponding State shate in the SNA. Interest earned on NRHM and NUHM for central share must be remitted to the consolidated funds of India C. Action on the following issues would be looked at while considering the release of subsequent tranche of funds: iv, State must have spent at least 75% of the total release (Central +State Shate), State should have deposited all the previous central share and corresponding State share in the SNA Interest eamed on NRHM and NUHM for central share in previous quarters have been remitted to the consolidated funds of India, Statutory audit report needs to be submitted by the states/UTs for release beyond 75% of central allocation Other Financial Matters vi The State should convey the district approvals within 30 days of issuing of RoP by MoHFW to State or by 31" May 2024 (whichever is later). ‘The State must ensure due diligence in expenditure and observe, in letter and spirit, all rules, regulations, and procedures to maintain financial discipline and integrity particularly with regard to procurement; competitive bidding must be ensured, and only need-based procurement should take place as pet ROP approvals ‘The unit cost/ rate wherever approved for all activities including procurement, p indicative for purpose of estimation. However, actuals are subject to transparent and open bidding process as per the relevant and extant purchase rules and up to the limit of unit cast approved, ng, ete. are only Third party monitoring of civil works and certification of their completion through reputed institutions, ‘may be introduced to ensure quality. Also, Information on all ongoing works should be displayed on the NHM website and PMS portal ‘The State to ensure regular meetings of State and District Health Missions! Societies. The performance of SHS/DHS along with financials and audit report must be tabled in Governing Body meetings as well as State Health Mission and District Health Mission meetings. As per the Mission Steering Group (MSG) meeting decision. only up to 9% of the total Annual State ‘Work Plan for that year could be budgeted for program management and M&E.for bigger States, while the ceiling could go up to 14% for small States of NE and the UTs. The states’ UTS will have to ensure that overall expenditure under programme management and M&E do not exceed the limit of 9%4/ 14% (as applicable) as mandated by MSG. ‘The accounts of State/ grantee institution’ organization shall be open to inspection by the sanctioning. Page | 9 NHM Administrative Approval for FY 2024-25 ond FY 2025-26 of Tripuraauthority and audit by the Comptroller & Auditor General of India under the provisions of CAG (DPC) Act 1971 and internal audit by Principal Accounts Officer of the Ministry of Health & Family Welfave. All approvals are subject tothe Framework for Implementation of NHM and guidelines issued from time to time and the observations made inthis document. viii. 12, The RoP document conveys the summary of approvals accorded by NPCC based on the state PIP for FY2024-25 and FY 2025-26. a. ‘The program wise details of approvals for FY 24-25 and FY 25-26 for the PIP appraised by NPCC have been given Annexure-S for reference and ease of implementation, b. The committed liabilities for the FY 23-24 which has become the part of RE for FY 24-25 have been placed at Amnexure-6 for reference. ©. The activities approvals under NHM for FY 24-25 and FY 25-26 is to be reflected in NHM-PMS Portal, State to ensure that the valid data entries are made in the portal and it will be analysed for progress under NHM along with key deliverables. 13. Infrastructure The approval for new infrastructure is subject to the condition that the States will use energy efficient lighting and other appliances. b. ‘The States/UTS should submit Non-Duplication Certificate in preseribed format ¢. The States! UTs should review quarterly performance of physical & financial progress of each project and share the progress report with MoHFW. 14. Equipment: The States/UTs should submit Non-Duplication Certificate in prescribed format 15. IT Solutions: All IT solutions being implemented by the State must be EHR compliant, In cases where there is Central software and the State is not using it, the State/UT must provide APIs of its State sofiware for accessing/viewing data necessary for monitoring, 16. Mandatory Disclosures: The State must ensure mandatory disclosures on the State NHM website of all publicly relevant information as per previous directions of CIC and letters from MoHFW. JISSK, JSY, NPY and other entitlement scheme The State must provide forall the entitlement schemes mandatorily. No beneficiary should be denied any entitlement because of any limitations of approved amount for such entitled bases. schemes. Wherever required, the State must suitably increase the provision in such FMR. The ceiling of 10% as per Para 8 shall not apply in such cases b. The State/I/T to ensure that ISY and NPY payments are made throueh Direct Benefit Transfer (DBT) mechanism through ‘Aadhaar’ enabled payment system or through NEFT under Core Banking Solution, - Page | 10 NHI Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraResources Envelope and approvals: Approvals over and above the Resource Envelope is accorded with the condition that there would be no increase in Resource Envelope and the State will have to prioritize and undertake the approved activities under existing RE. Any subsequent modification (if any) in the RE after approval of RoP shiall be communicated separately ‘Saroj Kumar) Director (NHM- III) Page | 11 NHM Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraAnnexure 1; Budget Summary Amount in Rs lakhs Fy 2028-25 CH Flexible Poo! (including Rl, IPP, NIDDCP) 6,794.29 6178.39 NDCP Flexible Pool (RNTCP, NVHCP, NVBDCP, NLEP, Top nner, et) 2,175.22 2062.17 NCD Flexible Pool (NPCB&VI, NMHP, NPHCE, NTCP, NPCDCS, PMINDP, NPPCCHH) aces) clase NUHM Flexible Pool 1,286.62 1275.08 Health System Strengthening (HSS) 37,534.85 36950.57927 NHI Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura FY 2025-26 RCH Flexible Poo! [including Rl, IPPI, NIDDCP) 6,113.76 ae a DCP Flexible Pool (RNTCP, NVHCP, NVBDCP, NLEP, | 4 sag ge. IDSP, NRCP, PPCL) 1799.62 NCD Flexible Pool (NPCB&.VI, NMHP, NPHCE, NTCP, ais NPCDCS, PMNDP, NPPCCHH) nee 1229.24 NUHM Flexible Pool 1,210.39 1195.04 Health System Strengthening (HSS) 30,542.35 30105.25559 Page | 12Annexure 2: Key Deliverables of FY 2024-26 NHI Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura Percentage of PW registered for ANC : Numerator: Total number of PW 1 | Output [ANC Coverage registered for ANC Percentage) 100% 100% | HMIS Denominator: Total number of estimated pregnancies Percentage of PW registered NG: for ANC in Ist trimester registration in Ist trimester of Numerator: Total number of PW 2 | Output | pregnancy registered in I* Trimester fPereenlage 859% 50% Has: (within 12 weeks) | Denominator: Total number of PW registered for ANC % of PW received 4 or more Pregwant ANC check-ups Womenwho 7 “EW 3 | ouput | received 4 or | Numerator: Tor mumberorPW Iacccenapel 90% 95% HMIS received 4 or more ANC more ANC check-ups] Denominator: Total number of PW registered for ANC % of high-risk pregnancies identifies basin Numerator: Total no. of PW PMSMA 4 | Oupur [aentiication of scntified as High-Risk Pregnancy |Percentage| 15% 15% — | Portal/RCH HRP (HRP) Portal Denominator: Total number of PW registered for ANC % of HRP Managed IM Numerator: Total no. of High- 5 | oupur |MarazementoH Risk Pregnaney (HRP) managed Percentags 100% | 100% | RCH Portal Denominator: Total number of High-Risk Pregnancies identified Page | 13Institutional © | Ouput | Deliveries '% of institutional deliveries out of total ANC registration Numerator: Total no. of institutional deliveries (public + private) Denominator: Total number of PW rexistered for ANC Perventag 90% 90% RCH Portal National Certification of LRs & OTs under LaQshya 7 | Output % of nationally certified LRs and OTs under LaQshya against target, Numerator: Total number of nationally certified LRs & OT. ‘Denominator: Total number of LaQshya identified LRs and OTs. [Percentage| LR or-4 (Additional Facilities) 1-4 oT-s (Addit Facilities) nal Report NHSRC LaQshya LR Number TLR TLR LaQshya OT Number lor 10T Public Health facilities notifiedunder SUMAN 8 | Output Percentage of public health facilities notified under SUMAN against target Percentage State Report ‘Suman facilities ‘Number 400 ‘Additional facilities 400 Additional facilities Maternal 9 | Output | death review mechanism [% of maternal deaths reviewed against the reported maternal deaths Numerator: Total no, of maternal deaths reviewed Denominator: Total no. of maternal deaths reported Percentage] 100% 100% MIs JsY 10) Outpat | peneticiaries Percentage of beneficiaries availed JSY benefits against RoP approval ‘Numerator: Total no. of !SY beneficiaries paid JSY benefits Denominator: Total no. of beneficiaries approved in RoP. Percentage| 100% of RoP| targets 100% of RoP targets ‘Source: As pe Ir state quarter ly reports. NHI Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura Number 10 10 A Page | 14SNCU Successful discharge rate out of total admission (A) SNCU —— |Numerator: No. of sick and small 11 | Output | successful] new-born dischargedsuecessfully discharge rate | (insuecessful denotes Death, LAMA and referral) Denominator: Total no, of sick snew-borns admitted in SNCUs Percentage of Districts with Percentage >80% | 80% |FBNC online) portal functional SNCU out of total approval in RoP Numerator: Total number of ou districts with functional 12 fourpur | Furetonalty | sncus (with functional equipment, trained HR as per FBNC guideline) Denominator: Total number of distict with approved SNCU in RoP. Percentage NICUS!_ | NICUS! 100% (9 | 100% (9 FBNC online| SNCUs) +7 Portal SNCUs)-7 Districts Districts AR training in Newborn Health Percentage of Paediatrician / Medical Officers and Staft Nurses trained in FBNC and NBSU Training Package. Numerato Output : Total Number of Newbom and] Doctors (Paediatrician/MOs) and Child Health | srafr Nurses trained in BNC and NBSU training package. Denor ator: Total Number of Doctors (Paediatrician / MOs) and Staff Nurses posted in SNCUs/NICUs and NBSUs. Percentage of Child Death Percentage] 90% vg | Quarterly 90% | state report Reported against Estimated deaths output | ill Death Numerator: Total no. of Child Reporting deaths reported. Percentage) Denominator: Estimated number ‘of Child Deaths basedon latest sone | C8] scan Infant Deaths} ins) portal _|_ SRS report (34000) NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura 0 Page | 15Stillbieth Outeome | Rite Still Birth Rate Numerator: Total no, ofStillbirth Reported Denominator: Total no. of Reported Deliveries Rate | Births <12 per 1000] <10 per 1000 Births; HMIS Home visits Output by ASHAs for New-born Percentage of newborns received complete schedule of home visits against total reported live births Numerator: Total no, of new- born received complete scheduled of home visits Denominator: Total no. of new- born Percent ines 100% Quarterly HBNC Report [Home visits by Output |ASHAs for few-borns, [Percentage of newborns received complete schedule of home visits wgainst total reported live births ‘umerator: Total no. of new-borns ceived complete scheduled of home visits Denominator: Total no. of new= rns 90% Percentage] (56136) 90% (0: 56136) ate quarterly BNC eport Roll out of HBYC visits inall districts Percentage of Distriet Roll out HBYC visits against RoP approval with trained ASHAS Numerator: Total no, of districts, trained ASHAs Denominator: Total no. districts approved in RoP for HBYC implementation implementing HBYC visits with Percentage} 100% (8, Districts) 100% (8, Districts) Kate uarterly lieve Report Output | Paediatric HDUMICU unit Percentage of Districts with functional Paediatrie HDU/ ICU ‘unit out of total districts. Numerator: Total no, of districts ional Paediatric HDU/ ICU unit Denominator: Total no. of districts with the approved Paediatric HDU 100% (7, PercentagePacdiatric DUS! ICUs) 100% (7 Paediatric HDUs! ICUs) Quarterly State Report NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura Page | 16NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura Number of facilities national certified against total identified facilites under MusQan Numerator: Total number of health facilities nationally certified Hie age under MusQan initiative (at least rarterl 20 | Outpur | MusQan eee Perens en (> ec oeotane (SNCU/NBSU, Puediatic OPD, Sere (tee Paediatrie Ward, Nuttion Rehabilitation Centre) Denominator: Total number of facilities identified under MusQan initiative ‘of Live Binh lamer: otal number o Live Birth reported Reported sina cat15é | 90% 6.54 fs) RCH 2) hhiveBinh meses) Pee Live Births) Portal Births) Estimated lpirehs: [51,282 as [per SRS, i2020 [Percentag| eof New born Screened at the time of birthout of total Live Births 2 Output Pen one Delivety, umerat | Pereentae | 100% 100% or: Number of New born Screened atthe time of birth Penomin ator: Page | 17‘Total lhumber of Live Birth Reported. Percentage of DEIC functional with Infrastructure, Essential Equipment and HR as per Guidelines against the RoP- approval, 100% 100% — {State Month) Funetional 23 | Output | “pecs | Numerator: Number of DEICs [Pere yee | 4DEIC | Report functional with Infrastructure, Essential Equipment, HR and ‘raining as per Guidelines. Denominator: Total number of DEICs approved in RoP. Percentage of Government & Government aided schools and Anganwadi Centre covered by RBSK MHTs ‘Numerator: Number of 100% | 100% |Government & Government aided AWC (2 AWC (2 24 | Output |RBSK MHTs | schools and Anganwadi Centre Jpercentage! Visit) | Visit) State Monthly covered by RBSK MHTSas per 20292 | 20282 | Report RBSK Guideline. School: 4305] Shoo! Denominator: Total number of. Public Schools and Anganwadi Centre in the block Source: State Quarterly Report Percentage of children screened by RBSK MHTs Screening of Children in Numerator: Number of Childrenin 100% 100% Government | Government & Government aided 06 Years (20-6 Years (2 & schools and Anganwadi Centre Visit) Visit) | sate Monthl 25 | Output | Government | screened by RBSK MHTs.s per Percentage) 630846 | 630846 Sts Mon aidedschools RBSK Guideline, 718 718 and Years- | Years- Anganwadi_ | Denominator: Total number of 569691 | 569691 Centre Children in Government & Government aided schools and Page | 18 NHM Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraNAM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura Secondary’ [Number of beneficiaries received Territory Secondary/ Territory management | management against RoP Quarterly 26 | Output | ofconditions | approval (for surgical Ne alls 305 | seate Report specified | intervention specified under under RBSK TnSK Percentage of Full Immunization Coverage (FIC) Numerator: Total number of Fut | children aged 9-11 months fully 28 | ouput jimmunization immunized with BCG* Three doses|Percentagel 95% 95% | uMIs coverage | of'pentavalent + three doses of ‘OPV + One dose of MRCV Denominator: Total No, of target children n 9-11 months'age group Percentage of children receiving rth dose Hepatitis Bas against institutional deliveries Coverage of ; : 29 | Output | birthdose | Numerator: Total no oF infants percentage! 9056 sox | MIs eames | immunized wih bi dose of Hepatitis B. Denominator: Total no. of institutional deliveries Percentage dropout of children from Pentavalent 1 to Pentavatent 3 Dropout % or | Numerator: Total no of hikren 30 | Output eet dten | immunized with Pentavatent 1 [Percentage 0 0 HMIS ‘Total no. ofehildren immunized with Pentavatent 3 Denominator: Total no. ofchilaren immunized with Pentavalen Percentage dropout of children from Pentavalent 3 © MR 1 Numerator: Tota no, of children Dropout % of | immunized with Pentavalent 3 — 31 | Output Jr children | Total no. ofchildren immunized |Pere"™B] ° HIS with MCVIMR 1 Denominator: Total no. ofehidren immunized with Pentavalent 3 Page | 19from MR 1 to MR2 Percentage dropout of children Numerator: Total no, of children due for MR 2 Iwithin one-hourbirth against total |Denominator: Total no. ofchildren| Percentage of newborn breastfeed 2 Dropout 2 |muraed wih Maal oe fcenaed 0 | 0 | ans of children immunized with MR 2 Ipenominator: Total no. of children immunized with MR L Percentage of children receiving Tato TT10 — |Numerator: Total no. ofehildren > 33 | Output | coverage | 10 years old immunized with Taio [Peeentaee] 75% ae eae Denominator: Total no. ofehildren > 10 years of age MRCV2 coverage 95% at state level MR-2- | Numerator: Total no. ofc 34 | Output | Coverage received MR2 [Percentage >95% | >95% | HMIS 395% e [Centre (NRC) Rehabilitation ander-five children discharged with satisfactory weight gain for3 consecutive days (>Sem/kg/day) live birth. Early 35 Initiation of | Numerator: Number of newborn |Percentazel 100% 100% | HIS Breastfeeding | breastfeed within one hour of bicth, Denominator: Total live births registered in that period. [Bed Oceupaney Rate at Nutrition RehabilitationCentres (NRCs) cee gy [Numerator- Total inpatient daysot| Rateaty | cate from 1 April 2022 t0 31st 36 | Output | \ettition | March 2023/1" April 2023 031" [Percentage] 50% 60% | State reports Rehabilitation tarot a2 Centre (NRC) | Denominator- Total availablebed days during the same reporting period Successful Discharge Rate at Successfiol | Nutrition Rehabilitation Centres Discharge (NRCS) Rate at 37 Nutrition | Numerator- Total number of [Percentage] 80% 80% | State reports NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura Page | 20from Ist April 2022 to 3st March 2023/1* April 2023 to 31" March 2024 Denominator-Total No. of under- five children exited fromthe NRC during the same reporting period Percentage of pregnant women given 180 IFA tablets as against pregnant women registered for ANC IPA coverage 38 | Output | Anaemia | Numerator: Number of pregnant [Percentage 90.00% | 95.00% |HIMIS report Mukt Bharat_| women given IFA tablets. Denominator: Number of pregnant ‘women registered forANC in that period. Percentage of children 6-59 months given 8-10 doses of IFA. syrup every month IFA coverage | | Numerator: Total number of 39 | Output {Anaemia Mukt) children 6-59 months given 8-10 [Percentaze| 30,9935 | ao.oox | HMIS report Bharat | doses of IFA syrup in the reporting : ‘month Denominator: Number of children 6-59 months coveredunder the programme (TargetBeneticiaries) Percentage of children 5-9 years given 4-5 IFA tablets every month) 30% 40% 7o%we | 80%we IFA coverage | Numerator: Total number of uggeatedin | suggested 40 | Output Anaemia Mukt} children 5-9 years given 4-5 IFA [Percentage| “WecC and. | and state |HMIS report Bherat tablets in the reporting month 50% as | had given Denominator: Number of children shared by | 75% pre 5-9 years covered under the state NPCC programme (TargetBeneficiaries) Public Health Facilities equipped PANOW ot 122008 of ccs and | CHCs and belated epeacbeee lt ad ove level of above level Mifepristone & Misoprostol), Equipment (MVA/EVA) and public Health) of public | CAC Annual 42. | Output | CACservices | ypatmed Provider (MTP Trained /Peteentagefaciities to be Health | Quarterly IMO/OBGYN) for providing CAC ener ecualgpel Report services against the total number a of Public Health Facil faates | 2.87 |, RoP targets (mca;_| facilities ge | 21 HIV Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraDH includit Numerator: Total no, of Public a Health Facilities that are Gilden equipped with Drugs (MMA ospital/ MCI Combi pack/ Mifepristone & yebrisas: Misoprostl), Equipment Cites (FRU) | Hospital (MVA/EVA) and Trained other sit ct: Provider (MTP Trained pievaet tavai| gous: MO/OBGYN) Hospitals: 1; [cHcs (FRUs) Denominator: Total number of 24X7 PHCs, [& Other Sul Public Health Facilities as per RoP Hao Re |soeence fae CHCs:t14;; | Level Other |Hospitals: 2 Pucs:19) }24x7 PHCS, Non FRU cHes:114;; Other PHCs:19) Medical Officers trained in CAC against the RoP approval vee N Total no, of Medical aues | “iEae™ [CAC Anal lamerator: Total no. of Medical 7 & Quarter 48 | Output | MOwrining |G Fcars (MBBS) trained | Number | D0COr | aang 2| © Ruane MMA Denominator: Target of Medical Traine: Officers (MBBS) to be trained as aaa per RoP Percentage of PPIUCD acceptance among Institutional deliveries PPlucD ‘Numerator: Number of PPIUCDS [Per . Denominator: Number of institutional deliveries in public facilities Percentage of Injectable MPA users among Eligible Couples Injectable MPA\ , 45 | Outpur [Mebe! Numerator: Total number of [Percentage 9,5 a7 |HMIs'ReH Injectable MPA doses/4 register Denominator: Number ofEligible Couples p Y Page | 22 NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripuraissuing the stock in FPLMIS out o total facilities (including Sub Centres) Numerator: Number of Facil )perationalizati] indenting and issuing the stock in states. ‘Average monthly Client load at AFHC/month in PE Distriets at DH/SDH /CHC level to increase by 25% in 2024-25 and 50% in 2025-26 from the baseline data of 46 | Output | of FPLMIS | FPLMIS (including Sub Centres) |PETeentaze| 99,09% | 100.00% | FPLMIS Denominator: Total Number of Facilities registered in FPLMIS (including Sub Centres) Remark: This key deliverable has been revised to include Sub Centres Numerator: No. of numnberge NPKs distributed 5 'Nayi Pabel Kits) Denominator: No. of ASHAs Mey: (NPK) | Source: MPV Quarterly Report | Numer | 2.5 pe lnomneas distributed per Remark: Report ASHA | This deliverable is applicable only to 13 MPY States and few other states INumber of Sass] No. of SBS Conducted 50 Bahu |Souree: MPV Quarterly Report Some xemark Number } 3411 sat | uaer (SBS) _ | This deliverable is applicable only petal Conducted | to 13 MPV States and few other Repost NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura pcan (uMIs/ Client toad at Quarterly s nna los 1 | ounyy aie Ne 80 100 atEe Numerator: Total Clients Report) registered at AFHC, Denominator: Number of AFHCS livided by no. of months(per ABHC per month) Page | 2352 | Output | WIFS coverage| Percentage coverage of in-school beneficiaries under WIFS Programme every month. beneficiaries covered Denominator- Targeted beneficiaries (In School) Numerator: Total no in School [Pereentaee| 90% 90% HIS 33 Percentage coverage of out-of- school (girls) under WIFS Programme every month. Output |WIFS coverage! ‘School beneficiaries covered Denominator- Targeted beneficiaries (out of School) Numerator-Total no out of |Pereen"aue) 95% 95% HIS 54 Percentage of Peer Educator selected against the target Selection of PeerFducator |Numerator- Total no PEs selected [Pee Penominator- Total No. of PEs to be selected Output 100% 100% | State PE Reports 35 Percentage of Peer Educator trained against the Peer Training of Educator selected. Peer Educator fPeernleee ‘Numerator- Total no PEs trained Denominator- Total No. of PEs selected 100% State PE Reports NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura Page | 24NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura Percentage coverage of Adolescent Girls against the target under Menstrual Hygiene Menstrual Schone 56 | Ourpur | "ysiene Numerator- Total no, of [Percentage] 0% 85% | MIS Scheme ma covernme | edolescent girls eclving sanitary napkins under MHS Denominator- Total No. of adolescent girls to be covered Percentage ofthe selected [Districts implementing Ayushman, Ayushman | Bharat School Health & Wellness Bharat Sel Programme aint the RoP 57 | Ourput | Health & a Percentage) 100% | 100% | Rue Programme | Numerator: Total no districts implementation’ implementing ABSHWP Denominator- Total No. of Districts selected for ABSHWP Percentage of Health & Wellness Ambassadors trained fo transact Ayushman | weekly activities in schools in the Bharat Schoo! select districts Health & $8) Oupur | Wetiness | Numerator-Total no of Health fPesenses) 100% | 100% | SHIWE Programme | & Wellness Ambassadors (HWAS) Pree implementation tialned Denominator: Total no of HWAs to be trained “Total Number|AS mandated by the PC&PNDT ‘of meetings | Aet law the DAC has to meet conducted by | minimum 6 times a year 59 | Output lstrict advisor|Numerator- Total No. of meetings [Percentage 100% | 100% | State Report committees | actually conducted by all districts (DAC) in the inthe stare state’ UT | Denominator- No of district *6 Percentage of salt samples Monitoring of | tested using Salt Testing Ki 60 | Output | salt& urine in (Qualitative testing) by ASHAin [Percentage] 90% 90% | state Report the StatefT lentified District. Numerator: Total Number of Page | 25‘Sample tested by ASH. »50 samples* 12 months, Denominator: Number of ASHA 61 Output lonitoring of Isat & urine in the State/UT tested (Quantitative) in Lal (Volumetric method) for estimation of iodine content Numerator: Number of sal (Volumetric method). Denominator: Number ofDist *25 samples*12 months. Percentage of salt samples amples tested (Quantitative)in Lab, b 7 It [Percentage} trict 90% 90% State Report 62 Output Monitoring of, salt & urine in the State/UT implementation tested for Urinary iodine estimation, ‘estimation, Denominat 25 samples*12 months. ‘Women for ANC services. Percentage of urine samples Numerator: Number of urine samples tested for Urinary iodine Number ofDistriet Percentage of Service Delivery Coverage of entitled Pregnant [Percentage] 80% State Report NHI Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura nition __ | Numerator: Total No. of PW received All ANC services (ANC 4 % 64 | Output in ANC? FANGS ANCH [Peteentage] >80% >80% | RCH Portal Coverage of | + TTI/TT2 + 1801FA tablen Pw Denominator: Total PW expected for Service based onreporting period Percentage of Service Delivery |Coverage of entitled Child [0-1 enplementation| Y*#"l fo" Immunization services. Se Numerator: Total No. of Child es | Own | eevee recsived All Immunization Ipereentagel >8u% | >80% | RCH Portal Delivery services (as per National Coverage of | Immunization Schedule) Child Denominator: Total child expected) p Page | 26Percentage of total Delivery reported of Pregnant Women. ce Numerator: Total No. of on of i Delivery reported application sta 66 | Output Denominator: Total PW Percentage} >90% | >90% | RCH Portal expected for Delivery basedon [Total Deliveries Teporting petted Reported Health provider (ANM) using ANMOL application for centering Data implementation] Numerator: Total No. of Users 67 | Ouput | of ANMOL | (ANM) doing data entry. [Percentage >80% | >85% | RCH Portal application Denominator: Total no. ative users (ANMS) registered in RCH Portal Weekly |, pe q 68 | ouput | Reporting —s |” 0FReporting Unit Reported inpercenayd ax | 9% | IDSPIIP form Weekly |y : 69 | Output | Reporting—p |”* OF RePortNg Units Reported Mlpercentape) 95% 95% | IDSPIHIP form Page | 27, NHM Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraNHIM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura 70 | Output "6 of Reporting Units Reported iMlpercentaye! 82% 92% | IDSP IKIP Weekly [Lab Access of Outbreaks reported Reporting— | under IDSP excluding TI | Output | Lab Accessor | Chickenpox,Food Poisoning, |Pe°enaze) 85% Soret AoSeHae Outbreaks Mushroom Poisoning Presumptive ; ; 72 | ouput TB Freee UE een Now 23500 | 23500. | state Report Examination Mpslstien Expansion of ipa [pid molecular] % OFTBpatients tested for | Nos. | 70% | >700% 73 | Outpst Tiagnostics for] Rifampicin resistance State Report 1B % Improvement in Annual TB Score Numerator: (State Annual TB. NIKSHAY 74 | Output [State TB Score] Score in Current Yee StateAnnual [Percentage] >90 >90 | Portal ‘TB Score in last yr) Denominator: State Annual TB Score in last yr L Page | 28"% of eligible patients recei benefit of DBT : ikshay Poshan|Numerator: No. of eligible patient: , NIKSHAY 7 all Percentage 100% | 100% | NIDSITS Denominator: No. of eligible No. of districts to achieve TB free| Districts with é is ‘TB free Status | # Bronze, # Silver, # Gold, #TB pet Sere (Gold) Stas Report Free district/City oe PF Gram | 9% OfGram Panchayat/ward to n yay Wat achieve TR free Status # Bronze, Percentage] 30% 50% | State Report Se) Silver, # Gold, #TB Free Status % Of patients| . S| % Ofconsented TB patients |p. ontay, = 78 adopted by Ni] Nigpied by NeKshay Min Peretaes) 100%] 100% | uate Report shay Mitra Expansion of | lapid molecular] % OF TB patients tested for 3 = 2 diagnostics for Nos. >10% 70% | State Report TB NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura ee Page | 29,NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura "ARV available at the Health Facilities as per Essential Medical List pvpms Portl/State Numerator- Total No. of Health Monthly Facility til PLC level having stocks report 80 | Output eran Percentage, 100% | 100% Source- DVDMS Portal/State Monthly report Rural Health Statistic. Denominator- Total No. of Health yay Facilities till PHC level (Souree- Availability of |_Rural Health Statistie~ MoHEW) Rabies Vaccine| and Rabies [mmunoalorulil Rabies Immunoglobulins available atthe Health Facil DypMs a3 per Evsentiel Medical 1 Porta/State Monthly [Numerator- Total No. of Health report JFaciity Gil CHC level having stocks si} ouput ee percentage] 100% | 100% Denominator- Total No, of Health Rural Health Facilities tll CHC level (Source- Statistic Rural Health Statstce Mol1FW) MoHEW) ‘Management off. aeean fnagener tr ecentage of Hepatitis C Patent soon | toa | sivece 82 | Output | MePals C- |" benefited ie. aumber who Percentage ee receivedtreatment against target. : rogram [Management o ment Ol percentage of Hepatitis B Patient cI 83 | Output | MEPaRtSB )"henefited ie.number who Percents 100% | 10m" |NVIICP MIs receivedtreatment against target Portal program Page | 30Pregnant | Percentage of pregnant women women _ | screened for hepatitis B (HBsAg) 100% 100% =| RCH 84 | Output | screened for | againstthe target (Institutional [P*"°"E6| Portal hepatitis B Deliveries) Administration) Percentage of new born of HBIG to administered HBIG among new yo, 14 as | output (1a r.ey born delivered to HBsAg positive|Percentage 10% =| 19% | ReH tifpi “AB positive “pregnant women at health care Portal a facility ‘women Percentage of Grade! | No of Districts with Grade IT 86 | Output | Disability | Disability (G2D) percentage less | Nos 3 3 | State Report (G2D) among | than 2%among new cases new cases Centfication of| eal ; No of Districts certified as 7 | Oupat | Dias os Leproey Eves Number az 2 | State Report eprosy Pree Clearance of | Number of Reconstructive backlog of | Surgeries (RCS) conducted 88 | Ourput |Reconstructive| during the F.Y./ Number of | Numbers] 1 1 | State Report ‘Surgeries | Patients Eligible for RCS during (RCS) the F.Y.*100 Malaria Reduction in a Numbers MES report, 90 | Output | xprarpisttee| No-of districts with API <1 5 5 NvEeE level Page | 31 NHM Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraAnnual blood Examination Rate MES report, 91. a percentage} >20% | >20% | MES por as 1 Round IRS report, ‘IRS population coverage in Focal spray only | NVBDCP each round 3 Round IRS report, NvBDcP State & No. of Distriets Certified as 0 0 | District, 4 ja MalariaFree Monten NvBDCP DataBase 13 Table caer MDA report ‘The proportion of districts/IUs 95. | Output ; Percentage and WHO itheoverage>65%for DA witheoverage>65%for aoe report 13 Table and 85% for IDA of the total MDA report 96. | Output population (admin and WHO wverage/independent assessment) Post MDA report Lymphatic ‘Non-Endemic for S Pilavasis Lymphatic Filarasis Morbidity management and Eel disease prevention (MMDP) 275 | Output serviees for hydroceleand | Number [ePortMonthl Lymphedema cases yMMDP report Cumulative number of endemic teas 98. | Output districtswhich achieved mf | Number ae rate<1% verified byTASL plan 7 Page | 32 NHIM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura[Cumulative number of distriets to| peers 99, | Output JachieveDisease Free Status-LF as| Number fe per TAS 3 Clearance renott Dengue & | Dengue Case Fatality Rate at : 100, | Outpet | chiktingunya Chic level percentage] N/A | CFR 1% Number of blocks achieved Kala Jol. | Output azar elimination ie.<1 ease per | Number | NA NA 10000population at block level 102. Number of blocks sustained Kala] ber | NA tA var elimination % IRS population coverage in. |p, 103. Kala-azar aaa Percentage] Focal spray only ‘%Complete treatment of KA 104, hai cearavyi Percentage] N/A N/A ine ~*Complete treatment of PKDL |parcentage] NA WA NHM Administrative Approvol for FY 2024-25 and FY 2025-26 of Tripura Cases Page | 33Increase in availability of Tobacco | No.of districts with Tobacco mis /NTCP| 106 | Output oe Number} 2 Na gb available Improved accessfor 107 Outcome] Tobacco | N0-of People availed tobacco | Number | 12000 | 15000 | MIS/NTCP cabeceo | cessation services in2022-24 portal Services NHIM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura {moved | parentage of trict covered 108 | Output | ere th { District Mental HealthUnits —|Percentag NA NA | State Report penta operationalized. Improved | Percentage increase Number of at | coverage of | persons cateredthrough District | Number/ 109 | Outpt | mental health Mental Health Units [Percentage] 33825 (10%) 87208 (10%4) State Report services Provision of primary and | Numerator: No. of DH with Geriatric heath] ©tiatrie Unit (at least!Obeds) 110 | Output Haase Number a 4 INPHCE QPR| ve Denominator: No. of total DH in Hospitaland the state below Provision oF primary and | Numerator: No. of DH with lo. ce sheath physiotherapy unit forelderly i 111 f oupur fers ea Number} 4 INPuicr. ape Danke | Denominator: No. of total DH in Hospitaland ae below | L p Page | 34aaa zy| Numerator: No, of CHCs with naeGehed physiotherapy unit i 112 | output {Serie heat ea 2 NPHCE, eee ice “| Denominator: No of total CHCs in —_ Hosptaland the state below. population |30+) registered] % of population (30+) registered National 13] Input ee NCD | in the National NCD portal [Peteentage| 257,150 | 2,59,740 | ON Services population | 4 ‘ 114 | Process | screened for | % of Population sereened for lpercentage| 2,57.150 | 2,59,740 | National Hypertension NCD Portal NCD population % of population sereened for National 11S Process | serened for ine Percentage 2.57,150 | 2,59,740 | enone : % of people on standard of care : Patient put on National 116 | Output se seane | for Hypertension against target [Percentage! 38,654 | 42,519 | Wome population : % of people on standard of care Patient put on ‘ " National 117 | Output | Pere ent | for Diabetes against target [Percentage 14,116 | 15,527 | AROMA population Eye care servicesunder [Percentage NPCBand VI| Percentage achievement of big provided at | Cataract operationsagainst 23500 | 12000 ne 118 | Output | F Reports istrict level targets nitinbed andbelow District level y Page | 35 NM Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraBye care Dialysis [feelity under PMNDP Calculated] servicesunder ee NPCB and VI] Percentage achievement of [Persentaes provided at | Collection of donated eyes for a a District 119 | Output | primary, | corneal Transplantation against Reports secondary al targets istrict level Lara andbelow level Eye care servicesunder NPCB and VI] No. of Free Spectacles to school 5 120 | Output | provided at children suffering fromRefractive) Number | 9799 2800 oe District level errors ne andbelow Disirict level Cataract No. of Distriets Certified as} Number 7 4 121 | Outcome | backlog Free State Report ranean Cataract backlog Free No, of distriets with dialysis 100% 100% District] 10” bs total number of distriets having) Number District 122 | ouput | Facil ine P iat centres ante bythe coverage | QUE, | State Report {otal number of districts in the state. Estimated number of dialysis Number of atput seme sessions (monthly) Caleulated as | Number | APL:0.246 | apL:0.273 125) Output sessions held in! 10% increase over the previous Bpt: 0.044 | apt: 0.048 | Stte Report year dialysis sessions cal | pstimated number of patients 124 | oupue | 38255, | pamelor pertoenttabas || og |g PMNDP nalainn improvement it) Percentage of water samples sample testing 125 | Outcome | SPE IME| ested for Fluoride levelagninst [Percentage] NA Na |NpPcD gpR| Larrea] Sumber of samples asper norms. L Page | 36 NHM Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraMedical management o| diagnosed | Percentage of patients provided ‘Aluorosis cases |medical managementto diagnosed) 7 126 | Outcome |”ncluding | fluorosis eases out ofthe total [Persenee) NA NA’ JNPPCD QPR} supplementatio diagnosedeases. nsurgery, and rehabilitation : Number of people with hearing 127 | Output | Hearing Aid probleme rehabilitated. | Number] 180 180 |NPPCD QPR| 128 | Output Numberset peoplesereattl fF | uviber 7 7 |NPPCD QPR| Facilities | deafmess/hearing impairment, ee Palliative care services under] Total no. of Distriet Hospitals Output |"'NPPC. | providing palliative careservices | NuPer programme ing | Percentage of PHFs providing Strengthening : HMIS 130 | Output | Oral Health | Gentateateservicrs upto CHC | Number | 30PHCS | 30PHCs | (Dental Services : 7 OPDYMPR CHC level (DH/SDH/CHC) ‘% of Medical officers in district Ircineicepacd ‘rained on diagnosis ond 131 | Output [URINE CAPS] management of HRIand ARI [Percentage] 60% 80% alicareeied lance in context of air alia pollution % of DHs and SDH with | Heat Retsted | operational min 5 bedded Heat | 132 | Ouput | "“tiness | Stroke Room (from tst Mareh~ [eee NA is ‘Bist July) Page | 37 NHI Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraAcute Respiratory | _ % of Sentinel Surveillance 133 | Output filiness (ARI) in] Hospitals reporting daily ARI [Percentage! 80% 90% context of Air cases on THIP portal Pollution ‘Number of operational urban health facilities(UPHCs and UCHCS) increased. improving |(#) UCHC¥%= Numerator: No. offPersemaee, 10 de moving | UCHC operationalized Mis.QpR/ 134 | Output | peatneare in | Detominater No, of CHC ‘Approved urban Ilia ee Siar (b) UPHIC % = Numerator: No. of UPHCoperationalized Denominator: No. of PHC Perventage, 10 tae approved cae No. of UPHCs converted to Improving | Ayushman Arogya Mandir 135 | ouput |, 288351 Numerator: No.of UPHC parsonage! 30 io | aeons | ” Put | healthcare in converted to AAMs Approv turban India |Denominator: Total No. of UPHCS baseeceia! approved % of UCHC and UPHC-AAMs Improving |. ofering spevalistservice eecectos | Numerator: No, of UCHC and AM Portal/ 136 ] Omer | acatiare in | UPHC-AAMS offing specialist [Percent 90% 908 | Approved taleROPS urban India| Denominator: No. of UCHC and UPHC-AAMS approved “Annual utilization of urban health facilities (UPHC-AAMs) lincreased with at least 50% visits ‘made by women to be sustained ) Urban Health Facilities Foorfal! Improvin& | Numerator: No of UPHC-AAMS |. 137 | Ourput | jettineare in | FePerting atleast average foottall |PeFENALS gg, 90% | AAM Portal (60 footfalls per 1000 population) urban India : lo of operational AAMS ) 9% Female footfall: ‘Numerator: Female footfall in current year Denominator: Total : footfall recorded in current year A Page | 38 NHI Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura138 Improving accessto healtheare in urban India Output ‘%No of Individuals screened. for NCD at UPHC-AAM ) For Hypertension Numerator: Individuals sercened for NCD-Hypertension Denominator: Total 30 years and above, Urbanpopulation as on I* April (Beginning of FY) ) For Diabetes: ‘Numerator: No. of individual screened for Diabetes Denominator: Total 30 years and above urban population as on Ist April (Beginning of FY) [Percentage 90% 138 % of individual screened for NCD at UPHC-AAM a) For Oral Cancer: Numerator: No, of individual screened for Oral Cancer Denominator: Total 30 years and above urban population as on Ist April (Beginning of FY) {(b) For Breast Cancer: screened for Breast Cancer Denominator: Total 30 years and above urban women population as on Ist April (Beginning of FY) (C)For Cervieal Cancer: ‘Numerator: No. of individual screened for Cervical Cancer Denominator: Total 30 years and above urban women population as ‘on Ist April (Beginning of FY) Percentage) 100% 139 Providing Output | quality healthcare %Urban pregnant women accessing 4 or more antenatal care at UPHC- AAM and UCHC Numerator: Total urban PW accessing 4 or more ANCS Denominator: Total urban PW ee NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura 90% | AM Portal 100% | AM Portal so | HMIS age | 39 Cree |registered Provi [Percentage of Urban Health and Nutrition Day(UHND)held Urbanindia diagnosed for Diabetes % of diagnosed patients put on treatment for Hypertension: jumerator: Number of patients pu 6n treatment for Hypertension Denominator: Number of patients wenosed for Hyperte ing organized MIS/HMIS quality pein 140 | Ouput | healthcare | Numerator: Number of monthly {Percentage 3732 3732 services in UHIND organized Approved, Urbanindia State RoPs Denominator: Number of monthly’ UHIND approved ‘Number of patients treated for Diabetes and Hypertension at UPHC-AAM (a)% of diagnosed patients put on} treatment forDiabetes: Providing | Numerator: Number of patients quality | put on treatment for Diabetes ie 141 | Output | healthcare | Number | 90% 90% pat services in [Denominator: Number of patients implementation % of Health Faciites up to AAMT ony 142 Output or DVDMS in | SHC implementing the DVDMS [™="E9 100% | 100% | os. Resort AAM SHC INQAS ceri a public heath | Cy mglative Number of NOAS : 143 | Output | © facies | Cumulative Number of NOAS | unter oat (mua, | certified public heatttucliis cane State) Init, Puli health ; NI facilities with | Number of public health faciities Sali 144 | Output |Kayakalp score} with Kayakalp score morethan | Number 100 110 | tition greater than | 70% (on external assessment) ae 70% Unit Page | 40 NAM Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraNOAS [Certified put health facilities) Percentage of NQAS Certified 145 | Output | (National + | Facilities (%) in Aspirational [Percentage] 480 528 | State report State) in Block Aspirational Block Number of diagnostic test available at DH/SDH/CHC/PHC asper NEDL 2019 Calculated as average of total number of diagnostics tests available at each SC: 14 test level of health facility SC: 1Mtest | PHC: 40 divided by the minimum number PHC: 40test| — test ‘of diagnosties testsspecified in CHC: 40test| CHC:40 FDSI (14/63/97/111/134) SDH :45test] test | HIMIS/ State guidelines lin PPP and 50| SDH:-45 | Reports! Free Diagnostic ymerator: Number of Healthcare [Percentage|_ test in In- | test in PPP | Dashboards! 146 | Output sSeriees aeilty undertaking full menu of nouse | and 55 test| Assessment fessential diagnostic tests prescribed IDH- 45 test in|in In-house} report the FDSI guidelines PPP and 65 | DH- 45 test test in in | in PPP and Denominator: Total number of house {70 test in in Primary Healthcare Facilites ies available in the State (Upto DH level) Number of District Percentage (%) of District 147 | ouput | Hospitals |Atosptals having functional Blood|Percentae] 100% | 100% | Rektkosh, having Blood Bank Banks Voluntary blood donation against 4s } Oupuc |, Nols | the biood collection unitstargeted|Percentage 43000 | 43000 | Fakes» for replacement/ donation Blood | percentage of blood banks havin operatic 149] Oupue | component een ee ee en apmeater e|ercentae Ln. | Blood Cell ae 1ood componentseparator eof 7no. of new BCSU's Fai | Number of integrated centres for Noo aeeeen | hemoglobinopathies & trict against 150 | Oupput | state at high | Memopnina inthe district aB2005¢) Number | - » | Blood cet Ciera high prevalence of istrcts _lyemoglobinopathies & hemophili Page | 41 NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Trioura: [Percentage of population screened : 151 Sickle Cell_ "for sichle celldisease against Percentage] NA ee annual target al 1s Sickle Cell Percentage of people registered on|percentage| NA NA | Sickle Cell Disease Sickle portalwith ABHLA 1D Portal 7 Sickle Cell | Distribution of Sickle cell Status | Number | NA. NA | Sickle Cell Disease card Portal ‘Numerator: Total functional Number of ‘AAMS in the state/ UT 154) Ourpar | ALON | Denominator: Total primary fpercemage} 8% | 18% | name portal Avouya Mandie| Healteare facilis inState/UT as perthe latest RHS ‘AAMs Numerator: No, of AAMs providing | providing all 12 expandedrange of services. 155 | Output | &xpanded erect terre] teaeeett ttn ages | Dewominator: Total functional ones baci AAMS in the state/ UT Numerator: No. of AAMs reporting at least average footfall as per (norm of 60 footfalls per 1000 population): ~ Rural: SHC-AAM @ Footfall at 300/month; PHC-AAM @ ‘AAMs 1800/month (Receiving = Urban: U-AAM @ 56 paar for 1200/month; UPHC-AAM @ ‘Output | Preventive, 3000/month promotive, aan Soe om tive, = Tribal: SH AAM rehabiliwtive | 180/month: PHC-AAM @ [Percentage Fora! andpalliative 1200/month care) Denominator: ‘Number of operational AAMs in ruralareas (SHC- AAM+PHC- ‘AAM) % of AAM where at least 80% of] ‘AAM Portal expanded range of medicines as AS per UT per Essential lis (Medicines: essential Medicine at_ |SHC-AAM- 105; PHC-AAM-171) 90% 90% | Drug Listfor 157 J Output | AAM against number of funetionat _|"°en"*e4 / |AAM-SC- 23 AAMs. )/__| For AAM- ve Page | 42 NHM Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraPercentage of AAM out of total functional AMS inState/UT th availability of diagnostics a Diagnostic sat per Essential list ae 90 90 158 | Output | "AM (Diagnostics: SHC-AaMerd; PeTeentage BAM Pons] IPHC-AAM-63) against number o functional AMS, [Numerator: No of ABHA verified Iprimary health care team members 90% 90% | SASHAKT |ASHA, MPW, CHO, SN and MO) Jpercentags portal registered in SASHAKT portal Denominator: Total number of in : position primary healthareteam Adoption of Jmembers (ASHA. MPW, CHO. SN ne and MO) in State/UT Training of | AAMprimary 159 | Output | Peeltheste Numerator: Total number of AAM| on ed primary healthcareteam teams _ [Percentage SASHAKT. expanded 1 SHA, MPW, CHO, SN and MO) ais trained in allexpanded service pales packages Denominator: Total number of i position primary healthcareteam ‘members (ASHA, MPW, CHO, SN ‘and MO) inthe state a) % of Individuals screened for NCDat AAMs = Hypertension and Diabetes Numerator: Individuals sereened percentage National for NCD- Hypertension and NCD portal iabetes 160 | Output. |NCD sereening| Denominator: 30+ population of State/UT 1) % of Individuals sereened for NCD at AAMs = Oral cancer, Breast Cancer and oc oc. Cervical Cancer 161 | Output eee Percentage gc. ac. | _ National Numerator: Individuals sereened cc. co. | NCD portal for NCD- cancers Denominator: 30+ population of State/UT. v Page | 43 NHM Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraNumerator: Number of wellness Wellness | sessions conducting aminimum of 162 | Output | cecsions at} 10 wellness sessions per month Percentage AAM Portal ‘AAMs Denominator: Total functional ‘AAMs in the state) ‘Numerator: Number of AAMs Teles conducting a minimum of 25 i Jeconsultations per month eSanjeevani Output | consultations | © [Percentage] te started at | : Liles ‘AAMs | Denominator: Total functional ‘AMS in the state) ‘Numerator: Number of JAS constituted at AAMsconducted at JAS: ings i v 164 | Output nee least 10 meetings ina year [Percentage| 100% 100% | AM Portal Denominator: Total no of JAS constituted AAMS Numerator: Number of AAMs Functional | Scoring more than 70%in 65 | Output |AAMawarded| Kayakalp peerassessment Ip centage! 25% 90% | Kayakalp Kayakalp report ‘Awards | Denominator: Total number of functional AAMs ‘Numerator: Number of VHSNCs that conducted atleast lOmeetings Functioning of | in the year (against the norm of VHSNC (in| minimum one meeting every 100% | 100% | AAM Portal 166 | OMPUt | Rural areas) month) [Percentags Denominator: Total VHSNCs formed 2) Numerator: Number of AAMs ‘whose primaryhealtheare teams have received timely incentives AAM (Performance Linked Payment and Team Based rimar 100% | 100% 167 | Output | jattneare | Incentives) minimum 10 timesa | Output ‘AAM Portal team's year incentives Denominator: Total number of functional AAMs NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura Page | 44Co- location of| Number of Public Health 168 | Output | AYUSH — Facilities with Co-locatedAYUSH] Number State Report facilities OPD Services NHM HR in] % of HRH in Position out of total 169 | Output | place posts approved underNHM* Pe"sentage) 82% oe % of HH available as per IPHS| (HR in Place/IPHSrequirement x 100) for six Key staff eategories* 9 MPW (Malet Female) 88% 90% 0 Staff Nurses 70% 75% hvisac ured Lab technicians'* Division ** Reduction in gap% applicable lonly for those levels of Percentage} “facilities where lab services 65% 70% HRH | including HR for lab have been 170 | Output | availability as outsourced) per IPHS © Pharmacists 95% 95% 0 Medical Officet-MBBS 85% 90% © Clinical specialists 50% 60% ‘% of Equipment Covered under Comprehensive Maintenance Contract/ Annual Maintenance seen Contract/ BMMP_ ee Calculated as total number of ate 71 | oupur | Eavipment | equipment covered under Pereentaee} 100% 100% | Equipment utput | caMcyAMC | CMC/AMC divided by total Inventory Sottware (e- number of equipment available a the facility (Average of 1 upkaran) L Facilities in percentage) ¥ Va Page | 45 NHI Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura% upkeep time of equipment ‘BMMP uptime Dashboard Calculated as State Equipment Me Percentage] 100% Equipment 172 | Ouput | Uokeeptime | tevel of facility against the Inventory specified uptime in BMMP (DH-| Software (e- 9 uupkaran) % of Public Health Facility certified as per AERB compliance Calculated as average number of health facilities (having X-Ray AERB AERB | Felated equipment) registered on|Percentage, 100% 100% | Compliance 173 | Ouput | Compliance | eLORA portal for AERB. certification license divided by the total dashboard number of health facilities having) X-Ray related equipmen Ensuring timely reporting of data by the State Data IManager/M& E/HMIS personnel by 20th of following month. 174 | Output ernie Numerator: No. of health [Perventage! 297% | 397% eat facilities reported data by 20" of following month, Denominator: Total no. of health facilities. Infrastructure (Rural and Urban health care facilities- a. DH, b. SDH, ‘Number of new constructions © CHCs, | “completed and handed over d. UCHCs, | against the projects sanctioned. Number 1 1 175 | Output State Report e. UPHCs, f PHS SHC Others IPHS % Of health care facilities compliance | achieved [PHS compliance. 176 | Outcome Percentage] 30% 50% | State Report J toes NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura‘Average cals received per day (output measurement by eal efficiency) ansg | Numerator: Total als recsived per day per cal operator against help contazel : Health Help| ‘Denominator - Average 130 call /P**°e"™84 State Report Desk | receivedper Call operator per day with avg. call handling time of Sminutes. % Of calls resolved out oftotal calls received service wise a. Health information, GRS& é 178} ouput | a elp b Counselling, PPereentazs State Report taal SUMAN, ECD. % of Ambulances functional as National | per population norms (one BLS| Ere eee 179) Output | ambulance [per 1 lakh Population and One|Percentage| State Report Services | ALS for every S-lakhpopulation) 180 | Output |Average response time per vehicld Minutes | ~ = | State Report 1st | Oupur| Mu | AYE ROOF IIPS Per MMU per | umpers| = + | State Report stp Average no. of lab investigations 7 : 182 | Output Sareea Numbers State Report °% of District hospitals initiated bu any of the followingcourses: - nathenin a. DNB 183. | Process | Smensthening courses percentage! ~ [state Report} as knowledge HEA edad a sing course health care courses x 0 Page | 47 NHM Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraAnnexure 3: Conditionalities Framework 2024 - 2026 Full Immunization Coverage (%) to be treated as the screening eriter - Conditionalities to be assessed only for those EAG, NE and hilly states which achieve at least 85% full Immunization Coverage. For rest of the States/UTs, the ‘minimum full Immunization Coverage to be 90% AAMs State/UT Score Implementation of DYDMS or any other logistic management 2, IT softwarewith API_ linkages to DYDMS up to PHC level, Registration of pregnant women and children (0-1) on RCH or 3. equivalent portal Human Resources for Health 4A Availability. of regular service delivery HRH as pet IPHS norms Based on overall score of AAMs conditionality (out of 100 marks) a b. co d. Score more than 75: +25 Score more than 50 or lessthan or equal to 75: +15 Score more than 25 but less than of equal to 50: =15 Score less than or equal to 25: 25 DVDMS implementation up to AAM- a b. -SC In 100% AAM-SHC: +5 80% or above but less than 100%: +3 ©. 50% or above but less than 80%: 3 Inless than 50%: -5 % basi a b. © Registration against estimated beneficiaries (Pregnant woman & Child registration 0-1 yr) on Pro- rata is 100% Registration: +5 80% or above but less than 100%: +3 50% or above but less than80%: ‘No Penalty less than 50%: -5 Percent of service delivery LHRH in-place in the regular cadve against IPHS norms for the six key categories as on 31% March 2025 and 31% March 2026: MPW(Male + Female), Staff Nurses, Lab Technicians, Medical Officers NHI Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura AAM portal DVDMS Portal or Any other similar system with API linkages to DvDMS RCH Portal or similar state portal State notifications, advertisements and PIP, HRH jon of 425 0-25 4510-5 +5 t0-5 47.5 10-75 Page | 48B. In-place contractual HRH against the approved posts (MBBS)and Specialists a. Al least 80%: 7.5 b. At least 70%, but less than80% 45 & At least 60%, but less than 70%: Nil d. Less than 60%: -7.5 Percentage of in-place contractual service delivery HRH of MPW (Male andFemale), Staff Nurses, Lab technicians, Medical Officers (MBBS) and Specialstsas on 31" Mareh 2025 and 31" March 2026: a. More than 90%: +7.5 b. More than 70% but up to 90%: 45 More than 60% but up to 70%: 3 d. 60% and below: -7.5 [District wise RoP uploadedon HIM website District wise RoP uploaded on NHM website within 30 days ofissuing of RoP by MoliFW to Stateor by 31" May 2022 (whichever is later) a, 100% districts whose ROPS for FY 2022-24 are uploaded on state NHM website: +5 b. Fewer than 100% districts: whose ROPS for FY 2022-24 areuploaded ‘on state NHM website: -5 State notifications, advertisements and PIP, HRH Division of NHSRC 47.5 10-75 State NHM website and D.O. letter 4510-5 6 |Implementation of Ne nal Viral Hepati ‘Control Programme (NVHCP) !s. Percentage put ontreatment for hepatitis Bagainst the target ‘@, More than 90%: incentive 3 points (+3) b. More than 60% upto 90% incentive 1 points (+1) ¢ More than 30% upto 60%-penalty 1 points (-1) 30% or Less: penalty 3 points 3) NHI Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura Report from NVHCP Division, MoHEW 4310-3 Page | 49Report from ichieving 90% of TBNotification NHM Administrative Approval for FY 2024-25 b. 60% t 80% of districts ‘ond FY 2025-26 of Tripura I Percentage put on treatment for | & More than 90%: incentive 3 NVHCP patitis Cagainst the target points (+3) Division, 4310-3 b. More than 60% to MoHEW ‘90%rincentive 1 points (+1) . More than 10% to 60%: penalty points (-1) 10% or Less: penalty 3 points(-3) More than 90%: incentive 3 Ic. Percentage of pregnant women |” points (+2) Report from reened forhepatitis B (HBsAg) |b. More than 70% t0 90%: NVHCP 4210-2 wgainst the target(Institutional| incentive 1 points (+1) Division, [Deliveries ¢. More than 50% to 70%: penalty 1 Mone: points (1) 50% or Less: penalty 2 points(-2) [D. Percentage of newboms More than 90%: incentive 3 fadministered — HBIGamong points (+2) Inewbomsdelivered toHBsAg |b. More than 70% to 90%: Report from ppositive pregnantwomen at health | incentive | points (+1) NVHCP 4210.2 care facility More than 50% to 70%: Division, penalty | points (1) MoHEW d. 50% or Less: penalty 2 points ea) 7 implementation of National Mental Health Program (NMHDP) [tate has established State MentalFeali [Authority a. If Yes: +2 be not -2 Report from Mental Actions taken forfulfilment of {State has established Mental Health Healthdivision, rovisions under Mental IReview Boards: MoHEW 4510-5 sate Ac 2017 MHA | ryan b. If not: -2 [state has created State Mental Health ‘Authority Fund a. Ityes: +1 not IX National Tuhercufsis Flimination Programme (NTFP) ‘a. More than 80% of districts |s. Percentage of Districts achieving 90% of target: +5 NTEP Ni- kshay Portal) +5 0-5 Page | 50achieving 90% of target: +2.5, & AM Portal Less than 60% of districts achieving 90% of target: -2.5 d. Less than 40% of districts achieving 90% of TB Notification target: -5 a, More than 80% of districts achieving 90% of target: +5 Ib, Percentage of Districts b. 60% to 80% of districts NTEP Nikshay Jachieving more than 85% of achieving 90% of target: +2.5. Reports 4510-5 freatment success rate . Less than 60% of distiets achieving 90% of target: 2.5 d. Less than 40% of districts achieving 90% of target: -5 ‘a. More than 80% of AAMs providing drugs to TB patients: +5 b. 60% t0 80% of AMS providing Percentage of AAMs providing | drugs to TB patients: #23 AAM report 4510-5 rugs to TBpatients Less than 60% of AAMSsproviding drugs to TB patients: 25 d. Less than 40% of AAMsproviding drugs to TB patients: -5 implementation of National Quality Assurance Programme and LaQshya ‘@. More than 80% of the targets | achieved for the FY: Incentive 10 points (+10) b. Between 51-80% of the targets achieved for the FY: Incentive 5 points (+5) Quality and Patient ¢. Between 25-30% of the targets Safety Division, IA. NQAS certification achieved for the FY: Penalty 5 NHSRC +10 t0-10 Kavainst the target) points (-5) di. Less than 25% of the targets achieved for the FY: Penalty 10 points -10) * Target for percent of public healthfacilities certified under NOAS tas per level of the facilities) will betaken fromthe attached DO letter as Annexure 4 Page | 51 HIM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripuraa, More than 80% of the targets achieved for the FY: Incentive § points (+5) . Between 51-80% of the targets achieved for the FY: Incentive 3 ints (+3) Between 25-50% of the targets achieved for the FY: Penalty 3 points (-3) Less than 25% of the targets achieved for the FY: Penalty 5 points (-5) LaQshya certification (Labour Room and Maternity Operation Theatre) JPY 2024.25 @ more than 15%: incentive: 20 points b. More than 10% up to 15%: 12 points ©. More than 5% to 10%: Incentives points d. Upto 5%: 3 points . No increase: no penalty and no incenti ‘Any decline: penalty 20 points 2025-26 f. Fy IPHS for {Compliance to Infrastructure . more than 30%: incentive: 20 points b. More than 20% up to 30%: 12 points ©. More 10% 20%: than to Incentive 6 points d. Up to 10%: 3 points, €. No increase: no penalty and no incentive: 0 = penalty 20 points i : SHC, PHC, CHC, SDH and DH, cumulative compliance would be taken Increase in State heath budgetby 10% or more over previous year’s budget: incentive 1Opoints Less than 10% increase: For calculation of increase in budget, entire State budget for public health, medical education, and AYUSH would be considered Increase in State irealuhBudget NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura Quality & Patient +5 to-5 Safety Division, ‘NHSRC and, State Reports 4200-20 State reports, State HealthBudget 19 10 0 Page | 52{ational Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD) % of annual sereening for a> 70% +5 Hypertension of target population b>60%: +4 National NED 30+) ©.>50%: 43 Portal a. 240%: +2 (5 t0-5) 230%: +1 £ 30%: 0 a <20%:-3 h. <10%:-5 IB. % of annual screening for a>10%: +5 [Diabetes of target population (30+) b>60%: +4 ‘National NCD 50%: +3 Portal a 240%: 42 G5 t0-5) ©. 530%: +1 £ 20%: 0 g. <20%:-3 h. <10%: 5 [C. % of people on standard of eare 2.560%: 45 (500-5) [for hypertension against the b. >50%: +4 National NCD targeted population (target 40%: 43 Portal [population: proportionateestimated 4. >30%: 42 opulation for target 75 million by ©. <30%: 0 [2025) £<20%: +3 g.<10%:-5 ID. % of people on standard ofcare a. 260%: +5 : (4510-5) for diabetes againstthe targeted b.>50%: +4 ‘National NCD yopulation(target population: 1c. >40%: +3 Portal [proportionate estimatedpopulation 6.230%: +2 lor target 75 million by 2025) ©. <30%: 0 £<20%:-3 10% 5 "The Conditionatities apply to both urban as weil as rural areas/faciities. 1 Numbers given in the table are indicative of weights assigned. Actual budget given as incemtive penalty would depend ‘on the final calculations and available budget. The total incentives to be distributed among the eligible states would be 20% of the total NEM budget. y tionality FY 2024.25 28 1. Indicator for achieving State Level AAM operationalization Targets: ‘a. State level 100% of AAMs operationalization against latest RHS ~ 15 marks b. Creation of regular cadre of CHO - 10 marks 2. AAMSs functionality - 75 marks, consists of 9 indicators ~ Average scoring of all the funetional Page | 53 NHM Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraAAMSs will be taken to arrive at the same. ‘AAM-OL: Functional 1 | AAMs providing all expanded range of services % 10 AM Portal ‘KAN-O2; Functional AMS reporting at least average footfall as per (norm oF 60 foottalls per 1000 population} ~ Rural: SHC-AAM @ 2 300/month; PHC-AAM @ 1800/month - Urban: U 1200;month; — UPLIC= AAM @ 3000/month ~ Tribal: SHC-AAM 180/month; PHC-AAM @ 1200/month % 10 ‘AAM portal : AMS fulfilling expanded range of medicines and as per Essentiallist of both 3 | (Medicines: SHC-AAM- 105: PHIC-AAM: m& SHC. AAM- 14 PHC- AAM- 63) % 10 10 AAM Portal "‘AAM-04: AMS 4 | providinga minimum — of 10 Wellness sessions per month 10 AAM portal ‘AAM-05: Functional 5 | AAMSs scoring more than 70% in Kayakalp peer assessment % 10 lor Kayakal preport ‘AAM-06: Utilization of 6 | National NCD App for sereening and tracking of all NCD patients, % tational INCD Portal NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura Page | 54- Sanjeevani ‘AAM-07: % of operational lapplication AAM providing active Teleconsultation services ‘AAM-08; Functional 8 [AAMs with —JASh6 {io 10 10 constituted and conducted at least 10 meetings ina year. ‘AAM-9: AAMs whose primary healthcare teams have received ely 9. | incentives (Performance We 10 Is 10 Linked Payment and Team Based Incentives) at least 10 times a year * For Kayakalp and teleconsultation any AAMs (SHC or PHC) fulfilling the eriteria are scored ] ho |AAM portal |AAM portal Page | 55 HM Administrative Approval for FY 2024-25 and FY 2025-26 of TripuraAnnexure 4a: HRH approvals RI AEOR, veareen od ftare weary Harera Frater vera, ag Reef» 110011 GOVERNMENT OF INDIA ae (ert amt INISTRY OF HEALTH & FAMILY WELFARE. Mino) eit NIRMAN BHAVAN, NEW DELHI - 110011 ‘ional Secretary & Mission Toltax' 23063687. 23063603 mall: mano|alani@icin .0.No.10(36}/2017-NHM-I 17 May 2018, Liew olbiagee. 5 Subject: PIP and HR Approvala MoHFW with the aim of strengthening and simplifying the planning process, has brought in major changes in the PIP budget sheet in FY 2018- 19. Adopting health system approach, the PIP has been categorised into 18 hheads required for implementation of any programme, ‘As mentioned in PIP guidelines any programme/ initiative planned were to be broken and budgeted in 18 given heads, as applicable, However, appraisal of PIPs show that few states have clubbed many activities together thereby defeating the very purpose of budget revamp. As informed in the NPCC meetings, any human resource (Programme Management or Service Delivery) proposed in the clubbed activities, which has not been proposed under dedicated heads for HR will not be considered for appraisal, Bven if the lump sum amount is approved unknowingly by the programme \livisions, no HR would be considered as approved. Further, to initiate HR integration and ensure rationalization of salaries of staff with similar qualification, workload and skills, additional budget (3% of the total AR budget) was approved by NPC in FY 2017-18 as Per state's proposal. This budget was approved with the condition that ‘the exact amount of individual increase should be decided by state in its EC and HR rationalization exercise and its principles including increases to be approved by SHS GB. States were directed to ensure that increases are approved in such a way that it smoothens the process of HR integration. In cases where the salary difference among ‘similar category position with similar qualifications and experience is very high (say more than 15%), it was to be done in parts as it may take 2-3 years to rationalize it fully. The same principle applies to the approvals of FY 2018-19. Therefore, wo continue to approve additional 3% of the total HR budget in FY 2018-19 for HR integration, subject to the states asking for i ee ARR ART NHIM Administrctive Approval for FY 2024-25 and FY 2025-26 of Tripura Page | 56Salaries of all staff have been approved in the ROP (FY 2018-19) as proposed by the state assuming that any inerease/ decrease of salary has been approved by the EC and GB. In case, any of the proposed salary has not been approved by the State EC and GB, the individuals will not be eligible to receive higher salary as approved in the ROP FY 2018-19 aiid only 5% of annual increase is to be provided on base salary approved in FY 2017-18. Any adcitional amount already paid would have to come from state budget. States must undertake HR integration process using the additional budget approved last year and this year. The details are to be submitted to MoflFW slong with a signed letter from Mission Director and a copy of minutes of meeting held with EC and GB based on which decision has been taken. Any deviation from the above would be treated as contravention of Record of Proceedings of NPCC and would apart from inviting audit objection would be flagged to Chiet Secretary for disciplinary action Wd nag ae Pano} Jhatani } Principal Secretary (Health) / Secretary (Health]/Commissioner (Health) of all States / UTS: Copy tor Mission Director (NHM) of all States / UTS Principles for calculation of remuneration The amount available for remuneration of existing posts has been calculated considering the maximum eligible budget as per budget approved in FY 2023-24. In case the budget proposed for remuneration of existing staf is within the available limit, the same has been approved as lump sum for 12 months in principle. In case, any position has been dropped by the stat, the available limit excludes the budget approved for those positions in the previous FY. Budget proposed for any new position has been calculated separately over and above the available limit 4. Additional 5% of the total HR budget is approved as increment and 3% of the total HR budget is approved for HR. Rationalisation, correction of typographical errors and experience bonus (as per cligibility and principles of rationalization) with the condition that: 4.1. Only those who have completed minimum one year of engagement under NHM and whose contract (in ease of annual contract) gets renewed willbe eligible for annual increment, 4.2. The maximum increase in remuneration of any staff is to be within 0% to 15% (based on performance and rationalization). The total budget used in increment and for rationalization should not exceed 8% of total HR. budget. HR rationalization exercise and its principles including increments to be approved by SHS GB. 4.3. In cases where the salary difference is more than 15%. salary rationalization may be done in parts as it may take 23 years to ratiomalize it ully 4.4, In case performance appraisal of NHM staffs not carried out by the state, only 5% increase on the base salary is t Page | $7 NHI Administrative Approval for FY 2024-25 and FY 2025-26 of Tripuratobegiven. Page | $8 NHM Administrative Approvol for FY 2024-25 and FY 2025-26 of Tripura4,5. In case any amount out of the 3% rationalization amount is used for correcting typographical error in approvals (if any), details forthe same is to be shared with MoHFW/ NHSRC HRH division 4.6, If any state disburses flat 8% increment to all irrespective of performance and salary disparity, or gives salary increases beyond 15% without approval of MoHFW the amount of 3% will be dedueted from HR budget. Any decrease of salary resulting from this will have to be borne from the State budget EPF (Employer's contribution) has been approved @ 13.36% for staff drawing salary < Rs.15000 per month as on Ist April 2015 and any other staff hired at Rs.15,000 or less after Ist April 2015, The State Administrative Officer looking after Salary must ensure proper calculation and disbursal as mentioned. Please refer to JS (P)'s leter dated 8 March 2016 (D.0.No.G.27034-8/2015-NHM(F)) regarding EPF and AS&MD's letter dated 2 August 2019 (D.O.No, G- 27034/182/2018/NHM (F)) for ESI. 6. The budget approved as remuneration hiring of specialists may be utilised as per guidance provided via AS&MD's letter dated 30 June 2017 (D.O.No.Z.18015/6/2016-NHM-II (Pt. I). 7. State will implement Minimum Performance Benchmark for all NHM staff shared by MoHFW and will link it t0 renewal of contract 8, In any case (without written approval of MoHIFW), NHM funds cannot be used to support staff over and above the requirement as per IPHS. HM Annexure 4b: Summary of HRH Approvals under HRH under National Health Mission Service Delivery (SD) HRH 4779.39 5554.00, 589.48 599.37 Programme Management (PM) HRH 2268.30 | 2353.10 | 80.50 86.94 Budget for data entry operation (DEO) 190.29 198.11 = 7 Budget for engaging support services on outsource basis/ Support Staff at facility level (SS-F) See, fore 7 7 Budget for engaging support services on outsource basis/ Support Staff in Offices (SS-O) tees on - - ‘Annual increment and Rationalization budget for ‘SD and SS-F ongoing positions a5a77. Into 989 a2 PM, DEO and SS-O ongoing positions eet eras, 137 28h EPF* for SD and SS-F positions 73.58 73.58 457 457 EPF* for PM, DEO and 55-0 p 91.86 91.86 1.68 Les Sub Total 793.83 | 860479 | 68749 | 717.38 CHO 3280.01 | 3441.01 z 5 Annual Increment and Rationalisation budget for CHO ongoing positions ee eee [ Ee Sub Total =. (3381.72 3550.86 - - per letter dated 8 Mi jon @ 13.36% for salaries <= Rs 15000 pr *(Employer's cont 8/2015-NHM(F)) Page | 59 NHM Administrative Approval for FY 2024-25 and FY 2025-26 of Tripura