PIP 2019 - 20 as the base for PIP Preparation of FY 20 20 -21 .

( An
auto Populated sheets containing all the approvals of the FY 2019 – 20)
along with newer additionalities – SUMAN, NRCP, NVHCP, SAPCCHI.
State requirements as per the Healthcare factoring the progress of FY
2019 -20 – Conditionalities Framework , Milestones and Targets.
New Areas / Activities ( Key Priorities ) to be added as per the STATE
PRIORITIES.
Innovations which can be imbibed in the State based on Good and
Replicable Practices.
States need to follow the ‘Health Systems Approach’ in order to
simplify the process of planning and budgeting
 Operationalization of Health and Wellness Centres (HWCs) for
provision of Comprehensive Primary Healthcare at SC, PHC and UPHCs
NCD Screening for 30+ population along with protocols for treatment and
follow up and roll out of NCD application
All well performing District hospitals and Trust hospitals to be notified as
Programme Study Centres for CHO training .
Ensuring Free Drugs and Free Diagnostics Services Initiative with
Grievance Redressal
Ensuring NQAS and LaQshya certification of high delivery load facilities
Operationalization of FRUs as per norms of response time
Roll out of Home Based Young Child Care (HBYC)
1. TB Case Notification from both public and private sectors
ut of National Viral Hepatitis Control Programme (NVHCP)
National Leprosy Eradication Programme (NLEP) in affected districts
Operationalization of DEICs
Early Childhood Development Interventions
Robust Health Helpline- doctor on call, grievance redressal, scheme
dissemination
Team Based Performance Incentives to ensure continuum of care
Inclusion of Good practices & Innovations
Roll out of Rotavirus vaccine
Roll out of Minimum performance benchmarks
Roll out of Telemedicine
Roll out of Midwifery initiative
1. ut

PIP SUMMARY :
 Summarize the State Issues pertaining to Healthcare
Deliverance , Strategies adopted, Measures taken and
Expected Outcome in the Key Performance Indicators of
the State. ( Quarterly Progress Report to be shared to
GOI).
 Focussed approach and enhanced Healthcare Deliverance
 Reduced Out of Pocket Expenditure
 Utilization of various sources of funds – State and Other
apart from NHM to maximize benefits to the Public .
PIP ANNEXURES : - Is inclusive of
1. Budget annexure with Budget Abstracts
2. Information annexure
3. Budget sheet with proper justifications for any new
activities proposed
4. Vision Document for operational zing AB-HWCs, both for
rural as well as urban areas.
 BUDGET ANNEXURES : Inclusive of 18 main budget heads
prepared on need based Plan.
 Is inclusive of old FMR codes, budget pool and programme
division for ease of reference compared w.rt ROP 2019 -20.
 New activities/ any other activities need to be clearly stated
and mapped as per pool pr PD in the PIP budget annexure.
NOTE : NO ADDITION / DELETION IN FMR CODES / ROWS
 • Each Budget Annexure is linked to the Budget summary sheet as well as the
corresponding budget abstracts.
• So carefully fill in the particulars in the budget Annexures which will automatically
get reflected in the corresponding Abstracts as well as the Summary sheet (linked).
BUDGET ABSTRACTS :
 Budget annexure will be linked to the Budget abstracts and
can be reviewed before final submission by the concerned
Programme Divisions.
 Planning should be done in budget annexures and not in
the State Abstract .
VISION DOCUMENT for operationalizing Ab-HWCs shall be

shared subsequently.
 All the items are to be budgeted in their designated budget
heads. Activities / items budgeted under unrelated heads will
not be appraised and approved by GOI.
The upper ceiling of Program management (including M&E)
budget is subject to approval of Mission Steering Group and is
currently pegged at 9% for the State.
Detailed PM HR Annexure will be provided along with the
ROP for ease of reference.
State should strive to integrate all the meetings, workshops,
supportive supervision visits, office expenses paraphernalia
etc. and ensure smooth roll out of the Programmes.
MoHFW would be approving the program management cost as a lump
sum, it is expected that the State would have a supportive supervision plan
(with provision of mobility) which will take care of the requirements of all
the programs.
No capex allowed for supporting National Ambulance Service as per MSG
decision of 2019.
No new positions of DEOs and Grade IV staff are to be proposed. These
services are to be outsourced to the extent possible.
Any new HR will be strictly appraised against the IPHS and work-load. No
service delivery HR should be proposed under any other head than FMR 8.
Any programmatic / service delivery staff is posted in urban facilities, the
same should be reflected under appropriate HR head in NUHM budget
sheet.
 Planning is an iterative process with fewer iterations and in the PIP
for the FY 2020-21, there is a cap on the number of iterations.
The first draft of FY 2020-21 will be submitted on which all the
divisions will give their comments. The consolidated comments will
be sent to the State, based on which the State will revise its PIP. The
second draft will be considered in the NPCC meeting.
• Ensure that all required information is filled (especially physical
and financial progress till November 2019). The data reported
should be accurate and financial and physical progress must
match with the FMR.
Ensure internal consistency within the NHM PIP such that
outcomes, outputs, activities, work-plan and costs (including
those given in annexure) are all systematically linked with
each other. Many a times data quoted at various places in PIP
differ widely and there is no explanation provided in the
remarks .
Total budget proposed by the State/UT should not exceed the
resource envelope by more than 50%. As there is the
limitation of the resource envelope, State must prioritize
before proposing activities.
OWNERSHIP : One person must take the ownership of the entire PIP for
each State/UT, especially for the health system components. Even if the
component is a collation from various divisions, one person must go
through it in its entirety and be able to provide replies to MoHFW queries
(if any).
The same principle is to be extended in implementation. For instance, the
Community intervention activities / Quality Assurance activities are to be
implemented in both rural and urban health facilities. Though the budget for
the same is being approved under two separate FMR (Quality Assurance
under FMR 13/ FMR U.13), one person should be made responsible for its
implementation across all the health facilities in the State/ District in
coordination with NUHM.
One State/UT must certify that there is no duplication of activities (both
within the PIP and between other sources of funding).
It is not possible to include all the State/UT specific interventions planned in
previous years under ‘Other Activities’. States/UTs are requested to add these
activities wherever applicable under ‘Other Activities’ given under each
major head and provide details in the Remarks column or in a write-up.
In case more than one activity is to be added under the same FMR, state may
provide the lump sum amount in the budget sheet and provide the breakup in
a separate excel/ word document.
NHM gives flexibility at the planning stage. Please refer to the section at the
end of this note to understand the concept of flexibility in NHM (Appendix-A
Planning is a complex iterative process. Suggested steps have been outlined
in the appendix-B
 Flexibility in NHM - Appendix-A
• NHM offers flexibility at the planning stage which however to be leveraged properly,
needs to be understood well. Firstly, it is the State government which decides the
interventions and key areas on which it wants to focus. Secondly, while 60% of the
NHM budget pool wise is determined by MoHFW, State decides where it wants to
apportion its 40%1. State is not mandated to apportion its 40% share as per
apportionment done for central share, but may decide to apportion it differently
based on State’s needs and priorities. Further 40% share against IM apportioned for
any of the pools. The approvals are generally given up to 25% above the resource
envelope. While this does not lead to increase in resource envelope of the State,
this is to help the States to fully utilize their resource envelope and enhances
flexibility. Hence, while the floor is set by the GoI share, within the approval limits,
State is free to propose activities on areas which it considers more important.
• State during the planning must determine where it wants to spend more and
propose accordingly. The table below would help in this exercise and should be
made part of the first chapter of PIP.

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National Health Mission Karnataka
Suggested Steps in Planning - Appendix-B
• Assess physical and financial progress made so far against last year’s PIP.
Identify the challenges and reasons for sub optimal performance (if
any).
• Study new evidence generated including State sheet of Burden of
disease, cost effective interventions, and survey reports, HMIS etc. to
list the major challenges and prioritize the ones that need to be
addressed in 2020-21.
• Draft guidance to district/block/facility teams for planning of DHAPs and
City PIPs. Communicate budget envelope to districts.
• Conduct planning workshops with district and regions/divisions to
discuss and finalize situation analysis and agree on strategies.
• Collate DHAPs including information annexures. DHAPs to have text as
well as budget annexures.
• State Program divisions to review the collated DHAPs and propose
revisions (if any) as well as add activities for State level.
• Drafting of final State PIP giving
a. Situation analysis using evidence from surveys, studies and
HMIS/MCTS data, collated from District level and State level analysis
to be added. 19
National Health Mission Karnataka
THANK YOU

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