Monitoring and Evaluation

Strategy & Plan

Document

2010-2013

Norway India Partnership Initiative

Page 1
 Introduction

Launched in 2006, Norway India Partnership Initiative (NIPI) has a mandate to contribute to
Millennium Development Goal 4 (MDG4) of reducing Child Mortality by two thirds in 2015. Since
child health is intertwined with maternal health, NIPI focuses its efforts on improving newborn
and related maternal health. Consequently, NIPI aims to contribute to achievement of MDGs 4
and 5. The strategic emphasis of NIPI is to reduce neonatal mortality working along the
continuum of care framework, strengthening newborn and related maternal health both at the
level of the facility and community by catalyzing the National Rural Health Mission (NRHM). The
continuum of care framework is based on the premise that preventive and curative interventions
go hand in hand. Along the continuum of care framework, 3 key elements of NIPI’s strategy
include:

 Quality health services for mother and child, both facility and home based
 Enabling mechanisms
 Learning and sharing of experiences

Central to this are the cross cutting issues of gender and equity.

Agreements have been entered into by the Royal Norwegian Embassy (RNE) with WHO,
UNICEF and UNOPS for carrying out child and related maternal health interventions under NIPI.
Each of the implementing Partners has a Memorandum of Understanding (MoU) with Ministry of
Health & Family Welfare (MoHFW), Government of India at the National level as well as the
Departments of Health & Family Welfare, at the State level. MoU has been entered at the State
level with State Governments of Bihar, Orissa, Madhya Pradesh, Rajasthan and Uttar Pradesh.
These 5 Focus States have been selected based on the fact that they are the lowest performing
States of India on indicators related to child and maternal health.

Programmatic interventions under the NIPI Partnership have been ongoing since 2008. Though
information to track progress of the Partnership has been collected since 2009, no rigorous and
systematic Monitoring & Evaluation (M&E) system has been in place. This strategy and plan
document encapsulates the framework for Monitoring & Evaluation (M&E) of NIPI interventions
in a systematic manner.

NIPI Monitoring and Evaluation framework is designed to be at 3 levels. At the highest level,
focus shall be at the National Rural Health Mission (NRHM) level. Level 2 shall focus at the
Overall Partnership. At level 3, the interventions specific to each Partner are monitored.

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 Communicate to RNE,
PMG, JSC

NRHM Level
1

2
Overall Partnership Level

WHO
Level 1
UNICEF Specific Partner’s Interventions 3
UNOPS
LFA

In the subsequent sections, details pertaining to the NIPI Monitoring & Evaluation for each level
are presented. At the outset, it is stated that this is a dynamic document and is refined at regular
intervals, keeping the core fundamentals in place.

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Section 1

Results Based Monitoring

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The overall Monitoring & Evaluation framework for NIPI is based on the results chain model (cf.
Figure 1).

Figure 1 Results chain model

Definitions:

Inputs: Donor and partner contributions- Royal Norwegian Embassy (RNE), Government of
India, UNICEF, WHO, UNOPS LFA, Research Institutes.

Activities: Tasks undertaken to convert inputs to outputs.

Outputs: Products and services delivered as a result of inputs and activities.

Use of outputs (Intermediate outcomes): How the products and services delivered by the
programme are being utilized.

Outcome: Benefits accrued to the target beneficiaries as a result of use of outputs.

Impact: Indirect benefits which cannot be attributed solely to the programme. Other external
factors play a role.

Since there are a number of health programs ongoing in India, it may be difficult to establish a
direct causal relationship of NIPI at the outcome and impact levels. Furthermore, at the outcome
level, the fact that while for some indicators direct causal linkages can be established, for some
others it may not be possible, needs to be factored in the M&E framework. Therefore, at the
interventions’ level, more focus shall be on the outputs and utilization of outputs (intermediate
outcome) levels in the results chain model. Utilization of outputs is considered as intermediate

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outcomes. Henceforth, it will be referred to ‘intermediate outcomes’. And outcome level will be
delved into as well to the extent attribution of any change can be directly or indirectly made to
NIPI.

Figure 2 Modified results chain model for NIPI

Attribution Gap

NIPI Monitoring and Evaluation Framework

Seven steps to NIPI Monitoring and Evaluation include:

i. Identification of main goal of NIPI

ii. Identification of key indicators for measuring the contribution of NIPI interventions
towards attainment of its main goal
iii. Development of Data Management Information System (DMIS)
iv. Comparison of key indicators over time to measure change based on
a. Routine Statistics through Health Management Information System (HMIS),
Ministry of Health & Family Welfare, Government of India
b. Regular, routine monitoring data of Partners’ programmatic interventions
c. Independent surveys such as National Family Health Surveys (NFHS) &
District Level Household Surveys (DLHS)
d. Independent assessment surveys commissioned by NIPI Secretariat
e. Other independent evaluations undertaken during the time period 2010-2013
f. Qualitative studies, case studies to document what works and what does not,
photo narratives, stories from the field
v. Measurement of effectiveness of NIPI interventions vis-à-vis costs based on
a. Unit cost analysis undertaken by Advisor, M&E, NIPI Secretariat

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 b. Independent evaluations undertaken to measure cost effectiveness of NIPI
interventions by a hired expert in the field of health economics
vi. Analysis, Reporting and Communications
vii. Integration of Data Management Information System with Health Management
Information System

1. Identification of main goal of NIPI

Overall goal of NIPI is to improve delivery of child & maternal health services.

2. Identification of key indicators for measuring the contribution of NIPI

interventions towards attainment of its main goal

NIPI is an initiative designed to facilitate States to improve delivery of child and related maternal
health services with efficient techno-managerial structures. Sustainability based on the uptake
of the system is fundamental.

The Indian public health system does not cater uniformly to all segments of society. While some
segments of society have access to quality health services, the poorer and marginalized
segments of the population lack access to quality health services. As a result, infant and
neonatal morbidity and mortality is more among the poor, marginalized segments of society.
Focus of NIPI is on these poor and marginalized segments of society.

In tune with the overall goal of NIPI, the following indicators have been identified for measuring
the contribution of the programme towards the National Rural Health Mission.

At the macro level (outcome and intermediate outcome i.e. utilization of outputs level in the
results chain model), indicators that shall be monitored are reflected in the Table given below:

The indicators measured at the NRHM and overall Partnership levels are reflected in the Table
below:

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Level Type of Indicator Definition of Indicator Data Sources
Children (12-23 months)fully HMIS, Coverage
immunized Evaluation
Survey, National
Family Health
Survey, District
Level Household
Survey, NIPI
National Rural Health Baseline/Midline/
Outcome
Mission Endline
Infant Mortality Rate Sample
Registration
System, National
Family Health
Survey
Neonatal Mortality Rate National Family
Health Survey
Institutional Births (%) HMIS, Coverage
Average retention period Evaluation
(hours) in case of Survey, National
institutional delivery (hours) Family Health
Survey, District
Post natal care provided to Level Household
mothers and neonates- Survey, NIPI
Children had check up Baseline/Midline/
within 10 days after delivery Endline, UNOPS
(based on last live birth) (%) LFA HBPNC &
Intermediate outcome  Institutional SNCU Formats
(use of output) deliveries
 Home
New born babies –
breastfed within 1 hour of
birth (%)
Overall Partnership
Referral done for mothers
with illness and
complications during
pregnancy (%)

Output Labour rooms with a Facility Survey

newborn corner matching
existing standards (%)

Input State level Allocation of State Programme

NRHM funds for Neonatal Implementation
Child Maternal Health Plan (SPIP),
(NCMH) Government
Expenditure
Reports, RBI
Report

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Since gender is a cross cutting issue, efforts shall be made to present analysis using this lens.
Wherever appropriate and possible, data shall be disaggregated by gender and analysed from a
gender perspective.

It would be the role of Advisor M&E, NIPI Secretariat to analyse the progress of programs based
on the agreed output and intermediate outcome indicators for each Partner and report at the
outcome / intermediate outcome levels.

3. Development of Data Management Information System (DMIS)

4. Development of Data Management Information System (DMIS)

In order to manage all the data collected from all Partners in a systematic and ordered way, a
data management information system is being set up. This will enable all data to be collated on
a periodic basis and analysed. The analytic reports would be available on a monthly, quarterly,
semi-annual and annual basis.

4. Comparison of indicators to measure change over time

NIPI Secretariat will follow 2 processes for comparing indicators to measure change over time.

1. Regular, ongoing monitoring process of the indicators for Partners’ interventions which
shall be carried out by Advisor, M&E, NIPI Secretariat, based on program progress
reports received from various Partners. Qualitative studies, case studies, photo
narratives to capture stories from the fields shall also be part of this ongoing monitoring
process.

2. Independent surveys and evaluations: Baseline has been conducted for UNOPS LFA
focus Districts in the year 2008. In the year 2010-11, the baseline for Betul District (an
additional District added in 2010) is planned to be conducted. It is planned to conduct an
endline in 2013 (towards the end of the Programme). It is also proposed to conduct a
midline to assess the programmatic interventions at a mid point.

Given that NIPI’s aim is to strengthen the existing public health programs in India, a
majority of the indicators that shall be monitored and evaluated at the macro level viz.,
level 3 are common to the public health programs in India. These indicators shall be
measured using the information from District level household surveys (DLHS) which are
conducted every 5 years and independent assessment surveys commissioned by NIPI.
Additionally, information from Health Management Information Systems (HMIS)
Government of India as well as other any independent evaluations shall feed into the
overall monitoring and evaluation system of NIPI. Furthermore, Ministry of Health &
Family Welfare (MoHFW) is in the process of institutionalizing Annual Health Surveys
which shall also be used for triangulating information collated from DLHS and
assessment surveys.

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 DLHS 3 was completed in 2008. Results from DLHS 4 should be available before 2013.
Data shall be compared to analyse trends over a period of time from 2008 to 2013.

Some qualitative studies, case studies shall be undertaken to delve deeper into key
query areas emerging from quantitative surveys.

Working with National/ State Health Management Information System (HMIS)

Uptake of the interventions by the Government system is a measure of sustainability. For the
program to be sustainable, it is necessary to strengthen the monitoring and evaluation system of
NIPI which is integrated within the National/ State Health Management Information System
(HMIS). In the same spirit, NIPI Secretariat shall work closely with Departments of Health and
Family Welfare both at the National and State levels to monitor NIPI interventions. Facility and
community based monitoring mechanisms shall be strengthened to ensure quality data and
analysis leading to informed decision making.

NIPI Secretariat is providing technical support to Ministry of Health & Family Welfare,
Government of India’s Monitoring and Evaluation Division to strengthen State/ District/ Block
levels health information management system, hospital based management information system,
mother and child name based tracking system and data triangulation. This, in turn, will ensure
quality data and use of data for decision making at the State, District and Block levels.

5. Measurement of effectiveness of NIPI interventions vis-à-vis costs

Government of Norway has contributed 500 million NOK (approx. USD 80 million) to
Government of India to reduce child mortality and improve child health with a view of attaining
Millennium Development Goal 4 by 2015. In order to assess cost effectiveness of NIPI
interventions, analysis is to be undertaken at two levels.

i. Periodic monitoring to assess unit cost of activity under each intervention vis-a-vis
funds spent. Focal areas of this periodic monitoring shall include:

a. What are the funds being utilized for?

b. Rate of utilization as a function of activity under each intervention
c. What are the achievements?

This shall be carried out by Advisor, M&E, NIPI Secretariat along with the Operations
Associate, NIPI Secretariat.

ii. Cost benefit analysis: This shall be carried out by a hired expert in the field of health
economics at two points of the NIPI programme. The 1st shall be undertaken in 2011
to give a mid-point scenario while the 2nd one shall be scheduled for at the end of
NIPI i.e. 2013.

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 6. Analysis and interpretation at the macro level focusing on key indicators identified
for results based monitoring of NIPI

Analysis is proposed to be carried out at different levels. At each level, results shall be
summarized and presented in the Monitoring & Evaluation framework1.

Overall Monitoring & Evaluation Framework

Indicators Performance Targets/ Data Sources/ Assumptions/ Risks
Indicators Reporting
mechanisms

Outcome Improved child and maternal National Family Consideration shall need to be given to any
health services in NIPI focus Health Survey 4; attribution gap.
States- universal immunization HMIS; Independent
coverage, reduction in infant assessments
mortality

Attribution Gap

Utilization of Improved safe delivery
practices, immunization
Outputs
& Post Natal Care
Programmatic Based on outputs from each partner
formats; District Level
Household Surveys;
HMIS; Independent
Assessments;
Programmme reports

Outputs Given under each Given under each Given under each Partner
Partner Partner

Activities Inputs
Given under each component

Analysis at the levels of intermediate outcome and outcome levels is carried out by NIPI
Secretariat using all information from the Partners. The caveat here is that there is an attribution
gap with regards to analysis at the outcome level. Since NIPI works within the overall NRHM
framework, a direct attribution in regards to changes in the indicators is not possible.

1
Guidelines for Preparing a Design and Monitoring Framework, Asian Development Bank, July 2007.

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Progress tracking system2 (PTS) is used for monitoring progress of NIPI interventions. To set
the status, a baseline indicator is taken into consideration which is measured over time. The
progress tracking system (PTS) as depicted in the attached template is used for presentation
purposes. In case there is no change witnessed from baseline to the time when the indicator is
being measured again, then it shall be depicted by “yellow” colour. In case the indicator shows a
regression, then it shall be depicted by “red” colour and in case of progression, it shall be
depicted by “green” colour.

2
Adapted from GTZ Results Based Monitoring System, 2008-2009.

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Progress Tracking System (PTS) for monitoring progress of Overall NIPI Partnership
No. Indicator Present Status Reasons for discrepancy Rating

Outcome (It needs to be considered that at outcome level, it may be seen as NIPI contribution but cannot attribute the
change entirely to NIPI)
Overall: Improvement in delivery of child and maternal health services in the NIPI focus Districts under National
Rural Health Mission
A Quality health services for child &
maternal health

a.1 Institutional births (%)

a.2 Average retention period (hours) in
case of institutional delivery (hours)
a.3 Post natal care provided to mothers
and neonates- Children had check up
within 10 days after delivery (based on
last live birth) (%) (Institutional
deliveries)
a.4 Post natal care provided to mothers
and neonates- Children had check up
within 24 hours after delivery (based
on last live birth) (%) (Home
deliveries)
a.5 New born babies – breastfed within 1
hour of birth (%)
a.6 Referral done for mothers with illness
and complications during pregnancy
(%)
a.7 Labour rooms with a newborn corner
matching existing standards (%)

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B Enabling mechanisms
b.1 State level Allocation of NRHM funds
for Neonatal Child Maternal Health
(NCMH)
C Learning and sharing of experiences
c.1 Documentation of innovations under
NIPI program
c.2 Uptake of NIPI interventions by
Government system
c.3 Expansion of NIPI interventions in non
NIPI States

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 Overall M&E System

The overall NIPI M& E system as envisaged is depicted below:

Sharing with RNE, JSC, PMG

Level 3: NIPI Secretariat

 Half Yearly Reports pertaining to Monitoring Formats for each Intervention

 Financial Status Reports
 Semi Annual and Annual Reports

UNOPS- LFA UNICEF WHO Research Institutes

Level 2: Partners’ Interventions

UNOPS- LFA UNICEF

Level 1
Programme Management at State, District and
Block Levels

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Details for Levels 2 and 1 have been provided under Sections 2 and 3. Levels 1 and 2 shall be monitored by
the Partners themselves. Semi annual and annual reports using the agreed upon standardised program progress
formats shall be used by the Partners and shared with the NIPI Secretariat.

NIPI Secretariat, in turn, shall analyse and share with the Donor (Royal Norwegian Embassy), Joint Steering Committee (JSC) and Program
Management Group (PMG).

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 Section 2
Monitoring & Evaluation of Partners’
Interventions

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Partners: UNOPS LFA, UNICEF, WHO,
Research Institutes
Figure 1

UNOPS
LFA

UNICEF
NIPI WHO
Secretariat

Research
Institutes

NIPI Secretariat is responsible for monitoring interventions of each Partner under the overall
NIPI umbrella. In the subsequent sections, this strategy and plan document attempts to detail
out the Monitoring and Evaluation framework for each Partner. Reports from each Partner feeds
into the overall M&E system of the NIPI Secretariat.

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In order to keep the Royal Norwegian Embassy (RNE) abreast of the progress of NIPI, the
following reporting mechanisms are followed by the NIPI Secretariat. Reports from Partners to
Royal Norwegian Embassy (RNE) via NIPI Secretariat need to be submitted at 2 points of time
in a year viz., by end of February and end of July. Therefore, all reports from the Partners need
to reach NIPI Secretariat no later than 7th of February and 7th of July each year.

Table 2
Type of reporting
Annual progress reports (to be prepared by
NIPI Secretariat using semi-annual reports
from Partners)
Semi annual reports (to be reviewed by Joint
Steering Committee (JSC))
Annual work plans and budget
Aspects covered
Description of actual outputs vis-à-vis planned
outputs (as defined in annual work plans)
Summary of use of funds compared to budget
Assessment of efficiency of services and
resulting contribution to implementation of NIPI
(Efficiency will include resources- financial,
personnel as inputs which are converted to
outputs)
Explanation of any major deviations from
annual work plans
Planned activities approved by JSC
Description of activities
Outputs achieved
Utilization of outputs i.e. intermediate
outcomes
Planned outputs for next half year
Income and expenditure projections
Main activities planned for each calendar year

In the subsequent sections, details of Monitoring and Evaluation system of interventions under
each Partner have been stated.

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UNOPS- Local Fund Agent (LFA)
Government of Norway has made available to UNOPS a Grant for implementation of
interventions aimed at improving child and related maternal health services during the stated
period of the programme (2006-20133).

UNOPS Local Fund Agent (LFA) includes the State Nodes of the Enabling Mechanism. This
consists of one office in each Focus State with 3 personnel in each office. These UNOPS LFA
State offices are set up within the State Health Societies (SHS) with the exception of the State
of Madhya Pradesh where it is located within the Information, Education, Communication (IEC)
Bureau.

Within UNOPS LFA, the Monitoring and Evaluation (M&E) Associate at the National Level with
support from Programme Associates at the State Level shall be responsible for managing the
UNOPS LFA Monitoring and Evaluation system to track progress of UNOPS LFA interventions.
Indicators shall be primarily measured at the levels of process, output and intermediate
outcomes. These levels are selected as it can be stated with greater confidence whether
UNOPS LFA interventions have brought about a change.

As a process, UNOPS LFA shall share all required quantitative and qualitative information
collected for each intervention with NIPI Secretariat which in turn will use this information to feed
into macro level reports for the Donor, PMG, JSC and other organizations. Reports from the
NIPI Secretariat will feed back to UNOPS LFA marking progress over time (cf. Figure 2).

3 th
NIPI was initially from 2006-2012. No cost extension has been agreed upon till 2013 at the 9 JSC meeting.

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Figure 2
NIPI Secretariat shares reports
with RNE, PMG, JSC. Also will
share as and when external
evaluation happens.

M&E Advisor, NIPI Secretariat

analyses and prepares programme
progress reports.

M &E Associate, LFA Delhi

analyses and share reports with
M&E Advisor, NIPI Secretariat.

Sends to M& E Associate, LFA Delhi LFA Delhi and State Offices use
Office. information for decision making.

Programme Associate collects,

Modifies programme in tune with
validates and analyses data on a
recommendations from programme
regular basis using prescribed
progress reports at State, District
uniform formats.
and Block levels.

Step-by-step Monitoring & Evaluation framework for UNOPS LFA has been stated in the
following paragraphs.

Monitoring & Evaluation framework of UNOPS LFA interventions:

 Identification of key interventions of UNOPS LFA

 Identification of key indicators for each UNOPS LFA intervention
 Monitoring progress of each UNOPS LFA intervention
 Analysis, Interpretation & Communication

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Identification of key interventions of UNOPS LFA

Putting in the strategic framework of NIPI, the key interventions for UNOPS LFA include:
Key elements of strategy Key interventions
Quality of health services Home Based Post Natal Care
Sick Newborn Care Units
Routine Immunization
Enabling Mechanisms Techno- managerial support
Yashodas/ Mamtas
Learning and Sharing Documentation of NIPI interventions through
National Child Health Resource Centre
(NCHRC)
Documentation of NIPI interventions through
State Child Health Resource Centre (SCHRC)
Uptake of NIPI Interventions by Government
for scaling up
Request for technical support for NIPI
Interventions in other non NIPI States
Documentation of interventions within the
public domain

All the above mentioned interventions are monitored on a regular basis by the Monitoring &
Evaluation in charge at National and State levels. Results emerging from are owned by the
Programme Staff in charge of each UNOPS LFA intervention as well as the State staff.
Suggested formats for monitoring UNOPS LFA interventions are provided as annexure.

Identification of key indicators for and monitoring progress of each UNOPS LFA intervention

Home Based Post Natal Care (HBPNC)

It has been noted that neonatal and infant care at home is a weak link in the service chain.
Neonatal deaths are primarily attributable to infections, asphyxia, hypothermia, and prematurity.
About a third of all neonates have low birth weight (less than 2.5 kgs) which is of grave
significance given that high proportion of mortality occurs in low birth weight babies.

In order to address this gap, NRHM has a strategy developed for comprehensive care of
neonate and child health interventions. Following from this, in October 2008, State Coordination
Committees in all 4 NIPI LFA focus States decided to implement Home Based Post Natal Care
(HBPNC) with support from UNOPS LFA.

There are two modules – 2 days and 5 days respectively- developed to train Accredited Social
Health Activists (ASHAs) on Home Based Post Natal Care. The training modules have been
developed under the leadership of All India Institute of Medical Sciences (AIIMS) and with
technical inputs from National Neonatology Forum (NNF), Indian Academy of Paediatrics (IAP),
WHO, and UNOPS LFA.

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ASHAs learn about the requisite information required to be imparted during their home visits,
get trained on counseling mothers on basic newborn care including breastfeeding, kangaroo
care and refer mothers and neonates in case of danger signs. ASHAs are to make 6 home visits
in the post natal period i.e. just after the birth of the child. In some States, there is one visit
during the 8th month of pregnancy whereby the ASHA counsels the pregnant woman on birth
preparedness and the importance of delivering in the presence of a skilled birth attendant.

In order to keep track of all the required visits made by the ASHA to one household, a Post
Natal Card (PNC) has been developed by the NIPI focus States with support from UNOPS LFA
(attached as annexure). This PNC card on completion is verified by the ASHA’s supervisor viz.,
Auxiliary Nurse Midwife (ANM) which is further counter signed by the Medical Officer (MO).
Thereafter this card is submitted to the Block Office for ASHAs to receive an incentive payment
of Rs 200/- per mother-neonate cohort that she follows. Additionally, ASHAs can refer neonates
identified with danger signs. For this, they receive a small fund for referral transport.

Continuous supportive supervision and learning is a key for this intervention to be successful
and UNOPS LFA is working in this direction.

Key intermediate outcome indicators to be measured include:

o Percent mother neonate cohorts visited 3 times during 1st 10 days after child birth
o Number/ Percent of mothers identified with danger signs
o Number/ Percent of mothers with danger signs referred to health facility
o Number/ Percent of neonates identified with danger signs
o Number/ Percent of neonates with danger signs referred to health facility
o Percent of neonates breastfed within 1st hour of birth
o Percent of institutional deliveries

Monthly reports are prepared using the information collected by ASHAs in the PNC card
(attached as annexure) to have a better understanding of the intervention outputs. These
monthly reports are collated and analyzed by the UNOPS LFA M&E team on a regular basis.

Analysed reports focusing on the 7 key intermediate outcome indicators are shared with NIPI
Secretariat on a semi-annual basis.

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The process for data collation and analysis under HBPNC is as follows:

National Analysis undertaken by UNOPS LFA

and NIPI Secretariat

All data from all States sent to

State Central Server located at
NCHRC/NIHFW

Data entry at Block/ District

Block/ Levels using software. Data
District checked and validated at State
Level

Supervisor validates and submits

Health to Medical Officer. Medical
Facility Officer counter signs and submits
at Block level

ASHA fills in PNC card,

Community
completes, signs and submits to
supervisor at facility level

Sick Newborn Care Units (SNCUs)

Sick Newborn Care Units (SNCUs) are part of the continuum of care efforts under UNOPS LFA.
NIPI focus States have adopted an integrated approach for establishing and equipping Level II
SNCUs which are 12 bedded facilities with staffing structures varying slightly between States.
Medical Colleges in these States are involved in training and providing oversight to these
SNCUs. Technical support has been provided to these States for setting up Level II SNCUs by
UNOPS LFA in collaboration with the Institute for Post Graduate Education and Research
(IPGMER), Kolkata, West Bengal.

Sick neonates are referred to these SNCUs both by Yashodas based in health facilities and
ASHAs present at the community level.

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As part of the UNOPS LFA M&E framework, a standardized format is used for monitoring the
SNCU intervention. Details of output indicators as covered in the monitoring format, frequency
of data collection and person(s) responsible are provided in the annexure. This information is
collected on a regular basis by the M&E team of UNOPS LFA.

The process for data collection with regards to SNCUs is as follows:

National M&E Associate, UNOPS LFA analyses

and shares with Advisor, M&E NIPI
Secretariat

Programme Associate at State level

State collates, validates, analyses and
prepares monthly and cumulative
report

District Child Health Manager

District collates in the required format

Nursing staff at SNCU provides

Health information
Facility

Key intermediate outcome indicators for measuring change because of SNCUs are:

 Number of neonates admitted in SNCUs

 Number of neonates treated in SNCUs
 Mortality rate at SNCUs

These intermediate outcome indicators are disaggregated by gender and inborn/ outborn
admissions. Analysed data for these intermediate outcome indicators are shared by UNOPS
LFA Team with NIPI Secretariat on a semi-annual basis.

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Routine Immunization

Focus of the routine immunization interventions under NIPI is to strengthen the Universal
Immunization Program (UIP) through improvements in service delivery and demand generation.
This is aimed to be achieved by way of techno-managerial support at Block and District levels.

Monitoring of the UNOPS LFA interventions under routine immunization would require focusing
on several components, especially program management, supply chain management of
vaccines and logistics, service delivery including health system capacity & performance, social
mobilization and program supervision & monitoring. While each of these components would
need several indicators to measure the progress, a few selected indicators outlining key
processes and outputs, monitored at regular periodicity (monthly) at several management levels
could give an understanding of program performance and progress. This shall be undertaken by
the M&E UNOPS LFA team on a regular basis.

Key intermediate outcome indicators include:

 Percent of planned immunization sessions held in a month

 Percent immunization sessions monitored with all vaccines and syringes available
 Percent immunization sessions monitored with ASHAs/ mobilizers
 Percent sessions monitored with updated due lists
 DPT1 to DPT3 drop-out rates
 Percent full immunization coverage at 1 year

Analysed data focusing on intermediate outcome indicators are shared by UNOPS LFA M&E
team on a semi-annual basis with the NIPI Secretariat.

Techno managerial support:

One of the pillars of National Rural Health Mission (NRHM) is the establishment of decentralized
planning processes. Accordingly, a number of responsibilities have shifted to the District and to
some extent to the Block level. Programme management units (PMUs) have been set up at the
State, District and Block levels to support managerial facilitation of service delivery.

However, it has been noted that there have been difficulties in absorbing all potentially available
funds. In this context, UNOPS LFA is facilitating the State Health Societies to access NIPI funds
to strengthen their techno managerial structures and systems so they can more efficiently and
effectively deliver quality child health services under the NRHM programme. Following from
this, NIPI States have identified critical staff positions to support the existing health
management system reach its potential.

For each State (directly employed by NIPI), 3 staff personnel are in place.

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 Senior Programme Officer

Programme Officer Programme Associate

The following staff personnel are employed by the District but supported by NIPI funds:

District

District Child Health Manager, Deputy Child Health Supervisor

Managers, Maternal & Child Health
Managers

Deputy Child Health

Supervisor
At the Block level, NIPI funds are supporting:

Block

Block Child Health

Manager

Other positions identified by States for NIPI support include:

 State Finance Assistant (All 4 NIPI focus States with the exception of Rajasthan)
 State Data Assistant (Bihar and Orissa)
 State Data Analyst (Madhya Pradesh)
 State Child Health Consultant
 State HR Assistant (Orissa)
 State Media and Communication Consultant

District level:

 Training Officer
 District Training Coordinator
 District Public Health Nurse Manager (Focus Districts of Rajasthan)

Page 27
  Divisional Logistic Manager (Madhya Pradesh)

Techno managerial support includes remuneration, mobility support, budget for attending
meetings, office expenses etc. This support can be measured against process indicators (list
attached as annexure). The process indicators are collected by the UNOPS LFA team on a
regular basis.

UNOPS LFA shares the following process indicator with the NIPI Secretariat on a semi-
annual basis.

 Number of positions being supported by NIPI funds

Gender lens will be used at the level of analysis.

Yashoda/ Mamta

Yashoda is a Hindi word meaning ‘foster mother’, the idea being that the Yashoda serves as an
advocate and guide for the mother and her newborn child. In Bihar, the word Mamta is used
instead of Yashoda. To improve quality of care, Yashodas provide counseling and guidance on
child care to new mothers and family members during their stay at the birthing facility. Linked is
the availability of birthing kit consisting of a delivery and neonatal kit in the NIPI focus States.

Yashodas hand over birthing kits to mothers in the labour room. Rationale is to create a bond
between the Yashoda and the mother as well as establish the principles of hygiene and
cleanliness right at the outset. Each kit costs no more than Rs 100 (less than NOK 15/USD 2).

Similar to the Accredited Social Health Activists (ASHAs) at the community level, Yashodas are
volunteer support workers who are paid an incentive. Yashodas are provided training in
accordance to the curriculum which includes an orientation, induction and on the job recurrent
training. Training manuals for Yashodas have been developed in close cooperation with the
Nursing Council of India, Trained Nurses Association of India, National Neonatology Forum
(NNF) and the National Institute of Health & Family Welfare (NIHFW).

A monitoring format for the Yashoda interventions has been developed which is collected on a
monthly basis (attached as annexure) by the Programme Associates at the State level and M&E
Associate, UNOPS LFA, National level. Raw data base generated in MS excel or MS Access is
shared with Advisor, M&E at NIPI Secretariat for analysis and report generation.

Page 28
Process for monitoring of Yashoda intervention

RNE, PMG, JSC

NIPI Secretariat

Analysis reports
UNOPS LFA

Compiles into monitoring format,

State level- validates & analyses along with UNOPS
Programme Associate LFA M&E Associate

District / Block Child District & Block levels

Health Manager/
DPMU

Child Health Supervisor / Data collation at Facility

Deputy Child Health level
Supervisor

Key measurable intermediate outcome indicators for this intervention are:

o Percent mothers staying at least 24 hours at the health facility after child birth
o Percent mothers initiating breastfeeding within 1st hour of birth
o Percent neonates weighed at birth
o Percent neonates immunized for 0 dose Polio
o Percent neonates immunized for BCG

Analysis is undertaken using the gender lens. Analyzed reports focusing on intermediate
outcome indicators are shared with NIPI Secretariat on a semi-annual basis.

Page 29
 UNOPS LFA Programme Progress Reporting Format
UNOPS LFA team share the progress reports on a semi-annual basis with the NIPI Secretariat.
1. Quality of Health Services
Key Interventions
a. Home Based Post Natal
Care
Description of activities/
processes during current period
Indicators Quantitative Data Qualitative Reasons for
to monitor change information to discrepancy in case of
(please indicate substantiate no change or negative
data source) quantitative change in indicators
data (please from last period
use additional
sheets, if
required)
Percent of mother
neonate cohorts
visited 3 times during
first 10 days after birth
Number & Percent of
mothers identified
with danger signs
Number & Percent of
mothers referred to
health facility with
danger signs
Number & Percent of
neonates identified
with danger signs
(disaggregated by
gender)
Number & Percent of
neonates referred to
health facility with
danger signs
(disaggregated by
Page 30
 gender)
Percent of neonates
breastfed within 1st
hour of birth
(disaggregated by
gender)
Percent of Institutional
deliveries
b. Sick Newborn Care Units Number of neonates
admitted in SNCUs
(disaggregated by
gender & Inborn/
Outborn)
Number of neonates
treated in SNCUs
(disaggregated by
gender & Inborn/
Outborn)
Mortality rate at
SNCUs (disaggregated
by gender & Inborn/
Outborn)
c. Routine immunization Percent of planned
sessions held per
month
Percent sessions
monitored with all
vaccines and syringes
available
Percent sessions
monitored with
ASHAs/ mobilizers
Percent sessions
monitored with

Page 31
 updated due-list
prepared
DPT1 to DPT3 drop-
out rates
Percent full
immunization
coverage at 1 year
2. Enabling mechanisms
Key Interventions Description of activities/ Indicators Quantitative Data Qualitative Reasons for
processes during current period to monitor change information to discrepancy in case of
(please indicate substantiate no change or negative
data source) quantitative change in indicators
data (please from last period
use additional
sheets, if
required)
a. Yashodas Percent mothers
staying at least 24
hours at the health
facility after birth
Percent mothers
initiating
breastfeeding within
1st hour of birth
Percent neonates
weighed at birth
(disaggregated by
gender)
Percent neonates
immunized for 0 dose
Polio (disaggregated
by gender)
Percent neonates
immunized for BCG

Page 32
 (disaggregated by
gender)
b. Techno managerial Number of positions
support being supported by
NIPI funds
3. Learning and Sharing
Key Interventions Description of activities/ Indicators Quantitative Data Qualitative Reasons for
processes during current period to monitor change information to discrepancy in case of
(please indicate substantiate no change or negative
data source) quantitative change in indicators
data (please from last period
use additional
sheets, if
required)
a. Documentation of NIPI a. Documentation of
interventions NIPI interventions
through National
Child Health
Resource Centre
(NCHRC)
b. Documentation of
NIPI interventions
through State
Child Health
Resource Centre
(SCHRC)
c. Documentation of
interventions
within the public
domain as peer
reviewed journal
articles, policy
briefs etc.
b. Uptake of NIPI a. Uptake of NIPI

Page 33
Interventions by Interventions by
Government NIPI focus State
Governments
b. Request for
technical support
for NIPI
Interventions in
other non NIPI
States

Page 34
Financial Monitoring

Routine financial monitoring is undertaken to keep track of whether funds have been utilized as
planned, for what activities are these funds utilized and the rate of utilization. This is undertaken
by UNOPS LFA on a regular basis.

Semi-annual reports are submitted to NIPI secretariat on the following format. NIPI Secretariat
is responsible for analysis and reporting to RNE, PMG and JSC.

Page 35
 Expenses incurred during the period January to December (Year)
All amounts in
Project Name : UNOPS-LFA INR

Uncommitted balance brought forward as on 1 January (Year) A

Funds received during (Year) B
Budget approved by JSC C=A+B
Funds committed during ( Year) (as per below table) D
Uncommitted balance as on 31 December (Year) 0 E=C-D

Uncommitted Funds Budget Amount Funds Uncommitted

balance brought received as approved by committed Balance E=C-D
forward as on 1 during JSC for (Year) during (Year)
January (Year) (A) (Year) (B) (C=A+B) (D)
Sr. Budget Heads
STATE
1 HBPNC
2 SNCU
3 YASODHA
4 Techno Managerial
5 Routine Immunization
6 Others

Total

Page 36
Analysis, Interpretation and Communication

NIPI Secretariat is responsible for analysis and interpretation of data/ information generated
from UNOPS LFA interventions. NIPI Secretariat communicates with the Partner, RNE and
shares requisite reports with RNE, PMG and JSC.

Semi Annual and Annual Programmatic Directions NIPI Secretariat shares

Progress Reports with UNOPS LFA

Programme Progress NIPI Secretariat shares

Semi Annual and Annual Reports with RNE, PMG and JSC
Reports Work plans
Financial status reports

Page 37
UNICEF
Under NIPI, Government of Norway has channeled funds through UNICEF for implementation
of child health interventions aimed at achieving MDG 4. Norwegian Ministry of Foreign Affairs
(MFA) and UNICEF entered into a framework agreement on 12 December 2003. UNICEF has
received a Grant not exceeding 130 million NOK to be used for NIPI interventions during the
stated period of the programme (2006-20134).

Key interventions

Using the strategic framework of NIPI, the key Interventions identified include:

Key elements of strategy Key interventions

Quality of health services Acceleration of immunization coverage
through strengthened cold chain and vaccine
management systems
Facilitation of community based newborn and
child care interventions across NIPI focus
States through planning, capacity building,
supervision and monitoring
Improved facility based newborn and child
care across NIPI focus States
Enabling Mechanisms District and Block planning and management
support across NIPI focus States
Learning and Sharing Develop and promote innovations for child
health service delivery, prototyping new
models and research activities

Monitoring

Semi annual reports are shared by UNICEF with the NIPI Secretariat. The following format is
used for measuring progress of the programme. Information is analysed by NIPI Secretariat and
shared with RNE, PMG and JSC.

4 th
NIPI was initially from 2006-2012. No cost extension has been agreed upon till 2013 at the 9 JSC meeting.

Page 38
Reporting Period:

(mention months)

Name of the Reporting Partner: UNICEF

Partner State / District(s):

Name of Reporter:

SUMMARY FOR THE CURRENT PERIOD

Significant Activities in the current

period

Outputs for this Period

Page 39
1. Quality of Health Services
Key Interventions Description of activities/ Indicators Quantitative Data Qualitative Reasons for
processes during current to monitor information discrepancy in case
period change (please to of no change or
indicate data substantiate negative change in
source) quantitative indicators from the
data (please last reporting period
use
additional
sheets, if
required)
a. Acceleration of Percent Primary
immunization coverage Health Centres
through strengthened (PHCs) with
cold chain and vaccine functional cold chain
management systems equipment
b. Facilitation of Percent of newborns
community based visited 3 times within
newborn and child care 10 days after birth
implementation across (denominator-
all NIPI focus States Number of Districts
through planning, in Advanced stage of
capacity building, implementation of
supervision and IMNCI)
monitoring Percent of
Community Workers
trained vs planned
in providing newborn
and child care
(denominator- of the
total number of
District Hospitals in 5
NIPI focus States)
c. Improved facility based Percent District

Page 40
 newborn care in NIPI Hospitals with SCNU
focus States (Special Care
Newborn Units)
Percent First
Referral Units with
newborn stabilization
units
Percent 24x7 PHCs Annual
with functional Assessment
newborn corners
Number of neonates Facility surveys
admitted to SCNUs and Reviews
(disaggregated by
gender)
Number of neonates Facility surveys
discharged alive and Reviews
from SCNUs
Number of neonates Facility surveys
left against medical and Reviews
advice from SCNUs
Number of neonate Facility surveys
deaths at SCNUs and Reviews
2. Enabling mechanisms
Key Interventions Description of activities/ Indicators Quantitative Data Qualitative Reasons for
processes during current to monitor information discrepancy in case
period change (please to of no change or
indicate data substantiate negative change in
source) quantitative indicators from last
data (please period
use
additional
sheets, if
required)
a. District and Block Percent Districts with Annual by
planning, management quality PIPs reviewing sample
and support reflecting evidence plans from each

Page 41
 based Reproductive District
Child Health (RCH)
interventions
Number of techno
managerial staff
supported by
UNICEF under NIPI
(disaggregated by
National, State and
District levels)
3. Learning and Sharing
Key Interventions Description of activities/ Indicators Quantitative Data Qualitative Reasons for
processes during current to monitor information discrepancy in case
period change (please to of no change or
indicate data substantiate negative change in
source) quantitative indicators from last
data (please period
use
additional
sheets, if
required)
a. Develop and promote Number of new
innovations for child interventions piloted
health service delivery, and shared with
prototyping new models Government system
and research activities
Number of peer
reviewed journal
articles, research
studies, policy briefs,
manuals on NIPI
related child health
interventions

Page 42
4. Please provide a write up in the form of bullet points:
Good practices:

Challenges to implementation :

Stories from the field with focus on Gender Equity:

Experiences in collection of data:

Any other issues related to M&E:

Page 43
Financial Monitoring

Semi-annual financial reports are submitted by UNICEF to NIPI secretariat on the following format. NIPI Secretariat is responsible for
analysis and reporting to RNE, PMG and JSC.

Expenses incurred during the period January to December (Year)

All amounts in
Project Name : UNICEF USD

Uncommitted balance brought forward as on 1 January (Year) A

Funds received during (Year) B
Budget approved by JSC C=A+B
Funds committed during (Year) (as per below table) D
Uncommitted balance as on 31 December (Year) 0 E=C-D

Funds
Uncommitted Budget Amount Funds
received
balance brought as approved by committed Uncommitted
Budget Heads during
forward as on JSC for (Year) during (Year) Balance E=C-D
(Year)
1 January (Year) (A) (C=A+B) (D)
(B)

Page 44
Analysis, Interpretation & Communication

NIPI Secretariat is responsible for sharing progress reports with RNE and the Joint Steering
Committee.

Progress Reports
Semi Annual and Annual R Shared with RNE
Work plans Shared at PMG, JSC
Financial status reports

Page 45
WHO
A Framework Agreement has been entered into between Government of Norway and WHO on
13 June 2003. Following this, a Grant not exceeding 65 million NOK is made available to WHO
for NIPI programme during the stated period (2006-20135).

Key interventions
Using the strategic framework of NIPI, the key interventions include:

Key elements of strategy Key interventions

Enabling Mechanisms Expansion of Pre-Service Integrated
Management of Neonatal and Childhood
Illnesses (IMNCI)
Strengthening of Quality Assurance for
Anaesthesia, and Emergency Obstetric Care
(EmOC)
Strengthening of Skilled Birth Attendance
(SBA) training for ANMs and Midwives
Accreditation process for Maternal, Neonatal,
Child Health (MNCH) services
Learning and Sharing Management of child malnutrition

5 th
NIPI was initially from 2006-2012. No cost extension has been agreed upon till 2013 at the 9 JSC meeting.

Page 46
Monitoring

Semi annual reports are shared by WHO with the NIPI Secretariat. The following format is used
for measuring progress of the programme. Information is analysed by NIPI Secretariat and
shared with RNE, PMG and JSC.

Page 47
Reporting Period:

(mention months)

Name of the Reporting Partner: WHO

Partner State / District(s):

Name of Reporter:

SUMMARY FOR THE CURRENT PERIOD

Significant Activities in the current

period

Outputs for this Period

Page 48
 1. Enabling mechanisms
Key Interventions Description of activities/ Indicators Quantitative Data Qualitative Reasons for
processes during current to monitor information discrepancy in case
period change (please to of no change or
indicate data substantiate negative change in
source) quantitative indicators from last
data (please period
use
additional
sheets, if
required)
a. Expansion of pre- Percent Districts
service IMNCI rolled out IMNCI
programs

b. Strengthening of Quality Percent 24x7 PHCs

Assurance for and above health
Anaesthesia and EmOC facilities providing
EmOC services

Percent 24x7 PHCs

and above health
facilities providing
LSA
c. Strengthening SBA Percent PHCs
training for ANMs and providing SBA
Midwives services
d. Accreditation process Number of States
for MNCH services implementing
accreditation
guidelines

Number of private
health facilities
accredited in NIPI
States

Page 49
 2. Learning and Sharing
Key Interventions Description of activities/ Indicators Quantitative Data Qualitative Reasons for
processes during current to monitor information discrepancy in case
period change (please to of no change or
indicate data substantiate negative change in
source) quantitative indicators from last
data (please period
use
additional
sheets, if
required)
a. Develop and promote Number of new
innovations for child interventions piloted
health service delivery, and shared with
prototyping new models Government System
and research activities
Studies undertaken
on malnutrition for
formulating
guidelines

Page 50
Financial Monitoring

Semi-annual financial reports will be submitted by WHO to NIPI secretariat on the following format. NIPI Secretariat shall be
responsible for analysis and reporting to RNE, PMG and JSC.

Expenses incurred during the period January to December (Year)

All amounts in
Project Name : WHO-NIPI USD

Uncommitted balance brought forward as on 1 January (Year) A

Funds received during (Year) B
Budget approved by JSC C=A+B
Funds committed during (Year) (as per below table) D
Uncommitted balance as on 31 December (Year) 0 E=C-D

Uncommitted Funds Budget Amount Funds Uncommitted

balance brought received as approved by committed Balance E=C-D
forward as on 1 during JSC for (Year) during (Year)
January (Year) (Year) (B) (C=A+B) (D)
Sr. Budget Heads (A)

Strengthening Childhood Immunization and Disease

(A) Control Activities

(B) Child Health Interventions

(C) Maternal Health Interventions

Total

Page 51
Analysis, Interpretation & Communication

NIPI Secretariat is responsible for sharing progress reports with RNE, Programme Management
Group and the Joint Steering Committee.

Progress Reports
Semi Annual and Annual Shared with RNE
Work plans Shared at PMG, JSC
Financial status reports

Research Institutes
5% of the total NIPI funds have been allocated for operational research. An Operations
Research Committee (ORC) and Sub Committee have been formed. From 1st July 2010, NIPI
Secretariat has been given the responsibility of coordination and management of all meetings
related to Operational Research. NIPI Secretariat keeps RNE and the Joint Steering Committee
abreast of all partnerships with research institutes under Operational Research. The time period
of sharing updates shall vary in accordance to the length of the research study.

A monitoring format shall be used to keep track of progress of operations research studies. This
is represented below.

Research Partners Time Update (time period to be added in accordance of Status as Reasons for Remark
Topic period for length of the study) on (Date) any s
research discrepancy
study from what
has been
planned
Process Preliminary Start Completion
findings Date Date

Not yet started

Delayed
On Time

Page 52
Financial status reports shall also be shared with RNE, PMG and JSC.

Research Partners Time Financial status Reasons for any

Topic period for discrepancy
research
study
Budget Expenditure
allocation

Analysis, Interpretation & Communication

NIPI Secretariat is responsible for sharing progress reports with RNE, PMG and JSC.

Semi Annual and Annual Progress Reports

Shared with RNE
Work plans Shared at PMG, JSC
Financial status reports

Page 53
Section 3
Programe Management

Page 54
Programme Management

Programme management is critical to the success of any development cooperation programme.

In this current section, processes, activities and inputs covered under programme management
shall be dealt with.

N S D B
Utilization of
Outputs
INPUTS

Personnel

Processes Implementation of Outputs

Financial Activities
inouts=========

Time

N= National; S=State; D=District; B=Block

Programme management for UNOPS LFA and UNICEF are covered under this component.
Suggested formats for measuring resources used for programme implementation are depicted
below6.
Action Plan
Focal Area:
Results
Level
Outcome
Use of
Outputs
Output

No. Activities Person in Implementation period Resources Notes

charge
J F M A M J J A S O N D P F Others
S C

P=Personnel includes Staff (S) and Consultants ( C); F=Financial

This information is collected by respective partners and made available to NIPI Secretariat as
and when required. The NIPI Secretariat, in turn, would then share this information with RNE,
PMG and JSC as and when required.

6
Adapted from SIMIMex Handbook GTZ, 2009

Page 55
Section 4
Annexures

Page 56
Information reflected herein is collected and analyzed by the M&E team of UNOPS LFA on a
regular basis. As and when required, information is shared with NIPI Secretariat.

Annexure 1

UNOPS LFA: Techno Managerial Support

A.
Process Definition Data source Whether Persons Programme staff
indicators &frequency of at State/ responsible responsibility
measurement District/ for data
Block collection,
level validation &
analysis
Number of  Senior Programme LFA format; State State Director UNOPS
positions Officer Semi annual Programme in LFA; Programme
sanctioned as NIPI  State Programme charge, State Lead at UNOPS
supported State Officer Programme LFA Delhi;
staff (for each NIPI  Programme Associates, Senior
focus State) Associate M&E Associate Programme
UNOPS LFA Officers at State
level

Number of  Senior Programme LFA format; State State

positions filled vis- Officer Quarterly; Semi Programme in
à-vis sanctioned  State Programme annual charge, State
NIPI supported Officer Programme
State staff (for  Programme Associates,
each NIPI focus Associate M&E Associate
State) UNOPS LFA

Number of Child  Support District LFA format; District & State

Health Managers Programme Quarterly Block Programme in
supported by NIPI Management Units charge, State
funds (for each in formulation of Programme
NIPI focus State) District Programme Associates,
Implementation M&E Associate
Plans (PIPs) for UNOPS LFA
child and related
maternal health
under NRHM
 Support District
Programme
Management Units
in implementation
of child and related
maternal health
interventions
Number of  Assisting in LFA format; State State
positions program Quarterly Programme in
supported by management for charge, State
UNOPS LFA in child and related Programme
NRHM Program maternal health Associates,
Management Units interventions M&E Associate
UNOPS LFA

Page 57
Number of  Responsible for LFA format; State State
positions supporting training, Quarterly Programme in
supported by capacity building, charge, State
UNOPS LFA at research, Programme
SIHFW/ SCHRC/ documentation & Associates,
SHSRC dissemination M&E Associate
UNOPS LFA

Number of  Responsible for LFA format; Division State

positions logistics support for Quarterly Programme in
supported by child health charge, State
UNOPS LFA at interventions Programme
Divisional levels Associates,
M&E Associate
UNOPS LFA

Number of Child  Responsible for LFA format; District State

Health Supervisors training, Quarterly level Programme in
at facility level (for monitoring, facility charge, State
each NIPI focus mentoring of Programme
State) supported Yashodas/ Mamtas Associates,
by UNOPS LFA M&E Associate
UNOPS LFA

Number of Deputy  Responsible for LFA format; District / State

Child Health training, Quarterly Block Programme in
Supervisors at monitoring, level charge, State
facility level (for mentoring of facility Programme
each NIPI focus Yashodas/ Mamtas Associates
State) supported M&E Associate
by NIPI UNOPS LFA

Number of active  Yashodas/ Mamtas LFA format; District / State

(trained and in counsel pregnant Quarterly Block Programme in
place at health women who come level charge, State
facility) Yashodas/ to facility for facility Programme
Mamtas delivery Associates,
 Refer mothers and M&E Associate
neonates in case UNOPS LFA
of danger signs
Remuneration of Financial State & State
staff supported expenditure District Programme in
through LFA funds format- UNOPS charge, State
and engaged in LFA; Quarterly Programme
State and District Associates,
Health Societies M&E Associate
UNOPS LFA

Expenditure on Financial State & State

mobility support, expenditure District Programme in
organizing format- LFA; charge, State
meetings, office Quarterly Programme
expenses etc Associates,
M&E Associate
UNOPS LFA

Page 58
 Annexure 2

UNOPS LFA: Yashodas

A.
Measurable indicators Frequency of data Responsibility
collection
Number of active Yashodas
Number / %age of births
including still births by gender
Number / %age of stillborns
by gender
Number / %age of neonates
identified with illnesses by
gender
Number / %age of neonates
dead after birth by gender
Number / %age of neonates
discharged within 6 hours by
gender
Number / %age of neonates
discharged between 6-12
hours by gender
Number of neonates
discharged between 12-24
hours by gender State Programme in charge,
Number / %age of neonates State Programme Associates,
discharged between 24-48 Monthly, Quarterly and Annual M&E Associate UNOPS LFA
hours by gender
Number / %age of neonates
discharged after 48 hours by
gender
Average retention time of
neonates by gender
Number / %age of neonates
given 0 dose Polio by gender
Number / %age of neonates
given BCG by gender
Number / %age of neonates
breastfed within 1 hour by
gender
Number / %age of neonates
weighed by gender
Number / %age of neonates
with weight more than 2.5 kgs
by gender
Number / %age of neonates
with weight between 2-2.5

Page 59
kgs by gender
Number / %age of neonates
with weight less than 2 kgs by
gender
Number of kits distributed to
mothers

Page 60
 Annexure 3

UNOPS LFA: Sick New Born Care Units

A.

Measurable indicators Frequency of data Responsibility

collection
Admissions (Inborn/ Outborn)
by gender (%age)
Birth weight (Inborn/Outborn)-
more than or equal to 2.5 kgs/
less than 2.5 kgs by gender
(%age)
Gestation (Inborn/Outborn)-
more than 37 weeks; less
than or equal to 37 weeks by
gender (%age)
Causes for admission by State Programme in charge,
gender (%age) State Programme Associates,
Monthly, Quarterly and Annual M&E Associate UNOPS LFA
Deaths (Inborn/ Outborn) by
gender (%age)
Primary cause of Death by
gender
Information on deliveries in
the hospital- normal, assisted,
C section by gender
Live births by gender (%age)
Still births by gender (%age)
Neonatal deaths by gender
(%age)
Maternal deaths (%age)

Page 61
B.

Form D 1 (District)

CLINICAL MONTHLY REPORTING FORM

SICK NEWBORN CARE UNIT (SNCU)

Name of Health Facility:

District: State:

Month: Year:

CURRENT MONTH
Male Female Total
A. ADMISSIONS
In-born
Out-born
Total Admissions

1. Birth Weight In-born

> 2500 gm
1800 – 2499 gm
1200 – 1799 gm
< 1200 gm
Total

2. Birth Weight Out-born

>2500 gm
1800 – 2499 gm
1200 – 1799 gm
< 1200 gm

3. Gestation In-born
>37 weeks
34 – 37 weeks
30 – 34 weeks
< 30 weeks

4. Gestation Out-born
>37 weeks
34 – 37 weeks
30 – 34 weeks
< 30 weeks

5. Causes for Admission (Multiple)

Sepsis or Pneumonia
Asphyxia
Hypothermia
Convulsions/seizures/fits

Page 62
Prematurity
Low Birth Weight
<1499 gms
1500 – 2499 gms
Tetanus Neonatorum
Congenital Anomalies
Hyperbilirubinemia
Any other cause
B. Deaths
Total Deaths in In-born
Early (0 - 6 days) deaths in In-born
Total Deaths in Out-born
Early (0 - 6 days) in Out-born
Deaths in birth weight < 1500 gm

6. Primary Cause of Death

Sepsis or Pneumonia
Asphyxia
Hypothermia
Prematurity
Low Birth Weight
Tetanus Neonatorum
Congenital Anomalies
Any other cause
C. General Information (Hospital)

No. of vaginal deliveries

No. of Cesarean Sections
Total Deliveries
No. of live births
No. of still births
No. of neonatal deaths (Labor Room, Maternity
Ward)
No. of maternal deaths

Page 63
 Annexure 4

UNOPS LFA: Home Based Post Natal Care

A. Home Based Post Natal Care Ver 2.0

Postnatal Care Card

(This part is to filled and retained by the ASHA as reference copy)

Village Sub-Center Block

Mother's Father's ASHA's

name name Name

Date of Place of Health Facility / Sex of Male /

delivery delivery Home baby Female

Birth
Mode of Normal/ Breastfeedin < 1 hr, 1 - 24 hr, > weight
delivery Assisted/ CS g started 24hr gms

Birth
Registration
Still Birth Yes / No No. Unique ID

Birth Preparedness Visit Birth Institutional Breast Breast

Date: Discussed: Plan Delivery Referrals Feeding Examination

Postnatal Care Card

(To be filled by the ASHA during home visits and handed over to ANM after completion of home visits)

Village Sub-Center Block

Mother's Father's ASHA's

name name Name

Date of Place of Health Facility / Sex of Male /

delivery delivery Home baby Female

Birth
Mode of Normal/ Breastfeedin < 1 hr, 1- 24 hr, > weight
delivery Assisted/ CS g started 24hr gms

Birth
Registration
Still Birth Yes / No No. Unique ID

Birth Preparedness Visit Birth Institutional Breast Breast

Date: Discussed: Plan Delivery Referrals feeding Examination

2nd
No. of Home Visit 1st Visit visit 3rd visit 4th visit 5th visit 6th Visit
(Day (Day 14- (Day 23-
Day of Birth (Day 1) 2-3) (Day 5-7) 17) 28) (Day 42-45)
Date of Home Visit
Baby (fill details if baby alive)
Is baby alive? (Yes/No), If
not, Date of Death

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Is the baby exclusively
breastfed? Y/N
Was anything else given in
last 24 hrs? Y/N
Is there any breast/ nipple
problem? Y/N
Is the baby sucking
effectively? Y/N
Has the baby passed urine?
(Y/N)
Has the baby passed stool?
(Y/N)
Is the baby covered well
and warm? Y/N
Look for Danger signs?
Mention Y/N
Convulsions/Fits
Fast Breathing (>60 per
minute)
Chest Indrawing
Not able to feed or stopped
feeding well
Temperature more than 37.5 Or
less than 35.4
Poor Activity/Lethargy
Birth Weight less than 2000 gm
10 or more Skin Pustules Or
One large boil
Yellow soles or palms
Is the baby having any local
illnesses? Y/N
Less than 10 skin pustules
Pus from or Redness around
Umblicus
Pus discharge from Eyes
Was the baby bathed?
(Y/N)
Has the baby received
BCG? Y/N
Has the baby received
OPV? Y/N
Weight of baby (gms)
Temperature of baby
Respiratory Rate
Is there any other problem?
Mother (fill details if mother
alive)
Is the mother alive? If not,
Date of Death
Look for any danger signs?
Mention Y/N
Heavy Bleeding
Fever
Convulsions/Fits
Severe Pain Abdomen
Is there any foul smelling
discharge? Y/N

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Is there any other problem?
(Passage of urine, stool
etc.)
Referral
Does the baby need
referral? (Y/N)
Does the mother need
referral? (Y/N)
Counseling & Assistance
Baby care
Mother care including
adequate food & rest
Exclusive breastfeeding
Family planning
Hygiene
Death registration (if
applicable)
Any Remarks

Signature of ASHA
Signature of
Mother/Family member

Supervisor's signature
Referral Information (where
applicable)
Who was Did they go? If Yes, Transport Result of Did ASHA
referred? Referred where? where did they go? arranged Referral accompany

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