Institutional Framework.

o State level

■ At the State level, the Mission functions under the overall guidance of the State Health Mission (SHM) headed by the Hon:ble Chief Minister of Kerala. The State Health & Family Welfare Society (SH&FWS) would carry the functions under the Mission. The Governing Body of the SH&FWS is headed by the Hon:ble Minister for Health and the Executive Committee of SH&FWS by the Additional Chief Secretary / Principal Secretary / Secretary (Health & Family Welfare)

■ Every district will have a District Health & Family Welfare Society (DH&FWS). The Governing Body of the District Health Mission (DHM) is be headed by Chair Person, District Panchayat. The Executive Committee of the District Health Mission (DHM) is be headed by the District Collector.

■ The State Program Management Unit (SPMU) acts as the main secretariat of the SH& FWS. The constitution and functioning of the SPMU and Executive Committee of the SH&FWS shall be such that there is no hiatus between the Directorate of Health and Family Welfare services and the SPMU.

■ State Health System Resource Centers (SHSRC) serve as the apex body for technical support to the State. Technical support focuses on problem identification, analysis and problem solving in the process of implementation. It also includes capacity building for district/city planning, and organization of community processes and over all dimensions of institutional capacity, of which skills is only a part. SHSRC also undertakes implementation research and evaluation and knowledge networks and partnerships in the states. SHSRC also provide support for policy and strategy development, through collating evidence and knowledge from published work, from experiences in implementation and serve as institutional memory.

(iii) NHM has six financing components: (i) RCH Flexipool (including Routine Immunisation, Intensified Pulse Polio Immunisation, National Indine Deficiency Disorder Control Programme), (ii) Health System Strengthening under NHM (iii) NUHM Flexipool, (iv) Flexible pool for National Disease Control Program, (v) Flexible Pool for Non-Communicable diseases and (vi) Infrastructure Maintenance

Within the broad national parameters and priorities, states would have the flexibility to plan and implement state specific action plans. The state PIP would spell out the key strategies, activities undertaken, budgetary requirements and key health outputs and outcomes.

The State PIPs would be an aggregate of the district/city health action plans, and include activities to be carried out at the state level. This has several advantages: one, it will strengthen local planning at the district/city level, two, it would ensure approval of adequate resources for high priority district action plans, and three, enable communication of approvals to the districts at the same time as to the state.

The fund flow from the Central Government to the states/UTs would be as per the procedure prescribed by the Government of India.

The State PIP is approved by the Union Secretary of Health & Family Welfare as Chairman of the EPC, based on appraisal by the National Programme Coordination Committee (NPCC), which is chaired by the Mission Director and includes representatives of the state, technical and programme divisions of the MoHFW, national technical assistance agencies providing support to the respective states, other departments of the MoHFW and other Ministries as appropriate.

All existing vertical programmes, shall be horizontally integrated at state, district and block levels. This will mean incorporation into an integrated state, district programme implementation plan, sharing data and information across these structures. It shall also mean rationalization of use of infrastructure and human resources across these vertical disease programmes.