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Application Form
(All supporting Documents/Certificates are required to be attached with Application Form)
Sr. Description To be Filled by the Candidate No. Application for the Post 1. General Information 1.1 Name of the Candidate (In Capital Letters) 1.2 Fathers Name 1.3 Date of Birth (Date/Month/Year) 1.4 Marital Status (Single/Married/Other) 1.5 Permanent Address 1.6 Postal Address (With PIN Code) 1.7 Category (Gen/SC/OBC/etc.) 1.8 Mobile/Contact No. 1.9 E-mail Address 1.1 Present Place of Living 0 (with Complete Address) 2. Academic /Professional Qualifications (Starting from Highest Degree) (Attach Additional Sheet, if Required) Degree/ Name of University/ Passing Status of Marks Name of Subject Studied Class Institute/ Board Year Total Obtained %

National/State/District Level Training(s) and Workshop(s) Attended (Attach Additional Sheet, if Required) Topic/Theme of the Training/Workshop Name of Date of Year Level (National/ Institution/ State/ District) Organization

3.

Capacity of Participation

4. Designation (From Latest Job)

Work Experience (Starting from the latest) (Attach Additional Sheet, if Required) Period of Job Name of Organization/ From To Deptt./Institution

Brief Profile of the Responsibilities Held

*Working as Assistant under Community Process Unit since joining and looking after the works of ASHA, SKS, AMG, UF, VHSC, Hemophilia, NGO etc under NRHM. 5. Any Other Information, the Candidate would like to give in support of her/his candidature (Attach Additional Sheet, if Required)

Declaration: All Information given in the Application Form are correct and true to the best of my knowledge. My candidature may be rejected, if found any information incorrect/false/misleading. Date: (Signature of the Candidate)

Term of Reference for Different Positions

1. 06 ASHA Master Trainer & Monitor
Training & Monitoring Support) (Responsible for 4-5 Districts

Eligibility and Essential Qualifications

BAMS/AYUSH Degree or Post Graduate Degree in Sociology or Social Work or Rural Development or Public Health. Post-qualification work experience of at least 3 years in training/management/ coordination of community processes programmes or community mobilization in health or rural development or public health sector. Desirable:Familiarity with/having worked in community health worker programmes, or on empowerment of health volunteers or NGO health projects at the State level. Experience of having worked as State Level Trainer in Community Processes or Rural Development and as organizer of training programmes at State level is essential. Computer proficiency with familiarity of data management and commonly used packages like MS Word, Excel, power point etc. Higher academic qualification will be given preference. Roles & Responsibilities: Develop support system for a region wise district ASHA program and other community processes budget and work plan. Ensure Coordination and Monitoring of ASHA Trainings in field Ensure smooth working relationship with DPMU and CMO to district level to strengthen implementation of Community processes. Facilitate documentation of best practices, case studies relating to community processes besides developing IEC/BCC materials. Analysis and provide feedback on training conducted on the community processes by District and NGOs. Undertake periodic visits to district and selected NGOs to do the supportive supervision of activity implementation. Provide support to NRHM for effective functioning of community processes through advocacy & networking. Building intervention for review and supportive supervision of community processes. Undertake any such assignments, which may be assigned by the State ASHA Programme Manager, ASHA Resource Center. Reporting: Would be located at SPMU and travelled to the allocated districts. Will report to the State ASHA Programme Manager SARC Age limit: Below 55 years of age Remuneration: Consolidated consultancy honorarium of Rs. 30,000/- per month. This is a contractual post: initial appointment upto limited period, extendable after assessment of performance. 4

2.

02 Consultants (01 for Village Health Sanitation and Nutrition Committee &
other Community Processes Activities and 01 for NGO Management)

Eligibility and essential qualifications Postgraduate qualification in any discipline of Social Sciences / Social Work / Rural Development / Public Administration / Public Health / Community Medicine / Preventive & Social Medicine Minimum 3 years of progressively responsible relevant post qualification work experience in the area of community participation / community health or local self governance or strengthening community institutions, is essential. Those with a mix of work experience in grass-root level programme as well as experience at district or state level programme management in large development programmes will be given preference. Competencies in participatory training and capacity building support as well as grass-root level participatory practices are essential. Policy advocacy and networking of civil society in large development programmes are desirable. An understanding and experience of working on issues of building local level community action on health and social determinants of health as well as village health planning and capacity of undertaking participatory processes at the community level and building them in to large scale programme interventions is highly desirable. An understanding of issues of reaching the unreached communities and capacity to plan and implement such interventions is desirable. Exposure to working of civil society groups in the area of healthcare/public health/rural development and decentralized governance is desirable. Computer proficiency with high level of familiarity with data base management programmes and commonly used packages like MS Word, Excel, and Power Point etc. Excellent communication and presentation skills, analytical and interpersonal abilities, excellent oral and written communication skills in English and Hindi. Roles and Responsibilities Assist the state in developing strategies and operational approaches for strengthening VHSNCs and mechanisms of community action on health and social determinants of health and Village Health Planning as well as Community Based Monitoring and Rogi kalian Samitis Design and implement strategies to ensure establishment of institutional structures for the VHSNC and other community processes interventions Ensure release of relevant guidelines as well as development of capacity building, supportive supervision and monitoring and database management systems. Design and implement capacity building and hand-holding support for health personnel regarding the VHSNC and other community processes interventions. Assist in periodic monitoring and assessment of VHSNC and other community processes interventions under NRHM. Design and implement the strategies and operational approaches for convergence of programme interventions of cross cutting government departments (PRI, Water and Sanitation and Dept. of Woman and Child Development) and other programmes to ensure improvement in service delivery goals and community health outcomes. 5

Design and implement processes for collaborations and engagement / recruitment and development of TORs for NGOs and other civil society groups and resource agencies / elected representatives, for VHSNC and other community processes interventions. Undertake such other assignments as may be required from time to time.

Reporting: Will work under the overall guidance of Nodal Officer Community Processes and under direct supervision of Team Leader of ASHA Resource Centre who will be responsible for regular coordination, guidance, monitoring and evaluating the performance. Age limit: Below 55 years of age Remuneration: Consolidated consultancy honorarium of Rs. 25,000 per month. This is a contractual post: initial appointment upto limited period, extendable after assessment of performance.

3.

01 Manager Community Processes

Eligibility and essential qualifications MA in Sociology, Social Work, Anthropology, Rural Development. Minimum 3 years of progressively responsible relevant post qualification work experience in the area of community participation / community health or local self governance or strengthening community institutions, is essential. Exposure to working of civil society groups in the area of healthcare/public health/rural development and decentralized governance is desirable. Computer proficiency with high level of familiarity with data base management programmes and commonly used packages like MS Word, Excel, and Power Point etc. Excellent communication and presentation skills, analytical and interpersonal abilities, excellent oral and written communication skills in English and Hindi.

Roles and Responsibilities: Proper implementation and supportive supervision of the community processes programmes under NRHM, i.e. ASHAs, VHSC/VLCs, VHNDs and SKSs etc in the state of Haryana. Provide technical and managerial assistance for the implementation of the community processes under NRHM at block and village level. Assist the community Processes unit at SPMU in all the matters relating to overall management of the community processes programmes. Provide mentorship to ASHAs and members of VHSC/VLCs and SKSs at block and village level. Analyze Physical and financial progress reports related to community Processes and ASHAs and to suggest corrective measures to SPMU/DPMU for improving the output. Submit district/regional reports and organize district/regional meetings for reviewing the community Processes Programme under NRHM in respective districts.

Ensure participation of intra/inter-sectoral government authorities, development partners under community processes to develop operational plan/strategies, supportive supervision and monitoring of the implementation process and progress. Provide innovative ideas for preparation of Annual Village Health Action Plans under NRHM. Documentation of the best practices, success stories and innovative practices under community processes programme under NRHM. Undertake extensive field visits across the state as per the scheduled programme finalized by the SPMU on a regular basis. Undertake any other duties assigned by the MD NRHM (Haryana) and Officer-in-charge community Processes Units at SPMU, NRHM State HQ (Haryana)

Reporting: Will work under the overall guidance of Nodal Officer Community Processes and under direct supervision of Team Leader of ASHA Resource Centre who will be responsible for regular coordination, guidance, monitoring and evaluating the performance. Age Limit: Below 55 years of age Remuneration: Consolidated consultancy honorarium of Rs. 20,000/- per month. This is a contractual post: initial appointment upto limited period, extendable after assessment of performance.