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Modified SET scheme


Pattern Of Assistance

For Voluntary Leprosy SET Scheme





In India, voluntary organizations have played a vital role all through the history of leprosy control in the country. Presently about 290 Voluntary Organizations are actively engaged in various types of Leprosy Relief Services. Most of the voluntary organizations are Multi –Functional. Their activities include case detection, case treatment, public awareness creation, training, physiotherapy, reconstructive surgery, research and rehabilitation services. A close partnership exists between these agencies and the National Programme. 127 Voluntary Organizations are involved in Survey, Education and Treatment activities out of which about 50 voluntary organizations are presently covered by SET grant from Govt. of India (GOI).

The Govt. of India have been encouraging the participation of the Voluntary Organizations engaged in medical relief work for supplementing the Govt. efforts to make available preventive, promotive and curative services especially to the weaker sections of the society and in the under served areas. The scheme for the financial assistance to voluntary organization for undertaking leprosy survey, education and treatment work has been in operation for quite sometime. The pattern of assistance under this scheme was first liberalized in 1979.

On the basis of the recommendations of the Working Group on Leprosy which had been set up by the Govt. of India to evolve a strategy for the eradication of the leprosy from the country by the turn of the century, the Govt. of India had constituted a National Leprosy Eradication Board on 19-04-1983 under the Chairmanship of the Union Health Secretary. The question of further liberalization of the pattern of assistance to voluntary institutions for leprosy SET Work was considered by the Board in its first meeting. The Board approved further liberalization of the pattern of financial assistance available to the voluntary organizations for leprosy SET Work. The Grant-in-Aid to the voluntary organization provide support towards : a) Remuneration of staff ; b) Cost of Drugs & contingent expenditure; and c) Non-recurring items. Assistance for some additional staff like Health Educator, Nursing Staff, for the maintenance of beds and an Organizer –cum-Administrator for ensuring better implementation of the programme was also introduced. The scheme was reviewed last in 1993 vide Order No. 11012/1/93-CCD, dated 12th November 1993 in respect to the quantum of Grant-in-Aid and Revised SET scheme was implemented w.e.f. 1-1-1994. The existing pattern of assistance was further reviewed at length with representatives of all the NGOs covered by SET scheme during the conference of NGOs involved in NLEP at RLTRI Raipur in July 1999. In view of decline in prevalence of leprosy and need for integration of leprosy services with General Health Care, suggestions were given to make certain modifications in the pattern of scheme for the future. The proposals were examined and suggestions were considered. The recommendation of the National Workshop for re-defining the role of NGOs in the context of Leprosy Elimination and Integration with GHC System has also been considered and incorporated. Under the modified scheme the NGOs will serve in remote, inaccessible, uncovered, urban slums, industria l / labour population and other marginalized population groups as special projects. The SET Scheme will be admissible based on Number of leprosy deformity cases (both active & inactive) in rural areas as given in the Chapter III of this booklet. The details of the schemes and other conditions which the voluntary organizations are required to fulfill for becoming eligible for the receipt of grant under the scheme are have been given in chapters II to VI. The Proforma for the application for grant-in-aid has been given at Annexure –I. State Leprosy Societies/Health Societies are requested to furnish their recommendations in the Proforma at Annexure – III. While forwarding the applications of the voluntary organizations for grant-in-aid under the scheme to the Govt. of India, SLOs/ DLOs should ensure that all the necessary documents have been enclosed. The State Governments are requested to give wide publicity to this scheme so that a large number of voluntary organizations can avail benefits of the scheme. All the NGOs working for Leprosy Elimination Project will follow these guidelines which would be uniformly applicable to all such agencies receiving funds from Govt., ILEP or any other sources, including self supporting NGOs.





1.The Scheme encourages voluntary organizations to work for elimination of leprosy by Survey Education and Treatment of leprosy cases in an area under their control for implementation of NLEP activities. The various activities that can be undertaken by the NGOs are Planning, Surveillance & Information System, IEC, Capacity Building, Prevention of Impairments and Deformities, Rehabilitation, Referral, Advocacy, Case Detection and MDT Delivery and District Technical Support Teams. Unlike previous SET scheme w.r.t defined population/ health unit for NGO's operation, it is recommended in this modified pattern of SET scheme that a suitable NGO/ VO should first identify the area of activity (as mentioned above) and then identify the geographical areas where the activity is to be/ can be carried out depending upon its capabilities. Then NGO can submit detailed proposal indicating activity, various aspects of implementation along with financial requirements. The implementation of SET scheme in a defined geographical area with limited population coverage on vertical pattern need not to be continued. All the above mentioned activities are important and NGOs may take up for carrying out one or more depending upon the expertise and infrastructure available with them. However, following activities were identified as priority activities : a) Promotion of early case detection and prompt MDT; b) Capacity Building; c) IEC & Advocacy and; d) POID.

2. The scheme prescribes different criteria in rural and urban areas for allotment of working units that will be covered by the Voluntary Organizations for undertaking leprosy work. The criteria for allotment of working unit in rural areas will comprise of not less than 20-75, 76-150, 151-300, 301-500 and > 501 deformity patients both active and inactive irrespective of area, depending on the capacity of the NGO. The criteria for allotment of corresponding working unit in urban area will be 0.60 to 1.4, 1.4-2.0, 2.0-3.0, 3.0-6.0 and 6.0 to 10.0 lakh marginalized and uncovered population of poor socio economic status.

3.The organization should be registered under the Societies Registration Act, 1860, or should be corporative society and/ or an institution of standing. NGOs should have required capability in terms of infrastructure & expertise depending upon the area of the activity opted for receiving the funding, which will be assessed by the concerned DLS & the funding agency.

4.Each voluntary organization participating in the programme should approach the State Govt./ State/ Distt. Leprosy Society to include the District Magistrate/ The Chief Medical Officer of the District, or their authorized representatives, as Members in their Governing Bodies or Executive Committee, for overseeing the activities and expenditure of the organization as a measure for safe-guarding the interest of the enhanced public funds given as grants to the organization.

5.The State Leprosy Society in consultation with concerned NGOs and DLOs should do the re-allotment of working areas where the se rvices of these NGOs units are required; both in rural and urban areas. The re-allotment of the areas should be made based on the criteria of

(a) Urban and per-urban slum areas that are not covered by the regular health system.

(b) Remote hilly and/ tribal areas, areas separated by geographical barriers and

(c) Leprosy is a problem in those area as evidenced by continued high and static prevalence. Mere non-availability of health services in an area should not be considered for additional NGO support.

6.The organization should appoint a qualified doctor trained in leprosy, to confirm cases and to render treatment to cases recorded and should also appoint adequate number of trained non-medical technical personnel in accordance with the pattern of the scheme. There should be no untrained or inexperienced medical officer / non – medical technical personnel in any organizations. The NGO should engage at least one Medical officer and one Paramedical worker to qualify for GIA under the scheme. Statement showing the following details in respect of the Medical Officer and the Para-Medical Workers for the current year and invariably with each application:- Name-Designation-Date of joining-Scale of pay, Pay and Salary Allowance drawn-whether training was received, Period of training whether worked with Leprosy for Institution more than 5 years. These particular units may be supported by an attested true copy of the certificate.  

7.The NGOs institutions should have experience of working satisfactorily for three years in the field. Those NGOs that are proposing to seek GIA should have functioned at least for 3 months in the field after the allotment of area for leprosy work by SLO and they should have minimum 20 active patients on record in Urban areas or 20 deformity cases in Rural areas. The NGOs will be supervised, monitored and assessed at certain intervals viz.

a) Quarterly monitoring through the performance reports by the NGOs on identifying their activity;

b) Every six month/ half yearly assessment by the team of concerned DLO and representative from the    funding agency and any other expert required in the case of specialized activity of NGOs;

c) Annual evaluation by States / UTs should be undertaken to assess the functioning and performance of the NGOs, the report of whic h should be shared with Central Leprosy Unit / GOI as well as concerned funding agency and the NGO, for taking measures as per observations and recommendation of the evaluation ;

d) At the National level Leprosy Division / GOI may undertake an in depth evaluation on the funding and performance of NGOs in different parts of the country may be on sample basis from time to time. NGOs/ VO should be accountable to the concerned district CMOH (DLO/ DHO) w.r.t. technical performance. NGOs should also get the super vision/ inspection report from the visiting officers from State/ Central or any other agencies providing funds. 

8.The proposal by the NGO seeking Grant-in-Aid (GIA) from GOI should be submitted through the concerned SLS who will examine and forward the same. The SLS in turn will forward the proposal with its clear recommendation to GOI. The duly completed proposal for GIA for the next financial year should reach to Under Secretary to Government of India, CCD Section, Ministry of Health & Family Welfare,  Nirman Bhawan, New Delhi – 110011  in the 4th quarter of the preceding financial year.

9.The processing of the application of the new NGOs should be completed by 31st of the March of every year and if the proposal is agreed to by the GOI, the funds may be released to the NGO directly in two installments. The 1st installment of 50% of the funds will be released in the 1st quarter of the financial year and 2nd installment of funds will be released in the 3rd quarter of the same financial year on furnishing of the audited statement of accounts and Utilization Certificates for the previous financial year, if applicable.

10.              The staff to be recruited for the office and field work should be on temporary honorarium basis through open advertisement, and selected by a committee of the organization including the medical officer or the senior most Medical Officer / Epidemiologist / Director of the project, as the case may be. Recruitment should be on secular basis with the reservations for Scheduled Castes and Scheduled Tribes as per rules of local State Govt., provided candidates for reserved seats fulfill the minimum qualifications for those posts. Candidates from backward communities and minorities should also be represented on the staff along with candidates of other communities or castes. Children of the leprosy patients and ex-leprosy patients should be given priority over others if they fulfill minimum qualifications and are physically competent to carry on the work. Staff shall be recruited temporarily, reappointed on yearly basis if performance is good. They should be given benefit of contributory provident fund & gratuity as admissible to staff in non-government establishments, from the resources of the organization. The Medical Officer of the Project Areas after selection should be sent for training to Central Leprosy Teaching and Research Institution, Chengalpattu/Tamil Nadu, RLTRI Raipur, Gouripur Aska or to any other recognized institution. The Non- Medical Supervisor, Para Medical Worker and other staff should also be similarly trained through training institutions recognized for conducting courses in leprosy earmarked for the different categories. The recognized training course for leprosy Para Medical Worker is of 4 month's duration conducted by recognized Leprosy Training Centers. They should also be given pre-service training. Stipends should also be given to these trainees from leprosy training centre funds wherever available. Provision should be made to ensure that as and when doctors and other workers are called up for periodical orientation / refresher training, the voluntary organization will make them available for such training.

11.              Organizations should regularly submit periodical progress reports of the work done to the State Leprosy Society, & DDG (L), Directorate General of Health Services, Nirman Bhawan, New Delhi, in the prescribed form within the prescribed period. Organizations should bear all other additional costs towards administrative or managerial services, hospital accommodation, laboratory fac ilities & salary of additional staff like shoe maker, physiotechnician. The NGO could also do such work through the available staff by giving suitable orientation etc. for proper organization and execution of leprosy control work. NGOs should not charge the patients for diagnosis, treatment, hospital admission or management of POD Services. The project is liable to be visited by the officers of the State/ Government of India, and all the records and registers maintained, the staff in position, material & equipment provided and the work done are liable to be inspected. If the work of the voluntary organizations is considered sub-standard and / or if they do not comply with the standards laid down by the Govt. of India, the assets acquired out of Govt. of India grants Viz. Vehicles, cycles, other equipments and buildings constructed out of the Govt. grants are returnable to the Govt. of India or transferred to a new organization and further Grant-in-aid to the NGO is liable to be stopped. An undertaking is to be given by V.O.s before the grant is received by them that they will abide by the terms and conditions of the grant as modified from time to time and an undertaking to participate in the leprosy control programme for a period of at least three years from the sanction of the first grant.

12.              Voluntary organization may undertake SET work in more than one center. However the maximum number of centers for which central assistance will be admissible to one voluntary organization will be restricted to two centers in a district, 5 centers in a State and 10 centers in the country. The compliance of this condition will not be insisted upon in case of the existing Voluntary Organizations engaged in leprosy SET work already receiving grants from this Ministry prior to the commencement of the instructions issued on 22.7.1979 provided their performance is otherwise satisfactory.

 All NGO desirous of undertaking SET work should have a rolling fund of Rs. 2 lakhs. If an NGO is desirous of undertaking more than one rural or urban unit it will have to possess at its credit a rolling fund of Rs.2.00 lakhs for each additional center that it undertakes to cover.

13.              The voluntary organization will also have to detect new cases and render complete treatment, ulcer care dressing and physiotherapy to the needy patients. The trained Para Medical Workers under the supervision of the Non-Medical Supervisor / Medical Officer – Incharge of the project should make village to village or ward to ward or house to house rapid survey at the risk population for detection of all cases of leprosy and should render outdoor and indoor treatment by distributing anti-leprosy drugs as per NLEP guidelines. Acute and complicated patients are to be treated by the organization particularly for correction of deformities, management of reactions, eye complications, neuritis, trophic ulcers, etc. The additional cost over and above Rs.440/- per bed per month that is provided in the scheme will be borne by the organization.

Each Para- Medical Worker will cover a population of about 75 thousand to 125 thousand in the allotted urban unit in addition to attending POD Work in a year. In the rural unit each PMW will cover minimum 20 cases for POD patients (active & inactive) beside the SET work in a year. The Voluntary Organizations should maintain records in the forms prescribed for the National Leprosy Eradication Programme according to operational guidelines. The revised recording and reporting forms can be obtained from the respective State Leprosy Society/ Directorate General of Health Services, Leprosy Division, Nirman Bhawan, New Delhi.

14.              A NGO once approved for providing Grant-in-aid for undertaking SET work by the MOH&FW/ GOI, shall be eligible for consideration to receive grant-in-aid for three years for undertaking SET work. Subsequent grant-in-aid to such NGO will be considered on receipt of the recommendation of the SLS.

15.              The ILEP run NGOs, if willing to seek assistance from GOI under SET Scheme; they will follow the same guidelines and will be governed by the same rules and regulation as that for the any other Voluntary Organization. Such NGOs will identify the relevant activities under the scheme which can be taken up by them and submit a proposal for assistance to provide services in such area. The ILEP supported NGOs will also be considered for financial assistance excluding salary. This is to avoid duplication of funding, NGO should give an undertaking that the same activity is not being supported by any other source.