Mobile Medical Units

Operational
Guidelines
For Mobile
Medical Units
Ministry of Health and Family Welfare

Government of India
Ministry of Health and Family Welfare
Government of India, Nirman Bhawan
New Delhi-110 011
Designed & Printed by: Royal Press # +91 93101 32888

Hkkjr ljdkj
LokLF;LokLF;
,oa ifjokj
,oa ifjokj dY;k.k
dY;k.k ea=ea =h
kky;
Hkkjr ljdkj
fuekZ.k Hkou] ubZ fnYyh & 110011
Minister of Health & Family
Government Welfare
of India
Department of Healthofand
Government Family Welfare
India
txrAnuradha uM~MkIAS
izdk’k Gupta, Ministry of Health and Family Welfare
Additional Secretary & Nirman Bhawan, New Delhi - 110011
JagatMission
Prakash Nadda
Director, NRHM
Telefax : 23062157 LoPN Hkkjr
E-mail : anuradha–[email protected]
FOREWORD
The successful implementation of NRHM since its launch is 2005 is clearly evident by the
many fold increase in OPD, IPD and other relevant services being delivered in the Public
Message
health institutions, however, the quality of services being delivered still remains an issue.
The offered services should not only be judged by its technical quality but also from the
perspective of service seekers. An ambient and bright environment where the patients
Improving equitable access and coverage to health services is a fundamental
are received with dignity and respect along with prompt care are some of the important
principle of service delivery, but this would not be complete unless there was a strategy
factors of judging quality from the clients’ perspective.
in place to reach the most underserved communities living in difficult to reach areas.
Despite
Till nowthe impressive
most gains
of the States’ approachin coverage, reaching
toward the quality lastonmile
is based populations
accreditation remains
of Public a
Health Facilities by
persistent challenge. Lack of services through fixed service delivery facilities is an area
external organizations which at times is hard to sustain over a period of time after that support is withdrawn.
thatQuality
we should address
can only as a matter
be sustained, if thereofis priority.
an inbuilt Mobile Medical
system within Units (MMUs)
the institution areownership
along with a key by the
service strategy
providers to in
working reach such As
the facility vulnerable populations.
Aristotle said “Quality is not as act but a habit”
2. Quality
It Assurance
gives me(QA) great pleasure
is cyclical to which
process introduce
needs tothese Guidelines
be continuously to enable
monitored states
against in standards
defined
operationalizing
and measurable MMUs.
elements.I Regular
am happy to noteofthat
assessment the facilities
health guidelines are based
by their on and
own staff reflections
state and ‘action-
andplanning’
learningforover the past
traversing the few years.
observed gapsStates
is thehave played
only way a major
in having rolequality
a viable in implementing
assurance prgramme in
MMUsPublicand rightfully,
Health. Therefore,therefore,
the Ministrythe guidelines
of Health represent
and Family welfare the distillation
(MOHFW) of valuable
has prepared a comprehensive
lessons
systemfrom
of thethe field.
quality I am also
assurance whichglad
can bethat the guidelines
operationalzed througharetheflexible enough
institutional to allow
mechanism and platforms
states to plan the coverage and functioning of MMUs so as to truly reach the most
of NRHM.
difficult areas.
I deeply appreciate the initiative taken by Maternal Health division and NHSRC of this Ministry in preparing
3. theseI guidelines
trust thatafter
states willrange
a wide use of
this opportunity
consultations. It isto rethink
hoped that and redesign
States’ MMUs and
Mission Directors to beProgramme
more effective
Officers and
will take efficientofand
advantage thesemake the best
guidelines use ofquick
and initiate resources,
and timeso as toactions
bound enableas access
per the road map
to health
placed inservices for all those who live in remote areas, who find it difficult to access
the guidelines.
services for reasons that transcend geography and for the vulnerable.
(Jagat Prakash Nadda)

(Anuradha Gupta)
348] ,&Lda/k] fuekZ.k Hkou] ubZ fnYyh&110011

348, A-Wing, Nirman Bhawan, New Delhi-110011
Tele : (O) : +91-11-23061647, 23061661, 23061751, Telefax : 23062358, 23061648
E-mail : [email protected]
Hkkjr ljdkj
LokLF; ,oa ifjokj dY;k.k ea=kky;
Governmentof
Government ofIndia
India
Department of Health and Family Welfare
Department
MinistryofofHealth andFamily
Health and Family Welfare
Welfare
Anuradha Gupta, IAS
Additional Secretary & MinistryNirman
of Health and Family
Bhawan, Welfare
New Delhi - 110011
Mission Director, NRHM
Telefax : 23062157
FOREWORD
MESSAGE
Mobile health services
perspectiveare
of a response
service seekers.toAnreaching populations
ambient and livingwhere
bright environment in remote,
the patients
difficult areas and those communities cut-off from mainstream services on account
of geography and climatic conditions. Mobile Medical Units (MMUs) represent a
significant investment
Till now most of the made by the toward
States’ approach Ministry of Health
the quality is basedand Family Welfare
on accreditation (MoHFW)
of Public Health Facilities by
to enable reaching
external such marginalized
organizations populations.
which at times is hard to sustain over a period of time after that support is withdrawn.
Quality can only be sustained, if there is an inbuilt system within the institution along with ownership by the
As Indiaworking
providers movesin thetowards achieving
facility As Universal
Aristotle said Health
“Quality is not Coverage
as act but a habit” and in a context
where substantial improvement has been made in overall access and coverage, the
Quality Assurance (QA) is cyclical process which needs to be continuously monitored against defined standards
needs of such populations in underserved areas must assume the highest priority. The
and measurable elements. Regular assessment of health facilities by their own staff and state and ‘action-
implementation
planning’ foroftraversing
MMUstheinobserved not new gapstoisthe states.
the only way inIndeed,
having a several of the
viable quality statesprgramme
assurance have in
implemented the MMUs
Public Health. Therefore,inthe
theMinistry
past. The persistent
of Health and Family challenge of unreached
welfare (MOHFW) populations,
has prepared a comprehensive
however, requires fresh approaches and a review of past strategies. The and
system of the quality assurance which can be operationalzed through the institutional mechanism taskplatforms
is
of NRHM.
challenging and each context demands a different response. However careful planning,
deployment ofappreciate
I deeply appropriate human
the initiative resources
taken by MaternalandHealthdesigning
division andservice
NHSRC of packages
this Ministrytoinmeet
preparing
different situations will go a long way in meeting the challenge.
these guidelines after a wide range of consultations. It is hoped that States’ Mission Directors and Programme
Officers will take advantage of these guidelines and initiate quick and time bound actions as per the road map
These
placed inOperational
the guidelines. Guidelines for Mobile Medical Units are intended to provide
a framework for states to improve use of MMUs. The guidelines also include model
tender documents that will assist states in building partnerships to reach marginalized
populations. I hope states are able to adapt and use these guidelines to the advantage
of the unreached and enable their inclusion in service delivery so that their health care
rights and entitlements are protected.
(Anuradha Gupta)
Hkkjr ljdkj
Government of India
Department of Health and
Government ofFamily
IndiaWelfare
C. K. Mishra, IAS Gupta, IAS
Anuradha MinistryOF
MINISTRY of Health
HEALTH and
& Family
FAMILYWelfare
WELFARE
AdditionalAdditional
SecretarySecretary
& & Nirman
NIRMAN Bhawan,
BHAVAN, NEWNew Delhi- -110011
DELHI 110011
Mission Director,
Mission Director, NHM NRHM
Telefax : 23062157
Telefax : 23061066, 23063809
FOREWORD
Foreword
The National Health Mission is commitment to providing affordable, accessible and
quality health services to all. The Mission has a mandate to reach everyone, particularly the
perspective of service seekers. An ambient and bright environment where the patients
vulnerable and marginalized in the rural areas While our endeavour has been to meet this
commitment, there are population sub groups in inaccessible areas where our success has been
only partial. Such communities often stay out of the coverage area of fixed facilities and are
out of the gaze of mainstream services.
Till now most of the States’ approach toward the quality is based on accreditation of Public Health Facilities by
external
Mobile Medical which
organizations Units atwere anisinnovation
times attempted
hard to sustain at scaleofin
over a period theafter
time pastthat
fewsupport
years, but
is withdrawn.
show mixed
Quality cansuccess.
only be These operational
sustained, if there isguidelines, whichwithin
an inbuilt system drawthe
from lessonsalong
institution in thewith
field offer by the
ownership
a broad framework and guidance on restructuring existing MMU implementation design to
providers working in the facility As Aristotle said “Quality is not as act but a habit”
provide an optimal service package through effective use of resources. The basic objective
Quality
of the MMU Assurance (QA) is cyclical
is to provide a rangeprocess which needs
of preventive, to be continuously
promotive monitored
and curative against
services, and defined
enable standards
and measurable
referrals. elements. Regular assessment of health facilities by their own staff and state and ‘action-
planning’ for traversing the observed gaps is the only way in having a viable quality assurance prgramme in
Public The guidelines include suggestions on context specific designs in both rural and urban
Health. Therefore, the Ministry of Health and Family welfare (MOHFW) has prepared a comprehensive
areas, which states could adapt to their needs. The guidelines also make provision for inclusion
system of the quality assurance which can be operationalzed through the institutional mechanism and platforms
of aofwider
NRHM.
range of stakeholders in operationalizing MMUs and to that end, Model Tender
Documents have been included to aid states in setting up fair and transparent mechanisms to
undertake
I deeplysuch partnerships.
appreciate the initiative taken by Maternal Health division and NHSRC of this Ministry in preparing
theseI hope
guidelines after a wideguidelines
the operational range of consultations.
assist statesItinis crafting
hoped that
theStates’
designMission
of MMUDirectors andso
services Programme
as toOfficers
benefitwill
thetake advantage
most of theseand
marginalized guidelines and initiate
those living quick and time
in inaccessible bound actions as per the road map
areas.
placed in the guidelines.
New Delhi (C.K. Mishra)

25th June, 2015
(Anuradha Gupta)
fuek
Ministr
Manoj Jhalani, IAS N
Joint Secretary
Telefax : 23063687 Hkkjr ljdkj
Government of India
Department of Health and
GOVERNMENT OFFamily
INDIAWelfare
Manoj Jhalani, IAS
Anuradha Gupta, IAS Health and FOREWORD
MINISTRY OF HEALTH & FAMILYWelfare
Ministry of Family WELFARE
Additional Secretary &
Joint Secretary Nirman Bhawan, New Delhi - 110011
NIRMAN BHAVAN, NEW DELHI - 110011
TelefaxMission Director, NRHM
: 23063687
E-mail :Telefax : 23062157
[email protected]
The National Rural Health Mission (NRHM) was launch
provide affordable and equitable access to public hea
has led to considerable expansion of the health serv
FOREWORD infrastructure, increased availability of skilled huma
flexibility in operations, increased budgetary allo
management. However, improvement in Quality of he
The successful implementation of NRHM stillsince
not perceived,
its launch isgenerally.
2005 is clearly evident by the
many fold increase Foreword
in OPD, IPD and other relevant services being delivered in the Public
health institutions,Perceptions
however, theofquality
poor quality of health
of services beingcare, in fact,still
delivered dissuade
remainspatients from us
an issue.
The offered
The National Rural Health serviceshealth
Mission, should issues
andnotnoware
onlytheamong the
be National most
judged byHealth salient
its technical of
Mission human
quality
hasbutconcerns.
made Ensuring
also from the qu
much headway in improving perspective
access toimproved
of service seekers.
health patient/client
care An level
and outcomes
ambientespecially
services, brightthrough at the
environment facility
where
strengthening level
the patients
the public health system. are received
However, withthere
dignity and respect
continue along twilight
to remain with prompt zonescareinare
manysomepartsof theof important
the country, where a smallfactorsbut
of significant Ministry
judging quality from
proportionof the
Health andperspective.
clients’
of people Family
do notWelfare,
get accessGovernment
to services of that
India is committed t
they are entitled to. Assurance Programme, which meets the need of Public Health system in
Till now most of the States’ approach toward the quality
The present is basedon
guidelines onQuality
accreditation of Public
Assurance hasHealth
been Facilities
preparedbywith a
externalMobile Medical Units were designed
organizations which at times isperception to meet
hard to sustain the needs of
over a delivery
of service such
period ofby communities.
timetheafter However
that support
clients. This would is withdrawn.
enhance satisf
the Quality
findingscanfrom various Common Review
only be sustained, if there Government Missions
is an inbuilt system and other
Healthwithin assessments
the and
Facilities institution from
reposingalong several
with
trust states
in ownership
the Public by the Syste
Health
show that theworking
providers functioning of MMUs
in the facility has notsaid
As Aristotle been optimal
“Quality is notand maybutnot
as act be the most efficient
a habit”
use of scarce resources. Based on theThe recommendations
Operational guidelines of such along-with
reports andstandards
in consultation
and checklist are exp
withQuality
the states, the Ministry of Health
Assurance (QA) is cyclical process and Family
which needs
improving Welfare
and to has
be continuously
sustaining developed
qualitymonitored these Operational
against defined
services beginning with standards
RMNCH-A serv
Guidelines for Mobile
and measurable Medical
elements. Units.
Regular assessment
to bring about a visible change in the services rendered by ‘action-
of health facilities by their own staff and state and them. The gu
planning’ for traversing the observed
The guidelines cover a range of gaps is
design
scope the only way in
parametersthesuch
for extending having a viable
as geography,
quality quality assurance
assurance inmapping and and in
disease control prgramme other na
Public Health. Therefore, the Ministry
routing of MMUs, service packages for that of Health
variousstates and Family
contexts,
will adopt welfare
norms (MOHFW)
for deployment,and
it comprehensively has prepared
and extend a
appropriatecomprehensive
in phases for bringin
system of the quality assurance which
human resource teams. A key recommendation can be operationalzed
Feedback from is that
the thethrough
service
patients the
aboutinstitutional
package mechanism
be broadened
our services and
is single-mostto platforms
important p
of NRHM.
move beyond reproductive child healthour to endeavour.
a more comprehensive set of services. In addition,
the guidelines underscore convergence with existing and newly launched initiatives such as
I deeply
those appreciate
for Free EssentialtheDrugs
initiative
andtakenI by Maternal
Diagnostics andHealth
acknowledge also division
and strive and
to get
appreciate NHSRC
the
the best of this for
value
contribution Ministry
byinNRHM
money
given preparing
division an
these guidelines after a wide range of
by using the MMUs for IEC, Sputum collectionconsultations. It is hoped that States’ Mission Directors and Programme
Ministry inetc.
preparing and finalizing the guidelines. I especially acknowle
Officers will take advantage of these guidelines and initiate quick and time bound actions as per the road map
taken by Dr. Himanshu Bhushan, Deputy Commissioner and I/C of Matern
placedAnin the
important lesson from implementation efforts of the past is that although states
guidelines.
Deputy Commissioner and I/C of family planning Division and Dr. JN Sriva
engaged with private organizations in for profit and not for profit sector, this has not resulted
guidelines.
in leveraging mutual strengths. In order to overcome this problem, the guidelines include
structured model tender documents and service guidelines to enable states to create and sustain
such partnerships to ensure reach with effective and efficient service delivery mechanisms.
I hope that states find these operational guidelines useful and adapt them to local
contexts as required so that the promise of universal access to health services becomes a reality.
(Anuradha Gupta)
(Manoj Jhalani)
List of Contributors
1. Shri. C.K Mishra AS&MD, MoHFW
2. Shri. Manoj Jhalani Joint Secretary (Policy), MoHFW
3. Shri. Gautam Guha Ex. - AS & FA, MoHFW
4. Ms. Limatula Yaden Director (NHM), MoHFW

Additional Commissioner Income Tax, then
5. Shri. R.C. Danday
Director (NHM), MoHFW
6. Dr. Sanjiv Kumar Executive Director, NHSRC
7. Dr Rajani R. Ved Advisor (NHSRC). MoHFW
8. Dr Jitendra Kumar Sharma Senior Consultant (NHSRC), MoHFW
9. Ms. Shraddha Masih Senior Consultant (NHM). MoHFW
10. Ms. Asmita Singh Senior Consultant (NHM). MoHFW
11. Ms. SumithaChalil Senior Consultant (NHM). MoHFW
12. Dr. Shahab Ali Siddiqui Senior Consultant (NHM). MoHFW

List of Contents
1. Introduction | 1
2. Target Geography | 2
3. Nature of Services to be provided by an MMU |2
4. Norms for deployment of MMUs | 3
5. Type of Services Provided |3

6. Suggested Models of MMU | 4
7. Operational aspects of MMU | 4
8. Human Resources | 5
9. Drugs, Diagnostics and Supplies | 6

10. Quality of Care |7
11. Monitoring & Mechanism | 7
12. Grievance Redressal | 8
13. Financing 8
Annexure I | 9
Suggested Package of Services to be provided at MMU | 9
Annexure II | 11
Duties and Responsibilities of the Staff of the MMU | 11
Annexure III | 13
Proposed List of Medical Equipment and Instruments of MMU | 13
Annexure IV | 15
Drugs and Consumable List | 15

Annexure V | 20
Financial Norms for the Recurring Cost of the exisiting MMUs | 20
Appendix I-A | 21
Appendix I-B | 53
1. Introduction
1.1 The vision of the National Health Mission (which encompasses the National Rural Health
Mission (NRHM) and the National Urban Health Mission (NUHM) as its two Sub-Missions)
is universal access to equitable, affordable and quality health care services. One major
initiative under the NRHM was the operationalization of Mobile Medical Units (MMUs)
to provide a range of health care services for populations living in remote, inaccessible,
un-served and underserved areas mainly with the objective of taking healthcare service
delivery to the doorsteps of these populations. With the launch of NUHM, the MMUs
services are also intended to cater to the urban poor and vulnerable population and
provide fixed services in areas where there is no infrastructure.
1.2 As of December, 2014 there were about 1301 operational MMUs in 368 districts across
the country. However both task definition and effectiveness of MMUs show variations.
Assessments and reviews show that on account of various operational and contextual
factors, the deployment of MMUs, their coverage and outcomes are not commensurate
with the investments in most States. Planning of MMUs has not followed the principles
of inaccessibility and the range of services has not been such that it addressed the needs
of the population living in remote areas. While support was provided to MMUs with
diagnostic vans, state experiences also show that it was often not found feasible to provide
effective X-ray services through the MMUs. Comprehensive planning and monitoring of
MMU sremained a challenge in most cases.
1.3 The MMU guidelines are thus being revised in light of learnings from past experiences
and existing good practices from some states. The rationale for revision is based on a
number of reasons. Over the past years, the experience of NHRM, has resulted in (i) better
mapping of inaccessible village clusters allowing for improved route planning of the
MMUs, (ii) more opportunity for mobilization given the presence of the ASHAs in even very
remote villages, saving the MMU teams much time and energy in reaching those in need,
(iii) increase in number of functional facilities has increased, allowing more opportunities
for referral to facilities at shorter distances, (iv) the presence of the 108 which enabled
better access in case of emergencies, (v) the more ready availability of telemedicine, and
(vi) better understanding of which service packages can be rendered effectively through
the MMUs.
The Free Diagnostics Services initiative under NHM is envisaged to facilitate effective use of
technology in digital imaging, use of tele-radiology, and a hub and spoke model for sample
collection and testing besides allowing MMUs to serve as sites for point of care diagnostics
and as collection centres for blood and sputum samples. X ray imaging services would
form part of the Diagnostics initiative and hence would no longer be advised for MMUs.
1.4 These revised Operational Guidelines are intended to enable states to restructure
implementation mechanisms for MMUs so as to enable optimal utilization of vehicles and
staff through convergence while ensuring that the outcome of the MMU contributes to
the objectives of reaching the last mile and the unreached with more than just basic OPD
services and a limited range of RCH services.
Operational Guidelines For Mobile Medical Units
1
The key objectiveof the MMU is to reach populations in remote andinaccessible areas
with a set of preventive, promotive and curative services including but not limited to RCH
services, which are free to the patient at the point of care.
2. Target Geography
3.1 In urban areas, MMUs would be deployed where there are habitations of marginalized
communities (ragpickers, homeless, migrants) that live on the fringes of cities and towns,
alongside highways just outside cities, or along railway tracks and under flyovers and
bridges. These are also often areas where dispensaries or Urban PHCs do not exist, and
even if they do they are just not accessible to such populations. The MMU could also be
deployed in localities where slum populations live and where there is simply no space for
creating fixed infrastructure.
3.2 In rural areas, MMUs would continue to be deployed in areas with limited or a complete
lack of access to health care services. Such areas include Tribal Areas, Conflict Affected
Areas (Insurgency, Left Wing Extremism), Hilly and Desert Areas/Islands/flood affected and
snow bound wherein situations envisaged are:
(i) Where even basic RCH services are not able to be provided because doctors, nurses
and even ANMs find it difficult to live there or because there is lack of infrastructure
since fixed services could not be established (urban slums, or in conflict affected
areas). Here the MMU would provide a complete range of services.
(ii) Where basic RCH services are available through ANM/sub-centers and the PHC is
functional, but the reach is limited on account of several habitations that are too small
to establish regular fixed services, or are too distant or cut-off to expect those in need
of health care to come to the nearest PHC for any care.
(iii) The range of services available in PHC is restricted to a limited set of RCH services
(provided by ANM, Nurse or AYUSH), and there is no accessible health centre with a
Medical officer. In this case, the basic and regular RCH services will be provided by
the PHC and the role of the MMU would be to provide the rest of the service package.
3. Nature of Services to be provided by an MMU

3.1 An MMU is envisaged to provide the following:
(i) Outreach services by ANMs in areas where no outreach services exist
(ii) Broader set of clinical services by a Medical Officer and her/his team, with ANM/
ASHA playing a mobilization role, (one vehicle outfitted as an outpatient clinic, with
examination table, light and sufficient facilities for basic lab investigations and a
second vehicle for team transport.
(iii) Facilitate referral back-up to afunctional primary health care system and specialist
services as required.
2
4. Norms for Deployment of MMUs
4.1 The currently approved norm is one MMU per district with a normative population of 10
lakhs, with a cap of five MMUs per district. This has been estimated as follows:
a) District with population 10 lakhs- 1 MMU
b) District with population of between 10 lakhs and 20 lakhs- 2 MMUs.
c) District with population of between 20 lakhs and 30 lakhs- 3 MMUs
d) District with population of between 30 lakhs and 40 lakhs-4 MMUs
e) District with population of over 40 lakhs - 5 MMUs
4.2 This can be further relaxed for hilly and tribal areas, where the populations are widely
dispersed and the geographical terrain is difficult.
4.3 States are expected to map the nature of diversity of their conditions and adopt the most
suitable and sustainable model to suit their state specific needs. However, States have also
been specifically requested to provide MMUs especially in areas inhabited by Particularly
Vulnerable Tribal Groups (PVTGs) so as to provide primary health care facility close to their
habitations.
5. Type of Service Provided

5.1 Mobile Medical Units are envisaged to provide primary care services for common diseases
including communicable and non-communicable diseases, RCH services, carry out
screening activities and provide referral linkage to appropriate higher faculties. (Please
see Annexure 1 for the set of services). The services provided would of necessity be
preventive and promotive and outpatient curative care. Where there are cases needing
acute medical care on the day the MMU reaches the site, such care would be provided and
patient referral organized.
5.2 In addition, the MMU is also expected to:
- provide point of care diagnostics: Blood glucose, pregnancy testing, urine microscopy,
albumin and sugar, Hb, Height/Weight, vision testing, RDT,
- collect sputum samples,
- screen populations over 35 for Hypertension, Diabetes and Cancers annually and
undertake follow-up checks during the monthly visit, including providing patients
requiring drugs with a monthly supply (Hypertension, Diabetes, Epilepsy)
- undertake IEC sessions on a range of health topics - improved preventive and promotive
behaviours for maternal and child health, communicable diseases, including vector
borne diseases, educate the community on lifestyle changes, the need for screening
for NCDs, and early recognition and appropriate referral.
3
5.3 The nature of services to be provided depends upon the contexts defined in Section 3. The
package of services in Annexure 1 is illustrative and states could add on more services such
as for eye care, dental care, etc. However the principle for adding on additional service
packages should be tied to the presence of additional human resources, appropriate
diagnostics and drugs. While multi-skilling of the core staff is possible and even desirable
under certain circumstances, it can only work to a limited extent, without overloading and
losing focus on priority services.
6. Suggested models of MMUs

There can be broadly 3 models of operationalizing MMUs:
a. Government operated MMU
b. Operation of MMU on Out sourcing basis- CAPEX & drugs and supplies provided by
Government
c. Out sourcing of MMU services including CAPEX and OPEX. However, drugs and supplies to
be provided by the Govt.
7. Operational aspects of MMU

7.1 Officer-in-charge will be the Chief District Medical Officer at district level, who will be
responsible for the operational aspects. Rogi Kalyan Samitis will also be involved in
operationalization of the MMU. States can also explore the option of outsourcing the
vehicle through public-private partnership with credible NGOs, which would follow the
same norms, and be accountable for a similar set of services and outcomes.
7.2 The Medical Officer in the nearest functional Primary Health Centre will provide support
to the MMU team as required. Where there are functional sub centres, in these areas, the
ANMs would be available on the day of the MMU visit to provide support. Referrals should
be made to the nearest CHC, or DH. In case tertiary care is needed, the use of 108 services
will be made, or patient would be shifted to the nearest road-head depending on the
conditions of the terrain.
7.3 The planning and dissemination of the MMU route map is the responsibility of the CMO
with support from the District team. The first step would involve a mapping of villages and
village clusters which are inaccessible and underserved. The deployment of MMUs should
be prioritised in those areas where there are no functional facilities. The mapping should
also identify referral sites that are the first point of referral for these inaccessible clusters.
The frequency of MMU visit must be at least once a month. Additional visits will depend
upon local condition such as all weather roads, access conditions, terrain, and accessibility
to health facility.
7.4 Depending on distances, the MMU could make upto one visit a day to distant villages,
planning for four hour travel time and about four to five hours in a given site. For shorter
distances additional villages could be covered, but these are to be planned based on local
4
context. The principle is regularity, with every area being visited on the same day in each
month and preceded by active mobilization with a well publicized monthly schedule of
visits through loudspeakers, announcements, etc. While the MMU could work a six day
week, Saturday and Sundays should compulsorily be working days. Weekly off of MMU
could be used for maintenance of vehicles, refilling supplies and entry of data etc.
7.5 The route of an MMU would be planned such that it reaches a site which serves a cluster
of villages that are otherwise inaccessible. The MMU may choose a service site in Villages
with a weekly market/Haat or where people from nearby village clusters (which are
otherwise inaccessible) tend to congregate. In urban areas, the MMU should be located
in the Mohallas or localities occupied by marginalised population. If possible the services
could be conducted in any adequate building with one or two rooms and toilets, such as
an Anganwadi center or Panchayat Bhavan or primary school.
7.6 Adequate arrangements for waiting area should be made by Gram Panchayat/VHSNC.
The ASHA and VHSNC would carry out the function of community mobilization, ensuring
that people who need services are informed of the MMU schedule, can mobilize those
in need of screening, those with communicable diseases or chronic conditions for follow
up medical examinations, women in need of family planning services, children in need of
medical care, follow up of children discharged from secondary or tertiary care facilities,
and those with acute medical conditions.
7.7 The MMU could also be used for natural or man-made calamities or in disaster situations
and epidemics to provide services to affected populations.
7.8 The MMU must not be seen as a stand-alone service delivery option, but rather as a way of
delivering primary care in remote, inaccessible areas, and establishing a continuum of care
with community level and outreach care as well as secondary and tertiary level care.
7.9 Regular monitoring of not just the operational issues related to MMU but the number
and types of patients serviced must be undertaken, so as to ensure that the MMU is
actually serving a need and is able to provide services for a larger number of people or a
comprehensive care for a smaller population who would otherwise not receive such care.
Such monitoring should also provide information on other health needs that need to be
addressed. The functioning of the MMUs in a district should be monitored regularly and
be an essential part of the review by the CEO of the Zilla Parishad/District Collector.
8. Human Resources`
8.1 The suggested HR for an MMU is as under:
MO (MBBS only, preferably women) One

GNM: One
Lab Technician: One
Pharmacist cum Administrative Assistant: One
Driver cum Support Staff: One
5
If the context in which the MMU is being deployed envisages the provision of the entire
gamut of services (sub-centre/VHND and Primary care) an additional ANM may be included.
If additional services such as dental or ophthalmic services are being provided, including
of para-medicals (ophthalmic assistant) in these fields may become necessary.
8.2 The operating cost has been calculated on the assumption that MMU would have
dedicated HR.
8.3 If recruited on a contractual basis, salaries should be at par with the salaries of other
staff and staff should receive additional benefits and hardship allowances (if any) in the
particular districts (specifically tribal and LWE affected) as per the State’s policy. In case of
medical officer or one of the staff going on leave, substitute officer could be appointed in
those days.
8.4 For the MMUs that are operated by the State Government, staff should not be withdrawn
from existing and functional facilities, which would render the facility dysfunctional. The
roles and responsibilities of the team members are at Annexure 2.
9 Drugs, Diagnostics and Supplies

9.1 The MMU should have the requisite drugs and supplies (Annexure 3 and 4) to be sourced/
refilled from the nearest facility/ warehouse. The drugs/supplies inventory management
for MMU should be part of the plan for the district in which the MMU is located. This system
is to be followed in cases of outsourcing as well. However a small discretionary amount
may be provided, and drugs could be purchased upon certification by the CMO that there
is indeed a stock out of the drug (s). A kit based Supply of medicines to the MMU is to be
avoided whether in the case of government managed or outsourced model. Requirement
of MMU drugs and supplies should be integrated into viable state procurement cum
logistic framework, and it should maintain three months stock of medicine, refilling as
required.
9.2 A set of basic laboratory investigations would be provided, which would include Point of
care technologies. Apart from the routine Hb, pregnancy testing, blood glucose, urinalysis
using dipsticks (albumin, glucose), states are free to add on a more sophisticated array of
tests such as a haematology analyser, or other biochemical tests. Equipment such as an
audiometer, refractometer, tonometer, digital ophthalmoscope, could also be added as
required, with the caveat being that there is a trained provider and that a continuum of
care beyond just diagnosis is established for the patient.
9.3 MMUs are also envisaged to collect sputum samples.
9.4 All drugs and investigations should be provided free.
6
10. Quality of Care
10.1 MMU services should meet the technical and service quality standards for a PHC.
Every patient is to be treated with respect and dignity irrespective of social, economic,
cultural or social status. All health data of patients should be kept confidential. Patient
privacy should be ensured during examination and procedures. Periodic feedback
from patients is to be collected (similar to exit interviews in facilities) and analysed.
Telephone numbers where patients can lodge their complaints to be displayed on
MMU for Grievance Redressal. Continuity of care should be assured with the tentative
date of next visit to be mentioned on each prescription along with details of follow up
with ANM/ASHA, when needed. Chronic patients on regular long term medications
should be able to collect their monthly medications from MMU. Adherence to Standard
Treatment Guidelines is mandatory. Care should be taken to ensure that no conflicts of
interests or pecuniary gain in the ways referrals are made. The first point of referral for
secondary care should be to the district hospital.
10.2 VHSNCand other community level structures should be actively involved in enabling
orderly service delivery. Managing over congestion and crowding should be undertaken
by such community structures.
10.3 Meticulous record keeping, compilation and analysis of indicators to be done on a

monthly basis:
A logbook shall be maintained by the MMU driver and supervised by MMU MO.
Logbook shall be available for verification by the District Health society nominee.
The MMU shall adhere to all the provisions of Motor Vehicle Acts and other
applicable acts in this regard.
In case of outsourced vehicle; for all off road days, the penalty should normally be
more than the one day running costs.
Parking will be responsibility of the District Health Society.
Each MMU to be provided with one ABC type fire extinguisher cylinder.
11. Monitoring Mechanism.

11.1 The data below should be updated on the State website as Mandatory Disclosure every
month
(i) Number of MMUs in the District (Sanctioned & Operational)
(ii) MMU managed by State Govt. /NGO /Private Provider
(iii) If MMU operated by State Govt, is the HR dedicated to MMU or existing HR in

facilities is assigned to MMU.
7
(iv) Number of Vehicles per MMU (2vehicle/ 1 vehicle)
(v) Number of Trips in a month
(vi) Number of Villages/Habitations visited with route map
(vii) Link with GPS for mobile tracking
The following data are to be reported every month:
(viii) Number of cases seen monthly categorized by ANC, Children immunized, FP

services provided, Patients with HT/Diabetes followed,
(ix) No. of Lab tests/month by MMU
(x) No. of blood smears collected / RDT tests done for Malaria
(xi) No. of sputum collected for TB detection / month by MMU
(xii) Number of patients referred to higher facilities
(xiii) Operational cost* per patient (excluding all capital cost)
(xiv) Operational cost* per trip(excluding all capital cost)
12. Grievance Redressal

An effectiveGrievance Redressal Mechanism should be integrated with grievance mechanism
for other services.
13. Financing
The approved operation cost /Recurring Cost with diagnostic van is Rs.24 lakhs while it is 28
lakhs for North Eastern states, J&K and Himachal Pradesh. As mentioned in foregoing para, the
cost is based on the assumption that MMU has dedicated HR. Further, while the operational
cost factors in budget for drugs, as already indicated, drugs should be sourced through the
nearest facility/ warehouse.
14. Uniform colour code of MMUs under NRHM

Under the National Health Mission a universal name” National Mobile Medical Unit” along the
colour coding has been prescribed. Adoption of a universal nomenclature with common colour
scheme and design is intended to enhance its visibility and create better awareness amongst
the target population.
8
Annexure 1:
Suggested Package of Services to be provided at MMU
1 Maternal Health Early diagnosis of pregnancy, Early registration, MCH Cards,
Birth planning (and preparing mothers and families in remote
areas to shift to a facility at least one week before the due date,
or to a maternity hut), Regular Ante-natal check-ups; includes
Screening for Hypertension, Diabetes, Anemia, TT Immunization
for mother, Iron-folic Acid & Calcium Supplementation,
Identification and referral of High Risk Pregnancy, Post Natal
Cases, Counselling, support and motivation for institutional
delivery, Nutrition, Enabling Take Home Rations (THR) for
pregnant woman through Anganwadi Worker,
2 Neonatal and Infant Health ( 0 Examination of low birth weight/preterm newborn/other

to 1 year old) high risk newborns and management or referral as required),
Counselling and support for early Breast Feeding, improved
weaning Practices, Identification of congenital anomalies,
other disabilities and appropriate referral, Family/community
education of Prevention of infections, Complete Immunization,
Vitamin A Supplementation, Care of Common illnesses of new
born, AGE with mild dehydration, pneumonia case management
3 Child and , Adolescent health Growth Monitoring, Prevention through IYCF counselling,
access to food supplementation- convergence with ICDS, De-
worming, Immunization- , prompt and appropriate treatment
of diarrhoea/ARI, referral where needed, detection of Severe
Acute malnutrition (SAM), referral and follow up care for
SAM, Prevention of anaemia, use of iodised salt; Prevention of
diarrhoea, Pre-school and School Child: Biannual Screening,
School Health Records, Eye care, De-worming; Early detection
of growth abnormalities, delays in development and disability,
Adolescent Health services: personal hygiene, Detection &
Treatment of Anaemia and other deficiencies in children and
adolescents
4 Reproductive health and Identifying eligible couples, and motivating for Family Planning-
Contraceptive Services delaying first child, spacing between two children, Access
to spacing methods- OCP, ECP, condoms, IUCD insertion and
removal, RTI treatment- Syndromic management/partner
treatment, First aid for GBV- link to referral centre and legal
support centre
5 Management of chronic Tuberculosis; HIV, leprosy, Malaria, Kala-Azar, Filariasis, Other
Communicable Diseases vector borne disease- identification, use of RDT/prompt
treatment initiation, vector control measures, Sputum
collection for TB, RDK + Lab testing and treatment for all vector
borne disease examination, follow up medication compliance,
Prevention – mass drug administration in filarias, immunization
for JE,
6 Management of Common Diagnosis and management of common fevers, ARIs and

Communicable Diseases & Basic diarrhoeas, Urinary Tract infections, skin infections. (scabies,
OPD care- (acute simple illness) abscess), indigestion, acute gastritis. Symptomatic care for
aches and pains
9
7 Management of Common Non- Undertake screening for over 35 age group , at MMU on an
Communicable Diseases annual basis or Opportunistic Screening for diabetes and
hypertension, Hypertension / Diabetes mellitus –Medication,
follow up diagnostics, refer for specialist consultation and
early referral for complications, Silicosis, Fluorosis – follow up
care, Diagnosis of common respiratory morbidities (COPD and
bronchial asthma) and treatment in all “chest symptomatic”,
Epilepsy- early case identification, enable specialist consultation
through referral.
8 Management of Mental Illness Community education and Preventive measures against
Tobacco use and Substance Abuse, Identification of people
for De-Addiction Centres, Referral of cases with mental illness,
follow up medication, counselling/support.
9 Dental Care Education on Oral Hygiene & Substance Abuse, in community

and schools- recognition of dental fluorosis- Referral for
gingivitis, dental caries, oral cancers, Treatment for glossitis,
candidiasis, fever blisters, aphthous ulcers;
10 Eye Care/ENT care School : Screening for blindness and refractive errors, Community
screening for congenital disorders and referral, Counselling and
support for care seeking for blindness, other eye disorders
-first aid for nosebleeds, recognizing congenital deafness, other
common ENT conditions and referral,
Eye care in newborn, Screening for visual acuity, cataract and
for Refractive Errors, Identification & Treatment of common
eye problems- conjunctivitis; spring catarrh, xerophthalmia,
first aid for injuries, referral, Management of common colds,
Acute Suppurative Otitis media, (ASOM), injuries, pharyngitis,
laryngitis, rhinitis, URI, sinusitis
11 Geriatric Care Management of common geriatric ailments; counselling,

supportive treatment, and Pain Management
12 Emegency Medicine Snake bites, scorpion stings, insect bites, dog bites, Stabilization
care in poisoning and referral first aid, trauma of any cause,
Minor injury, abscess management,
10
Annexure 2:
Duties and Responsibilities of the Staff of the MMU
1. Medical Officer
a) MO will be the in-charge and overall responsible for the effective functioning of the MMU.
The other staff of the MMU will work under his/her supervision on a day to day basis.
b) In case of referral to the nearest facility, the MO shall maintain suitable records (detail
address and the cause of emergency in the register and log book of the vehicle) and issue
a clear descriptive referral slips (Copy Annexed)
MO and MO i/c of the PHC shall take immediate appropriate actions during outbreaks of
diseases and epidemic and inform concerned DHO and RCH officer as well as to render
assistance as required and feasible.
c) MO shall work in collaboration with the MO i/c of nearest PHC under whose area services
are being rendered.
d) MO shall work in coordination and cooperation with the health staff of the department,
local authorities, Village Health Sanitation and Nutrition Committee (VHSNC) etc.
2. Staff Nurse/ANM
a) To assist the MO of the MMU in providing the health care services as listed.
b) To maintain cold chain for vaccines
c) To carry out all other relevant functions as tasked by the MO of the MMU
3. Pharmacist cum Administrative Assistant
a) To dispense the medicines to the patients prescribed by the MO in the MMU.
b) To take appropriate action for Bio Medical waste management with the MO
c) To maintain all adequate stock, inventory and issue registers.
d) To carry out all other tasks as ordered by the MO of the MMU.
4. Laboratory Technician
a) To carry out the diagnostic tests/laboratory tests as per the requirement and feasibility.
b) To work in coordination with RNTCP & NVBDCP for quality monitoring and keep the
required documents/records as per program guidelines.
c) To prepare the monthly report and submit to the MMU MO.
d) To carry out all other tasks as ordered by the MO of the MMU.
11
5. Role of ASHAs and VHSNC in MMUS
a) Generate awareness regarding the availability of MMU, service provided, frequency of visit
and schedule of MMU.
b) Mobilization through home visits and VHSNC meetings
c) Disseminate IEC in coordination with MMU staff and ANM/AWW.
d) Identify Community groups /patients who would particularly benefit from the services of
MMU.
e) It is important for ASHAs to have clarity on how to assist the service user to choose between
SC/PHC/MMU as site of referral based on what the referral is for, where there is greater
assurance of service and which is more convenient to access.
f ) To undertake preliminary screening or bring in suspected case of chronic diseases- e.g.

TB, Blindness, HIV, Leprosy, diabetes, Hypertension, asthma, epilepsy, childhood disability,
severe malnutrition.
g) To ensure regular follow up of patients who are on long term treatment for chronic diseases.
h) To enable easy access of referral services in emergency cases.
i) VHSNC should function as organizer of village level activities of MMU visit.
j) VHSNC members should help ASHAs/ANMs in mobilization of patients to access services

from MMU.
k) ASHAs should be paid the same incentive as for attending a VHND.
12
Annexure 3:
Proposed List of Medical Equipment and Instruments of MMU-
Name of the Instrument Quantity for MMU

Microscope with Light source (Binocular) 1
Sterilizer 38 cms with electric drums 1
Dressing Drum (11x9) 2
Weighing Machines Adults Simple 1
Weighing Machines Baby Simple 1
Stethoscope 2
B.P. Apparatus 2
Hemoglobin meter (Manual & digital) 1
Centrifuge machine (mini) 1
Incubator 1
Micro typing Centrifuge 1
Nebulizer 1
Ambu bag Adult 2
Ambu bag Paediatric 2
Laryngoscope Adult 1
Laryngoscope Child 1
Suction apparatus with accessories 1
Torch & spot light 1
Glucometer 1
Refrigerator (capacity 50 to 60 liters) 1
Needle cutter (manually operated) 1
Laboratory table- Portable 1
2 computers- laptop preferred 1
Laser Printer 1
Broadband Internet Data Card 1
Digital camera 1
Speaker 2
Amplifier 1
LCD Projector 1
Water Purifier 1
Foldable Half Bench 2
Foldable seats for staff 4
13
Waste Collecting bins, as per Biomedical waste Management
specifications
Stool 4
Cot 1
Examination table 1
Brackets for Oxygen Cylinder with adjustable straps 2
Detachable stretcher 1
Hooks for an intravenous bottle 4
Chairs 5
Generator 1
AC Fan 1
Transfusion Bottle Hook 2
Dvd Player 1
Fire Extinguisher 1
View Box 1
Digital clock 1
Height Measurement Instrument 1
Stainless Steel Cabinet 3
Water Storage Tank 1
Extension box 2
Screen (for privacy) 2
Emergency light 2
Soap Container 3
Towel Holder 2
Semi-Auto Haematology analyser (3 part) 1
Test tubes 1
Auto pipettes 1
Ophthalmoscope 1
Auto scope 1
Examination Torch 2
Mobile Lab 1
12 LED ECG Machine 1
14
Annexure 4:
Drugs and Consumable List
Type of medicine Name of medicine/consumables Quantity required
in a month (to be
estimated)
Inj. Atropine sulphate 0.6 mg
Inj. Calcium Gluconate 10%
Inj. Theophyllin 50.6 mg+ Etophyllin
169.4mg/2ml
Inj. Dexamethasone 2mg/ml
Inj. Oxytocin
Inj. Sodabicarbonate 7.5mg
Inj. ChlopheniramineMaleate (2ml)
EMERGENCY Inj. Adrenaline 1mg
MEDICINE Inj. Lignocaine 2%
Inj. Dopamine 200 mg
Inj. Diazepam
Inj. Vit K 10mg/ml (Menadion bisulphate)
Inj. Anti-Snake Venom serum
Inj. Frusemide
Inj. Anti Rabies
Tab. Amlodipine 5 mg
Tab. Roxithromycin 150mg
Tab. Erythromycin 250mg
Tab. Ciprofloxacin 250mg
Tab. Norfloxacin 400mg
Furazolidine tab.
Furazolidine Syp. Bottles
Metronidazole tab (400mg)
Metronidazole tab (200mg)
Cap. Amoxicillin 250mg
ANTIBIOTICS Syp. Amoxicillin 250mg
Septran SS Tab
Sofracort Eye+ ear drops
Soframycin Ointment
Syp. Ampicilin
Amoxicillin syp. Bottles
Ampicillin caps (250 mg)
Ciprofloxacin eye drop
Ciplox-TZ tab
Sy. Cotrimazole (septran)
15
ANTIAMOEBIC Sy. Furzolidine 60ml
Tab. Furzolidine 100mg
Tab. Metronidazole 200mg
ANTIFUNGAL Whitfield’s ointment
Griseofulvin tab.
Fluconazole Tab
Miconazole Tab
Tab. Griseofulvin 125 mg.
NUTRITIENTS Tab. Multivitamin
Tab/Cap Iron Folic Acid (S R)
Vitamin A/E Capsule
Vit. A Solution
Vit D Sache
Tab. Vit B Complex
Tab. Calcium carbonate
Tab. Etophylline & Theophyulline SR
ANTIMALARIALS Primaquine tab.
Pyrimethamine +Sulphadoxine tab.
ACT (A/SP, Adult)DMO
Chloroquine syrup bottles
Chloroquine tab.
ACT(RTSUN)
ACT(A/SP, <1 yr)
WORMICIDALS Albendazole syp.
Albendazole tab.
16
Amitriptyline tab.
Omeprazole cap.
Metoclopramide
Hydrochlorothiazide
Lasix tab.
Amlodipine Tab
Paracetamol Tab
Phenobarbitone tablet
Prednisolone Tablet
Ranitidine tablet
GENERAL MEDICINE Salbutamol tab.
AND NON
COMMUNICABLE Sorbitrate
DISEASES Cough syrup. Bottles
CPM tab.
Codeine Tablet
Diclofenac+ Dicyclomine tab.
Diclofenac SR tab.
Diclofenac tab
Dicyclomine tab.
Digoxin tab
Antacid tab
Brufen tab.
Aspirin tab
Asthalin Respiratory solution
Atenolol tab
BC tab
Betamethasone ointment (Betnovate)
Calamine lotion
Calcium tab
Carbamazepine tab.
Amlodipine tab.
17
Sy. Albendazole 10 ml
Tab. Albendazole 400mg
Sy. Paracetamol 60ml
Tab. Paracetamol 500mg
Tab. Citrizine 10mg
OTHERS
Urine Dip sticks
Condoms
Tab. Diclofenac sodium 50mg
Inj. Diclofenac sodium
Cap. Omperazole 20mg
Inj. Ondansterone 2mg/ml
Inj. TT
DEC Tab
Inj. Tonaboline
ORS Powder 27.5gm WHO Formula
ORS Powder 27.5gm WHO Formula
Gama Benzene hexachloride 1% w/w lotion
Framycetin sulphate BP 15mg (1.5%)
LOCAL Povidone-iodine-Ointment
APPLICATION Cream. Miconazole
Sukhad Oint- (Ayurvedic)
Ciprofloxacin eye drop
White petroleum Jelly
Lignocacine2% Jelly
Gentamycin eye/ear drop
Xylocaine Jelly 2 %
Tab. Clotrimazole 100mg (Vaginal Pessary)
IV FLUIDES Normal Saline 500ml
Dextrose 5% 500 ml
I.V. Dextrose in Normal Saline 500ml
Ringer lactate 500 ml
DISINFECTANTS Povidone Iodine Solution 500 ml
Denatured spirit
18
Surgical gloves
Scalp Vein set
Kidney tray (Plastic) 12”
OTHER Scapel Blade
CONSUMABLES Cotton roll 500gm
Rolled bandages
Paper Adhesive tape
Elastic crepe bandages Non-sterile-10 cm
Sterile water for injection
Disposable Syringes- 2cc, 5cc
IV set
Disposable Needle-22G, 24G, 23G
LABORATORY Tourniquet
EQUIPMENTS Collection bulbs-EDTA, PLAIN
Lancet needles
Stains field-A, B
Pregnancy Test Card
Multi Uri sticks
Widal test kit
Slides-Standard
Urine routine- Albumin/Sugar strips
Two sets of the IUCD kit having following
instruments-Stainless steel tray with lid,
Steel bowl, Cusco/Sim’s speculum, Sponge
holding forceps, Anterior vaginal wall
retractor, Uterine sound, Long curved
scissors, Artery clamp
19
Annexure 5:
Financial norms for the Recurring Cost of the existing MMUs
1 Vehicle
Manpower# Rs. 11.4lakhs p.a 95000pm
Drugs Rs. 3 lakhs p.a 25000pm
Maintenance and Repair of Vehicle Rs. 2.4 lakhs p.a 20000pm
POL (1vehicles)0 Rs. 1.80 Lakh p.a 15000pm
Total OPEX Rs. 18.6 lakhs p.a 1.55 lakhs pm
MBBS Doctor (Rs. 40000/m) Rs. 4.8 lakhs p.a

ANM/ Staff Nurse(Rs. 15000/m) Rs. 1.8 lakhs p.a
Lab tech(Rs. 15000/m) Rs. 1.8 lakhs p.a
Pharmacist(Rs. 15000/m) Rs. 1.8 lakhs p.a
Driver-1(Rs. 10000/m) Rs. 1.2lakhs p.a
Total HR Rs. 12.6 lakhs p.a
2 Vehicle 2
Manpower# Rs. 14.4 lakhs p.a 1.2 lakhs pm
POL (2vehicles) Rs. 3.60 lakhs p.a 30000pm for 2 vehicles
Total OPEX Rs. 23.4 lakhs p.a 2.15 lakhs pm

Lab tech(Rs. 15000/m) Rs. 1.8 lakhs p.a
Pharmacist (Rs. 15000/m) Rs. 1.8 lakhs p.a
Driver-2 (Rs. 10000/m) Rs. 2.4 lakhs p.a
X-ray tech (Rs. 15000/m) Rs. 1.8 lakhs p.a
Total HR Rs. 14.4lakhs p.a
3 Vehicle
Manpower# Rs. 15.6 lakhs p.a 1.3 lakhs pm
POL (3vehicles) Rs. 5.40 lakhs p.a 45000pm for3 vehicles
Total OPEX Rs.26.4 lakh p.a 2.22 lakhs pm

Lab tech (Rs. 15000/m) Rs. 1.8 lakhs p.a
Pharmacist (Rs. 15000/m) Rs. 1.8 lakhs p.a
Driver-3 (Rs. 10000/m) Rs. 3.6 lakhs p.a
X-ray tech (Rs. 15000/m) Rs. 1.8 lakhs p.a
Total HR Rs. 15.6 lakhs p.a
*3 vehicle is no longer encouraged and is only for those existing operational MMUs
20
Appendix I-A
DEPARTMENT OF HEALTH & FAMILY WELFARE
GOVERNMENT OF (Insert name of the

State)…………..
BID ENQUIRY DOCUMENTS

FOR
(Mobile Medical Unit MMU)
CAPEX+OPEX
21
Contents
Section Topics Page No
Section I Notice Inviting Bids (NIT) 23
Section II Instructions to Bidder 25
Section III Evaluation of Bid 27
Section IV Job Description 28
Section V Eligibility Criteria 30
Section VI Terms and Conditions 31
Section VII Appendices ( A to F) 34-39
Section VIII Service Level Agreement 40
22
SECTION
NOTICE INVITING TENDERS (NIT)

<Insert the name of the Procuring Authority (Department/Directorate/Agency/Institution)>
Address:…………………………………………..
………………………………………………......
URL: www……………………………………….
Email:…………………………………………….
Telephone:……………………………................
Bid Enquiry No. PHFW/ / / Dated: / /
NOTICE INVITING BIDS

1. <insert the designation and office of the Bid inviting authority and the department/agency>
hereinafter referred to as “Mobile Medical Unit Service Procuring Agency (MMUSPA)”
invites sealed Bids from eligible bidders willing to maintain and operate Mobile Medical Units
infrastructure to provide primary and selective secondary healthcare in identified regions. The
scope of services requires are enumerated in Section-IV of this document.
2. This document contains eight sections as follows:
(i) Section I : Notice Inviting Bids
(ii) Section II: Instructions to Bidder
(iii) Section III: Procedures for evaluations of Bids
(iv) Section IV: Responsibilities of Service Providers
(v) Section V: Eligibility Criteria
(vi) Section VI: Terms and Conditions
(vii) Section VII: Formats of Appendices (A to F)
(viii)Section VIII: Standard format for Service level Agreement
3. Schedule
Sl. No. Description Date/Place

1 Date of sale of Bid Enquiry Documents
4 Pre bid Meeting (Date & Time)
5 Pre-Bid Meeting Venue
6 Closing Date and Time of Receipt of Bid
7 Time, Date and Venue of Opening of Technical Bid.
8 Time, Date and Venue of Opening of Financial Bid.
23
4. Full set of Bid Enquiry Documents may be purchased on payment of non-refundable fee
of <insert Bid cost in INR.> per set in the form of Demand Draft, drawn on a scheduled bank
in India, in favour of “<insert the designation and office of the Bid inviting authority” payable
at <insert the place>.
5. If requested, the Bid Enquiry Documents will be mailed by Registered Speed Post to the
interested Bidders, for which extra expenditure per set will be INR 100.00 for domestic post.
The Bidder is to add the applicable postage cost in non-refundable fee mentioned in Para 3
above. The MMUSPA will not be responsible for late receipt/ non-receipt of Bid document by
the vendor.
6. Bidder may also download the Bid enquiry documents (a complete set of document is available
on website) from the web site www…………...com or www……………..nic.in and submit
its Bid by using the downloaded document, along with the required non-refundable fee as
mentioned in Para 3 above. The Bid papers will be summarily rejected if the Bidder changes
any clause or Annexure of the bid document downloaded from the website.
7. All prospective Bidders are requested to attend the Pre bid meeting either in person or
through their authorized representative. No representative is allowed to represent more than
one prospective Bidder. The venue, date and time are indicated in Schedule of Events as in
Para 2 above.
8. Bidders shall ensure that their bids complete in all respects, are dropped in the Bid Box located
at (place to be inserted) on or before the closing date and time indicated in the Para 2 above,
Bids submitted after the prescribed time will be treated as late bid and will not be considered.
The Bids sent by post/courier must reach the above said address on before the closing date &
time indicated in Para 2 above, failing which the Bid will be treated as late bid and will not be
considered.
9. In the event of Bid opening day being declared a holiday / closed day for the MMUSPA,
the Bids will be received/opened on the next working day at the same time.
10. The Bid Enquiry Documents are not transferable.
(Name & Designation of the Bid Inviting Authority)
24
SECTION
INSTRUCTIONS TO BIDDER
1. General Instructions
a) The Bidder should prepare and submit its offer as per instructions given in this section.
b) The Bids should be complete with all documents dully signed by Authorized personnel.
Those submitted by telex, telegram or fax shall not be considered.
c) The Bids which are for only a portion of the components of the job /service shall not be
accepted. (The Bids /bids should be for all components of the job /service.)
d) The prices quoted shall be firm and shall include all taxes and duties. This shall be quoted
in the format as per attached Appendix ‘D’ only.
e) The Bids (technical and financial) shall be submitted (with a covering letter as per Appendix
‘C’) before the last date of submission. Late Bids / bids shall not be considered.
2. Earnest Money Deposit (EMD)
a) The Bid shall be accompanied by Earnest Money Deposit (EMD) INR..as specified in the
Notice Inviting Bid (NIT) in the form of Bank Draft / Bankers cheque from any Schedule
Bank in favour of < Insert designation of the Bid inviting authority> payable at <insert
place>
b) No Biding entity is exempt from deposit of EMD. Bids submitted without EMD shall be not
considered.
c) The EMD of unsuccessful Bidder will be returned to them without any interest, after
conclusion of the resultant agreement. The EMD of the successful Service provider will be
returned without any interest, after receipt of performance security as per the terms of
agreement.
d) EMD of Bidder may be forfeited without prejudice to other rights of the MMUSPA, if the
Bidder withdraws or amends its Bid or impairs or derogates from the Bid in any respect
within the period of validity of its Bid or if it comes to notice that the information /
documents furnished in its Bid is incorrect, false, misleading or forged. In addition to the
aforesaid grounds, the successful Bidder’s EMD will also be forfeited without prejudice to
other rights of MMUSPA, if it fails to furnish the required performance security within the
specified period.
4. Preparation of Bid
The bids shall be made in TWO SEPARATE SEALED ENVELOPES as follows:
I. The first envelope shall be marked in bold letter as “TECHNOCOMMERCIAL BID” which
shall be sent forwarding letter Appendix ‘C’ and shall include the following:
1) Receipt regarding payment of Bid cost or Bank draft drawn in favour of MMUSPA for
the amount of non refundable fee if the Bid documents have been downloaded from
web.
25
2) Bank Draft /Bankers Cheque towards E.M.D.
3) Confirmation regarding furnishing Performance Securityin case of award of
agreement.
4) Original Bid document duly stamped and signed by the authorized personnel in each
page along with the Forwarding Letter confirming the performing the assignment as
per Appendix ‘C’.
5) Particulars of the Bidder as per Appendix ‘B’ Copy of the Income Tax Returns
acknowledgement for last three financial years.
6) Power of attorney in favour of signatory to Bid documents.
7) Copy of the certificate of registration of EPF, ESI and Service Tax with the appropriate
authority.
8) A declaration from the Bidder in the format given in the Appendix ’F’ to the effect
that the firm has neither been declared as defaulter or black-listed by any competent
authority of a government department, government undertakings, local bodies,
authorities.
In addition to the above documents,
1) The Bidder shall provide certificate of other similar services provided in private/public
sector in last three years and user’s certificate regarding satisfactory completion of such
jobs as per proforma given in Appendix ‘A’.
II. The second envelope shall contain the financial proposal and shall be marked in bold
letters as “FINANCIAL BID”. Prices shall be inclusive of all taxes & duties and quoted in
the proforma enclosed at Appendix ‘D’ as per scope of work / service to be rendered.
5. Bid Validity Period
The Bids shall remain valid for <180 days> from the date of submissionfor acceptance and the
prices quoted shall remain for the duration of the agreement. . The MMUSPA may requested for
further extension as deemed fit and the Bidder will send intimation of acceptance or otherwise
of request for extension with three days of issue of such request. The agreement may be
extended for another term with mutual consent.
6. Bid Submission
The two envelopes containing both technical and the financial bid shall be put in a bigger
envelope, which shall be sealed and superscripted with “BID NO <Insert Bid No.> due for
opening on<Insert due date for Opening>
The offer shall contain no interlineations or overwriting except as necessary to correct errors, in
which cases such correction must be initialed by the person or persons signing the Bid. In case
of discrepancy in the quoted prices, the price written in words will be taken as valid.
7. Opening of Bids:
The technical bid will be opened at the time & date specified in the schedule. The Service
providers may attend the bid opening if they so desire.
26
SECTION
EVALUATION OF BIDS
1. Scrutiny of Bids
The Bids will be scrutinized to determine whether they are complete and meet the essential
and important requirements, conditions and whether the Bidder is eligible and qualified as
per criteria laid down in the Bid Enquiry Documents. The bids, which do not meet the aforesaid
requirements, are liable to be treated as non-responsive and may be ignored. The decision of
the MMUSPA as to whether the Bidder is eligible and qualified or not and whether the bid is
responsive or not shall be final and binding on the Bidders. Financial bids of only those Service
providers, who qualify technical bid, will be considered.
2. Infirmity / Non-Conformity
The MMUSPA may waive minor infirmity and/or non-conformity in a Bid, provided it does not
constitute any material deviation. The decision of the MMUSPA as to whether the deviation is
material or not, shall be final and binding on the Service providers.
3. Bid Clarification
Wherever necessary, the MMUSPA may, at its discretion, seek clarification from the Bidders
seeking response by a specified date. If no response is received by this date, the MMUSPA shall
evaluate the offer as per available information.
4. Evaluation of Technical Proposal:
Criteria/Parameter Marks Tally Maximum Marks
1. Experience of the Bidder/Consortium in implementing similar

project at community level: 10 10
a.) 5 years and above 5
b.) 3-5 years 3
c.) 0-3 years
2.) No. of MMU being operated in states in last 5 years
a.) 30 and Above 10
b) 10-30 5 10
c) Less than 10 3
3.) Quality of skilled Human resources in the Provided MMU
a) With Doctor
b) Without Doctors 10 10
5
27
SECTION
Job Description
1. Service Aims
1.1 The primary obligation of the service provider will be to operate the Mobile Medical units
to provide primary and selected secondary health care ensuring that MMU
a. Is fully equipped with equipments listed in “AnnexureI” of Service Agreement list ;
b. Is manned by adequate manpower resources as per the requirement enumerated in

“Annexure III” of the Service agreement list.
c. The MMUs are provided with necessary fuel for carrying on operations on regular
basis
1.2 It is the responsibility of <Name of the MMUSPA> to arrange supply free of cost good quality
generic drugs and consumables as per the requisitions received from the service provider.
<Name of the MMUSPA> would make all effort to keep the MMUs well stocked with drugs and
consumables at all the times. Supplies shall be made within 3 days of requisitions.
2. Obligations of the service provider:
1. It will be the responsibility of service provider to arrange MMU vehicles along with all the
listed equipments, human resources to maintain the MMU operational. All the maintenance
cost of equipment as well as vehicles will be borne by the service provider since vehicles
and equipment are to be provided by the service provider. The vehicles should not be
more than two years old from the date of manufacturer on the day of commencement of
service. At no point of time during the currency of the Service agreement, the vehicle will
be more than 5 years old from the date of manufacturer.
2. The service provider shall follow the standard operating procedures (SOPs) as approved by
the competent authority in MMUSPA.
3. The service provider would recruit, deploy and maintain a team of competent personnel
for running the MMU. A list of minimum key personnel required with their qualifications
are given in “AppendixIII”of the service agreement list. The staffs so recruited/
appointed shall be exclusively on Pay roll of the service provider. The Service Provider will
ensure deployment of the minimum personnel as enumerated above to keep the MMUs
operational and capable of providing the services as agreed upon.
4. The Service provider shall follow the Service Plan/Route plan/Calendar for MMU as
approved by the District Health officer/CMO. It is expected that Sunday will be the day
on which no service would require to be provided and the weekly off on Sunday it could
be used for maintenance, refilling and data entry purposes. However, the competent
authority may declare any other day in the week as “off-day”. In exceptional circumstances,
the weekly off day can be cancelled by the competent authority.
28
5. The MMU should be equipped with the all the equipments proposed in “Annexure I” of
the servile agreement list”.
6. All drugs should be provided free to the service provider within 3 days of requisitions.
7. The service provider shall submit data to the state government every month as per
“Annexure II”of the service agreement list.
8. The service provider would procure all necessary road and goods permits for the MMU and
maintain the same throughout the period.
9. The logbook of movement of the MMU shall be maintained by the MMU driver and
supervised by the Medical Officer in charge of the MMU. Logbook shall be made available
for verification by the any authority nominated by MMUSPA.
10. Service provider shall communicate the names and addresses of the Team manning a
particular MMU during the currency of the agreement and any change in the composition
of the team must be intimated to the authority nominated by the MMUSPA. The names of
men at work at the MMU at any point of time must also be displayed prominently on the
MMU.
11. The Service provider will also comply with confidentiality and privacy laws including
patient details.
12. All records maintained by the Service provider regarding operations of MMUs will be made
available to any government authority including audit on demand.
13. It should be clearly understood that under no circumstances, the MMUs will be used to
advertise the operations of the service provider. It should be clearly mentioned on the outer
body of the MMU that the service is provided by the service provided by an agreement
between MMUSPA and the service provider.
14. Requirements of any Act promulgated by the Central State Law will have to meet by the
service provider. Details as required under RTI should be notified in the MMU.
29
SECTION
ELIGIBILITY CRITERIA
1. The bidder shall be a sole provider or a group of providers/NGO (maximum3) coming together
as Consortium to implement the Project, represented by a lead member. The bidder cannot be
an individual or group of individuals. A bidder cannot bid as a sole provider as well as a partner
in a consortium. No bidder can place more than one bid in any form in the state.The bidder
should be registered as a legal entity.
2. The bidder and in case of a consortium all the participants shall have at least three years
experience in providing medical care at community level. In support of this, a statement
regarding assignments of similar nature successfully completed during the last three years
should be submitted as per Performa in Appendix ‘A’. Users’ certificate regarding satisfactory
completion of assignments should also be submitted. The assignment of Govt. Depts. / Semi
Govt. Depts. should be specifically brought out. (The decision of the state government as to
whether the assignment is similar or not and whether the bidder possesses adequate experience
or not, shall be final and binding on the bidders). The bidders may in addition provide any other
documentation in support of their claims of experience in providing community healthcare.
3. The bidder should not be presently blacklisted by the MMUSPA or any government agencies/
local bodies.
4. In case of Consortium, the lead member shall be legally responsible and shall represent all
consortium members, if any, in all legal matters.
5. The bidders shall provide the balance sheet (Income & Expenditure account in case of NGOs) of
last three years.
6. The bidder(s) must have turnover not less than 60% of the bid amount quoted for each of the
last three years. In case of NGOs, cost of community healthcare services provided should not be
less than 60% of the bid amount quoted for each of the last three years.
30
SECTION
TERMS AND CONDITIONS

1. Signing of Agreement
The MMUSPA shall issue the Notice for Award of Agreement to the successful bidder within
the bid validity period. And the successful bidder will be required to sign the Service level
agreement with the MMUSPA or its nominee within 15 days of receipt of such communication.
2. A model copy of service agreement is at the Appendix_________.
3. Modification to agreement:
The agreement when executed by the parties shall constitute the entire agreement between
the parties in connection with the jobs / services and shall be binding upon the parties.
Modification, if any, to the agreement shall be in writing and with the consent of the parties.
The agreement shall be valid for a period of 3 years from the date of signing of the same.
In case the service provider fails to adhere to the rules, regulations or any of the terms and
condition of the agreement or in case the service provided is considered to be unsatisfactory
by the _________, the service provider will be asked to provide his response in writing within
15 working days to specific case of violations and unsatisfactory services. The MMUSPA would
be free to cancel the agreement after considering the response of the service provider and
recording the reasons for its decision.
4. Performance Security
a) The successful bidder shall furnish a performance security in the shape of a Demand Draft/
Bank Guarantee issued by a Nationalised Bank in favour of Tender Inviting Authority for
an amount equal to 5% of the total agreement value. The Bank guarantee shall be as per
proforma at Appendix ‘E’ and remain valid for a period, which is three months beyond
the date of expiry of the agreement. This shall be submitted within 15 days (minimum) of
receiving of Notice for Award of Agreement and before signing of the agreement failing
which the EMD may be forfeited.
b) If the agreement is cancelled at any time during the validity period of the agreement in
terms of para 4 above the Performance Security shall be forfeited
c) The MMUSPA will release the Performance Security without any interest to the firm /
contractor on successful completion of contractual obligations.
d) The total cost of tender would be the basis to calculate non operative cost per MMU per
day. For all days when a certain number of MMU has not been functional, cost deducted
would be:
(Cost per MMU per day)*(Total Number of MMU non operative)*(Number of days Non operative)
5. Compliance of Minimum Wages Act and other statutory requirements
The Service provider shall comply with all the provisions of Minimum Wages Act and other
applicable labor laws. The Service provider shall also comply with all other statutory provision
31
including but not limited to provisions regarding medical education and eligibility criteria of
human resources used by the Service provider for providing the services, biomedical waste
management, biosafety, occupational and environmental safety.
The overall legal responsibility of provision of medical care lies with the Authority/public health
facility.
The Service provider shall maintain confidentiality of medical records and shall make adequate
arrangement for cyber security.
6. Income Tax Deduction at Source
Income tax deduction at source shall be made at the prescribed rates from the Service provider’s
bills. The deducted amount will be reflected in the requisite Form, which will be issued at the
end of the financial year.
7. Periodicity of Payment
The payment will be made on monthly basis not extending beyond 12 noon of the last bank
working day of the month as per the clause no.11 in the service agreement list. The MMUSPA
shall give standing instructions to the bank for implementation of this requirement. The Service
provider will raise its invoice on completion of services during this period duly accompanied by
evidences of services provided. The payment will be subject to TDS as per Income Tax Rules and
other statutory deductions as per applicable laws.
8. Damages for Mishap/Injury
The MMUSPA shall not be responsible for damages of any kind or for any mishap/injury/
accident caused to any personnel/property of the Service provider while performing duty in
the MMUSPA’s / consignee’s premises. All liabilities, legal or monetary, arising in that eventuality
shall be borne by firm/ contractor.
9. Termination of Agreement:
The MMUSPA may terminate the agreement, if the successful Bidder withdraws its Bid after
its acceptance or fails to submit the required Performance Securities for the initial agreement
and or fails to fulfill any other contractual obligations. In that event, the MMUSPA will have the
right to purchase the same goods/ equipment from next eligible Service provider and the extra
expenditure on this account shall be recoverable from the defaulter. The earnest money and
the performance security deposited by the defaulter shall also be recovered to pay the balance
amount of extra expenditure incurred by the MMUSPA.
After completion of the tenure of Bid, the Service provider will be allowed to vacate the space
within a period of 15 days, in all the facilities where provider was providing the services.
10. Arbitration
a) If dispute or difference of any kind shall arise between the MMUSPA and the firm/contractor
in connection with or relating to the agreement, the parties shall make every effort to
resolve the sameamicably by mutual consultations.
b) If the parties fail to resolve their dispute or difference by such mutual consultations within
thirty days of commencement of consultations, then either the MMUSPA or the firm/
32
contractor may give notice to the other party of its intention to commence arbitration, as
hereinafter provided. The applicable arbitration procedure will be as per the Arbitration
and Conciliation Act, 1996 of India. In that event, the dispute or difference shall be referred
to the sole arbitration of an officer to be appointed by the <insert Bid issuing authority>
as the arbitrator. If the arbitrator to whom the matter is initially referred is transferred or
vacates his office or is unable to act for any reason, he / she shall be replaced by another
person appointed by <insert Bid issuing authority> to act as Arbitrator.
c) Work under the agreement shall, notwithstanding the existence of any such dispute or
difference, continue during arbitration proceedings and no payment due or payable by
the MMUSPA or the firm / contractor shall be withheld on account of such proceedings
unless such payments are the direct subject of the arbitration.
d) Reference to arbitration shall be a condition precedent to any other action at law.
e) Venue of Arbitration: The venue of arbitration shall be the place from where the agreement
has been issued.
11. General Terms and Conditions:
a. The Service provider shall commence the proposed services within the 30 days of signing
the agreement.
b. The Authority shall finalize the Standard Operating Procedures (SOPs) for each of the
services to be followed by the Service provider.
c. All payments should be made within 30 days of submission of necessary bills/invoices.
d. Patient Feedback/Suggestions/Grievance Redressal- Periodic feedback from patients
are to be taken on structured questionnaire. Result would be analyzed by the state
government for further improvement of services and feedback to the service provider.
Telephone numbers where patients can lodge their complaints will be displayed on MMU.
12. Applicable Law and Jurisdiction of Court:
The agreement shall be governed by and interpreted in accordance with the laws of India for the
time being in force. The Court located at the place of issue of agreement shall have jurisdiction
to decide any dispute arising out of in respect of the agreement. It is specifically agreed that no
other Court shall have jurisdiction in the matter.
<Insert name and address of the Bid inviting authority>
33
Appendix-A
Community based Health services provided in last 3 years.
1. Attach users’ certificates (in original) regarding satisfactory completion of assignments
Note: Attach extra sheet for above Performa if required.
Signature………………………………
Name …………………………………..
organization with
assignment done
Phone No. where
Was assignment
commencement
completed/It is
Agreement No
work/ services
Description of
satisfactorily
Sr. No
Assignment
assignment
completion
Agreement
Address of
provided
ongoing
price of
Date of
Date of
&date
10
34
Appendix-B
PARTICULARS OF THE BIDDER
(To be submitted by all BIDDERS including participant in Consortium)
1.
Name :
2. Type of Organisation : Prop./Partnership/Company/Consortium/Trust/
Not for Profit Organization
3. Address of Service centres in the region:
(a) Total No. of services personnel at the existing centres:
(b) Total No. of locations where organization currently has centres:
4. Number of service personnel:
Name Qualification Experience (Similar Service)
(use extra sheet if necessary)
5. Registration. Nos.
(a) EPF
(b) ESI
(c) Sales Tax
(d) VAT
(e) Service Tax
(f ) PAN No.
(g) Audited Accounts Statement for past three financial years
(h) Copy of Income Tax Return for past three financial years
(i) Experience certificate of Service provider
6. Brief write-up about the firm / company. (use extra sheet if necessary)
Signature of Service providers
Date: Name
Place: Office Seal
35
Appendix-C
Forwarding Letter for Technical Bid
(To be submitted by all Service providers in their letterhead)
Date:……………….
To
<Name, Designation and Address of Bid Inviting Authority>
Sub: Bid for provision of Mobile Medical Unit under Bid No….
Sir,
We are submitting, herewith our Bid for providing annual maintenance services / comprehensive
maintenance services for ……………………….
We are enclosing Receipt No……………….. or Bank Draft/Bankers Cheque No………………….,

Dated…………………(amount……………………)towards Bid cost/fee (if documents have been
downloaded from website) and Bank Draft / Bankers Cheque No………………. Dated………………
(Amount………………) towards Earnest Money Deposit (EMD), drawn on…………………… Bank
in favour of <Bid Inviting Authority>.
We agree to accept all the terms and condition stipulated in your Bid enquiry. We also agree to
submit Performance Security as per Clause No. 3 of Section VI of Bid Enquiry document.
4. We agree to keep our office valid for the period for the period stipulated in your Bid enquiry.
Enclosures:
1.
2.
3.
4.
5.

Signature of the Bidder……………………

Seal of the Bidder…………………………
36
Appendix-D
FINANCIAL BID
1. Name of the Bidder:………………………………………………………………..

2. Prices Quoted :-
S.No Cost Head per MMU Operational No. of Units Total Cost
Cost Per quoted for
annum (INR)
01 Human Resources (Per MMU)
02 Maintenance and Repair of vehicle POL
03 Equipment
04 Consumables & Regents (excluding drugs)
05 Fuel
Total Cost of the proposed project per annum

Total Cost per MMU per annum
(In words……………………………………………………………………………)
The prices shall be firm and inclusive of all taxes and duties presently in force.
Signature…………………………………
Name………………………………………..
37
Appendix-E
PROFORMA FOR BANK GUARANTEE
To
<Name, Designation and Office Address of Bid Inviting Authority>
WHEREAS……………………………………………………..(Name and address of the Service

Provider) (Hereinafter called “ the service provider” has undertaken, in pursuance of agreement
No……………….. dated …………………….. (Herein after “the agreement”) to provided specific
Mobile Medical Units.
AND WHEREAS it has been stipulated by you in the said agreement that the service provider shall
furnish you with a bank guarantee by a scheduled commercial bank recognized by you for the sum
specified therein as security for compliance with its obligations in accordance with the agreement;
AND WHEREAS we have agreed to give such a bank guarantee on behalf of the service provider;
NOW THEREFORE we hereby affirm that we are guarantors and responsible to you, on behalf of the
service provider, up to a total of………………………………………….. (Amount of the guarantee
in words and figures), and we undertake to pay you, upon your first written demand declaring the
service provider to be in default under the agreement and without cavil or argument, any sum or
sums within the limits of (amount of guarantee) as aforeside, without your needing to prove or
to show grounds or reasons for your demand or the sum specified therein. We hereby waive the
necessity of your demanding the said debt from the service provider before presenting us with
the demand. We further agree that no change or addition to or other modification of the terms of
the agreement to be performed there under or of any of the agreement documents which may be
made between you and the service provider shall in any way release us from any liability under this
guarantee and we hereby waive notice of any such change, addition or modification.
This guarantee shall be valid up to 15 (fifteen) months from the date of signing of agreement i.e. up
to………….. (Indicate date)
……………………………………………………………
(Signature with date of the authorized officer of the Bank)
……………………………………………………………….
Name and designation of the officer
………………………………………………………………..
Seal, name & address of the Bank and address of the Branch
38
Appendix-F
DECLARATION BY SERVICE PROVIDER
I / We ……………………………… agree that we shall keep our price valid for a period of one
year from the date of approval. I / We will abide by all the terms & conditions set forth in the Bid
documents No. …….. /
I / We do hereby declare I / We have not been de-recognized / black listed by any State Govt. /
Union Territory / Govt. of India / Govt. Organisation / Govt. Health Institutions.
Signature of the Service provider:
Date:
Name & Address of the Firm:
Affidavit before Executive Magistrate / Notary Public in INR 50.00 stamp paper.
39
Service Level Agreement
No_______________
SERVICE LEVEL AGREEMENT
Between
………….
(MMU Service Procuring Agency)
And
………….
(Service Provider)
To maintain and operate Mobile Medical Units (MMU) infrastructure to provide primary and
selective secondary healthcare in identified regions.
40
1. BACKGROUND
1.1 <NAME OF THE MMUSPA>hereinafter referred to as MMUSPA desirous of outsourcing
the services relating to operation of Mobile Medical Units in <name of the identified
region> had invited tenders from eligible bidders vide TE No ________________ dated
_____________. <Name of the Service Provider> having submitted his bid in response to
the tender enquiry and having been found technically qualified as per the conditions in the
same TE, has been awarded the agreement by the competent authority in the <MMUSPA>.
<Name of the Service Provider> has also performed required obligations after the award
of agreement was communicated to him.
1.2 Both <Name of the MMUSPA> and <Name of the Service Provider>hereinafter referred
to as Service Provider hereby willingly enter into this agreement and agree to abide by all
obligations enjoined on them by this agreement.
2. SERVICE AIMS
2.1 The primary obligation of the Service provider will be to operate the Mobile Medical Unit(s)
to provide primary and selected secondary health care ensuring that such MMU:
a. Is fully equipped with equipments listed in “AnnexureI” of Service Agreement list ;
b. Is manned by adequate manpower resources as per the requirement enumerated in

c. The MMUs are provided with necessary fuel for carrying on operations on regular
basis
2.2 It is the responsibility of <Name of the MMUSPA> to arrange supply of good quality generic
drugs and consumables as per the requisition received from the service provider. <Name
of the MMUSPA> would make all efforts to keep the MMUs well stocked with drugs and
consumables at all times. Supplies shall be made within 3 days of requisitions.
2.3 The Service Provider categorically states that if he avails of any loan to procure, lease or
hire purchase vehicles from any Banks, financial institutions, other agencies or individuals,
he will not make the MMUSPA a party in any manner in such transaction nor will use this
agreement as a guarantee of any manner nor will use future revenue expected to him from
this agreement to hypothecate such procurement of vehicles.
3. SERVICE OBJECTIVES
3.1 The service provider will also provide the operational set such as power generator, fuel for
the vehicles and all other requirements to keep the MMU vehicle in operational condition
at all times.
41
3.2 It is explicitly stated that both the parties are committed to enhance the health and well-
being of residents of the area covered by the Service Level Agreement by providing high
quality service, innovation and development and to meet identified needs within the
resources available to both the parties.
4. SERVICE DESCRIPTION AND RESPONSIBILITIES

Out-patient services:
4.1 The Mobile Medical Units will provide only out-patient services. These units will function
as mobile clinics and are not meant to transport patients.
4.2 The Service provider shall follow the Service Plan/Route plan/Calendar for MMU as
approved by the District Health officer/CMO and accordingly make the services of the
MMU available at the desired spot on the appointed days.
4.3 The Service Provider shall provide primary and secondary health care as per the standard
operating procedures approved by the Service procuring agency.
4.4 The Service provider hereby agrees that Mobile Medical Unit must always operate under
the supervision of a qualified Medical Officer. The Service provider further agrees that at any
time and under any circumstances, patient care would not be carried out by unauthorised
personnel.
4.5 Service provider agrees that failure to adhere to the Service Plan/Route Plan/Calendar
referred to Paragraph 4.2 above would constitute a variation in terms of Paragraph 12.1 of
this Agreement and a default of an obligation in terms of Paragraph 15.2 of this Agreement.
Service Component:
4.5 The service at the MMU will be clinically led by a qualified Medical Officer. Patients will
have access to primary and selective clinical management by a qualified Medical Officer.
4.6 Ailments which shall not normally require further referral/ specialist care will be treated at
the MMU only. Patients will be treated and provided drugs free of cost. No charges of any
kind will be recovered from the patients.
5. REFERRAL PROCESS & ELIGIBILITY

5.1 It will be the responsibility of <Name of the MMUSPA> to provide the Service provider
an “information matrix” for nearest facilities including their capacity in terms of existing
Laboratory services, diagnostic services, and human resources available.
5.2 It will be the responsibility of the Service Provider to keep the Medical Officer(s) in charge
of the MMU informed of the information matrix. For services not available at the MMU,
patients can be referred to nearest facility in accordance with the “information matrix“.
5.3 Both the parties hereby agree that no patient will be referred to any private medical
establishment either formally or informally without specific prior approval of the <Name
of the MMUSPA>.
42
6. INFORMATION AND REPORTING REQUIREMENTS
6.1 The Service provider shall ensure that information, records and documentation necessary
to monitor the agreement are maintained and are available at all times to the <Name of
the MMUSPA> or its authorised representative. The Service Provider hereby agrees that he
and all his staff shall at all times co-operate with the reasonable processes of the Service
procuring agency for the monitoring, evaluation and carrying out quality audit and
financial audit by any third party authorised by <Name of the MMUSPA>.
6.2 The Service provider hereby agrees to maintain all relevant data and records of all patients
treated at the MMU.
6.3 The Service provider further agrees to maintain confidentiality of these data and records
and commits that such data and records will not be shared with any third party for any
purpose.
6.4 The Service provider agrees to provide data to <Name of the MMUSPA> as per attached
Annexure II every month. Failure to do so may entail cancellation of the agreement.
6.5 The Service provider hereby agrees to maintain log book showing all movements of the
MMU vehicle and keep record of consumption of POL. The log book should be maintained
as per the format in vogue in any government office. Logbook shall be made available for
verification by the any authority nominated by Service procuring agency.
6.6 The Service provider agrees that the MMU vehicles will not be used to advertise any
product or organisation including the Service provider’s own. The following text must
appear on both sides of the MMU vehicle in reasonably big font-size to enable a normal
sighted person to read it from a reasonable distance:
“Mobile Medical Unit

Run by
Agreement No <No of the Agreement>
Between <Name of the Service Procuring Agency> and <Name of the Service Provider>”
6.7 The Service provider agrees to display copies of this agreement, list of medical equipment
available with the MMU, stocks of drugs and consumables at prominent place in the MMU.
The names of the Medical Officer and other personnel on duty must also be displayed
during duty hours.
7. PERFORMANCE
7.1 An half yearly review meeting will be held and attended by appropriate levels of officials
of Service procuring agency and Service providers to consider the performance, the
anticipated outcome of the agreement and future service developments and changes.
Further meetings may be arranged at any time to consider significant variation in the
terms or conduct of the agreement and where corrective action on either part is indicated.
43
7.2 Both the Service procuring agency and Service Provider agree to consider introduction of
any further service in line with any new initiative of the government or in response to local
demand which could not be anticipated earlier.
7.3 Both the Service procuring agency and Service Provider agree that such services should
be provided without extra cost. However, if it is felt by both the parties that the additional
services would require additional resources/manpower, the Service procuring agency
agrees to consider reasonable increases in amount disbursed to the Service provider. It is
agreed that the Service provider will be under no obligation to introduce the additional
service unless a commitment to reimburse additional cost has been provided to him.
8. HEALTH AND SAFETY

8.1 The Service Provider agrees to adequately train, instruct and supervise staff to ensure as
is reasonably practicable, the health and safety of all persons who may be affected by the
services provided under the agreement.
8.3 The Service provider agrees that he would collect periodic feedback from the patients
through structured questionnaire at his cost. The periodicity will not be less than once
in six months. Responses to the questionnaire will be submitted in original to the Service
procuring Agency Telephone numbers where patients can lodge their complaints to be
displayed on MMU.
9. DATA PROTECTION, CONFIDENTIALITY AND RECORD KEEPING

9.1 All Service Users have a right to privacy and therefore all information and knowledge
relating to them and their circumstances must be treated as confidential. The Service
Provider must advise all staff on the importance of maintaining confidentiality and
implement procedures which ensure that Service User’s affairs are only discussed with
relevant people and agencies.
9.2 The Service Provider shall comply with all legislations, which otherwise would have been
applicable had the services been run directly by the Government agencies.
10. STAFFING
10.1 The Service provider will ensure that, at all times, it has sufficient suitably trained staff to
ensure that services comply with all the statutory requirements and meet patient needs.
10.2 The Service provider agrees that he would ensure that a minimum complement of staff
mentioned at Annexure III of this Agreement would be in position in each MMU.
10.3 The Service provider agrees that a record of qualifications shall be maintained by the
provider and available for inspection.
10.4 The Service provider hereby expresses his commitment to training and staff development
and the maintenance of professional knowledge and competence.
44
11. FINANCE ARRANGEMENTS
11.1 Both parties agree that the payment arrangements as quoted by the Service provider in
his bid against the above mentioned tender enquiry and/or subsequent bid submitted
by him as a result of negotiations shall be adhered to.
11.2 It is agreed that payments would be made monthlybasis. To facilitate this, the Service
provider will submit invoices with all documents in support of his claims on every last
working day of the month. On the basis of such invoices, the Service procuring agency
agrees to provisionally transfer the amount electronically to the Service provider’s bank
account.
11.3 The Service procuring agency or any other agency as per existing rules of the government
will have the right to examine the invoices as required under relevant rules. If such
examination reveals any extra payment already provisionally made, the extra amount
will be adjusted from the next payment due to the Service provider under intimation to
him.
11.4 In case the last day of the month is holiday as a result of which invoices cannot be
submitted, the Service procuring agency agrees to make payment of an equivalent
amount of the last invoice submitted. Additional amount paid if any on the basis
of actual invoices submitted later and examination thereof will be adjusted from
subsequent payments under intimation to the Service provider.
11.5 The Service provider hereby agrees to maintain all required books of accounts and
agrees to provide them to such audit as may be required to be carried out.
11.6 The Service provider hereby agrees that the Service procuring agency will deduct from
all payments such amount of statutory taxes and duties as he is required to deduct
under provisions of law.
The amount would be deducted if the MMU becomes non operative as mentioned and
calculated above in Section VI.
12. VARIATION
12.1 This Service Level Agreement may not be varied unless a variation is agreed in writing
and signed by all parties.
13. DISPUTES
13.1 The agreement shall be governed by and interpreted in accordance with the laws of
India for the time being in force. The Court located at the place of issue of agreement
shall have jurisdiction to decide any dispute arising out of in respect of the agreement.
It is specifically agreed that no other Court shall have jurisdiction in the matter.
13.2 Both parties agree to make their best efforts to resolve any dispute between them by
45
mutual consultations.
14. ARBITRATION
14.1 If the parties fail to resolve their dispute or difference by such mutual consultations
within thirty days of commencement of consultations, then either the Service procuring
agency or the Service provider may give notice to the other party of its intention to
commence arbitration, as hereinafter provided. The applicable arbitration procedure
will be as per the Arbitration and Conciliation Act 1996 of India. In that event, the dispute
or difference shall be referred to the sole arbitration of an officer as the arbitrator to
be appointed by the <Name of the MMUSPA>. If the arbitrator to whom the matter is
initially referred is transferred or vacates his office or is unable to act for any reason, he
/ she shall be replaced by another person appointed by <Name of the MMUSPA> to act
as Arbitrator.
14.2 Work under the agreement shall, notwithstanding the existence of any such dispute or
14.3 Reference to arbitration shall be a condition precedent to any other action at law.
14.4 Venue of Arbitration: The venue of arbitration shall be the place from where the
agreement has been issued.
15. TERMINATION
15.1 Either party may terminate this agreement by giving not less than 3 months notice
in writing to the other. This notice shall include reasons as to why the agreement is
proposed to be terminated.
15.2 The Service Procuring agency may terminate the agreement, or terminate the provision
of any part of the Services, by written notice to the Service provider with immediate
effect if the Service Provider is in default of any obligation under the agreement, where
a. the default is capable of remedy the Service Provider has not remedied the default
to the satisfaction of the Service procuring agency within 30 days of at least two
written advice, or such other period as may be specified by the Service procuring
agency, after service of written notice specifying the default and requiring it to
be remedied; or
b. the default is not capable of remedy; or
c. the default is a fundamental breach of the agreement
15.3 If the Service procuring agency terminates the agreement and then makes other
arrangements for the provision of the Services, it shall be entitled to recover from the
Service provider any loss that had to be incurred due to such sudden termination of
agreement.
46
15.4 Both the parties agree that no further payment would be made to the Service provider,
even if due till settlement of anticipated loss as a result of premature termination of the
agreement.
15.5 The MMUSPA reserves the right to terminate the agreement without assigning any
reason if services of the MMU create serious adverse publicity in media and prima facie
evidence emerges showing negligence of the Service provider.
16. Indemnity
16.1 By this agreement, the Service provider indemnifies the Service procuring agency
against damages of any kind or for any mishap/injury/accident caused to any personnel/
property of the Service provider while performing duty.
16.2 The Service provider agrees that all liabilities, legal or monetary, arising in any eventuality
shall be borne by the Service provider.
17. PERIOD OF AGREEMENT

17.1 This Service Level Agreement shall take effect on ……..until ……….. . The period may
be extended for another period of three years with the agreement of both parties after
mutual negotiations.
47
1. Signed for and on behalf of the MMU Service Procuring Agency
(MMUSPU)……………………………………
Signed: ............................................................
Name: ............................................................
Designation:............................................................
Date:............................................................
2. Signed for and on behalf of the Service Provider:
Signed:............................................................
Name:............................................................
Designation:............................................................
Date: ............................................................
Witnesses:
1) ___________________________________________
2) ____________________________________________
3) _____________________________________________
48
Annexure I
Proposed list of Equipment in the MMU

Stethoscope 2
B.P. Apparatus 2
Incubator 1
Nebulizer 1
Ambu bag Adult 2
Glucometer 1
Laser Printer 1
Digital camera 1
Speaker 2
Amplifier 1
LCD Projector 1
Water Purifier 1
49
Waste Collecting bins, as per Biomedical waste Management 1
specifications
Stool 4
Cot 1
Examination table 1
Chairs 5
Generator 1
AC Fan 1
Dvd Player 1
Fire Extinguisher 1
View Box 1
Digital clock 1
Extension box 2
Emergency light 2
Soap Container 3
Towel Holder 2
Semi-Auto Hematology analyzer (3 part) 1
Test tubes 1
Auto pipettes 1
Ophthalmoscope Digital 1
Auto scope 1
Examination Torch 2
Portable Laboratory unit
Non invasive Hb-meter
12 Lead ECG Machine 1
Tonometer 1
50
Annexure II
Reporting Proforma for each functional MMU
S. Location Number Number Number Number of Number Nearest Facility

No. of MMU of OPD of ANC/ of Lab Test ECG/XRAYS of Patients to the MMU
PNC Conducted Referred (Name & type)
51
Annexure III
A. Staff Composition
Name of staff Qualification No. Of

persons
Medical Officer M.B.B.S 1
Nursing GNM preferable- if not ANM 2
Ophthalmic Technician Certificate course in Ophthalmology 1
Lab Tech +Male worker B.Sc DMLT/HSC DMLT 1
Driver cum Support Staff SSC Heavy Vehicle License & Indemnity bond of 2
Accident free driving in last three years.
52
Appendix I-B
DEPARTMENT OF HEALTH & FAMILY WELFARE
GOVERNMENT OF (Insert name of the

State)…………..
BID ENQUIRY DOCUMENTS

FOR
(Mobile Medical Unit MMU)
OPEX
53
Contents
Section Topics Page No
Section I Notice Inviting Bids (NIT) 55
Section II Instructions to Bidder 57
Section III Evaluation of Bid 59
Section IV Job Description 60
Section V Eligibility Criteria 62
Section VI Terms and Conditions 63
Section VII Appendices ( A to F) 66-71
Section VIII Service Level Agreement 72
54
SECTION
NOTICE INVITING BIDS (NIT)

<Insert the name of the Procuring Authority (Department/Directorate/Agency/Institution)>
Address:…………………………………………..
………………………………………………......
URL: www……………………………………….
Email:…………………………………………….
Telephone:……………………………................
Bid Enquiry No. PHFW/ / / Dated: / /
NOTICE INVITING BIDS

11. <insert the designation and office of the Bid inviting authority and the department/agency>
hereinafter referred to as “Mobile Medical Unit Service Procuring Agency (MMUSPA)”
invites sealed Bids from eligible bidders willing to maintain and operate Mobile Medical Units
infrastructure to provide primary and selective secondary healthcare in identified regions. The
scope of services requires are enumerated in Section-IV of this document.
12. This document contains eight sections as follows:
(vii) Section I : Notice Inviting Bids
(viii) Section II: Instructions to Bidder
(ix) Section III: Procedures for evaluations of Bids
(x) Section IV: Responsibilities of Service Providers
(xi) Section V: Eligibility Criteria
(xii) Section VI: Terms and Conditions
(vii) Section VII: Formats of Appendices (A to F)
(viii)Section VIII: Standard format for Service level Agreement
3. Schedule
Sl. No. Description Date/Place

1 Date of sale of Bid Enquiry Documents
4 Pre bid Meeting (Date & Time)
5 Pre-Bid Meeting Venue
6 Closing Date and Time of Receipt of Bid
7 Time, Date and Venue of Opening of Technical Bid.
8 Time, Date and Venue of Opening of Financial Bid.
55
14. Full set of Bid Enquiry Documents may be purchased on payment of non-refundable fee
of <insert Bid cost in INR.> per set in the form of Demand Draft, drawn on a scheduled bank
in India, in favour of “<insert the designation and office of the Bid inviting authority” payable
at <insert the place>.
15. If requested, the Bid Enquiry Documents will be mailed by Registered Speed Post to the
interested Bidders, for which extra expenditure per set will be INR 100.00 for domestic post.
The Bidder is to add the applicable postage cost in non-refundable fee mentioned in Para 3
above. The MMUSPA will not be responsible for late receipt/ non-receipt of Bid document by
the vendor.
16. Bidder may also download the Bid enquiry documents (a complete set of document is available
on website) from the web site www…………...com or www……………..nic.in and submit
its Bid by using the downloaded document, along with the required non-refundable fee as
mentioned in Para 3 above.The Bid papers will be summarily rejected if the Bidder changes
any clause or Annexure of the bid document downloaded from the website.
17. All prospective Bidders are requested to attend the Pre bid meeting either in person or
through their authorized representative. No representative is allowed to represent more than
one prospective Bidder. The venue, date and time are indicated in Schedule of Events as in
Para 2 above.
18. Bidders shall ensure that their bids complete in all respects, are dropped in the Bid Box located
at (place to be inserted) on or before the closing date and time indicated in the Para 2 above,
Bids submitted after the prescribed time will be treated as late bid and will not be considered.
The Bids sent by post/courier must reach the above said address on before the closing date &
time indicated in Para 2 above, failing which the Bid will be treated as late bid and will not be
considered.
19. In the event of Bid opening day being declared a holiday/closed day for the MMUSPA,
the Bids will be received/opened on the next working day at the same time.
20. The Bid Enquiry Documents are not transferable.
(Name & Designation of the Bid Inviting Authority)
56
SECTION
INSTRUCTIONS TO BIDDER
2. General Instructions
f ) The Bidder should prepare and submit its offer as per instructions given in this section.
g) The Bids should be complete with all documents dully signed by Authorized personnel.
Those submitted by telex, telegram or fax shall not be considered.
h) The Bids which are for only a portion of the components of the job /service shall not be
accepted. (The Bids /bids should be for all components of the job /service.)
i) The prices quoted shall be firm and shall include all taxes and duties. This shall be quoted
in the format as per attached Appendix ‘D’ only.
j) The Bids (technical and financial) shall be submitted (with a covering letter as per Appendix
‘C’ before the last date of submission. Late Bids / bids shall not be considered.
2. Earnest Money Deposit (EMD)
e) The Bid shall be accompanied by Earnest Money Deposit (EMD) of INR…. as specified in
the Notice Inviting Bid (NIT) in the form of Bank Draft / Bankers cheque from any Schedule
Bank in favour of < Insert designation of the Bid inviting authority> payable at <insert
place>
f ) No Biding entity is exempt from deposit of EMD. Bids submitted without EMD shall not be
considered.
g) The EMD of unsuccessful Bidder will be returned to them without any interest, after
conclusion of the resultant agreement. The EMD of the successful Service provider will be
returned without any interest, after receipt of performance security as per the terms of
agreement.
h) EMD of Bidder may be forfeited without prejudice to other rights of the MMUSPA, if the
Bidder withdraws or amends its Bid or impairs or derogates from the Bid in any respect
within the period of validity of its Bid or if it comes to notice that the information /
documents furnished in its Bid is incorrect, false, misleading or forged. In addition to the
aforesaid grounds, the successful Bidder’s EMD will also be forfeited without prejudice to
other rights of MMUSPA, if it fails to furnish the required performance security within the
specified period.
4. Preparation of Bid
The bids shall be made in TWO SEPARATE SEALED ENVELOPES as follows:
III. The first envelope shall be marked in bold letter as “TECHNOCOMMERCIAL BID” which
shall be sent forwarding letter Appendix ‘C’ and shall include the following:
57
9) Receipt regarding payment of Bid cost or Bank draft drawn in favour of MMUSPA for the
amount of non refundable fee if the Bid documents have been downloaded from web.
10) Bank Draft /Bankers Cheque towards E.M.D.
11) Confirmation regarding furnishing Performance Security in case of award of agreement.
12) Original Bid document duly stamped and signed by the authorized personnel in each
page along with the Forwarding Letter confirming the performing the assignment as per
Appendix ‘C’
13) Particulars of the Bidder as per Appendix ’B’
14) Copy of the Income Tax Returns acknowledgement for last three financial years.
15) Power of attorney in favour of signatory to Bid documents.
16) Copy of the certificate of registration of EPF, ESI and Service Tax with the appropriate
authority.
17) A declaration from the Bidder in the format given in the Appendix ‘F’ to the effect that the
firm has neither been declared as defaulter or black-listed by any competent authority of
a government department, government undertakings, local bodies, authorities.
In addition to the above documents,
2) The Bidder shall provide certificate of other similar services provided in private/public
sector in last three years and user’s certificate regarding satisfactory completion of such
jobs as per proforma given in Appendix ‘A’.
IV. The second envelope shall contain the financial proposal and shall be marked in bold
letters as “FINANCIAL BID”. Prices shall be inclusive of all taxes & duties and quoted in
the proforma enclosed at Appendix ‘D’ as per scope of work / service to be rendered.
5. Bid Validity Period
The Bids shall remain valid for<180 days >from the date of submission and the prices quoted
shall remain for the duration of the agreement. The MMUSPA may requested for further
extension as deemed fit and the Bidder will send intimation of acceptance or otherwise of
request for extension with three days of issue of such request. The agreement may be extended
for another term with mutual consent.
6. Bid Submission
The two envelopes containing both technical and the financial bid shall be put in a bigger
envelope, which shall be sealed and superscripted with “BID NO <Insert Bid No.> due for
opening on<Insert due date for Opening>
The offer shall contain no interlineations or overwriting except as necessary to correct errors, in
which cases such correction must be initialed by the person or persons signing the Bid. In case
of discrepancy in the quoted prices, the price written in words will be taken as valid.
7. Opening of Bids:
The technical bid will be opened at the time & date specified in the schedule. The Service
providers may attend the bid opening if they so desire.
58
SECTION
EVALUATION OF BIDS
1. Scrutiny of Bids
The Bids will be scrutinized to determine whether they are complete and meet the essential
and important requirements, conditions and whether the Bidder is eligible and qualified as
per criteria laid down in the Bid Enquiry Documents. The bids, which do not meet the aforesaid
requirements, are liable to be treated as non-responsive and may be ignored. The decision of
the MMUSPA as to whether the Bidder is eligible and qualified or not and whether the bid is
responsive or not shall be final and binding on the Bidders. Financial bids of only those Service
providers, who qualify technical bid, will be considered.
2. Infirmity / Non-Conformity
The MMUSPA may waive minor infirmity and/or non-conformity in a Bid, provided it does not
constitute any material deviation. The decision of the MMUSPA as to whether the deviation is
material or not, shall be final and binding on the Service providers.
3. Bid Clarification
Wherever necessary, the MMUSPA may, at its discretion, seek clarification from the Bidders
seeking response by a specified date. If no response is received by this date, the MMUSPA shall
evaluate the offer as per available information.
4. Evaluation of Technical Proposal:
Criteria/Parameter Marks Tally Maximum Marks
1. Experience of the Bidder/Consortium in implementing similar
project at community level:
a.) 5 years and above 10 10
b.) 3-5 years 5
c.) 0-3 years 3
2.) No. of MMU being operated in states in last 5 years
a.) 30 and Above 10
b) 10-30 5 10
c) Less than 10 3
3.) Quality of skilled Human resources in the Provided MMU
a) With Doctor
b) Without Doctors 10 10
5
59
SECTION
Job Description
1. Service Aims
1.1 Since the MMUSPA will provide all of Medical equipments and vehicles, the primary
obligation of the service provider will be to operate the Mobile Medical unit to provide
primary and selected secondary health care ensuring that MMU
c. Is manned by adequate manpower resources as per the requirement enumerated in

b. The MMUs are provided with necessary fuel and other necessities for carrying on
operations on regular basis
2.2 It is the responsibility of <Name of the MMUSPA> to arrange supply free of cost good
quality generic drugs and consumables as per the requisition received from the service
provider. <Name of the MMUSPA> would make all effort to keep the MMUs well stocked
with drugs and consumables at all the times. Supplies shall be made within 3 days of
requisitions.
2. Obligations of the service provider:

15. The service provider will provide the operational set such as Human resources, fuels for the
MMU vehicles and all other requirements to keep the MMU vehicles functional.
16. The service provider shall follow the standard operating procedures (SOPs) as approved by the
competent authority in MMUSPA.
17. The service provider would recruit, deploy and maintain a team of competent personnel for
running the MMU. A list of minimum key personnel required with their qualifications is given
in “AppendixIII”of the service agreement list. The staffs so recruited/appointed shall be
exclusively on Pay roll of the service provider. The Service Provider will ensure deployment of
the minimum personnel as enumerated above to keep the MMUs operational and capable of
providing the services as agreed upon.
18. The Service provider shall follow the Service Plan/Route plan/Calendar for MMU as approved by
the District Health officer/CMO. It is expected that Sunday will be the day on which no service
would require to be provided and the weekly off on Sunday it could be used for maintenance,
refilling and data entry purposes. However, the competent authority may declare any other day
in the week as “off-day”. In exceptional circumstances, the weekly off day can be cancelled by
the competent authority.
19. The MMU should be equipped with the all the equipments proposed in “Annexure I” of the
service agreement list.
20. All drugs should be provided to the service provider within 3 days of requisition.
21. The service provider shall submit data to the state government every month as per “Annexure
60
II”of the service agreement list.
22. The service provider would procure all necessary road and goods permits for the MMU and
maintain the same throughout the period.
23. The logbook of movement of the MMU shall be maintained by the MMU driver and supervised
by the Medical Officer in charge of the MMU. Logbook shall be made available for verification
by the any authority nominated by MMUSPA.
24. Service provider shall communicate the names and addresses of the Team manning a particular
MMU during the currency of the agreement and any change in the composition of the team
must be intimated to the authority nominated by the MMUSPA. The names of men at work at
the MMU at any point of time must also be displayed prominently on the MMU.
25. The Service provider will also comply with confidentiality and privacy laws including patient
details.
26. All records maintained by the Service provider regarding operations of MMUs will be made
available to any government authority including audit on demand.
27. It should be clearly understood that under no circumstances, the MMUs will be used to advertise
the operations of the service provider. It should be clearly mentioned on the outer body of the
MMU that the service is provided by the service provided by an agreement between MMUSPA
and the service provider.
28. Requirements of any Act promulgated by the Central State Law will have to meet by the service
provider. Details as required under RTI should be notified in the MMU
61
SECTION
ELIGIBILITY CRITERIA
7. The bidder shall be a sole provider or a group of providers/NGO (maximum3) coming together
as Consortium to implement the Project, represented by a lead member. The bidder cannot be
an individual or group of individuals. A bidder cannot bid as a sole provider as well as a partner
in a consortium. No bidder can place more than one bid in any form in the state. The bidder
should be registered as a legal entity.
8. The bidder and in case of a consortium, all the participants shall have at least three years
experience in providing medical care at community level. In support of this, a statement
regarding assignments of similar nature successfully completed during the last three years
should be submitted as per Performa in ‘AppendixA’. Users’ certificate regarding satisfactory
completion of assignments should also be submitted. The assignment of Govt. Depts. / Semi
Govt. Depts. should be specifically brought out. (The decision of the state government as to
whether the assignment is similar or not and whether the bidder possesses adequate experience
or not, shall be final and binding on the bidders). The bidders may in addition provide any other
documentation in support of their claims of experience in providing community healthcare.
9. The bidder should not be presently blacklisted by the MMUSPA or any government agencies/
local bodies.
10. In case of Consortium, the lead member shall be legally responsible and shall represent all
consortium members, if any, in all legal matters.
11. The bidders shall provide the balance sheet (Income & Expenditure account in case of NGOs) of
last three years.
12. The bidder(s) must have turnover not less than 25% of the bid amount quoted for each of the
last three years. In case of NGOs, cost of community healthcare services provided should not be
less than 25% of the bid amount quoted for each of the last three years.
62
SECTION
TERMS AND CONDITIONS

2. Signing of Agreement
The MMUSPA shall issue the Notice for Award of Agreement to the successful bidder within
the bid validity period. And the successful bidder will be required to sign the Service level
agreement with the MMUSPA or its nominee within 15 days of receipt of such communication.
2. A model copy of service agreement is at the Appendix_________.
3. Modification to agreement:
The agreement when executed by the parties shall constitute the entire agreement between
the parties in connection with the jobs / services and shall be binding upon the parties.
Modification, if any, to the agreement shall be in writing and with the consent of the parties.
The agreement shall be valid for a period of 3 years from the date of signing of the same.
In case the service provider fails to adhere to the rules, regulations or any of the terms and
condition of the agreement or in case the service provided is considered to be unsatisfactory
by the _________, the service provider will be asked to provide his response in writing within
15 working days to specific case of violations and unsatisfactory services. The MMUSPA would
be free to cancel the agreement after considering the response of the service provider and
recording the reasons for its decision.
4. Performance Security
e) The successful bidder shall furnish a performance security in the shape of a Demand Draft/
Bank Guarantee issued by a Nationalised Bank in favour of Tender Inviting Authority for
an amount equal to 5% of the total agreement value. The Bank guarantee shall be as per
proforma at Appendix ‘E’ and remain valid for a period, which is three months beyond
the date of expiry of the agreement. This shall be submitted within 15 days (minimum) of
receiving of Notice for Award of Agreement and before signing of the agreement failing
which the EMD may be forfeited.
f ) If the agreement is cancelled at any time during the validity period of the agreement in
terms of para 4 above the Performance Security shall be forfeited
g) The MMUSPA will release the Performance Security without any interest to the firm /
contractor on successful completion of contractual obligations.
h) The total cost of tender would be the basis to calculate non operative cost per MMU per
day. For all days when a certain number of MMU has not been functional, cost deducted
would be:
(Cost per MMU per day)*(Total Number of MMU non operative)*(Number of days Non
operative).
63
5. Compliance of Minimum Wages Act and other statutory requirements
The Service provider shall comply with all the provisions of Minimum Wages Act and other
applicable labor laws. The Service provider shall also comply with all other statutory provision
including but not limited to provisions regarding medical education and eligibility criteria of
human resources used by the Service provider for providing the services, biomedical waste
management, biosafety, occupational and environmental safety.
The overall legal responsibility of provision of medical care lies with the Authority/public health
facility.
The Service provider shall maintain confidentiality of medical records and shall make adequate
arrangement for cyber security.
6. Income Tax Deduction at Source
Income tax deduction at source shall be made at the prescribed rates from the Service provider’s
bills. The deducted amount will be reflected in the requisite Form, which will be issued at the
end of the financial year.
7. Periodicity of Payment
The payment will be made on monthly basis not extending beyond 12 noon of the last bank
working day of the month as per the clause no.11 in the service agreement list. The MMUSPA
shall give standing instructions to the bank for implementation of this requirement. The Service
provider will raise its invoice on completion of services during this period duly accompanied by
evidences of services provided. The payment will be subject to TDS as per Income Tax Rules and
other statutory deductions as per applicable laws.
The deduction for non availability of the MMUs shall be made while making the payment.
10. Damages for Mishap/Injury
The MMUSPA shall not be responsible for damages of any kind or for any mishap/injury/
accident caused to any personnel/property of the Service provider while performing duty in
the MMUSPA’s / consignee’s premises. All liabilities, legal or monetary, arising in that eventuality
shall be borne by firm/ contractor.
11. Termination of Agreement:
The MMUSPA may terminate the agreement, if the successful Bidder withdraws its Bid after
its acceptance or fails to submit the required Performance Securities for the initial agreement
and or fails to fulfill any other contractual obligations. In that event, the MMUSPA will have the
right to purchase the same goods/ equipment from next eligible Service provider and the extra
expenditure on this account shall be recoverable from the defaulter. The earnest money and
the performance security deposited by the defaulter shall also be recovered to pay the balance
amount of extra expenditure incurred by the MMUSPA.
After completion of the tenure of Bid, the Service provider will be allowed to vacate the space
within a period of 15 days, in all the facilities where provider was providing the services.
64
13. Arbitration
f ) If dispute or difference of any kind shall arise between the MMUSPA and the firm/contractor
in connection with or relating to the agreement, the parties shall make every effort to
resolve the sameamicably by mutual consultations.
g) If the parties fail to resolve their dispute or difference by such mutual consultations within
thirty days of commencement of consultations, then either the MMUSPA or the firm/
contractor may give notice to the other party of its intention to commence arbitration, as
hereinafter provided. The applicable arbitration procedure will be as per the Arbitration
and Conciliation Act, 1996 of India. In that event, the dispute or difference shall be referred
to the sole arbitration of an officer to be appointed by the <insert Bid issuing authority>
as the arbitrator. If the arbitrator to whom the matter is initially referred is transferred or
vacates his office or is unable to act for any reason, he / she shall be replaced by another
person appointed by <insert Bid issuing authority> to act as Arbitrator.
h) Work under the agreement shall, notwithstanding the existence of any such dispute or
i) Reference to arbitration shall be a condition precedent to any other action at law.
j) Venue of Arbitration: The venue of arbitration shall be the place from where the agreement
has been issued.
14. General Terms and Conditions:

e. The Service provider shall commence the proposed services within the 30 days of signing
the agreement.
f. The Authority shall finalize the Standard Operating Procedures (SOPs) for each of the
services to be followed by the Service provider.
g. All payments should be made within 30 days of submission of necessary bills/invoices.
h. Patient Feedback/Suggestions/Grievance Redressal-Periodic feedback from patients are

to be taken on structured questionnaire. Result would be analyzed by the MMUSPA for
further improvement of services and feedback to the service provider. Telephone numbers
where patients can lodge their complaints to be displayed on MMU.
15. Applicable Law and Jurisdiction of Court:

The agreement shall be governed by and interpreted in accordance with the laws of India for the
time being in force. The Court located at the place of issue of agreement shall have jurisdiction
to decide any dispute arising out of in respect of the agreement. It is specifically agreed that no
other Court shall have jurisdiction in the matter.
<Insert name and address of the Bid inviting authority>
65
Appendix-A
Community based Health services provided in last 3 years.
1. Attach users’ certificates (in original) regarding satisfactory completion of assignments
Note: Attach extra sheet for above Performa if required.
Signature………………………………
Name …………………………………..
organization with
assignment done
Phone No. where
Was assignment
commencement
completed/It is
Agreement No
work/ services
Description of
satisfactorily
Sr. No
Assignment
assignment
completion
Agreement
Address of
provided
ongoing
price of
Date of
Date of
&date
10
66
Appendix-B
PARTICULARS OF THE BIDDER
(To be submitted by all BIDDER including participant in Consortium)
7.
Name :
8. Type of Organisation :Prop./Partnership/Company/Consortium/Trust/ Not for Profit
Organization
9. Address of Service centres in the region:
(c) Total No. of services personnel at the existing centres:
(d) Total No. of locations where organization currently has centres:
10. Number of service personnel:
Name Qualification Experience (Similar Service)
(use extra sheet if necessary)
11. Registration. Nos.

(j) EPF
(k) ESI
(l) Sales Tax
(m) VAT
(n) Service Tax
(o) PAN No.
(p) Audited Accounts Statement for past three financial years
(q) Copy of Income Tax Return for past three financial years
(r) Experience certificate of Service provider
12. Brief write-up about the firm / company. (use extra sheet if necessary)
Signature of Service providers
Date: Name
Place: Office Seal
67
Appendix-C
Forwarding Letter for Technical Bid
(To be submitted by all Service providers in their letterhead)
Date:……………….
To
<Name, Designation and Address of Bid Inviting Authority>
Sub: Bid for provision of Mobile Medical Unit under Bid No….
Sir,
We are submitting, herewith our Bid for providing annual maintenance services / comprehensive
maintenance services for ……………………….
We are enclosing Receipt No……………….. or Bank Draft/Bankers Cheque No………………….,
Dated…………………(amount……………………)towards Bid cost/fee (if documents have been
downloaded from website) and Bank Draft / Bankers Cheque No………………. Dated………………
(Amount………………) towards Earnest Money Deposit (EMD), drawn on…………………… Bank
in favour of <Bid Inviting Authority>.
We agree to accept all the terms and condition stipulated in your Bid enquiry. We also agree to
submit Performance Security as per Clause No. 3 of Section VI of Bid Enquiry document.
4. We agree to keep our office valid for the period for the period stipulated in your Bid enquiry.
Enclosures:
1.
2.
3.
4.
5.

Signature of the Bidder……………………

Seal of the Bidder…………………………
68
Appendix-D
FINANCIAL BID
3. Name of the Bidder:………………………………………………………………..

4. Prices Quoted :-
S. No Cost Head per MMU Operational No. of Units Total Cost
Cost Per quoted for
annum (INR)
01 Human Resources (Per MMU)
02 Fuel
Total Cost of the proposed project per annum

Total Cost per MMU per annum
(In words……………………………………………………………………………)
The prices shall be firm and inclusive of all taxes and duties presently in force.
Signature…………………………………
Name………………………………………..
69
Appendix-E
PROFORMA FOR BANK GUARANTEE
To
<Name, Designation and Office Address of Bid Inviting Authority>
WHEREAS……………………………………………………..(Name and address of the Service

Provider) (Hereinafter called “ the service provider” has undertaken, in pursuance of agreement
No……………….. dated …………………….. (Herein after “the agreement”) to provided specific
Mobile Medical Units.
AND WHEREAS it has been stipulated by you in the said agreement that the service provider shall
furnish you with a bank guarantee by a scheduled commercial bank recognized by you for the sum
specified therein as security for compliance with its obligations in accordance with the agreement;
AND WHEREAS we have agreed to give such a bank guarantee on behalf of the service provider;
NOW THEREFORE we hereby affirm that we are guarantors and responsible to you, on behalf of the
service provider, up to a total of………………………………………….. (Amount of the guarantee
in words and figures), and we undertake to pay you, upon your first written demand declaring the
service provider to be in default under the agreement and without cavil or argument, any sum or
sums within the limits of (amount of guarantee) as aforesaid, without your needing to prove or
to show grounds or reasons for your demand or the sum specified therein. We hereby waive the
necessity of your demanding the said debt from the service provider before presenting us with
the demand. We further agree that no change or addition to or other modification of the terms of
the agreement to be performed there under or of any of the agreement documents which may be
made between you and the service provider shall in any way release us from any liability under this
guarantee and we hereby waive notice of any such change, addition or modification.
This guarantee shall be valid up to 15 (fifteen) months from the date of signing of agreement i.e. up
to………….. (Indicate date)
……………………………………………………………
(Signature with date of the authorized officer of the Bank)
……………………………………………………………….
Name and designation of the officer
………………………………………………………………..
Seal, name & address of the Bank and address of the Branch
70
Appendix-F
I / We ……………………………… agree that we shall keep our price valid for a period of one
year from the date of approval. I / We will abide by all the terms & conditions set forth in the Bid
documents No. …….. /
I / We do hereby declare I / We have not been de-recognized / black listed by any State Govt. /
Union Territory / Govt. of India / Govt. Organisation / Govt. Health Institutions.
Signature of the Service provider:
Date:
Name & Address of the Firm:
Affidavit before Executive Magistrate / Notary Public in INR.50.00 stamp paper.
71
No_______________
SERVICE LEVEL AGREEMENT
Between
………….
(MMU Service Procuring Agency)
And
………….
(Service Provider)
To maintain and operate Mobile Medical Units (MMU) infrastructure to provide primary and
selective secondary healthcare in identified regions.
72
Appendix-F
1. BACKGROUND
1.3 <NAME OF THE MMUSPA>desirous of outsourcing the services relating to operation of
Mobile Medical Units in <name of the identified region> had invited tenders from eligible
bidders vide TE No ________________ dated _____________. <Name of the Service
Provider> having submitted his bid in response to the tender enquiry and having been
found technically qualified as per the conditions in the same TE, has been awarded the
agreement by the competent authority in the <MMUSPA>. <Name of the Service Provider>
has also performed required obligations after the award of agreement was communicated
to him.
1.4 Both <Name of the MMUSPA> and <Name of the Service Provider> hereby willingly
enter into this agreement and agree to abide by all obligations enjoined on them by this
agreement.
3. SERVICE AIMS
2.1 Since the MMUSPA will provide all of Medical equipments and vehicles, the primary
obligation of the service provider will be to operate the Mobile Medical unit to provide
primary and selected secondary health care ensuring that MMU
a. Is manned by adequate manpower resources as per the requirement enumerated in “Annexure

III” of the Service agreement list.
b. The MMUs are provided with necessary fuel for carrying on operations on regular basis
2.2 It is the responsibility of <Name of the MMUSPA> to arrange supply of good quality generic
drugs and consumables as per the requisition received from the service provider. <Name of the
MMUSPA> would make all efforts to keep the MMUs well stocked with drugs and consumables
at all times. Supplies shall be made within 3 days of requisitions.
4. SERVICE OBJECTIVES
3.1 It is explicitly stated that both the parties are committed to enhance the health and well-
being of residents of the area covered by the Service Level Agreement by providing high
quality service, innovation and development and to meet identified needs within the
resources available to both the parties.
3.2 The service provider will also provide the operational set such as power generator, fuel for
the vehicles and all other requirements to keep the MMU vehicle in operational condition
at all times.
73
4. SERVICE DESCRIPTION AND RESPONSIBILITIES
Out-patient services:
4.1 The Mobile Medical Units will provide only out-patient services. These units will function
as mobile clinics and are not meant to transport patients.
4.2 The Service provider shall follow the Service Plan/Route plan/Calendar for MMU as
approved by the District Health officer/CMO and accordingly make the services of the
MMU available at the desired spot on the appointed days.
4.3 The Service Provider shall provide primary and secondary health care as per the standard
operating procedures approved by the Service procuring agency.
4.4 The Service provider hereby agrees that Mobile Medical Unit must always operate under
the supervision of a qualified Medical Officer. The Service provider further agrees that at any
time and under any circumstances, patient care would not be carried out by unauthorized
personnel.
4.5 Service provider agrees that failure to adhere to the Service Plan/Route Plan/Calendar
referred to Paragraph 4.2 above would constitute a variation in terms of Paragraph 12.1 of
this Agreement and a default of an obligation in terms of Paragraph 15.2 of this Agreement.
Service Component:
4.5 The service at the MMU will be clinically led by a qualified Medical Officer. Patients will have
access to primary and selective Secondary clinical management by a qualified Medical
Officer.
4.6 Ailments which shall not normally require further referral/ specialist care will be treated at
the MMU only. Patients will be treated and provided drugs free of cost. No charges of any
kind will be recovered from the patients.
5. REFERRAL PROCESS & ELIGIBILITY

5.1 It will be the responsibility of <Name of the MMUSPA> to provide the Service provider
an “information matrix” for nearest facilities including their capacity in terms of existing
Laboratory services, diagnostic services, and human resources available.
5.2 It will be the responsibility of the Service Provider to keep the Medical Officer(s) in charge
of the MMU informed of the information matrix. For services not available at the MMU,
patients can be referred to nearest facility in accordance with the “information matrix“.
5.3 Both the parties hereby agree that no patient will be referred to any private medical
establishment either formally or informally without specific prior approval of the <Name
of the MMUSPA>.
6. INFORMATION AND REPORTING REQUIREMENTS

6.1 The Service provider shall ensure that information, records and documentation necessary
to monitor the agreement are maintained and are available at all times to the <Name of
the MMUSPA> or its authorised representative. The Service Provider hereby agrees that he
and all his staff shall at all times co-operate with the reasonable processes of the Service
74
procuring agency for the monitoring, evaluation and carrying out quality audit and
financial audit by any third party authorised by <Name of the MMUSPA>.
6.2 The Service provider hereby agrees to maintain all relevant data and records of all patients
treated at the MMU.
6.3 The Service provider further agrees to maintain confidentiality of these data and records
and commits that such data and records will not be shared with any third party for any
purpose.
6.4 The Service provider agrees to provide data to <Name of the MMUSPA> as per attached
Annexure II every month. Failure to do so may entail cancellation of the agreement.
6.5 The Service provider hereby agrees to maintain log book showing all movements of the
MMU vehicle and keep record of consumption of POL. The log book should be maintained
as per the format in vogue in any government office. Logbook shall be made available for
verification by the any authority nominated by Service procuring agency.
6.6 The Service provider agrees that the MMU vehicles will not be used to advertise any
product or organisation including the Service provider’s own. The following text must
appear on both sides of the MMU vehicle in reasonably big font-size to enable a normal
sighted person to read it from a reasonable distance:
“Mobile Medical Unit

Run by
Agreement No <No of the Agreement>
Between <Name of the Service Procuring Agency> and <Name of the Service Provider>”
6.7 The Service provider agrees to display copies of this agreement, list of medical equipment
available with the MMU, stocks of drugs and consumables at prominent place in the MMU.
The names of the Medical Officer and other personnel on duty must also be displayed
during duty hours.
8. PERFORMANCE
7.1 A half yearly review meeting will be held and attended by appropriate levels of officials
of Service procuring agency and Service providers to review the performance, the
anticipated outcome of the agreement and future service developments and changes.
Further meetings may be arranged at any time to consider significant variation in the
terms or conduct of the agreement and where corrective action on either part is indicated.
7.2 Both the Service procuring agency and Service Provider agree to consider introduction of
any further service in line with any new initiative of the government or in response to local
demand which could not be anticipated earlier.
7.3 Both the Service procuring agency and Service Provider agree that such services should
be provided without extra cost. However, if it is felt by both the parties that the additional
services would require additional resources/manpower, the Service procuring agency
75
agrees to consider reasonable increases in amount disbursed to the Service provider
based on the cost of additional resources. It is agreed that the Service provider will be
under no obligation to introduce the additional service unless a commitment to reimburse
additional cost has been provided to him.
8. HEALTH AND SAFETY

8.1 The Service Provider agrees to adequately train, instruct and supervise staff to ensure as
is reasonably practicable, the health and safety of all persons who may be affected by the
services provided under the agreement.
8.2 The Service provider agrees that he would collect periodic feedback from the patients
through structured questionnaire at his cost. The periodicity will not be less than once
in six months. Responses to the questionnaire will be submitted in original to the Service
procuring Agency. Telephone numbers where patients can lodge their complaints will also
be displayed on MMU.
9. DATA PROTECTION, CONFIDENTIALITY AND RECORD KEEPING

9.1 All Service Users have a right to privacy and therefore all information and knowledge
relating to them and their circumstances must be treated as confidential. The Service
Provider must advise all staff on the importance of maintaining confidentiality and
implement procedures which ensure that Service User’s affairs are only discussed with
relevant people and agencies.
9.2 The Service Provider shall comply with all legislations, which otherwise would have been
applicable had the services been run directly by the Government agencies.
10. STAFFING
10.1 The Service provider will ensure that, at all times, it has sufficient suitably trained staff to
ensure that services comply with all the statutory requirements and meet patient needs.
10.2 The Service provider agrees that he would ensure that a minimum complement of staff
mentioned at Annexure III of this Agreement would be in position in each MMU.
10.3 The Service provider agrees that a record of qualifications shall be maintained by the
provider and available for inspection.
10.4 The Service provider hereby expresses his commitment to training and staff development
and the maintenance of professional knowledge and competence.
12. FINANCE ARRANGEMENTS

11.1 Both parties agree that the payment arrangements as quoted by the Service provider in
his bid against the above mentioned tender enquiry and/or subsequent bid submitted by
him as a result of negotiations shall be adhered to.
11.2 It is agreed that payments would be made monthly basis. To facilitate this, the Service
provider will submit invoices with all documents in support of his claims on every last
76
working day of the month.
11.3 The Service procuring agency or any other agency as per existing rules of the government
will have the right to examine the invoices as required under relevant rules. If such
examination reveals any extra payment already provisionally made, the extra amount will
be adjusted from the next payment due to the Service provider under intimation to him.
11.5 The Service provider hereby agrees to maintain all required books of accounts and agrees
to provide them to such audit as may be required to be carried out.
11.6 The Service provider hereby agrees that the Service procuring agency will deduct from
all payments such amount of statutory taxes and duties as he is required to deduct under
provisions of law. The amount would be deducted if the MMU becomes non operative as
mentioned and calculated above in Section VI.
12. VARIATION
12.1 This Service Level Agreement may not be varied unless a variation is agreed in writing and
signed by all parties.
13. DISPUTES
13.1 The agreement shall be governed by and interpreted in accordance with the laws of India
for the time being in force. The Court located at the place of issue of agreement shall have
jurisdiction to decide any dispute arising out of in respect of the agreement. It is specifically
agreed that no other Court shall have jurisdiction in the matter.
13.2 Both parties agree to make their best efforts to resolve any dispute between them by
mutual consultations.
14. ARBITRATION
14.1 If the parties fail to resolve their dispute or difference by such mutual consultations within
thirty days of commencement of consultations, then either the Service procuring agency
or the Service provider may give notice to the other party of its intention to commence
arbitration, as hereinafter provided. The applicable arbitration procedure will be as per
the Arbitration and Conciliation Act 1996 of India. In that event, the dispute or difference
shall be referred to the sole arbitration of an officer as the arbitrator to be appointed by
the <Name of the MMUSPA>. If the arbitrator to whom the matter is initially referred is
transferred or vacates his office or is unable to act for any reason, he / she shall be replaced
by another person appointed by <Name of the MMUSPA> to act as Arbitrator.
14.2 Work under the agreement shall, notwithstanding the existence of any such dispute or
14.3 Reference to arbitration shall be a condition precedent to any other action at law.
77
14.4 Venue of Arbitration: The venue of arbitration shall be the place from where the agreement
has been issued.
15. TERMINATION
15.1 Either party may terminate this agreement by giving not less than 3 months’ notice in
writing to the other. This notice shall include reasons as to why the agreement is proposed
to be terminated.
15.2 The Service Procuring agency may terminate the agreement, or terminate the provision of
any part of the Services, by written notice to the Service provider with immediate effect if
the Service Provider is in default of any obligation under the agreement, where
d. the default is capable of remedy the Service Provider has not remedied the default to
the satisfaction of the Service procuring agency within 30 days of at least two written
advice, or such other period as may be specified by the Service procuring agency,
after service of written notice specifying the default and requiring it to be remedied;
or
e. the default is not capable of remedy; or
f. the default is a fundamental breach of the agreement
15.3 If the Service procuring agency terminates the agreement and then makes other
arrangements for the provision of the Services, it shall be entitled to recover from the
Service provider any loss that had to be incurred due to such sudden termination of
agreement.
15.4 Both the parties agree that no further payment would be made to the Service provider,
even if due till settlement of anticipated loss as a result of premature termination of the
agreement.
15.5 The MMUSPA reserves the right to terminate the agreement without assigning any reason
if services of the MMU create serious adverse publicity in media and prima facie evidence
emerges showing negligence of the Service provider.
16. Indemnity
16.1 By this agreement, the Service provider indemnifies the Service procuring agency against
damages of any kind or for any mishap/injury/accident caused to any personnel/property
of the Service provider while performing duty.
16.2 The Service provider agrees that all liabilities, legal or monetary, arising in any eventuality
shall be borne by the Service provider.
17. PERIOD OF AGREEMENT

17.1 This Service Level Agreement shall take effect on ……..until ……….. . The period may
be extended for another period of three years with the agreement of both parties after
mutual negotiations.
78
3. Signed for and on behalf of the MMU Service Procuring Agency
(MMUSPU)……………………………………
Signed: ...................................................................
Name: ...................................................................
Designation:..........................................................
Date:.......................................................................
4. Signed for and on behalf of the Service Provider:
Signed: ............................................................
Name: ............................................................
Designation: ............................................................
Date: ............................................................
Witnesses:
4) ___________________________________________
5) ____________________________________________
6) _____________________________________________
79
Annexure I
Proposed list of Equipment in the MMU

Stethoscope 2
B.P. Apparatus 2
Incubator 1
Nebulizer 1
Ambu bag Adult 2
Glucometer 1
Laser Printer 1
Digital camera 1
Speaker 2
Amplifier 1
LCD Projector 1
Water Purifier 1
80
Waste Collecting bins, as per Biomedical waste Management 1
specifications
Stool 4
Cot 1
Examination table 1
Chairs 5
Generator 1
AC Fan 1
Dvd Player 1
Fire Extinguisher 1
View Box 1
Digital clock 1
Extension box 2
Emergency light 2
Soap Container 3
Towel Holder 2
Semi-Auto Hematology analyzer (3 part) 1
Test tubes 1
Auto pipettes 1
Ophthalmoscope Digital 1
Auto scope 1
Examination Torch 2
Portable Laboratory unit
Non invasive Hb-meter
12 Lead ECG Machine 1
Tonometer 1
81
Annexure II
Reporting Proforma for each functional MMU
S. Location Number Number Number Number of Number Nearest Facility

No. of MMU of OPD of ANC/ of Lab Test ECG/XRAYS of Patients to the MMU
PNC Conducted Referred (Name & type)
82
Annexure III
A. Staff Composition
Name of staff Qualification No. Of

persons
Medical Officer M.B.B.S 1
Nursing GNM preferable- if not ANM 2
Ophthalmic Technician Certificate course in Ophthalmology 1
Lab Tech +Male worker B.Sc DMLT/HSC DMLT 1
Driver cum Support Staff SSC Heavy Vehicle License & Indemnity bond of 2
Accident free driving in last three years.
83

Mobile Medical Units

Uploaded by

Copyright:

Available Formats

Mobile Medical Units

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Mobile Medical Units

Uploaded by

Copyright:

Available Formats

Operational

Ministry of Health and Family Welfare

Designed & Printed by: Royal Press # +91 93101 32888

(Jagat Prakash Nadda)

348] ,&Lda/k] fuekZ.k Hkou] ubZ fnYyh&110011

New Delhi (C.K. Mishra)

1. Shri. C.K Mishra AS&MD, MoHFW

2. Shri. Manoj Jhalani Joint Secretary (Policy), MoHFW

3. Shri. Gautam Guha Ex. - AS & FA, MoHFW

4. Ms. Limatula Yaden Director (NHM), MoHFW

7. Dr Rajani R. Ved Advisor (NHSRC). MoHFW

8. Dr Jitendra Kumar Sharma Senior Consultant (NHSRC), MoHFW

9. Ms. Shraddha Masih Senior Consultant (NHM). MoHFW

10. Ms. Asmita Singh Senior Consultant (NHM). MoHFW

11. Ms. SumithaChalil Senior Consultant (NHM). MoHFW

12. Dr. Shahab Ali Siddiqui Senior Consultant (NHM). MoHFW

5. Type of Services Provided |3

7. Operational aspects of MMU | 4

9. Drugs, Diagnostics and Supplies | 6

12. Grievance Redressal | 8

Drugs and Consumable List | 15

Financial Norms for the Recurring Cost of the exisiting MMUs | 20

Operational Guidelines For Mobile Medical Units

3. Nature of Services to be provided by an MMU

(i) Outreach services by ANMs in areas where no outreach services exist

Operational Guidelines For Mobile Medical Units

a) District with population 10 lakhs- 1 MMU

b) District with population of between 10 lakhs and 20 lakhs- 2 MMUs.

c) District with population of between 20 lakhs and 30 lakhs- 3 MMUs

d) District with population of between 30 lakhs and 40 lakhs-4 MMUs

e) District with population of over 40 lakhs - 5 MMUs

5. Type of Service Provided

5.2 In addition, the MMU is also expected to:

- collect sputum samples,

Operational Guidelines For Mobile Medical Units

6. Suggested models of MMUs

a. Government operated MMU

7. Operational aspects of MMU

Operational Guidelines For Mobile Medical Units

MO (MBBS only, preferably women) One

Operational Guidelines For Mobile Medical Units

9 Drugs, Diagnostics and Supplies

9.3 MMUs are also envisaged to collect sputum samples.

9.4 All drugs and investigations should be provided free.

Operational Guidelines For Mobile Medical Units

10.3 Meticulous record keeping, compilation and analysis of indicators to be done on a

 Parking will be responsibility of the District Health Society.

11. Monitoring Mechanism.

(i) Number of MMUs in the District (Sanctioned & Operational)

(ii) MMU managed by State Govt. /NGO /Private Provider

(iii) If MMU operated by State Govt, is the HR dedicated to MMU or existing HR in

Operational Guidelines For Mobile Medical Units

(v) Number of Trips in a month

(vi) Number of Villages/Habitations visited with route map

(vii) Link with GPS for mobile tracking

The following data are to be reported every month:

(viii) Number of cases seen monthly categorized by ANC, Children immunized, FP

(ix) No. of Lab tests/month by MMU

(xi) No. of sputum collected for TB detection / month by MMU

(xii) Number of patients referred to higher facilities

Parking will be responsibility of the District Health Society.