Overarching Issues

1
Overarching Issues

• Group 5

2
Group Members

• Dr. H. Sudarshan
• Ms. Seema Gupta
• Avindra Mandwal
• Dr. A.K. Srivastava
• Dr. Babbar
• Dr. Satyabrata Sahoo
• Ms. Sudipta

• Dr. Ajay Khare
• Dr. Devendra Kothari
• Ms. Urvashi
• Dr. Rammana
• Ms. Jhimli
• Dr. Saraswathi Sankaran
• Mr. Rajat Khanna

3
Issues Human Resources
4
Major Issues Recommendation - ASHA

• Role clarity of ASHA
• Selection of ASHA by Gram Sabha
• Training of ASHA Complete training
• Support for ASHA after training NGOs have can
  play a mentoring role
• Remuneration of ASHA minimum retainership (in
  sparsely populated states ). Streamline incentive
  payment to ASHA.
• Simplification of ASHA Diary
• Monthly meeting at PHC level
• Logistics of drug kit provision replenishment
  to ASHA to be streamlined

5
Major Issues Recommendations Human Resources

• ANM Nurses
• Need assessment for next 5-10 years
• Operationalize existing ANMTCs create new ones
  (if needed)
• Quality of training
• Male Nurses
• Promote LHV cadre
• Nurse practitioners

6
Major Issues Recommendation HR
Contd

• Contractual appointment and remuneration should
  be standardized
• 3 year course for MOs
• Additional human resources at State, district
  block level should be oriented and properly
  utilized
• Rationalization of placement of human resources

7
Program Management Issues of Transparency,
Accountability Governance
8
Major Issues Recommendations

• Collective failure of Govt UNOPS to procure
  supply RCH kit I II and vaccines
• Cumbersome bidding process
• Closing down public sector drug units
• Suggestions
• E-procurement to ensure transparency
• Capacity building public sector units for GMP
• RCH kits items can be individually procured and
  kits can constituted at State level include
  Paediatric Iron Syrup in the list (70 of
  children are anemic)
• Rationalize provider-equipment mismatch

9
Major Issues Recommendations

• State PIPs/District Action Plans
• Bottom up planning to be institutionalized
• Timely preparation of DAPs so that they feed into
  the State PIP
• Consultative process (NGOs others) to be
  adopted
• DAPs to focus on vulnerable population mapping
  of public private providers - Explore options
  for public provisioning of private health services

10
Major Issues Recommendations - Governance

• Frequent transfers of bureaucrats and Sr.
  Officials
• Fixed tenure or at least minimize frequency
• EMRI (trade name of Satyam Foundation)
• Suggested generic name Emergency Medical
  Services
• Involve multiple partners (and not put all eggs
  in one basket)
• Involve NGOs in the EMS scheme
• Community Planning Monitoring Pilot
• Scale-up community monitoring pilot to all
  districts
• Sensitization of community for quality service
  availability

11
Major Issues Recommendations

• Intra-sectoral convergence
• All national programs like - RCH, TB, Malaria,
  HIV/AIDS NACO, etc.)
• All levels including within Nirman Bhawan RCH
  NRHM (Separate reviews CRM JRM)
• Inter-sectoral convergence
• Education, RDPR,
• ICDS (Role definition, triangulation for ANMs,
  AWWs ASHA)

12
Issues Recommendations Project Management

• Mobility issues for ANMs
• ANM registers (Orissa has 30 ANM registers!)
• Standardize HMIS and reporting formats
• Utilize HMIS at all levels data analysis
• For maintenance and repairs Buildings
  Equipment DPMU to have engineers (as in some
  states)
• Involve orient PRIs in BCC activities
• Accountability to ensure no adverse vaccine
  reaction

13
Major Issues Recommendations NGOs

• NGO participation is essential in planning
  process
• Flexi-pool for NGOs involvements in state PIP
• Transparency in NGO selection (MNGO/FNGO/etc.)
• Technical guidance in MNGO program similar to
  NACO (for Eg. creating a body like ARC)
• Bottlenecks / Delays in NGO payments
• Streamlining payments, provision of advances,
  etc.
• Some states not promoting MNGO scheme
• Standard guidelines for all states
• NGO coordination cell at State/district and block
  level.

14
Thank You