HEALTH BUDGET AND PLANS – CHALLENGES AND EXPERIENCES FROM AMRAVATI DISTRICT

PRESENTATION BY KHOJ

PLANNING PROCESS –

NRHM IS THE BIGGEST COMPONENT OF HEALTH IN THE DISTRICT

NRHM REQUIRES BOTTOM UP PLANNING NRHM REQUIRES PARTICIPATION AT ALL

LEVELS

PLANNING PROCESS IS GIVEN A MONTH WHICH IS INSUFFICIENT TO REACH OUT TO THE NEEDS OF THE GRASSROOTS

THERE IS NO BUDGETARY INFORMATION ASKED FROM THE PHC OR SUB CENTRES BUT LIST OF DEMANDS

FOCUS OF PLANNING HAS BEEN ON HUGE INFRA STRUCTURES

THERE IS NO PLANNING FOR EFFECTIVE MONITORING AND EVALUTION PROCESSES

THERE IS LITTLE FOCUS ON PEOPLE WHO PROVIDE THE SERVICE AND ON THOSE WHO ARE THE RECEIPENT OF THE SERVICE

E.G. – PEOPLE WORKING IN THE BHARARI PATHAK(FLYING SQUADS) ARE PAID Rs 12000/- per month

THESE ARE ON ADHOC BASIS THEY WORK IN THE REMOTEST PARTS OF

THE AREAS OF MELGHAT THEY DO NOT GET ANY HILLY OR TRIBAL

AREA BENEFITS

WHILE CONSTRUCTION OF LABOUR ROOMS (CALLED AS REPAIRS) AT 60 LOCATIONS COSTS RS 1.40CRORES

AND ON CONSTRUCTION OF WALL COMPOUNDS OF 17 PHC’S THE COSTS IS 1.74 CRORES

THERE IS A Rs 10LAC BUS CALLED AS MOBILE HEALTH SQUAD WHICH HAS BEEN LYING WITHOUT USE IN 2 BLOCKS

THERE IS BLOOD COLLECTION VAN LYING AT AMRAVATI WITHOUT ANY VLAUABLE USES

ADOLESCENT SEXUAL REPORDUCTIVE HEALTH PROGRAMME HAS SEEN NOT EVEN 1% EXPENDITURE DESPITE A LOW BUDGET IN ITSELF IN THE LAST 2 YEARS

BUDGETING EXERCISE –

BUDGETING EXERCISE DOES NOT SEEMS TO TAKE INTO ACCOUNT THE ACTUAL NEED AND EXPENSES

IT IS ONLY A 10% ADDITION OVER LAST YEAR

IN THE MONTH OF FEBRUARY 2011, ONLY 52% FUNDS UNDER NRHM HAD BEEN UTILISED AND THE DISTRICT WAS CONFIDENT OF SPENDING 48 PERCENT IN 2 MONTHS.. NO ONE COULD ANSWER THE HOW

EG. WHILE THERE ARE APPROXIMATELY 50,000 CHILDREN WHO ARE SEVERELY OR MODERATELY UNDEROURISHED, THE BUDGET FOR THE YEAR 2011-12 IS ONLY TO CATER TO 10,000 CHILDREN

THERE IS NO REASON WHY ONLY 10,000 CHILDREN WERE BUDGETED

THERE IS NO HEALTH PLAN FOR THE STATE AND THERE IS NO STRATEGY TO FOCUS ON ANY LOCAL ISSUE

THE ONLY PLANNED, MONITORED PROGRAMME IS THAT OF PULSE POLIO AND MAY BE THE OTHER NATIONAL PROGRAMMES LIKE TB, LEPROSY AND MALARIA

THERE IS NO MEANS OF TRACKING THE EXPESNES AT THE BLOCK LEVEL

THERE IS NO MECHANISM FOR TOP DOWN FLOW OF INFORMATION FROM THE MIS COMPILED AT THE DSITRICT OR THE STATE LEVEL

LAST, THERE ARE NO OFFICERS WITH FULL CHARGE – DD, DHO, ADHO, THO, ARE ALL ON DEPUTATION

STRUGGLE IS TO REVERSE THE PROCESS TO MAKE IT PEOPLE CENTRED

THE FOCUS IS TO MAKE HEALTH AN ACCOUNTABLILTY OF THE STATE – OVER 4.5CRORES FROM THE DISTRICT HAS BEEN GIVEN TO PRIVATE HOSPITALS UNDER RSBY, COULD THIS FUNDS NOT HAVE BEEN INVESTED TO STRENGHTEN THE PUBLIC HEALTH SERVICES AND PROVIDE THESE SERVICES THROUGH THE STATE