As part of a research project sponsored by the erstwhile Planning Commission and the NITI Aayog, the Indo Dutch Project Management Society (IDPMS) of Bengaluru studied the role of Panchayati Raj Institutions (PRIs) in the health care system of Karnataka. The IDPMS published a findings report along with recommendations suggesting corrective measures. The title of the report is -Research Study on ‘’Effectiveness of Panchayati Raj Institutions (PRIs) in Health Care System: Impact of Duality and role of bureaucracy in new approach-in the State of Karnataka”.
For the benefit of UPSC Civil Services (Mains) 2017 Exam aspirants, we are providing key recommendations suggested in the report. They following material will be helpful for the preparation of GS II and Public Administration Optional preparation.
The recommendations are -
• First and foremost sensitization and capacity building training programmes should be conducted for the elected representatives and health officials. This programme should focus on minimizing the trust deficit; improve coordination between the two sets of authorities.
• Training programmes should also be conducted for the ZP, TP and GP elected representatives to make them aware of the existing opportunities for reviewing the monitoring health activities and health functionaries.
• Proper capacity building programmes have to be conducted for Arogya Raksha Samiti (ARS) / (Rogi Kalyan Samithi (RKS) members in respect of conducting meeting, budgeting, accounting and management.
• In order to improve the monitoring capacity of Standing Committees, proper information flow (MIS – Managament Information System) should be established among the three tiers, preferably independent of health department system.
• Evaluation studies and survey related should be conducted by Standing Committees; its members should visit the health centers frequently and interact with the community.
• A Health information register could be a good basis for the Mediacal Officer (MO) to estimate the demand for drugs and disease mapping.
Performance review system
• Wider consultations with health fraternity, legal and PRI experts have to be held before drafting a detailed performance review system. An expert committee should be constituted.
• To start with elected representatives should be given the responsibility of writing their review on the performance of health functionaries working under their geographical jurisdiction. But they should do so after full consultations with District Helath Officer (DHO) and the Chief Executive Officer (CEO).
• Ultimate authority should be with DHO and Health Commissioner. However, they should mandatorily consider the reviews of elected representatives.
• Enough opportunities should be given for the health officials to contest these reviews.
• Jansunvais should be used as a community audit to review the performance of health functionaries. Jansunvais should be mandatorily conducted by GPs with the help of independent well meaning publicly acclaimed persons. The outcome of this social audit should be the basis to review the performance of health officials at village level and the quality of health services.
• To start with on a pilot basis, in selected GPs, salaries of ANMs and SC staff should be deposited with GPs and salaries of MOs and PHC staff should be deposited with Taluk Panchayats (TPs) and their salaries can be released after TPs and GPs in consultation with the community reviewing their performance. These institutions should be provided with proper escort service.