Citation: Bhojani UM, Madhav G, State Mentoring Monitoring Group Karnataka (Narayan T, Sudarshan H, Premadas E, Basavaraju E, Prabha N, Saligram P, Oblesha KB, Karpagam S) Community-based planning & monitoring of public health services: Lessons from the South-Indian state of Karnataka, International Conference on Health Systems Strengthening, Chennai, May 2010.
Publication year: 2010
Publication type: Conference presentation – Poster
Conference: International Conference on Health Systems Strengthening
Abstract:
Issues:
To ensure accountability within government health services in India, the National Rural Health Mission, launched in 2005, proposed community-based monitoring as one of its key strategy. It was the first time that the government proposed institutionalisation of community-based monitoring of health services in nine states across the India including Karnataka on pilot basis.
Description:
In Karnataka, in the first phase, 180 villages were selected from 36 Primary Health Centres (PHCs) across 4 geographically apart districts through stratified sampling and later almost all villages under selected PHCs were covered. Under the stewardship of the state mentoring group (representatives from government and civil-society) nodal NGOs were selected for each district and block that in turn facilitated community processes in its respective area. Village Health and Sanitation Committees(VHSCs) comprising of frontline health workers, community representatives, and elected local-government members were formed at village level and were oriented on issues related to monitoring and planning of health activities. VHSCs produced Report Cards and Village Health Plans as outputs of periodic monitoring and planning exercises at village level. These outputs were discussed by VHSCs with health staff at PHC level in form of public dialogues and action plans were formed. Similar committees and platforms were created at PHC and block level.
Lessons learned:
Report cards revealed that across the districts curative services, quality of care, utilisation of allotted funds, disease surveillance and maternal health scheme were perceived to be in a poor state of affairs while child health fared comparatively better. Over the project period all these parameters showed differential degree of progress. Public dialogues resulted in a few examples of concrete actions from health staff. Complexity of report cards, administrative delays and inadequate time for community processes were some of the major constraints. With committed NGOs and government cooperation it is possible facilitate such process at a wider scale.
Way Forward:
Karnataka government is in a process of up-scaling this programme to cover all the districts in the state. It is important that lessons learnt from the pilot phase are used to improvise planning and conduct of such initiative.
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