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Decentralisation of supervision structures, Assam
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Subject Area="Human Resources." Objective="Effective decentralised management of services."
Details for Reform Option "Decentralisation of supervision structures, Assam"

Background: Due to a lack of supervision and authority at all levels, efficient management of the workforce in the district has been problematic. Action: Administrative and financial control of workers in the district has been transferred from state government to the district agency - which has in turn delegated the responsibility to the block level Primary Health Centre (PHC) Medical Officers (MOs) in Nagaon district, Assam. These powers include disciplinary action and reallocation of health workers and MOs between facilities as necessary. There are plans for delegating the annual confidential report (ACR) of the workers, including the MOs, to the block Sub Divisional Medical Health Officer (SDMHO). The SDMHO will then be able to decide on issues such as annual leave without consulting the district agency. Salary certificates have to be countersigned by the local block SDMHO. Results: These measures have substantially changed attendance records of workers in the facilities.

Cost No cost involved.
Place Nagaon District, Assam, since August 2000.
Time Frame Can be effected immediately, if authorisation is delegated by the state government.

Better Regulation: Due to more efficient control of workers at the local level, the attendance and regularity of service provision has improved.


Shortage of manpower: Due to shortage of staff, problems are sometimes encountered in implementing the measure.


Motivated district officials who are interested to improve workforce supervision in outlying areas.

Who needs to be consulted

The health and family welfare department of the state government. The district agency. MOs in outlying areas.



The programme is running well since 2000.

Chances of Replication

The program has been replicated in some other districts of the State.




Submitted By

ECTA PROD team, New Delhi. July 2002. Last updated: Juy 2006

Status Active
Reference Files
Assam PPT.ppt Reform initiatives in the health sector- A power point presentation.
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