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Devolution of financial and administrative powers to districts, Haryana
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Subject Area="Management structures and systems." Objective="Decentralisation."
Details for Reform Option "Devolution of financial and administrative powers to districts, Haryana"
Summary

Background: The State Government of Haryana decided that to meet the rising cost of healthcare and rising expectations of the community it must bring in a programme of decentralisation to increase local ownership and community participation and make it more responsive to local needs. Action: Decentralisation and devolution of financial and administrative powers at district and sub-district levels with the aim of simplifying administrative and financial procedures. Powers at different levels have been devolved as follows: (i) Civil surgeon Transfer and depute all categories of staff within the district. Employ specialists, staff nurses, Auxiliary Nurse Midwives (ANMs), Lady Health Visitors (LHVs), drivers, etc. on contract basis. Purchase drugs, material and equipment. Delegation of financial powers of Director General of Health Services (DGHS) for sanction and incurring expenditure under the scheme/project. Get buildings repaired /constructed from appropriate agency.* Responsible for disciplining class III category employees. Readjust/reallocate sub-centre population to ensure effective health care delivery. Assign additional job responsibilities to different categories of health staff in the district. Ability to delegate administrative or financial powers to the most senior district program officer. (ii) Medical superintendent Purchase drugs, equipment, consumable or non-consumable materials and get any repairs done up to INR 50,000).* (iii) Senior Medical Officer (SMO) Redistribute/depute the class III and Class IV staff within his/her area with the approval of the civil surgeon. Carry out minor disciplinary action to class IV staff. Procure medicines, equipments, materials, consumables and non- consumables up to INR 10,000.* (iv) Medical officer Redistribute/depute class III and class IV staff within his/her area with the approval of SMO/civil surgeon. Recommend minor disciplinary action. Purchase/repair up to INR 5000 .* (v) Health supervisors & health workers Purchase/repair up to INR 500. Employ helpers from local area for sub centre.* (* As per the district action plan approved by the state reform cell) Results: Visible improvement to infrastructure (particularly district hospitals). See pictures in References section. Shared authority between the centre and local units has improved their ability to meet national health objectives and respond to local health needs.

Cost Costs met from user fees.
Place Yamunanagar district, Haryana, since May 2001.
Time Frame Six months for implementation.
Advantages

Efficiency: More efficient district and sub-district management of resources. Speed: Swifter management decisions.

Challanges

Power struggles: Understanding of roles and responsibilities needs to be provided to facilitate the transfer of power from one agency to another. Flexibility: A decentralisation programme must be flexible enough to adapt during implementation to meet unexpected needs. Capacity building: Health personnel must be trained to understand how best to use their new powers.

Prerequisites

Decentralisation accepted as state policy and a government order from state government. Strengthened monitoring and supervision at state, district and sub-district levels.

Who needs to be consulted

State Government

Risks

Sustainability

Good, if political will persists. This project is being run until the end of the EC-Supported Sector Investment Programme in December 2006 and will then be reviewed.

Chances of Replication

No information available.

Comments

Haryana State Government is committed to a programme of decentralisation but a significant unfinished agenda remains (as of January 2006). This includes the physical merger of societies and formation of a management andmonitoring cell as well as capacity building of senior officers at the health directorate, 17 districts and PRIs.

Contact

Submitted By

Dr K B Singh, Programme Advisor, European Commission Technical Assistance, New Delhi. July 2002. Updated February 2006.

Status Active
Reference Files
20-98-2001-4HB-III dated 19-06-2001 (PROD No 35).doc
EC SIPO C-1-2001-275-280 dated 02-05-2001 (PROD No. 35).doc
EC SIPO C-1-2001-282-287 dated 02-05-2001(PROD No 35).doc
Decentralisation2.ppt Powerpoint presentation on Decentralisation, State Government of Haryana, January 2006.
Reference Links
 
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