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Transfer of rural Sub-Centres to Panchayati Raj Institutions, Haryana
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Subject Area="Management structures and systems." Objective="Link with PRIs (local councils)."
Details for Reform Option "Transfer of rural Sub-Centres to Panchayati Raj Institutions, Haryana"
Summary

Action: Administration of a total of 347 rural sub-centres was transferred to Panchayati Raj Institutions (PRI) on a temporary basis as a pilot project in three districts of Haryana in 2001. It is still being attempted in these districts (as of October 2004) but has not been successful due to perceived management weakness of PRIs in the state. Under the project, existing health workers keep their status as government servants and the terms and conditions of their service is protected. They continue to receive salaries and perform the standard job responsibilities. However vacancies from retirement/ promotions/ other eventualities are filled by PRIs on a contract basis from candidates available in the local area, as per guidelines issued by the state government and not exceeding 25% of the posts. PRI-appointed staff are paid out of sector investment programme funds during the first two years. Responsibilities of PRIs: (i) Management & day-to-day functioning of sub-centres. (ii) Provision and maintenance of sub-centre building. (iii) Review of all national health programmes. (iv) Levy of user charges with the approval of the District Health & Family Welfare Society. (v) Ensuring that health workers posted to sub-centres maintained their headquarters by providing rent-free accommodation out of funds generated by PRIs. (vi) Enforce discipline amongst staff. Role of government: (i) Supervision of health workers. (ii) Review of all national health programmes. (iii) Medicines, equipment etc shall continue to be supplied during this period through Zila Parishads/ Panchayats. Results: Yamunanagar District Health and Family Welfare Society handed over 112 health sub centres to PRIs during the month of September 2001 and trained 160 male and 83 females PRI members about various state and national Health programmes. The training took two days and was held at block level. As of October 2004 the PRIs were still in charge of the subcentres and the DH&FW Society reported that the scheme was working well. It is also still functioning in Ambala (October 2004), where 101 sub centres were handed over.

Cost Estimated costs: Ambala DHF&W gave each Panchyat INR 2,500 for minor repairs for each subcentre and the State Government contributed INR 10,000 per sub-centre.
Place Ambala, Karnal, Yamunanagar (districts of Haryana) from 2001.
Time Frame Three months.
Advantages

Organisation: Better accessibility to services (through possible relocation of sub-centres) and better provision and supervision. Accountability: Auxiliary Nurse Midwives in sub-centres accountable to local community body. Local community body is in turn accountable to electorate for maintenance of sub-centre building and equipment.

Challanges

Needs an able PRI: Doesn’t work if there is a lack of interest/ commitment/ poor management by PRI. Cooperation dependent: Risk of poor working relations between PRI officials and health officials. Possible opposition: Risk of opposition from district health authorities who may see it as an infringement of their powers.

Prerequisites

Decentralisation accepted as state policy. Government order from state government.

Who needs to be consulted

State government; PRIs; state and district health officials.

Risks

Sustainability

The scheme did not prove to be sustainable due to a weakness in the management skills of the PRIs.

Chances of Replication

The programme managers feel the scheme would be replicable in states where there are strong PRIs.

Comments

None

Contact

Submitted By

Dr K B Singh, European Commission Technical Assistance, New Delhi. October 2004.

Status Active
Reference Files
Haryana Health Dept Memo No 20-98-2001-5B-III(PROD No 33).doc
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