Objective="Technical assistance for implementation of health care programmes."
Details for Reform Option "Regional Resource Centre for North Eastern States, Assam"
The North Eastern States are of special importance due to their diversity of culture, language and ethnicity. Despite receiving increased funds for health in the second phase of the Reproductive and Child Health programme (RCHII) and the National Rural Health Mission (NRHM), these 8 ‘focus’ States have shown no significant improvement in vital health indicators. This was due largely to a lack of managerial and technical capacity, not only at the State level but also in the field, meaning that the increased allocations were not effectively absorbed.
In November 2005, a collaboration of development partners, the European Commission (EC), the United Nations Populations Fund (UNFPA) and the Department for International Development (DFID) assisted the GoI in establishing a Regional Resource Centre (RRC) at Guwahati, Assam, with the aim of improving the technical and managerial capacity of the north eastern States at all levels.
When completed, the RRC will consist of a team of experts in the following fields:
i) Public Health
ii) Programme Management/ Management Information Systems
iii) Financial Management and Accountancy
iv) Social Science
v) Architecture/ Civil Engineering
The centre will provide technical assistance to the State Health and Family Welfare Departments and help them in the implementation of NRHM. Its main tasks will be:
i) To produce situational analysis on various aspects of the health sector and to prepare policy proposals. Key areas include:
a) organisational restructuring at the State, district and sub-district levels (including integrated societies at State and district levels and autonomous societies for management of hospitals).
b) institutionalisation of integrated planning and management.
c) strengthening and streamlining of financial and managerial systems
d) devolution of financial and administrative powers
e) strengthening and streamlining of procurement and logistics
f) standardisation of norms (services, staffing and infrastructure) at the primary and secondary levels
g) strengthening and streamlining of Health Management Information Systems (HMIS) and Monitoring and Evaluation (M&E)as per GOI guidelines, integration of disease surveillance within the HMIS
h) development of drug policy
ii) To facilitate in the preparation of district and State health plans.
iii) To coordinate the logistics of the training programmes including assisting in the development of training modules for the implementation of NRHM
iv) To facilitate development of the institutional mechanisms for local planning and community participation, including training and orientation of Panchayati Raj Institutions (PRIs) and other local government structures, such as autonomous councils
v) To undertake studies on the health problems of the tribal peoples of the northeastern region.
vi) To facilitate mainstreaming of the tribal medicine systems
vii) To assist the States in establishing
a) Integrated District Health and Family Welfare Societies;
b) Autonomous hospital management societies;
c) Programme Management Units for the State and District Societies.
The RRC will ultimately be monitored by a Governing Council and an Executive Council. Until these councils are constituted, an interim body, the Executive Committee, will begin the process by preparing a plan of action and reviewing the centre’s work every six months.
It will take time to set up the RRC with a full compliment of staff, so it was decided to use an intermediary organisation – the Hindustan Latex Family Planning Promotion Trust (HLFPPT) which is already providing technical assistance to the EC-assisted Sector Investment Programme (SIP) - to initiate the work.
The agreement includes financial provision for the RRC until December 2006. However the HLFPPT may be required to help develop the RRC into a legal or corporate entity well before the current arrangement expires. The European Commission Technical Assistance team (ECTA) has agreed to help in this process.
A State facilitator will be appointed to each State and will be located in the State Directorate. This person will be the link between the state and the RRC.
The Resource Centre will be pre-programmed to ‘work itself out of a job’, meaning the organisation may be dismantled as soon as the State Governments in the region attain the adequate managerial capacity – expected to be by 2012.
The North East Regional Resource Centre is still very much in its infancy, having been inaugurated only on November 9, 2005. It will take at least a year for any results to be visible.
Around INR 30 lakhs on hiring staff, buying equipment, and on building rental charges.
The European Commission provided about INR 2 crores initially to support the RRC under the ongoing SIP.
The estimated expenditure on the RRC for a seven year period is likely to be INR 18 crores.
Other development partners, such as UNFPA and DFID have also expressed willingness to share costs.
Guwahati, Assam. Operational with five consultants since November 2005.
Six to 8 months.
Focussed: The RRC will identify and focus on key areas in need of technical and managerial assistance.
Locally available resource: Will speed up and simplify methods of providing support to north eastern States
Programme supervision: Will allow GoI continuous monitoring of the progress of programme implementation, planning and monitoring
Donor coordination: Could be problematic bringing together all the donors supporting the institution to make decisions
Commitment from donors and GoI
Who needs to be consulted
GoI and donors.
The RRC is designed to be dismantled once it has achieved its goal of raising the level of managerial capacity in the north eastern states.
Chances of Replication
The RRC could be replicated in other areas of the country, with the assistance of a nodal agency from the government.
Tessa Laughton, Research Consultant, ECTA. November 2005
Last updated: October 2006