HEALTH BUDGET AND PLANS

1

• HEALTH BUDGET AND PLANS CHALLENGES AND
  EXPERIENCES FROM AMRAVATI DISTRICT
• PRESENTATION BY KHOJ

2
HEALTH BUDGET AND PLANS CHALLENGES AND
EXPERIENCES FROM AMRAVATI DISTRICT

• PLANNING PROCESS
• NRHM IS THE BIGGEST COMPONENT OF HEALTH IN THE
  DISTRICT
• NRHM REQUIRES BOTTOM UP PLANNING
• NRHM REQUIRES PARTICIPATION AT ALL LEVELS

3
HEALTH BUDGET AND PLANS CHALLENGES AND
EXPERIENCES FROM AMRAVATI DISTRICT

• PLANNING PROCESS IS GIVEN A MONTH WHICH IS
  INSUFFICIENT TO REACH OUT TO THE NEEDS OF THE
  GRASSROOTS
• THERE IS NO BUDGETARY INFORMATION ASKED FROM THE
  PHC OR SUB CENTRES BUT LIST OF DEMANDS

4
HEALTH BUDGET AND PLANS CHALLENGES AND
EXPERIENCES FROM AMRAVATI DISTRICT

• FOCUS OF PLANNING HAS BEEN ON HUGE INFRA
  STRUCTURES
• THERE IS NO PLANNING FOR EFFECTIVE MONITORING AND
  EVALUTION PROCESSES
• THERE IS LITTLE FOCUS ON PEOPLE WHO PROVIDE THE
  SERVICE AND ON THOSE WHO ARE THE RECEIPENT OF
  THE SERVICE

5
HEALTH BUDGET AND PLANS CHALLENGES AND
EXPERIENCES FROM AMRAVATI DISTRICT

• E.G. PEOPLE WORKING IN THE BHARARI
  PATHAK(FLYING SQUADS) ARE PAID Rs 12000/- per
  month
• THESE ARE ON ADHOC BASIS
• THEY WORK IN THE REMOTEST PARTS OF THE AREAS OF
  MELGHAT
• THEY DO NOT GET ANY HILLY OR TRIBAL AREA BENEFITS

6
HEALTH BUDGET AND PLANS CHALLENGES AND
EXPERIENCES FROM AMRAVATI DISTRICT

• WHILE CONSTRUCTION OF LABOUR ROOMS (CALLED AS
  REPAIRS) AT 60 LOCATIONS COSTS RS 1.40CRORES
• AND ON CONSTRUCTION OF WALL COMPOUNDS OF 17 PHCS
  THE COSTS IS 1.74 CRORES

7
HEALTH BUDGET AND PLANS CHALLENGES AND
EXPERIENCES FROM AMRAVATI DISTRICT

• THERE IS A Rs 10LAC BUS CALLED AS MOBILE HEALTH
  SQUAD WHICH HAS BEEN LYING WITHOUT USE IN 2
  BLOCKS
• THERE IS BLOOD COLLECTION VAN LYING AT AMRAVATI
  WITHOUT ANY VLAUABLE USES
• ADOLESCENT SEXUAL REPORDUCTIVE HEALTH PROGRAMME
  HAS SEEN NOT EVEN 1 EXPENDITURE DESPITE A LOW
  BUDGET IN ITSELF IN THE LAST 2 YEARS

8
HEALTH BUDGET AND PLANS CHALLENGES AND
EXPERIENCES FROM AMRAVATI DISTRICT

• BUDGETING EXERCISE
• BUDGETING EXERCISE DOES NOT SEEMS TO TAKE INTO
  ACCOUNT THE ACTUAL NEED AND EXPENSES
• IT IS ONLY A 10 ADDITION OVER LAST YEAR
• IN THE MONTH OF FEBRUARY 2011, ONLY 52 FUNDS
  UNDER NRHM HAD BEEN UTILISED AND THE DISTRICT WAS
  CONFIDENT OF SPENDING 48 PERCENT IN 2 MONTHS.. NO
  ONE COULD ANSWER THE HOW

9
HEALTH BUDGET AND PLANS CHALLENGES AND
EXPERIENCES FROM AMRAVATI DISTRICT

• EG. WHILE THERE ARE APPROXIMATELY 50,000
  CHILDREN WHO ARE SEVERELY OR MODERATELY
  UNDEROURISHED, THE BUDGET FOR THE YEAR 2011-12 IS
  ONLY TO CATER TO 10,000 CHILDREN
• THERE IS NO REASON WHY ONLY 10,000 CHILDREN WERE
  BUDGETED

10
HEALTH BUDGET AND PLANS CHALLENGES AND
EXPERIENCES FROM AMRAVATI DISTRICT

• THERE IS NO HEALTH PLAN FOR THE STATE AND THERE
  IS NO STRATEGY TO FOCUS ON ANY LOCAL ISSUE
• THE ONLY PLANNED, MONITORED PROGRAMME IS THAT OF
  PULSE POLIO AND MAY BE THE OTHER NATIONAL
  PROGRAMMES LIKE TB, LEPROSY AND MALARIA

11
HEALTH BUDGET AND PLANS CHALLENGES AND
EXPERIENCES FROM AMRAVATI DISTRICT

• THERE IS NO MEANS OF TRACKING THE EXPESNES AT THE
  BLOCK LEVEL
• THERE IS NO MECHANISM FOR TOP DOWN FLOW OF
  INFORMATION FROM THE MIS COMPILED AT THE DSITRICT
  OR THE STATE LEVEL
• LAST, THERE ARE NO OFFICERS WITH FULL CHARGE
  DD, DHO, ADHO, THO, ARE ALL ON DEPUTATION

12
HEALTH BUDGET AND PLANS CHALLENGES AND
EXPERIENCES FROM AMRAVATI DISTRICT

• STRUGGLE IS TO REVERSE THE PROCESS TO MAKE IT
  PEOPLE CENTRED
• THE FOCUS IS TO MAKE HEALTH AN ACCOUNTABLILTY OF
  THE STATE OVER 4.5CRORES FROM THE DISTRICT HAS
  BEEN GIVEN TO PRIVATE HOSPITALS UNDER RSBY, COULD
  THIS FUNDS NOT HAVE BEEN INVESTED TO STRENGHTEN
  THE PUBLIC HEALTH SERVICES AND PROVIDE THESE
  SERVICES THROUGH THE STATE