Equipping missionaries for the mission:Case study of the capacity building initiatives by Public Health Resource Network and the decentralized health planning under NRHM in Jharkhand,India-

Case study of the Capacity Building Initiatives by Public Health Resource Network and the Decentralised Health Planning under NRHM in Jharkhand State, India

NRHM Planning process in JharkhandDescribing the Inputs, the expected

outputs and resultsAnalysis of the resultsConclusions

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The National Rural Health Mission has initiated Decentralized planning and flexible pool funding Program Management Units at State, District and

Block Community Participation

Public Health Resource Network evolved as a collective of concerned organizations and individuals, to support the mission in those needy areas Mission needs Missionaries, and it need them where

the challenges are greatest Jharkhand was one amongst the 4 states of initial

interventions (Bihar, Chhattisgarh, Jharkhand, orissa)11 April 2023 3Public Health Resource Network - PHRN

A strong presence of experts in Public Health is required at the district level to take NRHM forward.

Doctors nor the PMU seem to understand public health

The Hypothesis Building the capacity of local persons from

within the government system and the civil society will improve the level of District planning for health and its implementation.

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District Plans were prepared by state consultants

District Officials and PMU were not taking accountability for any programme ‘if you want to do anything in the district, you

will have to get a letter from the state RCH officer or the MD’ Civil Surgeon to Development Partners

‘I am not sure of my role and responsibility, neither does the Civil Surgeon allow me to do anything or visit the field’ - DPM

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Fast Track Training on District Health Planning and Management For Medical Officers and DPMs Three six-days training package (18 days) spread over a year. Partnership and Support from NHSRC

Distance Learning for Civil Society members: Training self-supported by participants, Modules and course management with ICCHN support

Placing of Community Health Fellows in select districts, with ICCHN support

PG Diploma in District Health Planning and Management in partnership with IGNOU

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PG Diploma -IGNOU29 officials and 19

Civil society persons enrolled

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Fast Track TrainingA total of 155

persons trained to cover 24 districts.Community

Health Fellows10 fellows posted

Distance Learning85 Civil Society

members trained in 10 districts

10 out of 24 districts have in-house capacities for district health planning.

Have prepared the plans without external support

Six of them have been rated as being of good quality (Saraikela, Dumka, Gumla, Jamtara, Pakur and Latehar)

All other districts attempted the preparation of the DHAP on there own.

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Innovative local ideas added into the DHAPs and accepted in the state PIP-RoP

Boat clinics for Sahibganj. Provision of garments to the newborn for promotion of

institutional delivery. Incentives to ASHA for referral of Malnourished children provisioning of food at CHCs for inpatients

Moving towards Block Health Action Plans this year.

“Landmark results in other states as well- e.g. district financial envelops and guidelines in Bihar”

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Excited about Civil Society Participation It truly demonstrates a PPP. People working for the govt., the

NGO's & CBO's share a common platform & try to bring about change in the existing health scenario at different levels.

Being in command - Seeing clearly Personally I found the log frame analysis very useful (Dr Poonam

Mehta).

It has helped in understanding the health situation better for my block and district and preparing a district specific plan ( Dr. GP Seth).

It has benefitted in understanding the planning process and looking in to things scientifically, systematically and in a broader way ( Dr. Ajit Xalxo).

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Comfortable with Public Health and Management The capacity for understanding the health situation in my

district and personal capacity has enhanced I now feel that I own this program and can do something

Understanding the process – Planning makes Sense I was able to understand how existing resources of

manpower and materials can be optimally utilized and critical gaps can be identified and addressed. 

To mark specific activities for each strategy and design the activities at tentative time frame. 

Helped to study situational analysis and make recommendations towards policy or workforce management.

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I have a team now! The whole process of capacity building programme

has helped because after training the entire district team has been equipped. Earlier only one persons was form social and management background.

Due to this, planning group has been formed in the district and now the task for planning and even in management has become very easy.

Empowering spiral I have been able to ensure that the process has been

decentralized and reached up to HSC level. Many new things are coming due to this process.

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Feel wanted We were kept outside the system earlier. Due to these

planning processes initiated in the blocks and district we have been able to bring in the ground realities in the district plan. We are now valued in the district and been called for every meetings now (sahibganj)

Understand Public Health Challenges Network has been able to help us understand the public

health scenario and its provisions in our district .It facilitated us to ask for and add area specific health plans in the district. Due to our enhanced knowledge and skills , the deputy commissioners always asks us for suggestions.

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Selection of Medical officers and DPMU staffs

Handpicked by name and not by nominations (5 MOs from each district)

Only those who were interested ( with at least two meetings in each district to assess them)

Motivated Willing to attend all three sessions.

Team building and Rapport Join the network – set up district chapter Feel like a family ‘Conspire’ for ‘good’, together.

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Innovative and new sessions Practical and group work based Post Training support with post training

assignments Post training assignments.doc Resource Persons

Experience in working with Government Cross – learning (Resource persons from

Orissa for malaria, North –east for Tuberculosis, Unicef for maternal health)

All resource persons were voluntary Personally inspiring

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Bringing in the Civil Society One cause, one team – with district

health team Able to better articulate health issues. Complement resources – brining in field

data and reality

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The Community Health Fellow Positioning the fellow at the District level

▪ Our District did not have a DPM, the Community Health Fellow organized all the meetings for the District Health Planning. – East Singhbhum District Health officers

▪ The Community Health Fellow was a real support, she really helped me. – DPC of West Singhbhum

Positioning the Fellow with a local NGO Continuous learning Cycle and field

experimentation 11 April 2023 Public Health Resource Network - PHRN 17

What worked – synergy of Theoretical learning Handholding for experiential learning Civil Society participation Team Spirit

Local teams can be empowered in a short time We just need to search and identify

motivated and talented people.11 April 2023 Public Health Resource Network - PHRN 18

JRHM and SPMU, Govt. of Jharkhand NHSRC, New Delhi SHSRC/VSRC, Jharkhand SHSRC, Chhattisgarh PHRN , New Delhi UNICEF, Jharkhand Ekjut, Jharkhand AROHAN Trust, Sundarpahari, Gooda (Jharkhand) NE RRC, Guwahati ICCHN, Pune RTF Campaign, Jharkhand EFFICORE, SAHEBGANJ, Jharkhand BGVS, Dhanbad

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Dr. Suranjeen Prasad- [email protected]

VR Raman- [email protected]

Rajan Kumar- [email protected]

Ms. Shampa Roy- [email protected]

Mr. Alexander Kerketta- [email protected]

Dr. Dinesh - [email protected]

Dr. Vandana Prasad- [email protected]

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