The Centre for the Study of Social Exclusion and Inclusive Policy (CSSEIP), University of Mysore, has found in its study that there was lack of coordination between Panchayat Raj Institutions (PRI) and Public Health Institutes (PHIs) which has come in the way of delivering quality healthcare services in rural areas.
Although the panchayat raj system is intended to authorise people under health decentralisation to exercise their choice on the extent of public health system services they would like to have, PRIs, in reality, have a “weak linkage” with the PHIs, especially in the rural areas, and it seems PRIs have not been successful in developing, supervising and delivering quality healthcare services in the rural parts, according to the study.
The study titled ‘A Benchmark Assessment of Capacities of Panchayat Raj Institutions to Administer the Grassroot Health System in Karnataka’ was funded by the Indian Council of Medical Research (ICMR), New Delhi, and conducted by D.C. Nanjunda, Associate Professor, and his team of the CSSEIP.
Conflict
The study has found a conflict between healthcare providers and the local government as regard their obligations and the responsibilities over the issue of healthcare services. “Also, many elected PRI members are unaware of their roles and responsibilities on the healthcare issues as they are busy in politics only,” said Dr. Nanjunda.
Functionaries of the PRIs were of the view that the Health Department and its employees should accept the authority and power of the PRIs on health issues; but most of the department staff are not serious and neglect this power of the PRIs, the study revealed.
Coverage
The study was carried out in 10 districts between 2015 and 2017 and the report was submitted to ICMR in January this year. Appaji Gowda, Srikanth, Karuna Shree, P.T. Dinesha and V.G. Siddaraju were in the study team.
The study has found that PRIs and PHIs lack cordial relations. Although there should be standing committees to promote health issues, in many cases PRIs have not shown interest to create such committees.
Only 32.2 per cent of PRIs have constituted a Village Health and Sanitation Committee, 18 per cent have constituted a Nutritional Committee and only 25 per cent of PRIs have constituted Rogi Kalyana Samithi in the State, according to the study.
Devolution of funds
The study has also found that inadequate devolution of funds, functions, and functionaries contributed to panchayats not taking any significant initiatives to improve healthcare system in rural settings.
PRIs do not have enough resources to upgrade PHCs and CHCs because of which they are running short of manpower, required equipment and other essential items. The study concluded that PRI members need more training to handle healthcare issues, and judicious allocation and prioritisation can be successful, which depends on the political will and local representatives’ active participation.
