Ageing Treatments

Improving Panchayat Raj Services, Public Health

Improving Panchayat Raj Services, Public Health

* Ramaiah Bheenaveni

Panchayats in India are an old institution for governance at village level. In 1992, through the enactment of the 73 rd Constitutional Amendment Panchayati Raj Institutions (PRI) were strengthened local government organizations with clear areas of competence, adequate power, authority and funds in line with responsibilities.

Panchayats have been allocated 29 rural development activities, including several that are related to the stabilization of health and population. The calendar includes XI of Family Welfare, Health and Sanitation (including hospitals, primary health care clinics) and the program includes Health XII Public.
"Thus, the possible scope of the influence of the panchayats is spread over a large part of public health problems. The Gram Sabha, where power has the potential to act as a mechanism of accountability of the community level to ensure that the functions of the village panchayat in the area of public health and welfare of the family, actually respond to the needs of the people. "

The 73rd Constitutional Amendment makes it mandatory for related functions the provision of primary health care – maternal health and family welfare are the responsibility of the PRI. In addition to the departments in different sectors development are the functional competence of the district panchayat. Creating a health system with the panchayats are responsible for monitoring and controlling health services seems be an ideal model.

The National Health Policy of 2001, also emphasizes the implementation of public health programs through local self-government institutions, especially with regard to national disease control. The Planning Commission established a Working Group to review the role of PRI in various sectors and to make recommendations on the PRI's share specific to each sector. A Report of the Group for five major programs in HFW and special features of the PRI. The Working Group report summarizes the main functions of each level of the PRI with respect to five major programs, Reproductive and Child Health (RCH), and programs of Vector-Borne Diseases, Blindness Control of Tuberculosis programs, and STI / AIDS. Many activities proposals relate to the identification of persons in need of services, in collaboration with the health system and monitoring level health workers and facilities primary and secondary health care. Currently, the PRI are not prepared to take in planning and oversight functions, nor a knowledge of the system health of the role of the PRI.

Critical role of Panchayati Raj institutions in the success of the National Rural Health Mission

PRI is considered essential for the planning, implementation and monitoring of the NRHM. The NRHM is seen as a vehicle to ensure that prevention and promotion interventions to reach vulnerable groups and marginalized through expanding outreach and linking with local government institutions. The key to the success of the NRHM are: sectoral convergence directed community ownership through community health committees at the Gram Panchayat level, and a strong system of public sector health sector support private. Behind this is a commitment to systemic reform in the health sector for better regulation of medical facilities, public health oriented medical education, strengthening management capacity, and effective and rational human resource policies. The success of the NRHM in the achievement of results much depends on the proper functioning of gram, block and district level Panchayats. It is anticipated that the NRHM, a working group specifically created to recommend and study the centrality of the PRI to the NRHM.

ASHA, the mechanism to strengthen service delivery at village level will be a local resident and selected by the Gram Panchayat or Village Health Committee (VHC). She leaned back in his work for the PDA, school teacher, members of local community organizations, such as self-help groups and village health committee. ASHA role would be to facilitate the search for care and provide support for the deposit of a package of basic medicines. She be recovered in an action plan based on pay.

The Village Health Committee (VHC) forms the link between Gram Panchayat and the community. HCV is responsible for working with the Gram Panchayat to ensure that the health plan is in harmony with the local plan in general. This committee is expected to draw a village health plan and maintaining the data at the village level, under the supervision of the Gram Panchayat. The involvement of Gram Sabha and other groups in planning and control village Health Plan assume that transparency and accountability.

Under the NRHM, untied funds of about Rs 5,000-Rs. 10,000 were placed in the ANM to cover unforeseen expenses and to ensure that the lack of medicines and other supplies is not a problem. In the central sub-level planning and use of these funds support at the appropriate level of the panchayat.

effective health care is not within the scope of the health department. On the level convergence village is required with the agencies that provide nutrition, sanitation, education, livelihood / poverty reduction plans and training for least. Beyond the staff of each department, the only institution at the village level that can coordinate all these functions is the PRI. Actually no But there is little convergence at village level in many states, let alone an active role
by the PRI to facilitate convergence. District level the District Health Mission NRHM coordinate functions. Sanitation is aligned with the NRHM.

Several health-monitoring program by the PRI:
ACCELERATED WATER SUPPLY RURAL PROGRAM (ARWSP)
Under ARWSP, the Central Government is to complement the efforts of state governments to facilitate access to safe drinking water to all rural households country.
The role of PRIs in the implementation of this system are:
 Panchayati Raj Institutions should be involved in implementing the particular in selecting the location of the public fountain in situ sources, operation and maintenance, water pricing / process, etc.
 Implementation of sector reform projects in identified pilot districts should also be carried out by the District Panchayats or Water District and Sanitation Mission (DWSM), which must be registered societies under the supervision, control and guidance of the District Panchayat.
 They are always PRI firmly in place and ready to take responsibility and are strong enough for it, running their own projects instead of DWSM.
 At the village level, the individual Rural Water Supply Schemes will be implemented through Village Water and Sanitation Committees should committees gram panchayats.
 Drinking assets water is transferred to the appropriate level of panchayats and panchayats as shall be authorized to perform the operation and maintenance of potable water systems.
CENTRAL RURAL SANITATION PROGRAMME (CRSP)
This program aims to improve the overall quality of life in rural areas, speed up coverage in rural areas, generation demand by creating awareness and health education and control the incidence of diseases related to water sanitation.
The role of the PRI in execution if the system are: –
 Total Sanitation Campaign (TSC) is a community based program where Panchayati Raj Institutons are at the forefront.
 In accordance with the guidelines of the ACC, the application to the district level should be done by the panchayats in the district. Panchayats in the block and village level should participate fully in the implementation of the program.
 In case of District Panchayat is not in a position to implement the program, being implemented by the District Water and Sanitation Mission which is chaired by the Chairman of District Panchayat and village committees are chaired by the Presidents of Gram Panchayats. In the latter case, village water and sanitation Mission are part of the Gram Panchayat.
SWAJALDHARA
This program aims to provide Rural Community Potable Water. Key elements of this program are as follows: (i) demand and focus of community involvement, (ii) panchayats and communities to plan, implement, operate, maintain and manage all drinking water systems, (iii) partial participation capital cost of the communities in advance in cash, (iv) full ownership of drinking water assets with Gram Panchayats and (v) full Operation and maintenance by the users / Panchayats.
The role of PRIs in the implementation of this scheme are as follows: –
 Gram Panchayat shall convene a Gram Sabha meeting where the Water Supply system of choice of people, including design, etc and the cost should be completed. Gram panchayats are to carry out the acquisition of materials and services for the implementation of plans and monitor the implementation scheme.
 A resolution must be passed in the Gram Panchayat meeting calling for users / beneficiaries contribute 10% of the cost of capital. However, GP can refer to the contribution of the community of their revinue taxes (no government subsidy) with the approval of Gram Sabha.
 decide Gram Panchayat if you want to run the Panchayat plan itself or wants the State Government Agency to carry out the execution.
 After completion of these schemes, the Gram Panchayat shall be responsible for the Schemes of Operation and Maintenance (O & M).
 Panchayat must decide on user fees community for adequate funding available to conduct Panchayat O & M.

Conclusions:
However, the extent to which reproductive health is reinforced by the panchayats based on funding and functions assigned to them to carry out these responsibilities. Clarity in the separation of powers between the representatives elected and bureaucracy in local government are important in this context. While development goals include reducing the incidence of mortality and morbidity, the question remains whether the institutional interventions and resource allocations are adequate to deal with these problems. Gram Panchayat has a supervisory role to ensure adequate provision of services. Many of them were not aware of what comprises the role and responsibility of the panchayats in the delivery of health services.
References:
1. Manual on Target Free Approach, Department of Family Welfare, Ministry of Health and Family Welfare, Government. of India

2. Panchayat Raj Institutions In India a National Evaluation Institute, Rural Development, 1995.

3. Vijayanand, SM, Decentralization and Health, Paper presented on paper Local Government Institutions Population Stabilization, Institute of Social Sciences, New Delhi, February 2003.

4. Dash, Dhanlaxmi (2006) – Women's Environment and Health, Deep Manga Publications, Delhi.

5. The Constitution (Seventy-third amendment) Act 1992

6. Rosenstock IM. What research in motivation suggests for public health. Am J Public Health. 1960, 50:295-301.

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