Population Foundation of India, May 28, 2015
Advisory Group on Community Action Members present
- Dr Abhijit Das
- Mr A R Nanda
- Mr Gopi Gopalakrishnan
- Dr H Sudarshan
- Ms Indu Capoor
- Dr M Prakasamma
- Dr Narendra Gupta
- Ms Poonam Muttreja
- Prof Ranjit Roy Chaudhury
- Dr Sharad Iyengar
- Dr Padam Khanna, Senior Consultant- Public Health Planning, NHSRC
- Dr K Shashikala, Senior Consultant- Public Health Planning, NHSRC
- Mr Syed Mohd. Abbas, Consultant- Community Processes, NHSRC
Representatives from the AGCA Secretariat
- Mr Bijit Roy
- Dr Ajay Misra
- Ms Tripti Chandra
- Ms Seema Upadhyay
- Ms Jolly Jose
AGCA members who could not attend the meeting and were given leave of absence
- Dr Abhay Shukla
- Mr Alok Mukhopadhyay
- Ms Mirai Chatterjee
- Dr Saraswati Swain
- Dr Thelma Narayan
- Dr Vijay Aruldas
Special invitees who could not attend the meeting and were given leave of absence
- Dr Sanjiv Kumar, Executive Director, NHSRC
- Dr Rajani Ved, Advisor, Community Processes, NHSRC
Ms Poonam Muttreja welcomed the participants and shared that the objectives of the meeting were to:
- Give a brief on the draft National Health Policy (NHP)
- Share the progress update on the Strengthening Community Action for Health under the National Health Mission (NHM) programme for the period January – May 2015 and future plans
- Reflect on AGCA priorities for the current Financial Year (2015-16).
The meeting began with Ms Muttreja reading out a condolence message in memory of Dr Ajay Khare, a driving force of the community monitoring programme in Madhya Pradesh, who passed away on March 5, 2015. The group paid homage to Dr Ajay Khare by observing silence for a minute. The AGCA members conveyed their heartfelt condolences to his family.
Confirmation and Action Taken on the Minutes of the 30th AGCA meeting held on January 16, 2015
The members confirmed the minutes of the 30th AGCA meeting held on January 16, 2015.
Bijit Roy, Team Leader, AGCA Secretariat, shared an update on the Action Taken on the 30th AGCA meeting.
Compliance on action points of the 30th AGCA Meeting
|Organise meeting with the Ministry of Women and Child Development (MoWCD) to discuss the next steps for collaboration on community monitoring of the Integrated Child Development Services
|Meeting with the MoWCD was held on April 7, 2015. Minutes of the meeting were shared with the MoWCD team. Follow up on the next steps in progress
|Provide inputs on the draft National Health Policy
|AGCA Members and Secretariat
|AGCA’s inputs were shared with the MoHFW on February 26, 2015
|Develop and submit the AGCA proposal for the next phase
|Proposal submitted to the MoHFW on February 20, 2015
|Organise 2nd AGCA sub-group meeting on community based planning
|Inputs on the State Programme Implementation Plans (PIPs) shared with the MoHFW and NHSRC. Follow up meeting organized with NHSRC on May 15, 2015
|Provide regular updates to AGCA members on state processes
|Regular updates being shared with AGCA members
|Share AGCA’s inputs with the MoHFW on the State PIP template for community action for health component
|Details shared with MoHFW on January 29, 2015
Brief on the National Health Policy Processes
Dr Padam Khanna, Senior Consultant, Public Health Planning, NHSRC, shared the following update regarding the National Health Policy –
- Thematic/ technical groups were constituted to seek inputs on specific areas
- Meetings were organized with the State Health Secretaries and Mission Directors to seek inputs on priority areas
- A National Steering Committee was constituted for framing the draft policy document. The committee included representatives from the Ministries of Health and Family Welfare, Women and Child Development, Panchayati Raj, Rural Development and Education
- The development of the NHP included the following steps:
- Regional and national level consultations were organized with the Indian Medical Association (IMA), Federation of Obstetric and Gynaecological Societies of India (FOGSI), Confederation of Indian Industries (CII), Federation of Indian Chambers of Commerce and Industry (FICCI) and NGOs to seek their inputs on the policy. Based on the above processes, a draft policy was developed and shared for inputs/suggestions.
- Over 5,000 feedback/ suggestions were received on the draft policy document. These feedback/ suggestions were categorized and are currently being reviewed by the NHSRC.
- In addition, new sections on nutrition and adolescent health have been included.
- The revised draft policy will be shared with various ministries for feedback and discussed at the next National Steering Committee meeting scheduled on June 15, 2015.
Feedback from AGCA members
The following inputs were provided by the AGCA members:
- A framework for implementation should be developed along with the NHP to ensure effective implementation of the policy.
- There is a need to integrate the National Health Assurance Mission and the Universal Health Coverage within the policy document.
- The MoHFW should consider increasing the budgetary allocations to at least 2.5 % of Gross Domestic Product to support effective implementation of the NHP.
- Reducing over-medicalisation should be a guiding principle to improve access and quality of health services. There are often concerns from professional bodies regarding surgical procedures. The emphasis is on ‘Who does it‘ rather than on whether ‘Quality is maintained’. For example, an AYUSH doctor can be engaged for providing abortion care services.
- The role of the private sector should be clearly defined. In addition, a regulatory framework should be established for engagement with the private sector.
- Action on social determinants of health requires coordination among various ministries. It is therefore, important to mention the nature of involvement of each ministry in contributing towards the overall goals of the NHP.
- A large proportion of the NHM funds are currently being allocated for providing incentives under various schemes/programmes. The MoHFW should assess whether these incentives are leading to better health outcomes.
Update on the progress of AGCA activities
Bijit Roy made a presentation on Update on the Strengthening Community Action for Health under the National Health Mission (NHM) Programme for the period January – May 2015. The presentation included activities undertaken at the national and state levels, expenditure details for the last Financial Year 2014- 2015, challenges and support required from the MoHFW.
Feedback from AGCA members
- An annual joint meeting of the National ASHA Mentoring Group and the AGCA could be organized to deliberate on common strategies to strengthen implementation of the communitization processes. The AGCA Secretariat will request the MoHFW to consider the suggestion.
- The AGCA Secretariat should request the MoHFW to write to the State Governments to engage NGOs as resource organizations in community action processes, based on the National NGO Guidelines.
- Exposure visits should be organized for state government officials to orient them on the community action process.
- Resource materials developed by the Secretariat should be both in English and Hindi.
- Social accountability and community mobilization are key focus areas of several donor funded health programmes. The Secretariat should, therefore, explore possibilities of organizing a meeting with key donors such as the Bill and Melinda Gates Foundation (BMGF), the Department for International Development (DFID), the MacArthur Foundation, the Open Society Foundations (OSF), the Tata Trust, the United States Agency for International Development (USAID), the World Bank and others to brief them on the AGCA’s work and the technical support which could be extended.
Update on the inclusion of community action for health component in the State Programme Implementation Plans in FY 2015-16
In the current Financial Year 2015-16, 25 states have included community action for health component as part of their State PIPs. The total amount requested by states is Rs 49,54,36,000 (Rupees forty nine crore fifty four lakhs thirty six thousand only), which is a 24% increase over the last Financial Year. New states, which have proposed implementation of the component, are Tripura, Nagaland, Himachal Pradesh and West Bengal.
Update and inputs on the AGCA Sub-Committee on Community Based Planning
Bijit Roy briefed members on the second sub-group meeting organised on May 15, 2015.
The following inputs were provided:
- The decentralized participatory health planning process could be piloted in one district across the 5 states of Maharashtra, Rajasthan, Karnataka, Nagaland and Odisha. All blocks from each district will be selected covering all Community Health Centres (CHC), Primary Health Centres (PHC), Sub-Health Centre and selected VHSNCs within them. The NHSRC can lead the process in collaboration with the AGCA.
- Adequate funding needs to be allocated to support the participatory health planning process.
- Epidemiological data should be analysed for developing block and district level plans. In addition, triangulation of data from the Health Management Information System (HMIS) and household surveys should also be used to guide prioritizing of the PIP.
- The draft concept note shared by Dr Abhay Shukla, Member AGCA, will be revised as per the above mentioned suggestions and shared with the NHSRC for inputs. Thereafter, the concept note will be shared with the MoHFW for review and approval.
Reflection on AGCA priorities for the current Financial Year (2015-16)
Re-organization of states among AGCA members
AGCA members volunteered to guide processes in the following states:
- Mr A R Nanda – Odisha
- Mr Gopi Gopalakrishnan – Madhya Pradesh
- Dr H Sudarshan – Uttar Pradesh, Telangana and Andhra Pradesh
- Dr M Prakasamma – Assam
- Dr Narendra Gupta – Punjab and Uttarakhand
- Prof Ranjit Roy Chaudhury – Delhi
- Dr Sharad Iyengar – Uttar Pradesh and Uttarakhand
The Secretariat will request AGCA members who could not participate in the meeting to share their preference for states that they would like to support.
Expectations from the AGCA Secretariat
- The Secretariat should enhance the visibility of AGCA’s work by
- Documentation and dissemination of best practices with state governments and nodal organizations.
- Posting field experiences, case studies, photographs from the field on the community action for health website.
- Request the MoHFW to include a presentation on community action for health at the National Best Practices Summit.
- Upload bios of AGCA members and Secretariat staff on the community action for health website.
- The Secretariat should share the learnings and recommendation emerging from the Grievance Redressal study at the next AGCA meeting. Thereafter, support needs to be provided to the MoHFW to develop a policy guideline for grievance redressal under the NHM.
- It was suggested that the next AGCA meeting would be organized at the MoHFW, if possible.
The meeting ended with a vote of thanks by Ms Poonam Muttreja.
Action Points from the 31st AGCA Meeting
|Request the MoHFW to consider organizing an annual joint meeting of the ASHA Mentoring Group and AGCA
|Request the MoHFW to write to the State Governments to engage resource organizations in community action processes
|Organize meeting with key donors to share AGCA’s work
|Share the concept note on community based planning with the MoHFW for review and approval
|NHSRC and AGCA Secretariat
|Document and disseminate best practices to state governments and nodal organizations
|Upload a) case studies and experiences from the field and b) bios of AGCA Members and Secretariat staff on the community action for health website