Management of PHC (NEW)

To address emerging need of health, new forms of action and partnership are needed. There is aclear need to break through traditional boundaries within government sectors, between governmental, nongovernmentalorganizations, and between the public and private sectors. Government of Orissa has time and again articulated the need for collaborating with NGOs and privateagencies to provide and facilitate the use of health service delivery in hard to reach and underserved areas. One of major objectives of the NRHM is also to operationalise the community Health Centers (CHCs)/PHCs/First Referral Units (FRUs) with prescribed Indian Public Health Standards (IPHS) and PPP could be an alternative strategy to achieve the objective and to meet the public health goal. There are several levels at which the contracting out can be done depending on the degrees offreedom given to the NGOs and Private agencies. They are like:-

• Government hands over the physical infrastructure, equipment, budget and personnel of a healthunit to the selected agency.
• Government hands over the physical infrastructure, equipment, budget but gives freedom to theselected agency to recruit personnel as per their terms and conditions but following the government normssuch as oneANMper 5,000/3,000 population.
• Government hands over the physical infrastructure, equipment, and budget but gives freedom to the select agency to have their own services delivery models without following the fixed prescribed pattern.
• Government hands over the physical infrastructure, equipment, budget and gives freedom to theselect agency to have their own personnel, service delivery models, freedom to expand types of servicesprovided and freedom to introduce user fee and recover some proportion of costs.

The NGO undertaking the management of PHC will facilitate the following activities:

• Act on behalf of the government of Orissa in effective planning and delivery of services in the PHC sector.
• Provide curative, preventive and promotive services at the PHC.
• Full participation in all the national health programmes.
• Strengthen referral services for secondary health care centers such as SDHs and District HeadquartersHospital.
• Promote comprehensive client centered integrated Public Health Communication strategy to bring abouta change in knowledge, attitude, behavior and practices in the population through Community HealthPartnership Programme.
• Encouraging Institutional services for pregnant women, family planning sterilization etc.
• Training of SBAs, Community health workers, ASHA, AWWs etc, for capacity building on variouspreventive aspects of health care.

NGOs effectively supplement the Public health system by assisting in

• Increasing Immunization coverage, antenatal care and institutional delivery.
• Increasing use of family planning methods.
• Dispelling myths and misconceptions associated with contraceptive use, sex and sexuality.
• Building awareness and mobilizing community on health issues.
• Identify and addressing local needs in a customized manner.
• Extending services to remote areas through outreach health services.
• Providing an effective platform for a range of activities such as Tetanus Toxoid (TT) campaigns, Pulse Polio.
• Campaign, reproductive and child health (RCH) camps.
• The crux of this initiative is partnership. The strengths of both the Government and NGO sector is called in toachieve a shared objective. Networking with local NGO or private agency in various PHC areas is key to the

AGREEMENT

• NGO to provide preventive, promotive, and curative health services by managing PHC.
• Improving quality, accessibility, availability, acceptability and efficiency.
• Exchange of skills and expertise between public and private sector.
• Mobilization of additional resources for better health services.
• Strengthening the existing health system by improving the management.
• Widening the range of services and number of service providers.
• Clearly defined sharing of risks.
• Community ownership for health services.

Department of Health, Government of Orissa invited PEACE to manage the Public Health Centre of P.Govindapur in Mohana Block under Gajapati district where technical staffs could not stay due to lack of communication, infrastructure and co-operation of the people. PEACE had taken charge of the PHC and ensures its smooth functioning.