Jharkhand Common Review Mission - Health Infrastructure Recommendations

10thCommon Review Mission-Jharkhand Dissemination meeting Vigyan Bhawan/2ndJune 2017

Major findings Implementation of Clinical Establishment Act (Notification of an appropriate authority and Registration) appreciable Health promotion through Participatory Learning and Action has been a good practice. Engagement with Rural and Urban Community for better outcomes?! Long standing vacancies are burdening already under utilized health services Undue delay in newer buildings coming up and made operational coupled with instances of idle capacity in resource strapped settings is hampering service delivery.

Recommendations State must, on a priority basis, revisit infrastructure development and maintenance mechanism in the state. Definite timelines need to be drawn with penalty clause and transparent monitoring mechanism for identifying, initiating, completing, and ensuring its functionality post hand-over. Commit on absorption of certain percentage (say, 5%) of health personnel who have completed a prescribed period of contractual service (say, 5 years) into regular service. Also put in place a transparent mechanism of recruitment, appointment, transfer, promotion, superannuation etc. and strengthen it through an HRMIS.

Recommendations The conduct of death reviews should be an indicator for assessing Civil Surgeons & District Collector (Commissioner) performance. Approach platforms provided for community engagement with an accountability framework Root cause of dis-functionality at various levels is largely contributed by Governance system and influencing this is important for effecting change by engagement with the elected representatives

State Response to CRM Observations Dissemination meeting Vigyan Bhawan/2ndJune 2017 Jharkhand State

Human Resources & Policy The draft HR Policy has been prepared by a constituted committee, and same will be presented before Executive Body, JRHMS and Governing Body Meeting for ratification. First phase of recruitment has already completed and for rest existing vacancies selection of HR recruiting agency is in final stage. JRHMS has well defined and transparent transfer policy which is approved by Executive Body, JRHMS.

Death Reviews (MDR/CDR) To sensitize regarding MDR, reporting and Verbal Autopsy for maternal deaths, letter has been issued to all Civil Surgeons (Letter no- 2495(MD)dated 13-05-16 & RCH dated-23/02/17). Chief Secretary instructed all DCs for ensuring reporting and review of all Maternal death. State Task Force for MDR has been conducted on 16th March 2017. Involvement of Medical College and Private Health Facilities for MDR reporting. To monitor the progress of MDR and CDR, regular Video Conference has been conducted and state team visited for monitoring as per need. Letter No-184(D)

Response to other suggestions Infrastructure State is doing work through state Building Corporation and regularly monitored by health department. Handholding support is being provided to Civil Surgeons for making function of handed over facilities. Implementation of GoI guidelines State is fast tracking implementation of GoI guidelines National Ambulance Services, National Dialysis programme, Bio-medical Equipment Maintenance Mechanised laundry Programme, and

Response to other suggestions NUHM, in convergence with line departments meetings at four districts completed and other districts is in process. VHSNC member trained in various issue like Village health Plan & Untied fund. RKS/ HMS members training has been proposed in PIP 2017-18. Details of spending of untied funds and AMG are now shared with all members in the meeting. In order to bring abortion services to below district level 727 MOs trained (In FY 2016-17 total 2896 MTP conducted in below district level facilities) State plans to operationalise 13 more SNCUs and 17 NBSUs by Aug. 2017

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