Decentralized Participatory Health Planning (DPHP) for Community Priorities

1. An experience from implementing Decentralized Participatory Health Planning (DPHP) process in Maharashtra A process of conversion of people’s demand into budget proposals (PIP) Presented by Dr. NitinJadhav SATHI- Support for Advocacy and Training to Health Initiatives

2. Obstacles faced while working in context of PIP- • The government’s process of preparing the PIP is often completed in very short time due to certain larger constraints. • There are very few spaces in this PIP process for community members to present their health needs and for them to be incorporated in the PIP. • The current PIP framework is complicated and allows limited flexibility, hence it needs to be modified and simplified to enable greater participatory inputs. • The local Health officers and providers have not been oriented about the importance of ensuring participatory and community based processes while preparing the PIP.

3. Proposed Scale of DHP process District Block PHC PHC PHC Village Village Village Total 260 villages, All PHCs covered under 26 blocks from 14 CBMP districst

4. People’s health priorities have been received from ... 205 Villages 77 PHC 30 Blocks 14 Districts

5. Level wise analysis of people’s priorities discussed from 14 districts Total 1860 issues raised from 205 villages

7. Top 5 health priorities emerged from community mobilization process at various levels

8. Other than health, priorities expressed by community during meetings from 205 villages • Water facilities in village • Sanitation system in village • ICDS services • Kitchen facility/ THR (packet food distributed in anganwadi) • Roads and accessibility & transport system

9. Analysis of priorities from 6 districts after district & block level consultation meetings

10. Some of examples of people’s health priorities to be included in PIP

11. Tools and mechanisms for DHP

12. Step- 1:Community mobilization foridentification of community priorities/needs Proposed stakeholders Meetings with VHNSC and community with participation of active community members, marginalised people and women • VHNSC committee • Community especially marginalized community groups and women Activity Tools and techniques- - Awareness materials such as poster, slide show, flex posters about PHP process. - Gram Sabha, discussion guide on health planning, micro-planning techniques such as PRA etc. • Minimum 5 prioritized needs about • Village and sub centre level health services • PHC related health services • RH/SDH related health services

13. Step-2: Compilation, categorization and prioritization of community priorities/needs Proposed stakeholders Joint meeting between RKS committee and Monitoring & Planning committee in each selected PHC and RH • Members of RKS committee • Members of Monitoring & Planning committee • Medical Officer and staff of PHC • RH superintendent and staff of RH level Activity • Tools and techniques- Template for categorization and prioritization of people’s health priorities. • Issues which can be resolved through dialogue or through CBMP. • Issues which require budget/funds (RKS or PIP). • Systemic or policy level issues which can be resolved at state or district level. Catogorization

14. Step- 3 :Compilation of community needs at block level and development of budget proposals based on prioritized community needs Proposed stakeholders Block level workshop for various stakeholders. • Chairperson and active, interested members of RKS committee from each selected PHC and RH • THO office and block accountant • Medical officers and RH superintendent • District NHM cell especially DPM, DAM Activity • Tools and techniques- • Template for formulation of budget proposals. • List of potential sources of funds. • Criteria for scrutiny of budget proposals. • - To orient and understand about DHP to RKS committee • - To discuss and finalize action plan related to community needs which can be resolved through PIP budget.

15. Step- 4:Finalization of budget proposal at district level Proposed stakeholders Multi-stakholder district level meeting including DPDC/District Monitoring and Planning committee • Members of District Planning and Development Committee • DHO and CS • DPM and DAM Activity Tools and techniques- - District level PIP preparation guidelines and budget template - To scrutinize and give final approval to devloped budget proposals - To discuss and develop plan of action for intervening in the next year’s PIP preparatiom process

16. Step- 5:State level review of included community needs based proposals in district PIP Proposed stakeholders State AGCA meeting for reviewing budget proposals and addressing policy and systemic level issues • MD, NHM, Maharashtra • Members of State Mentoring Committee • NHM senior officials • SPM and SAM • Representatives of SHSRC • CBMP implementing State nodal organization Activity • Tools and Techniques- • Criteria for scrutiny of budget proposals. • State level PIP preparation guidelines and budget template

17. Enabling factors • Investing adequate time and giving priority to DPHP process by district and state level Health officials. • Investing adequate resources for effective implementation of DPHP process. • Engaging external force/agency like community based active groups, Civil Society Organizations for facilitating and coordinating community mobilization processes.

18. Thank you!!!!