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3 rd CRM Visit to Sikkim

De-briefing report from the 3rd CRM team's visit to Sikkim on 22nd Dec '09 at Vigyan Bhawan. Positive findings include improvements in infrastructure, service delivery, and institutional mechanisms. Concerns highlighted delegation of powers, fund flow, and operational issues. Recommendations focus on decentralized planning, fund streamlining, feedback mechanisms, and skill-based trainings.

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3 rd CRM Visit to Sikkim

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  1. 3rd CRM Visit to Sikkim De-briefing 22nd Dec’09 VigyanBhawan

  2. 3RD C.R.M. TEAM MEMBERS

  3. NAME OF THE HEALTH FACILITIES VISITED

  4. POSITIVE FINDINGS • Infrastructure- considerable improvement in physical structure & equipments • FRUs are being functionalized • Labor rooms at Sub-centers • HR • Some specialists at district hospitals, MO.s at PHCs have been posted. • Sub-centers have 1 female & 1 male Health Worker supported by 2 attendants (one S/C for 1300-1500 population) • ASHAs have been selected & trained upto 5th Module

  5. POSITIVE FINDINGS • Service delivery • Deliveries are being conducted at Sub-centers • Immunization sessions are being planned and held at health facilities & outreach sessions • All activities pertaining to National Disease Control Programmes are being carried out. • ASHAs provided with drug kits • Institutional mechanisms • VHSC s, RKS & Sub-center committees in place with regular meetings & fund utilization for untied & other funds • SPMU, DPMU & BMU are operational • Concurrent audit has started & audit report for 2008-09 has been received at centre • E-banking facility in the State upto district level is in place

  6. CONCERNS • Delegation of powers has not yet disseminated to districts • No synchronization of district action plans & SPIP- district & blocks are yet to receive the final approved action plan • Civil works & tender processes often take a long time • Operation Theatres still require strengthening in terms of staff & equipments

  7. CONCERNS • Fund flow need to be streamlined • SHS are allocating funds to districts activity-wise rather than as flexible pool • RKS money not reaching the District Hospital & PHCs; user fees are also being deposited to the states

  8. RECOMMENDATIONS • Decentralized planning to ensure district priorities are reflected in the State PIP • Administrative & fiscal functions need to be devolved to the district level • Fund flow need to be streamlined, ensure timely release of RKS funds to the DH & PHCs • State must start settlement of pending advances for civil works at the earliest.

  9. RECOMMENDATIONS • Mechanism for feedback to the districts need to be institutionalized- Regular review meetings with State & district level officers should be conducted • Inter-sectoral co-operation models should be developed in areas of hygiene, sanitation, besides education • Skill based trainings & multi-skill trainings need to be expedited • State specific problems need to be identified and solutions provided • Home deliveries for low risk women by SBAs in difficult areas & severe weather conditions • Adequate compensation for travel to ASHAs

  10. If you care at all, You’ll get some results If you care enough, You’ll get incredible results -Jim Rohn Thanks

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