NHM对卫生系统治理和人力资源的影响

Impact of the National Health Mission on Governance, HealthSystem, and Human Resources for Health Draft Report Indian Institute of Public Health, GandhinagarIndian Institute of Management, Ahmedabad National Health Mission – Impact andLearnings for the future Impact of the National Health Mission on Governance, Healthsystem, and Human Resources for Health Draft Report by Indian Institute of Public Health, Gandhinagar & Indian Institute of Management, Ahmedabad AUTHORS ProfessorDileep Mavalankar, MD, DrPHPrincipal Investigator Dr.Mahaveer Goleccha,MS, PhDProject lead and Co-investigator DrRajesh Chandwani,MD, PhDCo-investigator ProfessorSunil Maheshwari,PhDCo-investigator MsTasneem Bohra, MPH DrJallavi Panchamia,PhD ACKNOWLEDGEMENT The findings presented in this report are the result of months of efforts by researchers at the IndianInstitute of Public Health, Gandhinagar, and the Indian Institute of Management, Ahmedabad. Thisreport represents a part of NITIAayog’s vision and comprehensive undertaking to encourageresearch into the National Health Mission and its impact on the Indian health system from the time ofits inception in 2005, through 15 years of implementation. The authors of this report express their gratitude to all the officials and experts at various levels ofgovernment and the NHM, and other organisations who provided invaluable insights into the missionthroughtheir in-depth knowledge of the health system,and exhaustive understanding of itsfunctioning at various levels. The aim of this report is to present a stock-taking of the NHM after fifteen years of implementationacross the country, through a wide variety of schemes and programs, some of which preceded themission itself and were then brought under its umbrella in order to provide an affordable, seamless,and comprehensive experience to the Indian healthcare seeker. The authors are confident that thisreport will initiate a discussion into the future of the NHM, what directions it should take, andprovide a plethora of lessons, especially in the areas of governance in healthcare, the management ofhuman resources for health, and the decentralisation and communitisation of health decision making. We are grateful to Prof. Vinod Paul, Member, NITI Aayog and Shri Alok Kumar, Advisor, NITIAayog for their inspiration and guidance that made this report possible, and Dr. K Madan Gopal andMs. Nina Badgaiyan for their vital contributions to this research endeavour. We would also like toacknowledge Dr. Vishal Jani, Assistant Professor, IIPH-Gandhinagar and Priyanka Shah, ResearchAssociate, IIPH-Gandhinagar for the technical support provided throughout the duration of thisexercise. This study was carried out with the financial support of NITI Aayog, Government of India,and conducted by Indian Institute of Public Health-Gandhinagar. DISCLAIMER The Indian Institute of Public Health-Gandhinagar has received the financial assistance under theResearch Scheme of NITIAayog(RSNA- 2018) to prepare this report. While due care has beenexercised to prepare the report using the data from various sources, NITI Aayog does not confirm theauthenticity of data and accuracy of the methodology to prepare the report. NITI Aayog shall not beheld responsible for findings or opinions expressed in the document. This responsibility completelyrests with the Indian Institute of Public Health-Gandhinagar. Contents ACKNOWLEDGEMENT....................................................................................................................iiiDISCLAIMER......................................................................................................................................iiiList of Tables and Figures....................................................................................................................viiABBREVIATIONS................................................................................................................................xEXECUTIVE SUMMARY....................................................................................................................1Background......................................................................................Error! Bookmark not defined.Objectives.............................................................................................................................................Findings................................................................................................................................................1. Structural and coordination issues...............................................................................................2. Data based strategic planning concerns and M & E Issues for states..........................................3. Issues related to HRH- Equity and justice concerns....................................................................Conclusion...........................................................................