Vision and Mission
Defining the SHRC rols
SHRC as institutional innovation
SHRC as a process
The State Health Resource Centre, Chattisgarh is an autonomous organization which was designed as an “additional technical capacity to the Department of Health & Family Welfare Chhattisgarh”. Its main role is to provide support in the process of health sector reforms.
This includes support in:
Policy Planning and Strategic Thinking
Development of Innovative and Adaptive Programme Desings
Community Based Health Programmes
Conducting Health System Research
Assisting the Department of Health & Family Welfare, Chhattisgarh to implement innovative strategies
To facilitate this, the SHRC has an innovative work charter, a special organisational structure and an appropriate positioning.
Formation of the SHRC:
In March, 2002, RCH Society, Chhattisgarh and the Regional Office (Raipur) of ActionAid India Society (AAI) executed a Memorandum of Understanding. The MoU was signed in the context of European Commission and Sector Investment Programme (SIP). The State Health Resource Centre, Chhattisgarh was founded as additional technical capacity to the Department of Health & Family Welfare, Chhattisgarh and as a state-civil-society body whereas the ActionAid’s role was to coordinate civil society organisations in setting up such a body. During the following two years the initial team was put together and the institution was made able to stand on its own. Since 2004 the SHRC has been functioning as a fully autonomous institution.
In addition to managing the SHRC, it was agreed in the MoU (paragraph 4.2.) to perform the following other tasks:
evolve systems for the effective functioning of the SHRC. More specifically, it will develop all Facilitates, on behalf of the GOC, the development of operational framework for forging partnerships with NGOs, CBOs and people’s movements for effective implementation of the reforms process.
evolve systems for the effective functioning of the SHRC. More specifically, it will develop all Conduct independent reviews of the intensity and direction of the reform process on behalf of the GOC.
evolve systems for the effective functioning of the SHRC. More specifically, it will develop and co-ordinate with the State Resource Group – which is an advisory body comprising health activists -, community health practitioners, NGOs, CBOs and human rights organisations based in Chhattisgarh.
Vision: We as a State Civil Society Partnership Organization of Public health Professionals are an enabler in Chhattisgarh attaining for its every citizen highest attainable level of physical mental, social and spiritual health and quality health care that is equitable universally accessible, affordable and gender sensitive through empowerment of communities and development of an accountable and responsive health system.
Mission: To aspire for achievement of the highest level of efficiency & quality in delivery System both Government & Non government to provide the most professional technical support to Government, to act as a catalyst and innovator in public health, to inspire and sustain motivation of committed staff and civil society groups in community health.
1. Generating evidence for policy formulation & strategic planning of interventions in health.
2. Conceptualizing and designing Programmes addressing prioritized health Problems.
3. Piloting innovations for feasibility of up scaling.
4. Community mobilization, organization and capacity building leading to empowerment.
5. Training & skill up-gradation of health functionaries, Stakeholders and partners and their networking.
6. Monitoring and evaluation of Programmes, services for quality, client satisfaction, impact and outcomes.
1. Upholding human dignity, universal brother hood and harmony.
2. Equity & Justice.
3. Intolerance to corruption & exploitation of the weak.
4. Preferential option for the poor and giving chance to the marginalized.
5. Excellence and quality in everything we do.
6. Convergence and networking rather than doing alone.
7. Empowerment & system building for sustainability.
8. Putting people and communities first above our own interest.
The SHRC, Chhattisgarh has been called upon to play the following roles:
Assist the department in evolving projects and programmes and in providing strategic analysis that would guide the process of planning.
Develop guidelines, communication material, and draft orders etc. for approved innovative projects and health sector reform strategies that have to be implemented.
Locate and contract in suitable technical expertise to work with state teams to develop proposals, evaluate programmes or assist implementation.
Undertake formative as well as operational research, and hold rapid programme appraisals to make planning based on evidences and to assess progress towards initiating corrective measures.
Support the directorate and implementation authorities in monitoring reform measures, troubleshooting problems and building consensus and providing internal advocacy for reform measures at various stages of implementation.
Sustain civil society participation in reform process and ensure all support measures for the partnership programmes’ success. For example, the NRHM is promoting a number of committees – state and district health societies, hospital development committees, village health and sanitarian commitees etc. – but there has to be a model organisation to ensure that the public does participate and that such participation has sufficient quality and that the usual hesitations to letting the public into public health are overcome.
Undertake financial planning and management support for new and innovative programmes of a sort that the department is unused to running. Such management functions – may be on a turn key mode – with the directorate enabled to take up the activity soon once they the systems of management are established.
One major example of SHRC role has been in the mitanin programme where it built up an innovative and locally adapted programme design, helping to find and to support people within the government to play leadership roles and to bring in and to train the best within civil society. The SHRC scientifically took up the programme and based on feedback, improved the design, trained the trainers and even routed the funds through the district health societies. Moreover it built up flexible but rigorous accounting procedure that ensured an expenditure and utilization in the desired manners.
Another example of the role of the SHRC is the life saving skill training in emergency obstetrics. The SHRC negotiated with professional health faculties to initiate the training, convinced key players in the districts and in the directorate of the need for this approach, it built up evaluation and support systems so that the initial poor results of this approach were overcome. It provided personal support to the trainees till at least some of them have started providing emergency obstetric services in remotest areas of Chhattisgarh. There are many more examples – big and small – of the diverse catalyst roles that are needed and today it is inconceivable to think of health sector reform without such drivers for change. Whether it is changing prescription practices of doctors or procurement practices of the administration, whether it is introducing new training programmes or ensuring that BCC programmes conform to a scientific implementation framework, change does not happen only on the basis of right thinking and capacity building. Change requires having to contend with existing knowledge and mindsets and institutional structures and that is where the SHRC contributes.
SHRC as institutional innovation
Institutionally, therefore, the SHRC is unique and has the following specific features:
It is an autonomous, with its own governing body and executive committee with its own rules and regulations. The government has sufficient representation in it to ensure transparency of all its operations. But all recruitments, contracts etc. for the SHRC team are done autonomously by SHRC itself, and independent on the government.
The SHRC is assigned tasks which it has to deliver in a time bound manner. There are a set of long term tasks (like the Mitanin Programme) and many immediate tasks that the government assigns to it from time to time. The MoU is renewed as a token of the government’s satisfaction with the SHRC’s performance on these tasks. The SHRC is not bound to accept all tasks and can potentially refuse tasks that it feels is beyond it, or that it does not agree with – though in practice such a clause has never had to be exercised.
The SHRC has no formal power over the government officers or implementation authorities. It is purely facilitating and advisory in nature. This prevents it from becoming a parallel authority and prevents contestations of power that are the bane of other institutional arrangements. Its effectiveness is derived from the quality of inputs it provides and its ability to internally leverage processes of change.
The SHRC, however, has a ‘note-sheet’ level relationship with the directorate and department and the state health society so that its advice is available in a routine manner, on a wide number of issues and forms part of the official records. The SHRC faculty may be assigned specific monitoring or coordination tasks by the directorates as nodal officers where such need arises.
In view of the unique nature of demands made on the organization and also due to the considerable capacities needed in house, the SHRC has had to evolve an innovative and appropriate set of HR policies that brings in, builds and retain talents. Typically, SHRC faculty turnover is low, and the work culture and collective decision making and opportunity to learn provides an alternative to the high salaries that other comparable institutes offer and which SHRC itself can ill afford.
As mentioned above, the SHRC was established through a ‘host’ organisation which then had experienced officers who had worked closely with the government. The partnership with the NGO – ActionAid in SHRC case – was formalized through a MoU which mandated the NGO to set up and manage the SHRC for and on behalf of the State, till it could be a truly autonomous institution.
The decision to engage a ‘host’ organisation guaranteed the freedom of being able to find the right initial persons and build the team for the SHRC. There was also considerable flexibility to head-hunt for suitable persons to constitute the initial team.
To ensure that the SHRC had a character of an organization working for change, and for reaching health care to the poor, the governing body was evolved out of a number of individuals and organizations known to be committed to such values and who had a good track record of supporting institutional development. The NGOs who were interested and who participated in the formulation of a health sector reform strategy were constituted into a state advisory committee for health sector reform and with their support the governing body was constituted. The executive committee was made of those who were part of the full time team.
Knowing the lack of skilled persons who would be available to work in the EAG states at the pay scales that we could offer (comparable or marginally higher than government scales – but not certainly at international agency pay scales) – the SHRC followed a policy of recruiting persons with the right mix of background and motivation and building up their capacities in house. This required a certain type of leadership and great emphasis on mentoring arrangements.
Knowing that this work requires experience and expertise on a wide number of areas, and it would not be possible to hire persons with such experience, the SHRC followed a policy of ‘contracting-in’ experts to work with its team and recorded this experience of working together in its institutional memory so that the expertise available locally increased cumulatively.
“Managing change” requires patience and persistence, the ability to withstand criticism and sometimes hostility both from within (the government) as well as from outside (e.g. civil society organisations’ initial refrain that the Mitanin initiative represented government’s intention to ‘withdraw’ from its public health responsibility). The change agents, at the same time, need to understand and negotiate with different points of view, take various initiatives and risks when no one else is ready to do so and yet understand that “success” requires ownership of the idea and the work by others – sometimes to the exclusion of the main movers. The SHRC, therefore needed to build-in a strong element of networking with similar minded individuals and organizations both in the state and national level, so that there was mutual solidarity and a specially created peer support for supporting the change process.
The bottom-line of SHRC experience, in other words, is not just about ‘establishing’ yet another structure but finding a suitable NGO and formalizing a partnership with it which allows the NGO partner sufficient flexibility in finding the right individuals who would become a team in supporting the State Directorate / State Institute for Health and Family Welfare / State Society on an on-going basis.