URBAN

REPRODUCTIVE & CHILD

HEALTH

APPROPRIATE
MANAGEMENT STRUCTURES

WHAT SHOULD BE THE ROLE OF

GOVERNMENT IN URBAN HEALTH & FW
SECTOR?
SHOULD IT BE A PROVIDER OF FREE/LOW COST
CURATIVE HEALTH SERVICES FOR ALL?
SHOULD IT BE A PROVIDER OF FREE/LOW COST
PREVENTIVE HEALTH SERVICES FOR ALL?
SHOULD IT BE A PURCHASER OF PREVENTIVE
HEALTH SERVICES FOR THE POOR?
SHOULD IT BE A REGULATOR OF HEALTH
SERVICES?
SHOULD IT BE AN ENABLER AND FACILITATOR OF
GOOD QUALITY HEALTH SERVICES?
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SHOULD IT BE ALL OF ABOVE PUT TOGETHER?

WHAT IS THE IMPLICATION OF

EACH ROLE?
PROVIDER OF FREE/ LOW COST
CURATIVE HEALTH SERVICES
SHOULD GOVERNMENT CONTINUE TO SUBSIDISE THOSE
WHO CAN PAY FOR CURATIVE SERVICES?
SHOULD IT CONTINUE TO COMMIT A LARGE FIXED
EXPENDITURE WITHOUT BEING SURE OF ITS UTILITY AND
EFFICIENCY?
SHOULD GOVERNMENT SEARCH FOR ADDITIONAL
RESOURCES FOR PREVENTIVE HEALTH CARE ESPECIALLY
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THE POOR WHILE EXISTING BUDGETS ARE USED UP
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FOR CURATIVE SERVICES?

PROVIDER OF PREVENTIVE HEALTH

SERVICES IN URBAN AREAS
GOVT. WILL NEED TO BUILD A NEW INFRASTRUCTURE.
IT WILL NEED TO HIRE MEDICAL AND PARA-MEDICAL
STAFF.
IT WILL HAVE TO ENSURE AVAILABILITY OF MEDICINES.
SHOULD IT HAVE TO PAY FOR THE INFRASTRUCTURE
AND STAFF IRRESPECTIVE OF HOW MUCH IT IS USED BY
THE RESIDENTS?
SHOULD IT HAVE TO COMMIT A LARGE FIXED
EXPENDITURE WITHOUT BEING SURE OF ITS UTILITY
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AND
EFFICIENCY?

AS A PURCHASER OF PREVENTIVE
HEALTH SERVICES FOR THE POOR
ESTABLISH SOUND MECHANISM OF PURCHASING
PREVENTIVE & CURATIVE HEALTH SERVICES FROM
VARIOUS PROVIDERS.
GOVERNMENT CAN FOCUS ON THE NEEDY.
IT CAN LIMIT WASTAGE BY SPENDING ONLY WHEN A
SERVICE IS UTILISED/DELIVERED TO THE
SATISFACTION OF USER.
IT CAN DEMAND AND RECEIVE GOOD QUALITY
SERVICES AS BUYER OF SERVICES FROM PRIVATE
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PROVIDERS.

AS A REGULATOR OF HEALTH
SERVICES
GOVT. WILL NEED TO CLEARLY DEFINE PHYSICAL AND
CLINICAL STANDARDS FOR HEALTH CARE SERVICES.
IT CAN SAFEGUARD INTERESTS OF THOSE WHO
CANNOT AFFORD TO PAY OR THOSE WHO CANNOT
PAY FULL MARKET PRICE OF HEALTH CARE
SERVICES.
ENSURE MEANINGFUL PARTICIPATION OF PVT.
SECTOR IN PREVENTIVE HEALTH CARE FOCUSSED ON
POOR. THIS IS NEGLIGIBLE AT PRESENT.
ALL POPULATION SEGMENTS WILL BENEFIT THROUGH
APPROPRIATE REGULATION.
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ENABLER AND FACILITATOR OF

GOOD QUALITY HEALTH SERVICES
GOVT. WILL NEED TO CLEARLY DEFINE PHYSICAL AND
CLINICAL STANDARDS FOR HEALTH CARE AND ALLIED
SERVICES.
ESTABLISH SOUND MECHANISM OF PURCHASING
PREVENTIVE & CURATIVE HEALTH SERVICES FROM
VARIOUS PROVIDERS.
ESTABLISH A GOOD REGULATORY AND MONITORING
SYSTEM.
CREATE AN ENVIRONMENT FOR GREATER PRIVATE
SECTOR PARTICIPATION IN BOTH PREVENTIVE &
CURATIVE HEALTH CARE.
ENABLE AS WELL AS MONITOR THEM TO PROVIDE
SERVICES
TO THE POOR ON MUTUALLY AGREED 7
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TERMS.

WHAT ARE APPROPRIATE

MANAGEMENT STRUCTURES FOR
URBAN HEALTH & FW SECTOR?
SHOULD IT BE A DEPARTMENT OF THE MUNICIPAL
CORPORATION OR THE HEALTH DEPARTMENT?
SHOULD IT BE COMMITTEE OF REPRESENTATIVES OF
MUNICIPAL CORPORATION, HEALTH DEPARTMENT,
PRIVATE HEALTH SECTOR, NGOs AND OTHERS
CONCERNED?
SHOULD IT BE AN AUTONOMOUS SOCIETY/BOARD OR
PUBLIC LIMITED COMPANY OF STAKEHOLDERS HAVING
POWERS TO MANAGE HEALTH PROGRAMMES ON SELF
RELIANT
BASIS?
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IF THE MANAGEMENT BODY IS A

DEPARTMENT OF THE MUNICIPAL
CORPORATION OR HEALTH DEPT.
IS THE MUNICIPAL CORPORATION / HEALTH DEPT.
WILLING TO TAKE UP THE FINANCIAL RESPONSIBILITY
OF PROVIDING HEALTH SERVICES TO ALL RESIDENTS IN
THEIR AREA OF CONTROL?
DOES IT HAVE THE FINANCIAL CAPACITY?
DOES IT HAVE THE NEEDED MANAGEMENT CAPACITY?
WILL IT BE COST EFFECTIVE FOR MUNICIPAL
CORPORATION TO BECOME PROVIDER OF HEALTH
SERVICES
OR A FINANCIER OF HEALTH CARE?
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IF THE MANAGEMENT BODY IS A COMMITTEE

OF REPS. OF MUNICIPAL CORP., HEALTH
DEPT., PVT. HEALTH SECTOR, NGOs & Ors.
WILL THIS COMMITTEE HAVE THE POWERS TO:
CONTRACT PVT. SECTOR PROVIDERS,
LEVY USER FEE,
DECIDE HOW TO USE/SHARE FEE,
RAISE DEBT FUNDS FOR HEALTH IMPROVEMENT?
WILL IT HAVE THE FINANCIAL CAPACITY?
WILL IT HAVE THE NEEDED MANAGEMENT CAPACITY
AND AUTONOMY?
WHAT WILL BE ITS LINKAGES WITH THE GOVT. BODIES
AND HOW WOULD IT HAVE MEANINGFUL PARTICIPATION
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THE EXISTING PRIVATE HEALTH SECTOR?

IF THE MANAGEMENT BODY IS AN

AUTONOMOUS SOCIETY OR A
PUBLIC LTD. CO. CONSTITUTED BY
MAJOR STAKEHOLDERS
WHAT WILL BE ITS FUNCTIONS AND POWERS?
STRATEGIC PLANNING, MONITORING, EVALUATING,
REGULATION, CERTIFICATION / ACCREDITATION,
INTERSECTORAL PARTNERSHIPS,
CONTRACTING, JOINT VENTURES,
RAISING,
PAYMENT FOR HEALTH SERVICES TO POOR.

FUND

WHAT WILL BE ITS ORGANISATIONAL AND

MANAGEMENT STRUCTURE?
WHAT WILL BE ITS LINKAGES WITH EXISTING PUBLIC
HEALTH CARE FACILITIES?
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KEEPING IN VIEW ALL FACTORS, WHAT

WILL BE APPROPRIATE FOR US IN THE
CITIES OF MADHYA PRADESH?
LET US THINK IT THROUGH!
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