Intersectoral coordination
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The document discusses intersectoral coordination for health, which involves coordinating health initiatives with other sectors that impact health, like education, agriculture, rural development, etc. It outlines key principles like development influencing health and equity. Areas of coordination include nutrition, water supply, sanitation, and maternal/child health. Coordination mechanisms involve forming committees to jointly plan initiatives across sectors. Benefits are achieving goals no single sector can alone and preventing overall welfare losses from uncoordinated policies.
Intersectoral coordination
- 1. INTERSECTO RAL COORDINATIO N Mrs. NAMITA BATRA GUIN Associate Professor
- 2. INTRODUCTIO N • The Alma-Ata Declaration suggests a multi sectoral approach as one of the basic principles underlying primary health care. • The approach is based on the assumption that health is intrinsically linked with other development issues in a synergic manner. • Some of the departments for inter-sectoral coordination are Women and Child Development, Department of Education, Rural Development, Rural Water Supply and Sanitation, Panchayati Raj Institutes, NGOs, the Department of Agriculture, the Department of Social and Tribal Welfare, and the Department of Forest.
- 3. INTRODUCTIO N • The changes in other sectors affect health and similarly health affects the development in other sectors also. • Therefore, a better understanding of the relationship between health and other development sectors is needed for best results.
- 4. GUIDING PRINCIPLES IN INTERSECTORAL COORDINATION 1. Development is basic to health: Health is closely related to development. Health influences development and also influenced by development. According to social scientists, improving the state of health contributes to economic development, labour productivity and growth. There is strong relationship between economic development and health, economic development trends to improve health status, while better health contributes to economic development.
- 5. GUIDING PRINCIPLES IN INTERSECTORAL COORDINATION 2. Equity: The most common understanding of equity, in terms of health, is that “every man, woman and child, no matter where he or she lives, has the right to enjoy good health and deserves to have access to health care services”. This definition, then, implies the following. First, there must be enough health care services - availability. Second, whatever is available must be accessible to the poor, forgotten, and the marginalised.
- 6. GUIDING PRINCIPLES IN INTERSECTORAL COORDINATION 3.Promoting Economic Capacity of the Poor People: The economy“status plays an important role in determining the health status of the people. It not only enables the people to undertake preventive and curative health care measures, but also promotes sustainability of their health status. Many countries have initiated community specific strategies, and programmes to improve economic capacity of the poor. Some of the key strategies are: (i) asset creation and development, (ii) capital formation, (iii) employment opportunities in the private or public sector, and (iv) access to market avenues.
- 8. AREAS OF COORDINATIO N 1. Promotion of Nutrition: the Health Department organises activities related to educating pregnant and lactating mothers regarding quantity and quality of food, supplementary nutrition, nutritional care of child, educating adolescent girls and boys regarding health, food habits, food hygiene, balanced diet, malnutrition among children, food for geriatrics, adulteration of food and subsequent diseases, role of kitchen garden, mid-day meals in schools; organising nutrition education and preventing problems of malnutrition and anaemia in the community. Other departments involved in coordination are: Agriculture, Education, Social Welfare, panchayat raj, animal husbandry, cooperative banks etc.
- 9. AREAS OF COORDINATIO N 2. Supply of water: Health departments need to coordinate with the public health department for supply of safe drinking water. The public health department is involved in site selection and surveys for water sources; water analysis; and educating communities on how to get safe water. Other departments involved are: Agriculture, education, Panchayati Raj and social welfare/ Women and child welfare development.
- 10. AREAS OF COORDINATIO N 3. Excreta Disposal: Health and Public Health Department conducts education at the household level for use of sanitary latrine and safe garbage disposal. Other departments involved are: Agriculture, Education, Panchayat Raj, Rural development and social welfare.
- 11. AREAS OF COORDINATIO N 4. Waste Water Disposal: Health and Public Health Department organises health education camps on methods of safe disposal of waste water and its advantages to the community. Other sectors involved are: Education, Agriculture, Panchayat Raj, Rural Development, Social Welfare
- 12. AREAS OF COORDINATIO N 5. Maternal and Child Health: Health Department is responsible for health education on ante-natal, natal, and post- natal care; infant and child care; and other related maternal and child health care services. Other sectors are: Cooperative societies, Education, Panchayat Raj, Social welfare.
- 13. AREAS OF COORDINATIO N 6. Family Health Care Education: The Health and Family Welfare Department conducts health and family welfare education through various communication methods at the grassroots. Other Departments: Education, Panchayat Raj, Social Welfare and Social welfare.
- 14. AREAS OF COORDINATIO N • 7. Immunization against major Infectious diseases: Health Department organizes and conducts educational programmes and provide service facilities on immunization through the health centre personnel at various levels. Other departments included: education, Panchayat Raj, Social welfare, women and child development.
- 15. AREAS OF COORDINATIO N • 8. Prevention and Control of locally endemic diseases: Health Department organises education on diagnosis, treatment, and follow-up of cases of TB, leprosy, malaria, scabies, etc. Other department are: Animal Husbandry, Education, Panchayat, Social Welfare.
- 16. AREAS OF COORDINATIO N • 9. Improvement of overall environment in Primary Health Care premises: This includes plantation, gardening, water supply, sanitation. Department involved are: Forest, Public Health, Panchayat Raj, NGOs and Community organizations.
- 17. COORDINATION MECHANISM • i) listing out the programmes which need joint efforts • ii) identifying the areas where coordination is required • iii) knowing the categories of health personnel whose activities should be integrated • iv) locating the levels of health systems where joint efforts are needed • v) forming coordination committee of members of district health team which includes all the middle level supervisors and specialised functionaries working at district level and
- 18. COORDINATION MECHANISM • vi) forming operations teams at field level • vii) list different sectors, such as social welfare, women and child development, public health, rural development, municipalities, and municipal corporations, and the heads of those sectoral units which are directly or indirectly related with health and family welfare programmes • viii) identify the non-governmental and voluntary health organisations, which are working in the area of health and family welfare. • Ix) constitute a coordination committee with the representatives from district, block, and village levels • x) formulate specific task-forces
- 19. COORDINATION MECHANISM • xi) jointly decide the objectives and areas for coordination to achieve desired goals • xii) decide the role and responsibility of each department and mechanism of reporting and feedback sharing • xiii) develop a plan of action that focuses on independent tasks, joint tasks, sharing of resources, and field work in teams.
- 20. BENEFITS OF INTER-SECTORAL COORDINATION • i) achievement of goals which cannot be achieved alone, • ii) increases the chance that those policy alternatives are chosen which are most likely to result in the highest overall welfare gains • iii) helps prevent overall welfare losses because of policies that entail positive welfare effects for individual actors, but disadvantageous from an overall point of view • iv) provides legitimacy and acceptance to public policy.
- 21. Requisites for Effective intersectoral coordination • Establishing an overall inter-sectoral strategy • Establishing commonly agreed or binding priorities • Defining common limits by setting parameters for sectoral activities • Arbitration of inter-sectoral differences • Avoiding policy divergences among sectors and seeking consensus • Consultation with others • Information Exchange among the sectors
- 22. STEPS IN ISC • Proper orientation of policies and programme of each developmental department at all level. • Formation of joint coordination committee at each level i.e., village/block/ district. • Defining roles and responsibilities of participatory agencies and classifying them to each other. • Participatory decision making. • Developing a formal system of interaction, discussion and debate. • Sharing of the problems faced in implementation of health programmes and seeking cooperation from each partner.
- 23. STEPS IN ISC • Spelling out strategies and procedures. • Joint monitoring and evaluation. • Remedial measures in solving problems related to coordination/resource mobilization.