Strategic Plan of HRH Karnataka. Dr.S.S.Shapeti Dr.M. Selva raj Dr.D.Ravi Shankar Preamble • The Health Administrators & Planners in Karnataka have realised the shortage of skilled man-power(HRH) but the magnitude of the problem & systemic changes of a comprehensive nature which is needed is now understood. The remedial measures taken till now were ad-hoc & more in the nature of crisis mitigation. Current scenario Doctors at Sanctioned Working Vacant/Gap Remarks PHC 2234 2041 196 Specialist 834 691 152 Staff 2123 1673 450 Nurses ANM’s 8487 7028 1459 Reason for Gaps • Shortage of educational institutions leading to shortage of skilled man power. • Specialist Doctors & Staff Nurses- Immigration abroad & poaching by private medical institutions, development of home nursing service institutions. Changes implemented to resolve Gaps • Increase in salary of MOH ( 9000 to 18000 in last 2 years) • SN from 3000 to 7000, ANM’s from 3500 to 6000. • Remote area allowance Rs. 1000/- per month, SDP(Special Development Plan based on Human Deprivation Index) • An extra allowance of Rs. 500/- per month in addition to HRA if quarters not available for ANM’s • Decentralization of decision making & delegation of increased financial powers to programme officers, DPMO, DH&FWO, Chairman, District Health Society. • Provision for PG deputation facility State specific challenges • Not attractive salaries. • Delayed promotions • Difficult service conditions • Contract jobs vs Regular jobs • Percentage of salary outgo to total plan size 846crores to 362crores about 44%, where as National Health Policy guidelines-upto 50-60% Innovative measures to fill in the gaps • Merger of NRHM with KHSDRP at the state level for better integration and to avoid duplication and conflict resolution. • Appointment of retired doctors on contractual basis. • Contracting of specialist doctors at Rs. 40,000/- for RCH care under NRHM • Retainership to private practitioners Rs.5000/- per month & Rs.1000/- per event. • Training of AYUSH doctors in Emergency Medicine & normal deliveries. • Prasooti Aaraike/Madilu/Evening OPD/Tele medicine-2 to increase the better efficacy of existing HRH. • Interest free loan to buy 2 wheeler to ANM’s Developing Human resources in Karnataka • ANM training centres to most of the districts & permitting private NGO’s to open up new training centres. • Rs. 500/- HRA to ANM’s & appointing SN in place of ANM’s after short training. • Blood collection centres at all Taluk level hospitals. • Karnataka has 29 districts, 39(10 govt, 29 private)medical colleges with annual output of about 4000 doctors Changes • Political committed Leadership • Effective leadership in middle level management-by deputing Doctors to Leadership training. Strengthening of Monitoring • Invite constructive criticism. • Training in e-governance & net connectivity for middle level managers and critical staff. • Timely feedback to PHC MOH for course correction. • District Programme Officer to be appointed as nodal officer for Taluk for focussed monitoring by verification of beneficiary. • Having Sub centre wise indices. Financial implications • Current expenditure for HRH is Rs.284 crores for 2007-08. • for 2008-09: Rs.372crores • Remarks: State Planning Department allows 10- 15% annual increase. • Projected expenditure for HRH needs as per IPHS. 2008-09: Rs. 408crores 2009-10: Rs. 487crores 2010-11: Rs. 587crores Action Plan • Correction of mismatch in 3 months by 1.08.2008 • About 810 Para medical workers outcoming batch by Dec 2009 • By using GOI & WB as platform to convince policy makers for supporting these reforms. • Support from GOI/WB to provide financial assistance.
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