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Devolution and health
1. DEVOLUTION PLAN AND HEALTH CARE IN PAKISTAN CHALLENGES AND CONSTRAINTS Dr. Nayyar Raza Kazmi Courtesy Dr Babar T. Shiekh, Aga Khan University
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3. Devolution, Decentralization, Debundling It is the transfer of authority, or disposal of power in public planning, management and decision making from the national level to sub- national levels or from a higher to lower levels of government.
4. Main Objective: philosophical & ideological Providing the means for community participation and local self-reliance and ensuring the accountability of government officials to the population.
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10. Public Health District Headquarters Hospitals Basic Rural Health Centre Mother & Child Health Population Welfare EDO: Health District Coordination Officer DISTRICT ADMINISTRATIVE STRUCTURE:
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12. DISTRICT HEALTH MANAGEMENT TEAM What is the purpose of a DHMT ? Develop a Team approach Share and Exchange Views Reduce the workload of the DHO Optimize Utilization of the Human Resources Improve Cooperation and Collaboration among stakeholders
13. How is a DHMT Constituted ? E DO(H) Other District Managers Public Sector Health Care Providers Private Sector Health Care Providers Community or its elected leaders
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22. THE INTERNATIONAL DEVELOPMENT TARGETS 1. A reduction by one half in the proportion of people living in extreme poverty by 2015 2. Demonstrated progress towards gender equality and the empowerment of women by elimination gender disparity in primary and secondary education 3. A reduction by two-thirds in the mortality rates for infants and children under age 5 and reduction by three-fourths in maternal mortality - all by 2015
Notas del editor
To bring about a change in the dominant mindset, where social sector investment is perceived in a mathematical input versus output equation, to one where human resource development is acknowledged as a pillar for sustainable development.
Promoting good governance in health sector by prompt, equitable and professional services delivery Human resource development for sustainable development.
Hospital referral systems and ambulance services. Develop and maintain budgets Procurements and M&R activities. Personnel management
Interact with donors and International Agencies. Personnel Management of the Provincial Cadres in Health. Provincial Procurements and M&R. Plan, implement, supervise and monitor Health Programs.
Continuous monitoring and surveillance on continuity and quality of services. Ensuring sustainability of the services and programs. Creating motivation, confidence and trust in the public. Devolved district health services represents an opportunity to tackle the health-financing picture.
Devolved district health services represents an opportunity to tackle the health-financing picture. User willingness to pay for PHC in the public sector services, if they receive improved care. The districts can recover substantial costs and can retain the incomes Services & programs designed on the concept “by the people, of the people, for the people”
Training for the new district managers regarding financial management / allocations. Strengthening HMIS Broadening of administrative and financial base, hence debundling of powers.
Status of Federal vertical programs like EPI, AIDS, Malaria, TB and LHW programs. Awareness in the general public Adaptability of the public with the new devolved system. Lack of communication mechanism at the provincial level
Access through the primary healthcare system to reproductive health services for all individuals of appropriate ages as soon as possible, and no later than the year 2015 The implementation of national strategies for sustainable development in all countries by 2005, so as to ensure that current trends in the loss of environmental resources are effectively reversed at both global and national levels by 2015 The slow pace of progress in new devolved system, may hamper the pace of achievement of the internationally set targets in health sector.
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