Dear Irina,
Thank you for highlighting the paper in the International Journal of Health Governance [ https://www.hifa.org/dgroups-rss/support-systems-32-q2-have-you-ever-par... ]
Sharma, S., Rawat, S., Akhtar, F., Singh, R.K. and Mehra, S. (2022), "Assessing community health governance for evidence-informed decision-making: a cross-sectional study across nine districts of India", International Journal of Health Governance, Vol. 27 No. 1, pp. 8-20. https://doi.org/10.1108/IJHG-05-2021-0051
'The authors assessed the village health sanitation and nutrition committees (VHSNC) on six parameters, including their formation, composition, meeting frequencies, activities, supervisory mechanisms and funds receipt and expenditures across nine districts of the three states of India. VHSNCs are envisaged to ensure community participation in health planning, but their actions and performance are shaped by contextual factors, such as availability of funds and motivation, and willingness of its members to perform. The study sheds light on the irregular and delayed receipt of funds, lack of supervisory visits by medical officers or Integrated Child Development Service (ICDS) Scheme staff or their assessments of the accounts, nonperformance of the key activities, such as making a village health plan, monitoring services and organizing VHSND. They argue that the poor performance of VHSNC in some of the areas may be linked to multiple factors, including inadequate training of VHSNC members on their key roles and responsibilities.'
The above paper resonates with a paper from Zambia we highlighted earlier in the discussion:
'Using Open Public Meetings and Elections to Promote Inward Transparency and Accountability: Lessons From Zambia'
https://www.hifa.org/dgroups-rss/support-systems-18-introduction-and-som...
The Zambia study found that 'governance committee members need support and mentorship to adequately prepare for and facilitate meetings and elections'.
Overall, our current HIFA SUPPORT-SYSTEMS discussion is asking: How can decision-making processes for health systems strengthening and universal health coverage be made more inclusive, responsive and accountable? It seems that at least part of the solution is to support decision-makers in how to 'prepare for and facilitate meetings and elections'. And indeed health policymakers require a wide range of skills that go beyond preparing and facilitating meetings and elections. It would be interesting to build a picture of what skills are required at different levels in the health system, and what skills are especially lacking. At a fundamental level, skills are required to establish procedures and guidance. What tools and handbooks are available that might support health policymakers at national, subnational and local levels?
Neil Pakenham-Walsh, Global Coordinator HIFA, www.hifa.org neil@hifa.org
Global Healthcare Information Network: Working in official relations with WHO
