CHSJ had initiated Community level Monitoring of Health Expenditure in the states of Orissa and Assam. The main objective of the project was to facilitate communities to become aware of their health related entitlements (including financial entitlements) and to track out of pocket expenditure incurred during their treatment. The project also aimed to empower community groups to monitor budgetary allocation and expenditure patterns especially of funds that are to be managed at the local level. The project was funded by International Budget Partnership. The project was implemented in 24 villages under 6 PHC areas in the two districts- Chirang in Assam and Bolangir in Orissa. At the same time desk research to review state level and district level planning and budgeting processes was also initiated.
The process was intended to increase transparency and accountability among health providers and government health departments regarding health expenditure. The activities included:
Mobilisation: Meetings were conducted with Gaon Kalyan Samiti (GKS) and Rogi Kalyan Samiti (RKS), on NRHM related financial entitlements and secondary data was gathered from frontline workers and PRI members. Wall writing, translating posters into local languages were other activities to increase awareness related to health expenditure and entitlements.
Community Enquiry: A community enquiry was conducted that included community mobilization meeting, village health mapping and free listing exercises, group discussions with women and capturing case studies on history of illnesses. Health facilities like Sub Centres, Primary Health Centres and Sub Divisional Hospital were also observed under this activity.
The process revealed people’s low awareness about health and financial entitlements and referral transport support. Women are not aware about the transportation cost provided under JSY. People had little knowledge about expenditure of the flexi funds like Untied Funds or the Annual Maintenance Grants