CHSJ had initiated Community level Monitoring of Health Expenditure in the states of Orissa and Assam. It is currently implementing the project in 24 villages in these two states. A range of activities that had taken place include meetings with Gaon Kalyan Samiti (GKS), Rogi Kalyan Samiti (RKS), Secondary data collection from various stakeholders, wall writing and so on. A Community enquiry had been conducted that include mobilization meeting, village health mapping, free listing, Group discussion with women, case studies, observation in Sub Centre (SC), Primary Health Centre (PHC) and Sub Divisional Hospital (SDH). The GKS and RKS members are being trained.
CHSJ initiated Community level Monitoring of Health Expenditure in one district each of Orissa and Assam. This project is seen as a follow up of the earlier community monitoring process in which Village Health and Sanitation Committees and PHC Planning and Monitoring Committees were trained to undertake community monitoring of mandated services under NRHM using simple community score cards. The main objectives of the project are 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 aims 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 is being funded by International Budget Partnership. The project is being 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.
CHSJ is working on this project with its partners The Ant (in Chirang) and The Humanity (in Bolangir) respectively. Through this process we also intend to increase transparency and accountability among health providers and government health departments regarding health expenditure. Activities include:
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.