Providing health care services to the thinly distributed population of Rajasthan is a daunting task, especially because of difficult terrain. The state provides health care services through a chain of health care facilities including 9,600 sub-centres, 1,616 Primary Health Centres (PHCs), 238 Community Health Centres (CHCs), approximately 300 dispensaries, 35 districts and satellite hospitals and a number of associated hospitals under the control of six Government-run Medical Colleges. These facilities are manned by more than thirty-thousand staff. The human resource engaged in delivering the requisite services consistently need upgrading their knowledge and skills as once recruited their total service span is about 35 years. In last fifty years of independence, State has created variety of in-service training centres - 27 District Training Centres (common parlance: Auxiliary Nurse Midwife Training Centre), 3 regional level HFWTC and at state level State Institute for Health and Family Welfare (SIHFW). The trainings under different projects are fragmented and have narrow focus to a larger goal of improving the quality of health care delivery and achievement of comprehensive health indices. It was realized that developing a comprehensive training policy for the state health and family welfare department will be a useful pathways to strengthen the in-service training component. This was also mooted by programme implementers, policy makers and development partners.
There is large number of people working in the healthcare services in the state of Rajasthan. They need regular refresher training to keep their skills up-to-date and relevant throughout an average 35-year career in Government service. To date there is no cohesive or well-planned training policy which will ensure an efficient workforce and programme implementers, policy makers and development partners are keen for one to be developed.
The European Commission-funded Health and Family Welfare Sector Investment Programme and the UNFPA-supported CP-6 Project asked the State to develop a training policy in health sector.
The State Government requested the State Institute for Health and Family Welfare (SIHFW) to facilitate the development of a Training Policy in the Health Sector.
A Committee, chaired by internationally-acclaimed training expert Professor Udai Pareek, was constituted by the Secretary, Medical and Health, Government of Rajasthan.
The committee in turn thoroughly reviewed and revised the draft document developed in 1997-98 but it decided that developing a comprehensive human resource development policy would take too long. They therefore restricted the work to developing a training policy alone.
The specific objectives of training policy were listed out and modus operandi for the same was worked out.
A series of workshops were organized to deliberate on the scope and content of the document on training policy. .
The resulting policy document outlines the challenges before the existing training institutions as a result of the shift of the focus of health programmes from family welfare to quality of care and reproductive and child health. It suggests developing a linkage between various training institutions and service institutions within the state.
Further, SIHFW would be strengthened and all training institutions would bring under its administrative, financial and technical control.
Director SIHFW would be designated as Director Training of the State.
The document also lists out in detail the structure of training system and its implementation, training capacity and approaches, staffing pattern and development of training modules.
It gives a brief job description and responsibilities of district level health care officials and functionaries.
The document stresses the need for three types of training:
(i) induction training
(ii) executive training programme for senior officers and deputy Chief Medical Hospital Officers (CMHOs)
(iii) Management development programme for district level officers.
The draft was then presented to a group of all the State level officers under the chair of the Principal Health Secretary in the second week of May 2004. The suggestions evolved in the discussion were incorporated before formally submitting the Policy Draft to State Government for endorsement. Governments’ response on the document is awaited.
Following to drafting of training policy for health care staff, the state government asked SIHFW to draft job chart for all level of staff – reproductive child health care officer, Dy. CM&HO Sub-division, district Tuberculosis officer, Principal Medical Officer (PMO), Deputy Superintendent/ Deputy Controller, District Hospital, Specialists, Nursing Superintendent, Ward- In-charge, Nurse, MOI/C CHC, Medical Officers, PHC, Block Health Supervisor, Health Assistant, Health Worker, Radiographer, Ophthalmic Assistant, Laboratory Technician and Computer operator.