Details for Reform Option "Rogi Kalyan Samiti, Meghalaya"
Rogi Kalyan Samiti / Hospital Management Committee is a simple yet effective management structure. This committee, which would be a registered society, acts as a group of trustees for the hospital to manage the affairs of the hospital. It consists of members from the local NGOs, local elected representatives and officials from Government sector who are responsible for proper functioning and management of the hospital / Community Health Centre / FRUs/PHCs. RKS / HMS is free to prescribe, generate and use the funds with it as per its best judgement for smooth functioning and maintaining the quality of services.Action: Ganesh Das Hospital, which is exclusively a maternal and child hospital in Shillong is a pilot case study wherein RKS was introduced that is also being extended to the PHCs , CHCs and other district Hospitals. This government run hospital provides free health care delivery services to the mothers and children. A Memorandum of Association was signed with the State Government by the 8-member society including 2 women. These women are from ‘Sengkynthei’, a community-based women’s organisation, tribal tradition of Meghalaya society. Four meetings by this society have already been held in one year following the formation on 22 February 2006.
Objectives of Society:
Ø Maintenance & upkeep of the hospital
ØAcquiring of equipment for the hospital
ØExpanding the hospital building
ØImproving boarding and lodging for the attendants accompanying the patients
ØEntering into partnership with the private sector for the improvement of the support services such as cleaning, laundry, diagnostic facilities and ambulance services.
ØDeveloping and leasing out vacant premises for generating funds
ØAdopting sustainable and environment friendly measure for management of the hospitalIn this 400 bed hospital, which conducts an average 20-30 deliveries daily and around 2000 caesareans operation and around 2000 tubectomies annually has 9 double private rooms , along with 5 single rooms & 19 three bedded rooms. Shops were rented out for setting up phone booths for the convenience of the people visiting the hospital. A shopping complex is also under way on the hospital premises. Earlier private wards were the only source of income for this government run hospital and this was to be returned to the State government. Now the money generated from the private wards along with the additional sources like user fees, donations etc is to be kept with the society. In fact the government encourages the hospital to generate funds now that RKS is in place. This has empowered the hospital to manage the funds for buying medicines, oxygen cylinders and carrying out minor repairs among other things for which they do not have to wait for government’s approval for the day to day running of the hospital. Money for the Jananai Surakha Yojana (JSY) scheme given under the National Rural Health Mission (NRHM) is being released directly to Ganesh Das Hospital Management Society by an account payee cheque from the State Health Society, facilitating them for quick and smooth disbursal to the beneficiaries. At the PHC level also, RKS has taken shape. A case study of Mawphlang PHC, approximately 20 kms from Shillong, is one such example. It caters to 65 villages and 3 sub centres. It is a 10-member society with the village headman as the member chairperson. This society has representation from the church, school and community based organisations (CBO). All the members contribute towards the society in their own capacity. The church leader has provided the ambulance for this PHC and the CBO, ‘Sengkynthei’ has provided the dustbins. Similarly the chairperson, who also works with the Public Health Engineering Department (PHED) in the State government, has donated the benches for the PHC. His involvement with the PHC management has proved doubly beneficial because now he uses his position in PHED to prioritise road building in the area. This has made a great difference in transporting patients from far flung areas.
1. Generation of money through additional sources.
2. Community Involvement leading to ownership.
3. Improvement in the overall management and services of the hospital.
4. Increase in the number of patients visiting the hospital.
5. Increase in the number of referral patients to the PHC and further to the district.
6. Under JSY, 2234 beneficiaries have been compensated since May 2006 till January 2007.
Information not available
Shillong, Meghalaya & Mawphlang PHC, approximately 20kms away from Shillong.
1-2 months to set up the committees
1. Community involvement & ownership
2. Additional income generation
3. Quick Disbursal of money
4. Quick Remedial Steps
5. Increase in the standard of the hospital
1. Increased patient load
2. Lack of support staff
3. Maintaining Quality Health Care Services
Who needs to be consulted
State government, RKS management bodies and staff of hospitals
Sustainable but requires commitment and close monitoring and supervision
Chances of Replication
Can be replicated.
MOA between the RKS of the Mawphlang PHC & State government
Manisha Ghose, Research Consultant, Central Bureau of Health Intelligence
Paromita Ukil, Research Consultant, ECTA