Decentralized Participatory Planning for Reproductive & Child Health Services

Author : J.S. Deepak, Aradhana Johri, Gadde Narayana, K.M. Sathyanarayana

To ensure delivery of reproductive and child health services according to the clients needs and in tandem with the local resources it is important to adopt a decentralized participatory planning approach. In Uttar Pradesh, SIFPSA has developed processes for the development and implementation of decentralized plans. It used the decentralized approach to develop district action plans for 6 districts that have been discussed in this paper. The district action plans (DAPs), thus formulated follow a client centred approach with flexibility in programme implementation and greater involvement of stakeholders.

This has in turn contributed to more effective programme management. Each DAP contains a number of specific interventions depending upon local needs. Some of the important ones that are a must for effective delivery of reproductive health services have been discussed in the paper. The key interventions are: creating a conducive environment; generating demand; improving quality of services; improving access to integrated RCH services; and involving the non-government sector. For each intervention a specific set of activities have been identified and the plans contain a timeframe for completion of each of them.

A review of the decentralized participatory approach at the end of the first year revealed that it had led to more involvement of local stakeholders and helped in identifying and addressing clients' needs. At the same time, flexibility in implementation has resulted in effective project management and enabled managers to make quick decisions. Integrated quality services and increased access have contributed to improved reproductive and child health programme performance. This model has been found suitable for replication in other districts and is soon likely to be extended to 29 districts covering a population of 78 million.

Presented / Published

Paper presented at Global Health Council, 27th Annual Conference, June 13 -16, 2000, Arlington, Virginia, USA

Key Words: Decentralization, Reproductive and Child Health Services, Uttar Pradesh