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Rationalisation of Infrastructure and Human Resource Deployment

Dr. Subrato Kumar Mondal, Research, Monitoring and Evaluation Team, CINI-Child In Need Institute, CINI-Child In Need Institute, 357A Ashok Nagar, Road No-5, Ranchi, India, 91-651-2245370, subratom@gmail.com

It has been told that the Indian public health care system is non-functional for variety of reasons. Many health economists have tried to analyze the system in isolation in the sense workforce and infrastructure has been analyzed separately. An analysis of these issues in isolation does not reveal the true picture of why certain levels of health-care institutions are underutilised or why certain functionaries are not able to perform their assigned duties adequately. Quality and timely service delivery is possible only if an optimum number of factors work simultaneously. The different kinds of mismatches such as, trained personnel vs equipment, specialists vs related support, and so on are found through a systematic study in eight Indian States. These wrong input mixes are not due to a want in implementation, but due to mismanagement by the state government, especially in the recruitment and posting of qualified physicians in an unsuitable place. This reveals the ‘technical inefficiency' of a particular health-care institution. The following three kinds of mismatches are also identified, viz., positional, technical and managerial mismatches and analyzed in this paper to provide reasonable rectification strategy.

Type-1 mismatch: positional mismatch Positional mismatch can be identified as the right person posted in the wrong position, for example, a medical specialist being positioned in a PHC where only an MBBS graduate is expected to undertake assigned tasks. Type-2 mismatch: technical mismatch In simple terms, technical mismatch can mean that the ‘instruments' are available but the ‘technicians' are not posted or vice versa; for example, working x-ray machines vs radiographer, working operation theatre vs surgeon or anaesthetists, working pathological laboratory vs pathologist, working vehicle vs driver, and so on. Due to this mismatch, considerable hardships are being faced by the sick, especially when the referral system is not effective.

Type-3 mismatch: managerial mismatch A situation in which the instrument as well as the manpower is available, but technical skills are not imparted to handle the instruments is described as a managerial mismatch.

The right person should be available at the right place and time, for optimal utilisation of personnel as well as institutional capacity. All types of personnel requirements against available instruments or vice versa should be met without any lapse of time.

Learning Objectives:

Keywords: Public Health Administration, India

Presenting author's disclosure statement:

Any relevant financial relationships? No

Improving the Health Workforce: Issues and Opportunities

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA