A mixed-method study to evaluate the knowledge and marshalling of untied funds in rural area
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20230640Keywords:
Untied fund, Mixed-method study, Rural area, Knowledge, ExpenditureAbstract
Background: NRHM provides health facilities with unlimited flexible funds to improve the quality of care, in addition to funds for the upkeep and improvement of health facilities, human resources (contractual appointments), equipment, supplies, and medicine, training, and capacity building. The Untied Funds (to be used at the discretion of the facility in charge, primarily as a contingency fund). This study was conducted to gain a better understanding of the financing strategy, knowledge, facilitators, and barriers to underutilization of untied funds.
Methods: A mixed-methods study was carried out to determine the utilisation patterns and knowledge of health workers about untied fund. A qualitative study that used a grounded theory approach to identify the facilitators and barriers to effective use of Untied funds. RHTC-Mandawar and its six subcenters were included in our study.
Results: The entire mixed-method study clearly demonstrated the barriers and facilitators observed at the subcenter sites. Because health workers were understaffed and overburdened with work, their knowledge was also alarmingly low. Furthermore, no refresher training was provided to them. Finance, a tricky aspect of this programme, was handled with extreme caution.
Conclusions: Before untied funds lapse, they must be reviewed and monitored. Refresher training and detailed guidelines are required before funds can be used to improve the health facility and provide additional services to beneficiaries.
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References
An assessment of the status of village health and sanitation committees in Bihar, Chhattisgarh, Jharkhand and Orissa. Available at: https://www. phrsindia.org/wp-content/uploads/2016/02/17An-Assessment-of-VHSC.pdf
Untied fund? assessment of village health and sanitation committee involvement. Available at: https://nhm.gov.in/images/pdf/guidelines/nrhm-guidelines/guidelines_of_untied_funds_nrhm.pdf. Accessed on 20 November 2022.
Kumar SP, Raut AV, Maliye CH, Gupta SS. Performance of village health, nutrition and sanitation committee: A qualitative study from rural Wardha, Maharashtra. Health Age. 2013;1(4):112-7.
Aggrawal M, Mathur T, Mohan P. Village health sanitation and nutrition committees: reflections on strengthening community health governance at scale in India. BMJ Glob Health. 2018;3(3):e000681.
Keshri VR, Raut AV, Mehandale AM, Garg BS. Assessment of knowledge and utilization of untied fund provided to VHNSCs in selected villages of 5 sub centre area of PHC, Anji in Wardha District. IJPH. 2017;50:65-9.
Anonymous (2012) Population Census of India 2011. Available at: https://censusindia.gov.in/census. website/data/population-finder. Accessed on 20 November 2022.
Village health. Available at: https://nhm.gov.in/index1. php?lang=1&level=1&sublinkid=149&lid=225. Accessed on 20 November 2022.
Deoki N, Mohanty MK, Das S, Misro MM, Kumar P, Shivdasani JP. Rapid appraisal of functioning of village health and sanitation committees (VHSCs) under NRHM in Orissa. Available at: https://www.nihfw.org/ doc/RAHI-I%20Reports/Kalinga/Kalinga.pdf. Accessed on 20 November 2022.
Guidelines regarding constitution of village health and sanitation committees and utilization of untied grants to these committees. Available at: https://nhm.gov.in/ images/pdf/guidelines/nrhm-guidelines/guidelines _of_untied_funds_nrhm.pdf. Accessed on 20 November 2022.
Dindod SM, Makwana NR. Knowledge of members regarding village health and sanitation committee (VHSC). Int J Sci Res. 2013;2(9):23-8.
Singh R, Purohit R. Limitations in the functioning of Village Health and Sanitation Committees in a North Western State in India. Int J Med Public Health. 2012;2(3):39-46.
Shah, CM Singh, PK Jain, KS Nair, P Kumar, N Dhar, D Nandan. Assessment of utilization of untied fund provided under the national rural health mission in Uttar Pradesh. Indian J Public Health. 2009;53(3):137-42.